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Could better jobs improve mental health? A prospective study of change in work conditions and mental health in mid-aged adults
  1. Lyndall Strazdins1,
  2. Rennie M D'Souza1,
  3. Mark Clements1,
  4. Dorothy H Broom1,
  5. Bryan Rodgers2,
  6. Helen L Berry1
  1. 1National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
  2. 2Australian Demographic and Social Research Institute, The Australian National University, Canberra, Australia
  1. Correspondence to Dr Lyndall Strazdins, National Centre for Epidemiology and Population Health, Building 62, Mills Road, The Australian National University, Canberra, ACT 0200, Australia; lyndall.strazdins{at}


Objectives To investigate the extent improvement or deterioration in employee job security, control or workload is associated with a change in mental health.

Design Self-report panel data (2000, 2004) on mental health (symptoms of depression and generalised anxiety) and job demands, control and insecurity. Changes in exposures and outcomes were calculated by subtracting wave 1 from wave 2 scores. Changes in mental health were regressed onto changes in work conditions, adjusting for confounders. Sensitivity analyses assessed reverse causation, floor and ceiling effects.

Setting Two adjoining cities in south-east Australia.

Participants 1975 employees aged 40–48 years, 50% (n=995) male.

Results Improvements and deterioration in each work condition were associated with corresponding improvements or deterioration in mental health. The association between changes in job insecurity and symptoms of depression was B=0.386 (95% CI 0.245 to 0.527) and with anxiety symptoms was B=0.434 (95% CI 0.267 to 0.601). Similarly, changes in job control were associated with changes in depressive (B=−0.548; 95% CI −0.791 to −0.304) and anxiety symptoms (B=−0.608; 95% CI −0.896 to −0.319) as were changes in job demands (B depression=0.386; 95% CI 0.245 to 0.527; B anxiety=0.434; 95% CI 0.267 to 0.601). Excluding people with severe symptoms at baseline did not alter the findings; however, path analyses indicated that depression may precede a worsening of work conditions.

Conclusion Among mid-aged employees, deteriorating work conditions may amplify population health burdens, especially anxiety. Furthermore, better quality jobs, combining an array of positive conditions, could alleviate major population health burdens.

  • Anxiety
  • depression
  • occupational stress
  • psychological distress
  • workplace

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  • Funding Funding for the PATH study was provided by a unit grant (no 973302) and new program grant (no 179805) from the National Health and Medical Research Council (NHMRC), and additional support from the Australian Rotary Health Research Fund and the Australian Brewers' Foundation Medical Research Grant Scheme. BR is supported by NHMRC research fellowship no 471429.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval The research protocols (M9807 and 2002/189) were approved by the Australian National University Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.