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Mental health inequalities in times of crisis: evolution between 2005 and 2021 among the Spanish salaried population
  1. Laura Esteve-Matalí1,2,
  2. Clara Llorens-Serrano1,3,4,
  3. Jordi Alonso5,6,7,
  4. Gemma Vilagut5,6,
  5. Salvador Moncada3,
  6. Albert Navarro-Giné1,2,8
  1. 1 Research Group on Psychosocial Risks, Organization of Work and Health (POWAH), Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
  2. 2 Biostatistics Unit, Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public Health, Faculty of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
  3. 3 Instituto Sindical de Trabajo, Ambiente y Salud-Fundación Primero de Mayo (ISTAS-F1M), Barcelona, Spain
  4. 4 Department of Sociology, Faculty of Sociology and Political Sciences, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
  5. 5 Health Services Research Unit, IMIM - Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
  6. 6 CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
  7. 7 Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
  8. 8 Institute for Labour Studies (IET), Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
  1. Correspondence to Dr Albert Navarro-Giné, Research Group on Psychosocial Risks, Organization of Work and Health (POWAH), Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain; albert.navarro{at}uab.cat

Abstract

Background Studying the working population’s mental health in times of crisis (such as the 2008 recession or the COVID-19 pandemic) is very relevant. This study aims to assess the prevalence of poor mental health among the Spanish salaried population, according to the labour market inequality axes (2005–2021).

Methods Repeated cross-sectional study by comparing different surveys from 2005, 2010, 2016 and 2021 on workers residing in Spain who had been working in a salaried job during the week preceding the survey. n=7197 (2005), n=4985 (2010), n=1807 (2016) and n=18 870 (2021). Outcome variable: poor mental health (Mental Health Inventory of the 36-item Short Form Health Survey scale). Explanatory variables: gender, age, occupational class and type of contract. Prevalence of poor mental health was estimated for each year by means of logistic regression models with robust clustered SEs, stratifying by the explanatory variables. Additionally, prevalence ratios (PR) were estimated by means of robust Poisson regression models to assess differences between the explanatory variables’ categories. All analyses were weighted to address unrepresentativeness.

Results Poor mental health significantly increased in 2021 (55.92%), compared with the previous years of study (15%–17.72%). Additionally, pattern changes were identified on inequality axes in 2021, with better mental health status among older workers (oldest group PR: 0.76; 95% CI 0.71 to 0.8) and permanent workers (PR: 0.9; 95% CI 0.85 to 0.94).

Conclusion This study shows a steep worsening of mental health among the salaried population in 2021 compared with previous periods. In 2021, health inequalities have apparently narrowed, although not by improving the disadvantaged groups’ mental health but by worsening the typically advantaged groups’ mental health.

  • COVID-19
  • health inequalities
  • mental health
  • occupational health

Data availability statement

Data are available upon reasonable request.

This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/jech-2022-219523

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Contributors L-EM analysed the data and drafted and revised the paper. CL-S and SM designed the surveys, monitored data collection and revised the draft paper. JA and GV revised the draft paper. AN designed the surveys, monitored data collection, wrote the statistical analysis plan, revised the draft paper and acted as guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

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