Psychosocial work exposures among European employees: explanations for occupational inequalities in mental health.

BACKGROUND Social inequalities in mental health have been demonstrated but understanding the mechanisms remains unclear. This study aims at exploring the role of psychosocial work factors in explaining occupational inequalities in mental health among European employees. METHODS The study sample covered 33,443 employees coming from the European Working Conditions Survey 2010. Mental health was measured by the WHO-5 well-being index and socioeconomic position by occupation. Twenty-five psychosocial work factors were constructed including job demands, job influence and development, role stressors, social support, quality of leadership, discrimination, violence at work, working hours, job promotion, job insecurity and work-life imbalance. Multilevel linear regressions and bootstrap analyses were performed. RESULTS Occupational differences were observed for poor mental health and almost all psychosocial work factors. Factors related to job demands, influence and development at work, social relationships and leadership, working hours and other factors contributed to explain the occupational inequalities in mental health. In particular, factors related to influence and development contributed substantially. Among men, workplace violences were found to contribute little whereas among women these factors did not play a role. CONCLUSIONS Future prevention interventions should have a broad and comprehensive focus in order to reduce social inequalities in mental health.