Persistent low job control and subsequent major depression: A prospective cohort study of Australian working males

Workers' perception of control over work is a key construct in the relationship between the psychosocial work environment and health. While exposure to low job control has been prospectively linked to poor mental health including depression and anxiety, there is less research examining the impact of prolonged exposure to low job control on mental health. Data from 5054 employed men from 2013 to 2021 in the Australian Longitudinal Study on Male Health was used to examine persistent and intermittent low job control and subsequent major depression symptoms. Persistent low job control was based on consecutive self-reports of low job control over waves 1 and 2. Combinations of low and high job control were classified as intermittent exposure and continuous high job control exposure over both waves was classified as persistent high job control. Major depression symptoms, derived from the Patient Health Questionnaire-9, was measured in wave 3. Generalised linear models and augmented inverse probability weighting were undertaken. There was a strong stepwise relationship between low job control and major depression. Compared to persistent high job control, intermittent low job control was associated with an increased risk of subsequent major depression symptoms by 32% (RR 1.32, 95% CI 0.82, 2.15); and persistent low job control by 103% (RR 2.03, 95% CI 1.21, 3.41). Compared to men exposed to persistent high job control, the average treatment effect for persistent low job control was 0.036 (95%CI 0.014, 0.058) and intermittent low job control 0.019 (95%CI 0.006, 0.032) equating to a risk ratio of 2.46 (95%CI 1.43, 3.50) and 1.79 (95% CI 1.14, 2.45) respectively. This study's findings have implications for public health and occupational policies, as they underscore the importance of reducing prolonged exposure to low job control to protect against the risk of major depression in the working population.