Mediators of the relationship between precarious employment and mental health

Precarious employment is associated with poor mental health among workers. However, the underlying mechanisms are not well understood.

To investigate whether skill use and discretion, social environment, work intensity and working time quality mediate the relationship between precarious employment and mental well-being.

Using the Sixth European Working Conditions Survey, data across 35 countries were analysed. We conducted causal mediation analyses to decompose the association between the precarious employment index and mental well-being (measured using the 5-item World Health Organization Well-Being Index [WHO-5]) into natural direct and indirect effects through four potential mediators, namely skill use and discretion, social environment, work intensity and working time quality. We additionally fitted a parallel multiple-mediator structural equation model as a robustness check.

Data from 31 903 employees were analysed. The total effect of the precarious employment index on WHO-5 scores was statistically significant (P < 0.001). The natural indirect effects were statistically significant through skill use and discretion index (34% mediated; 95% confidence interval, 28-40%) and social environment index (53% mediated; 95% confidence interval, 45-60%). Indirect effects through work intensity and working time quality were not statistically significant (both P > 0.05). The structural equation model showed the same pattern.

Precarious employment negatively impacts skill use and discretion as well as social environment, which significantly mediate its effect on mental well-being. Interventions targeting these mediators may help mitigate the adverse effects of precarious employment on workers' mental health.