Precariousness and depressed mood: a network analysis in the multi-ethnic HELIUS study

Precariousness, which refers to experiencing a high level of insecurity and instability in life, manifests in multiple life dimensions and can give rise to mental health issues. Associations with mental health are potentially influenced by migration background. In this study, we examine the associations between precariousness in different life dimensions and depressed mood among individuals with and without migration background.

We included 22,039 participants from the baseline measurement of the HELIUS (HEalthy LIfe in an Urban Setting) study, representing the six largest ethnic groups in Amsterdam. We used 13 indicators of precariousness in five life dimensions (employment, financial, housing, cultural and social), 9 assessed through a self-report questionnaire and 4 from neighborhood-level data. Depressed mood was classified as > 9 on the Patient Health Questionnaire (PHQ-9, Dutch version). Network models were applied, stratified by migration background.

In total, 14.6% experienced depressed mood. Among those who experienced precariousness in at least four dimensions, the corresponding number was 22.1% to 46%, depending on the specific dimensions of precariousness that were experienced. Associations between depressed mood and indicators of precariousness were similar for those with and without a migration background. Depressed mood was associated with marginal work or unemployment, social satisfaction, social frequency, income inadequacy, discrimination, and financial difficulties, and additionally with lost friendship and health literacy among those with a migration background.

Individuals with and without depressed mood differ markedly in their experience of precariousness, but associations are mostly consistent between those with and without a migration background.