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Related Experiment Videos

Explaining social class differences in depression and well-being

S A Stansfeld1, J Head, M G Marmot

  • 1Department of Epidemiology & Public Health, University College London Medical School, UK.

Social Psychiatry and Psychiatric Epidemiology
|February 4, 1998
PubMed
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Job characteristics like skill discretion and decision authority significantly impact well-being and depression, explaining most socioeconomic disparities in British civil servants. Social support also plays a role, but work environment factors are most influential.

Area of Science:

  • Occupational Health
  • Psychosocial Epidemiology
  • Socioeconomic Determinants of Health

Background:

  • Socioeconomic status (SES) gradients in well-being and depression are well-documented.
  • The specific mechanisms driving these disparities, particularly within occupational settings, require further elucidation.
  • Previous research suggests psychosocial factors at work may mediate SES-health relationships.

Purpose of the Study:

  • To investigate the extent to which work characteristics and social support explain the socioeconomic status gradient in well-being and depression.
  • To differentiate the contributions of psychosocial work environment, social support, life events, and material difficulties.
  • To examine the role of social selection in the observed SES gradients.

Main Methods:

Related Experiment Videos

  • Cross-sectional analysis of data from middle-aged British civil servants in the Whitehall II Study.
  • Socioeconomic status assessed by employment grade.
  • Work characteristics measured using the Karasek model (skill discretion, decision authority).
  • Social support measured by the Close Persons Questionnaire.
  • Depression assessed using the General Health Questionnaire (GHQ).
  • Well-being measured by the Affect Balance Scale (ABS).

    • Main Results:

    • Work characteristics, specifically skill discretion and decision authority, explained the majority of the SES gradient in well-being and depression.
    • Social support accounted for approximately one-third of the gradient.
    • Life events and material difficulties explained less than one-third of the gradient.
    • Social selective factors (upward mobility) showed a small contribution.

    Conclusions:

    • The psychosocial work environment is a primary determinant of the socioeconomic status gradient in well-being and depression among British civil servants.
    • Interventions targeting work characteristics may be effective in reducing health inequalities related to socioeconomic status.
    • While social support is important, the work environment appears to be a more dominant mediator of SES-health disparities in this population.