Steady work and mental health -- is there a connection?

Despite low overall unemployment, Canada's manufacturing industry has cut 88,000 jobs this year, with nearly all the losses occurring in Ontario. Also, part-time employment has grown by 3.5 per cent in 12 months, much faster than the 0.9 per cent growth in full time work. A new report from the World Health Organization (WHO) on the social determinants of health demonstrates that these kind of employment changes can affect more than your wallet. Research from the Centre for Addiction and Mental Health (CAMH)'s Dr. Carles Muntaner in the WHO report highlights the profound impact of employment conditions on health.

Dr. Muntaner and his research team found that poor mental health outcomes are associated with precarious employment (e.g. temporary contracts or part-time work with low wages and no benefits). When compared with those with full-time work with benefits, workers who report employment insecurity experience significant adverse effects on their physical and mental health.

The research team have also found that stress at work is associated with a 50 per cent excess risk of coronary heart disease, and there is consistent evidence that jobs with high demands, low control, and effort-reward imbalance are risk factors for mental and physical health problems (major depression, anxiety disorders, and substance use disorders). Canada and a number of other wealthy countries such as the U.K., the United States, Australia and New Zealand all face similar challenges, Dr. Muntaner notes, because there's a greater tolerance for inequities than in some other countries such as Sweden and Denmark.

"Access to healthcare is not the only determinate of a healthy community," says Dr. Muntaner. "All aspects of our lifestyle, including how we work, are intrinsically linked to our wellbeing and our quality and length of life. If the face of Canada's ever-changing labour market, we must understand and improve the relationship between health and work." In the report entitled Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health, three overarching recommendations to achieve health equality are made, including improving employment and working conditions, and the report contributors call for – and outline steps to achieve - global, national and local actions to improve employment and working conditions.

This landmark study from the WHO is the culmination of three year's work by an eminent group of policy makers, academics, former heads of state and former ministers of health who have been investigating the differences between and within countries that result from the social environment where people are born, live, grow, work and age – the social determinants of health. Together, they comprise the WHO's Commission on the Social Determinants of Health, which has produced Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health.

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The data and recommendations on workplace came from the Employment Conditions Knowledge Network (EMCONET), one of nine Knowledge Networks established to inform the final report, chaired by Dr. Muntaner, Addictions Nursing Research Chair and scientists in CAMH's Social Equity and Health (SHE) research section, and Joan Benach, (SHE) adjunct scientist.