Precarious Employment and Mental Health: The Moderating Role of Household Income and Family Type in Sweden

Signild Kvart, Karolinska Institutet
Lluís Mangot-Sala, Karolinska Institutet
Amanda Aronsson, Norwegian University of Science and Technology
Kathryn Badarin, Karolinska Institutet
Kim Bosmans, Vrije Universiteit Brussel
Virginia Gunn, Karolinska Institutet
Gun Johansson, Karolinska Institutet
Mireia Julià, Universitat Pompeu Fabra
Bertina Kreshpaj, University of Copenhagen
Nuria Matilla-Santander, Karolinska Institutet
Fabrizio Mendez-Rivero, Universidad Católica del Uruguay
Emelie Thern, Karolinska Institutet
Per-Olof Östergren, Lund University
Theo Bodin , Karolinska Institutet

Background: This study investigated whether household disposable income and family type moderate the association between precarious employment (PE) and diagnosed mental disorders (DMD). Methods: Register data from the Swedish Work, Illness, and Labour-market Participation (SWIP) cohort. The study population included all individuals aged 27–65 who were employed in 2016 (n = 2,509,229). PE was measured using the Swedish Register-based Operationalization of Precarious Employment (SWE-ROPE 2.0), which captures employment insecurity, income inadequacy, and lack of rights and protection. DMDs during 2017–2019 were identified through national inpatient, outpatient, and prescription registers. Household disposable income and family type (2016) were examined as moderators. Cox regression models estimated the effect of PE on DMDs, with moderation assessed using two-way interaction terms. Results: Individuals in PE had a higher risk of DMDs (HR 1.21, 95% CI 1.18–1.23) than those in standard employment, across household income levels and family types. High household income was protective, but the interaction between PE and high income indicated that this protective effect was reduced for individuals in PE, both among men (interaction HR 1.22, 95% CI 1.04–1.43) and women (interaction HR 1.25, 95% CI 1.13–1.38). Among women, family types other than “couple without children” amplified the effects of PE on DMDs. For single mothers (HR 1.27, 95% CI 1.14–1.42), the combined effect of PE and single motherhood exceeded the sum of their individual effects. Conclusion: Higher household income only partly buffers the negative impact of PE on DMDs, and the negative impact of PE appears stronger for women, especially mothers.

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 Presented in Session 53. Family, Wellbeing and Health