Mediators of the relationship between precarious employment and mental health

BACKGROUND: Precarious employment is associated with poor mental health among workers. However, the underlying mechanisms are not well understood. AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.