Stressful work in primary health care and mental health: The role of gender inequities in Brazil

Araújo, Tânia Maria de; Sousa, Camila Carvalho de; Siegrist, Johannes

doi:10.1002/ajim.23360

Cited by 8 publications

(7 citation statements)

References 43 publications

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“…As assumed, work stress was found to be directly associated with depression and anxiety among community PHWs, which supported and expanded the previous findings on occupational mental health among primary healthcare workers or medical staff. For example, a cross-sectional study conducted in Brazil found a significant positive relationship between ERI and common mental disorders among healthcare workers (44). Similar results were found for the significant positive effects of work stress on anxiety and depression among Chinese healthcare workers and medical staff (45,46).…”

Section: Discussionsupporting

confidence: 56%

Association between work stress and mental health in Chinese public health workers during the COVID-19 epidemic: mediating role of social support and self-efficacy

Dong

Zhu

Chang

et al. 2023

Front. Public Health

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BackgroundLittle is known about the mediating mechanisms underlying the association between work stress and mental health, especially among primary public health workers (PHWs). We aimed to evaluated the association between work stress and mental health among PHWs, and explore the mediating roles of social support and self-efficacy.MethodsA large-scale cross-sectional survey was conducted among 3,809 PHWs from all 249 community health centers in 16 administrative districts throughout Shanghai, China. Pearson correlation and hierarchical linear regression were used to explore the associations among work stress, social support, self-efficacy and mental health. Structural equation modeling (SEM) was conducted to examine the mediation effects.ResultsThe prevalence of depression and anxiety symptoms among primary PHWs was 67.3 and 55.5%, respectively. There is a significant positive direct effect of work stress on mental health (β = 0.325, p < 0.001). Social support and self-efficacy partially mediated the relationship between work stress and mental health, respectively. Meanwhile, the chained mediating effects of social support and self-efficacy also buffered the predictive effects of work stress on anxiety and depression symptoms (β = 0.372, p < 0.001).ConclusionWork stress has significant direct and indirect effects on mental health among primary PHWs. Enhancing social support and self-efficacy may be effective psychological interventions to mitigate the effects of work-related stress on mental health. These findings highlight the severity of mental health problems among primary public health workers and provide new evidence for early prevention and effective intervention strategies.

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Section: Discussionsupporting

confidence: 56%

Association between work stress and mental health in Chinese public health workers during the COVID-19 epidemic: mediating role of social support and self-efficacy

Dong

Zhu

Chang

et al. 2023

Front. Public Health

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“…The substitute list was made together with the sample list. Additional information on the methodological aspects of this study can be obtained from Araújo et al 19 …”

Section: Methodsmentioning

confidence: 99%

“…The substitute list was made together with the sample list. Additional information on the methodological aspects of this study can be obtained from Araújo et al 19 A research team was formed in each municipality, coordinated by the researchers from the universities and health services of each place. The management of the project included general coordination and coordination of the municipalities that participated in the project.…”

Section: Sample Selection Wasmentioning

confidence: 99%

Occupational stressors and mental illness in healthcare work: An intersection between gender, race, and class

de Sousa,

Araújo,

Maturino

2023

American J Industrial Med

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BackgroundPrevious studies have supported the relevance of using broad and complex approaches, including multiple explanatory categories, to analyze mental disorders in the working population. This study aimed to assess the direct and indirect effects of gender, race, social class, and occupational stressors on mental health.MethodsA cross‐sectional study used a random sample of 3343 health workers. The effort–reward imbalance (ERI) scale measured occupational stressors. The World Health Organization Self‐Reporting Questionnaire (SRQ‐20) evaluated common mental disorders (CMDs) as outcomes. The role of gender, race/color, and class determinants (level of schooling and income) in the relationship between occupational stressors and CMD was assessed. Structural equation modeling was used to determine associations and effects.ResultsOccupational stressors were directly associated with CMD and mediated the relationship between income and CMD. Gender was directly associated with occupational stressors, income, and domestic overload. Race was associated with education and with CMD through indirect paths mediated by class indicators. Class indicators contributed to increasing exposure to occupational stressors and the occurrence of CMD.ConclusionThe results highlight the relevance of gender, race/color, and class in understanding the unequal distribution of work stressors and mental illness in health workers.

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“…This dimension is characterized by excessive effort, aiming for recognition and approval 9 . The interaction between excessive commitment and the ERI is harmful, exposing the worker to high levels of stress 22 .…”

Section: Measurementmentioning

confidence: 99%

Combined effects of gender, race, and occupational stressors on mental health

Sousa,

Araújo

2024

Rev. bras. saúde ocup.

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Objective: analyze the isolated and combined effects of gender, race, and occupational stressors on the mental health of healthcare workers. Methods: cross-sectional study with a random sample of health workers in Bahia, Brazil. The primary exposure variables were gender, race, and occupational stressors, assessed using the Effort-Reward Imbalance (ERI) scale. The Self-Reporting Questionnaire (SRQ-20) measured common mental disorders (CMD), the outcome variable. The interaction measures were verified based on the additivity criterion by calculating the excess prevalence, excess prevalence ratio, and relative difference. Results: 3,343 workers participated, 77.9% were female. CMD prevalence was 21.7% higher among women, Black people, and those exposed to work stressors. Among Black women in a situation of ERI, the prevalence of CMD was three times higher compared with white men in a situation of balance (reference group). Discussion: black women workers accumulate social disadvantages and are more susceptible to occupations that require more significant effort and less reward. CMD prevalence was higher at the intersection of exposures. Combined effect of the factors exceeded the sum of the isolated effects, demonstrating an interaction between gender, race, and occupational stressors.

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Stressful work in primary health care and mental health: The role of gender inequities in Brazil

Cited by 8 publications

References 43 publications

Association between work stress and mental health in Chinese public health workers during the COVID-19 epidemic: mediating role of social support and self-efficacy

Association between work stress and mental health in Chinese public health workers during the COVID-19 epidemic: mediating role of social support and self-efficacy

Occupational stressors and mental illness in healthcare work: An intersection between gender, race, and class

Combined effects of gender, race, and occupational stressors on mental health

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