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Workplace and mental well-being: The Whitehall II study

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Abstract

This chapter aims to provide policy makers, researchers, organizations, and individuals working in the public health sphere with an understanding of the evidence on how factors at work might influence mental wellbeing. It uses the Whitehall II study, one of the leading cohort studies in the field, as an illustrative example. This chapter provides an overview of major theories, describes the assessment methods used to measure mental wellbeing in the Whitehall II study, and reviews the main research findings. Finally, it discusses next steps for research, including suggestions for evidence-based interventions to minimize adverse effects on mental health and promote wellbeing at work.

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The aim of this study was to prospectively investigate the effect of potential workplace closure, an externally attributed form of job insecurity, on fatigue and psychological distress. In April 1999, the minister responsible announced that a governmental agency would close down one of its two locations. Baseline data from the employees were available before the closure announcement (n = 574) because they were enrolled in the Maastricht Cohort Study on "Fatigue at Work." In the closure group, the relative risk for becoming a psychological distress case was 1.61 (95% confidence interval [CI] = 1.27-2.05) during 13 months after the closure threat. Within the closure group, a difference in relative risk for psychological distress was observed between employees who self reported an increase in job insecurity (relative risk = 1.85; 95% CI = 1.41-2.42) and employees who did not report an increase in job insecurity (relative risk 1.14; 95% CI = 0.58-2.24)
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We used two studies to examine whether mental health and hostility predicted temporary employment. Study 1 involved a cohort of 970 Finnish hospital employees (102 men, 868 women) who had temporary job contracts at baseline. After adjustment for demographics, organisational tenure and part-time work status, doctor-diagnosed psychiatric disorder predicted continuing in temporary employment instead of receiving a permanent job by the end of the 2-year follow-up. A higher level of hostility was also associated with temporary employment, but only among employees in low socioeconomic positions. In Study 2, anxiety and aggressive behaviour were measured in a cohort of 226 Finnish school children (116 boys, 110 girls) at 8 years of age. Anxiety in childhood predicted temporary employment at age 42. Aggressive behaviour in childhood was related to ongoing temporary employment status in adulthood among individuals in low socioeconomic positions. Our findings suggest that selection by individual characteristics operates between the temporary and permanent workforces. Mental health problems, a part of which are already seen in childhood, seem to restrict individuals' possibilities to gain secure labour market positions. Hostility and aggressiveness seem to be related to labour market prospects only among individuals in low socioeconomic positions.
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