Association of precarious employment with depressive symptoms and insomnia: Findings from the Korean Working Conditions Survey

Abstract

Precarious employment (PE) is an important occupational health concern. This study aims to examine the relations between PE and depressive symptoms and insomnia in Korean workers. This study included a nationally representative sample of 49,420 adult workers. A modified version of the Employment Precariousness Scale (EPRES), which comprises six dimensions (temporariness, disempowerment, vulnerability, exercise of rights, uncertain work schedules, and wages), was used to quantify PE levels on a scale ranging from 0 to 100. PE levels were categorized into four groups based on quartile values. Depressive symptoms were assessed using the World Health Organization-5 Well-Being Index, and insomnia was assessed using the Minimal Insomnia Symptom Scale. Logistic regressions were performed, and odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. The prevalence rates of depressive symptoms and insomnia were 10.7% and 8.4%, respectively. Compared with the lowest PE level, the highest PE levels were associated with both depressive symptoms (OR: 2.86, 95% CI: 2.61-3.14) and insomnia (OR: 1.33, 95% CI: 1.21-1.47). An interquartile range increase in the EPRES score was associated with a 1.84-fold (95% CI: 1.76-1.92) and 1.23-fold (95% CI: 1.17-1.29) increase in the odds of depressive symptoms and insomnia, respectively. All six individual dimensions were positively associated with depressive symptoms, whereas three dimensions-vulnerability, uncertain work schedules, and wages-were associated with insomnia. PE is a risk factor for depressive symptoms and insomnia. Policy interventions are required to safeguard mental health of precarious workers.

Keywords: Mental health; Occupational health; Sleep; Social determinant of health.