The mental health impacts of health and human service work: Longitudinal evidence about differential exposure and susceptibility using 16 waves of cohort data

The health and human care workforce comprise a substantial and increasing proportion of the employed population in high income countries. This diverse workforce is comprised of high skilled workers, such as doctors and nurses, as well as lower skilled workers such as carers and support workers. This paper assessed psychosocial working conditions among health and human care workers compared to other workers. We also examined the effects of psychosocial working conditions on mental health. The data source was 16 waves of the Household Income Labour Dynamics in Australia survey. The exposure was a multidimensional, previously validated psychosocial job quality index. The outcome was changes in the Mental Health Inventory-5 (MHI-5). The effect modifier was a multicategory health and human care occupational variable. Random and fixed effects linear regression models were used to unpack between- versus within- person differences. Time varying confounders were controlled for. We found evidence of effect modification. Carers and support workers experienced a 4.90-point decline (95% CI -6.23 to 3.57) on the MHI-5 when reporting 3 or more job stressors compared to no stressors. These workers also reported lower levels of mental health than other occupational groups and had greater exposure to poor psychosocial working environments. Health workers also reported substantial declines on the MHI-5 when exposed to 3 or more job stressors (-3.50, 95% CI -5.05 to -1.94). Understanding the quality of employment in this workforce, and consequent impacts of this employment on mental health is critical to ensuring sustainable individual, organizational and client-related outcomes.