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Work and Mental Health

- An Analysis of Canadian Community Health Survey. Work and Mental Health. Miao Fang McMaster University May 13, 2005. Outline. Introduction Data, Sampling and Variables Analyses Results Discussion and Conclusion. Background.

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Work and Mental Health

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  1. - An Analysis of Canadian Community Health Survey Work and Mental Health Miao Fang McMaster University May 13, 2005

  2. Outline • Introduction • Data, Sampling and Variables • Analyses • Results • Discussion and Conclusion

  3. Background • Over 30% of Canadians reported that most days at work were quite a bit or extremely stressful. • 12% of Canadians aged from 15 to 64 suffer from a mental disorder or substance dependence. • The estimated cost of poor mental health in workplace is inbillionsof dollars. • Work Poor mental health disability and loss of productivity in workplace

  4. Objective • Describe the relationship between work and mental health. • Describe the relationship between work and mental health care use for people with mental disorders and substance dependences. • Further explore covariates and interactions of any relationships.

  5. Data • Canadian Community Health Survey • CCHS1.1 Response rate: 84.7% Sample size: 131,535 (Ontario workers:23,110) • CCHS1.2 Response rate: 77.0% Sample size: 36,984(Ontario workers: 8,008)

  6. Sampling • Complex survey – multistage stratified cluster design • All estimates were weighed to represent the target Ontario workers population

  7. Variables • Dependent variables - Mental disorders and substance dependences (MDSD) CCHS1.1 – Depression (0,1) CCHS1.2 – Any mental disorder or substance dependence (AMDSD) (0,1) Mental disordersSubstance dependences Major depressive episode Alcohol dependence Manic episode Illicit drug dependence Panic disorder Social phobia Agoraphobia

  8. Variables - Mental health care utilization CCHS1.1 – Consultation with a m.h professional (0,1) CCHS1.2 – Utilization of any resource (for mental health) (0,1) • Main predictors (exposures) Work stressors (0-48) • Covariates Age, sex, BMI, race, marital status, education, income, type of smokers (all are categorical variables).

  9. Analyses • Descriptive Analysis • Bivariate analysis • Logistic regression analysis

  10. Descriptive Analysis Two-sample t test

  11. Contingency Table Analysis • Pearson Chi-Squared test for independence

  12. Measuring Association • The coefficient of contingency • Goodman and Kruskal’s Gamma - test for trend P - concordant pairs Q – discordant pairs

  13. Multiple Logistic Regression Model

  14. Point Estimation of Coefficient

  15. Variance Estimation • Maximum likelihood estimation

  16. Variance Estimation • Bootstrap method BOOTVARE_V21.SPS 1) Calculate the point estimate using the final weight. 2) Calculate B estimates using the B bootstrap weights. 3) Calculate the variance of the B estimates.

  17. Assessing the Fit of the Model- Hosmer-Lemeshow goodness of fit test To calculate the test statistic • Order the fitted values • Group the fitted values into g classes of roughly equal size • Calculate the observed and expected number in each group • Perform a goodness of fit test

  18. 10 10 8 8 Percent 6 6 4 4 Percent 2 2 0 0 12 15 18 21 24 27 30 33 36 39 3 3 6 6 9 9 12 15 18 21 24 27 30 33 36 39 42 Mean=19.1 (sd=5.2) Mean=19.4 (sd=5.0) Work Stressors (0 – 48) CCHS1.1 CCHS1.2

  19. Work stressors in different depression groups

  20. Work Stressors by MDSD CCHS1.1 CCHS1.2

  21. Other variables by MDSD All values are significant at 0.05 level except those in parentheses.

  22. An Example: Logistic Regression Model for AMDSD

  23. An Example Model for AMDSD (Continued) Goodness-of-fit: Hosmer and Lemeshow x2=3.79 on 8 d.f., P=0.88

  24. Comparison of Variance Estimations

  25. Comparison of Variance Estimations (Continued)

  26. Summary of Findings • MDSD • Work stressors highly predicted MDSD • Sub-groups at higher risk of MDSD: non-white, women, younger workers, smokers, higher BMI, not married

  27. Summary of Findings (Cont.) • Mental health care use • CCHS1.1 -More likely to consult with a mental health professional: older worker, women, whites, education at least to high school graduation • CCHS1.2 - More likely to use any resource: older worker, women, non-whites, lower work stressors

  28. Conclusion • Work stressors were confirmed as predictive of MDSD. • Identified sub-groups that do not use the health care service for their mental health problems.

  29. Thank you!

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