Soc Psychiatry Psychiatr Epidemiol (2009) 44:628635
1007/s00127-008-0479-x
ORIGINAL PAPER
Leigh Ann Simmons Jennifer E. Swanberg
Psychosocial work environment and depressive symptoms
among US workers: comparing working poor
and working non-poor
Received: 18 March 2008 / Revised: 14 November 2008 / Published online: 12 December 2008
j Abstract Background The psychosocial work
environment has been associated with mental health
outcomes; however, little research has examined this
relationship for low-wage workers. The purpose of
this study was to investigate the relationship between
psychosocial job characteristics and depressive
symptoms for US workers using an expanded model
of job quality. Methods Data were from the 2002
National Study of the Changing Workforce, a nation-
ally representative study of wage and salaried workers
in the US. Working poor was defined as households
earning <250% of the federal poverty threshold.
Results Multivariate logistic regression models show
for working poor employees, job insecurity was
the single significant correlate of depressive symp-
toms after controlling for other demographic and
work environment variables. For working non-poor
employees, high psychological demands and low
supervisor and coworker support were associated with
depressive symptoms. Conclusions Findings suggest
all jobs do not equally affect employees depressive
symptoms. Implications for research that may improve
the mental health of the working poor in the US are
presented.
L.A. Simmons, PhD (&)
Dept. of Family Studies and Dept. of Health Services Management
University of Kentucky
315 Funkhouser Building
Lexington (KY) 40506-0054, USA
Tel.: +1-859/257-1648
Fax: +1-859/257-3212
E-Mail: leighann@uky.edu
J.E. Swanberg, PhD
Institute for Workplace Innovation
SPPE 479
College of Social Work
University of Kentucky
Lexington (KY), USA
DOI 10.
j Key words psychosocial job characteristics
depression depressive symptoms United States
working poor flexibility
Introduction
Research has shown that psychosocial work factors
contribute to social inequalities in health [41]. In fact,
recent changes in workplace structure, such as higher
rates of unemployment, underemployment, and
forced early retirements, have increased work-related
stress and psychiatric morbidity [44, 51]. A number of
studies have underscored the link between the psy-
chosocial work environment and mental health.
Godin and Kittle [20] found middle and upper income
workers who experienced job strain and reported low
control at the workplace had higher rates of mental
health problems. Among a sample of Swedish work-
ers, shift work, job strain, and low stimulation at work
all contributed to depression [5]. Similarly, nationally
representative data from Canada showed workers who
reported high job strain, lack of social support, and
low decision authority were more likely to experience
major depressive episodes [6], and job strain itself
was an independent risk factor for mental disorders
[55].
Despite data suggesting low-income populations
are especially vulnerable to work stress and associated
mental disorders [21, 55], few studies have examined
the relationship of psychosocial job characteristics
and mental health for low-wage workers. This is a
significant gap in the literature given data that dem-
onstrate strong associations between poor economic
status and mental health [1, 16, 24, 49]. Poor mental
health is a critical barrier to employment among low-
income workers [24, 39], and individuals with mental
health problems often earn lower wages and work
fewer hours [17, 25].

Over the last 27 years, the demand-control-support
model developed by Karasek [28] and expanded by
Johnson and Hall [27] and others [46] has dominated
the research on the relationship between the psy-
chosocial work environment and health. This model
suggests jobs high in psychological demands and low
in decision latitude create psychological strain [30].
Alternatively, jobs high in psychological demands and
high in decision latitude produce feelings of job sat-
isfaction and motivation to learn new things [30].
Support from coworkers and supervisors moderates
these relationships. Jobs with high demands, low
control, and low support produce the most risk for
illness [26, 27, 29], while jobs with high demands, low
control, and high support have reduced risk of illness.
Although the demands-control-support model is
well established, the changing nature of workforce
demographics in the US has led to recent efforts to
expand this model to better reflect twenty-first cen-
tury jobs [810, 41, 52]. More workers are now single
parents, partners in dual earner couples, and family
members with caregiving responsibilities [8, 10], and
these workers experience daily challenges in meeting
both work and family responsibilities. Consequently,
Swanberg and Simmons [52] suggested researchers
consider how these changing demographics affect the
relationship between job characteristics and health. In
their study of US workers, they found flexibility on
the job, a previously understudied factor in relation to
employee health, was an important psychosocial job
characteristic that requires further examination.
Given a growing proportion of workers in the US
are employed in low-wage jobs [13], and given the
limited research on the relationship between the
psychosocial work environment and mental health for
low-wage workers, the goal of this research was to fill
a gap in the literature. We sought to address two
primary research questions using an expanded model
of psychosocial job factors that includes workplace
flexibility: (1) What psychosocial job characteristics
are associated with depressive symptoms for wage
and salaried workers in the US? (2) Do these factors
differ based on working poor status? Findings have
the potential to inform research and policies aimed at
improving the health and well-being of the working
poor in the US.
Methods
j Data
We used data from the 2002 National Study of the Changing
Workforce (NSCW) conducted by the Families and Work Institute
[18]. The NSCW is based on a stratified unclustered random
probability sampling design that is used to survey a representative
sample of the nations labor force on all aspects of employment,
including psychosocial job characteristics. Using a computer-
assisted telephone interviewing system, phone interviews lasting
approximately 45 min were conducted with 3,504 participants
629
between October 2002 and June 2003 who met the following
inclusion criteria: (a) at least 18 years of age, (b) earning wages or
salaries from employment or a self-operated income-producing
business within the civilian labor force, (c) residing in the contig-
uous 48 states, and (d) not among the institutionalized population.
Random digit dial methods were used to generate potentially eli-
gible participants who were initially contacted by phone. Upwards
of 5060 calls were made as necessary for busy signals, no answers,
answers by a non-eligible indicating there may be an eligible, and
answers by an eligible requesting a call-back. Participants received
$25 as remuneration. The overall response rate for the NSCW was
52%. See the Families and Work Institute (http://familiesand-
work.org/site/research/summary/nscw2002summ.pdf) for addi-
tional information on the survey. For the present study we used
data only from respondents who earned wages and salaries through
employment by another person or entity (N = 2,584). Small busi-
ness owners and self-employed independents were excluded be-
cause of fundamental differences in the nature of this employment
and its effects on the psychosocial work environment.
j Dependent measure
Depressive symptoms were measured using an indicator that as-
sessed respondents for two domains of depression in the last
month: feeling down, depressed, or hopeless and little interest
or pleasure in doing things. Research has shown that concurrent
positive responses to both domains are a reliable indicator of
clinically significant depressive symptoms reflecting dysthymia,
major depression, or any depressive disorder [23]. Thus, subjects
who responded in the affirmative to both questions were coded as
1 = positive for depressive symptoms; those who scored in the
affirmative to only one or none of the domains were coded as
0 = negative for depressive symptoms. Cross tabulations indicated
there were significant differences (P < 0.001) between working
poor and working non-poor individuals on depressive symptoms.
j Independent measures
We examined demographic covariates and psychosocial job vari-
ables thought to affect depressive symptoms for wage and salaried
workers. Demographic covariates included sex, age, ethnicity,
educational status, marital status, urbanicity, children under 18 in
the household, full-time/part-time work status, and working poor
status, all of which have been associated with mental health. Sex
was measured dichotomously (1, male and 2, female). Age was in
four categories (1, 1825 years; 2, 2634 years; 3, 3549 years; and
4 = 50 years). Ethnicity was dichotomous (White, non-White).
Marital status included three categories: married, living with a
partner in a marriage-like relationship, and single, which repre-
sents those who are single, divorced, separated, or widowed. Edu-
cation was categorized as 12 years of school (high school/GED) or
less, some college/post-secondary school, and 16 years (college
degree) or more. Urbanicity was classified as urban, suburban, or
rural. The presence of children under 18 years was measured
dichotomously (1, yes; 0, no). Work status was measured dichot-
omously (1, full-time; 2, part-time). Working poor status was de-
fined as those respondents who were living in households earning
less than 250% of the federal poverty threshold (n = 548), and was
coded as 1 (working poor) and 2 (working non-poor).
In addition to demographic covariates, we controlled for
physical health status, given the well-documented relationship be-
tween physical and mental health. Physical health status was
measured using a single-item dichotomous indicator of health
status, where 0, good or excellent health and 1, fair or poor health.
Seven variables that reflect current trends in research on the
psychosocial work environment were included. These variables
were created using questions that align with validated measures of
the corresponding constructs. Psychological demands included the
mean of seven items on a four-point Likert scale (1, strongly agree;
4, strongly disagree): (a) have to work hard, (b) have to work fast,
630
(c) never enough time to get work done, (d) excessive work, (e)
conflicting job demands, (f) hectic pace, and (g) often interrupted.
Higher scores indicated fewer demands, and scale reliability was
calculated at a = 0.79. Physical demands were measured by a single
item on a four-point Likert scale (1, strongly agree; 4, strongly
disagree): job is physically demanding/tiring. The item was stated
in the reverse, so that a lower score indicated a more physically
demanding job.
Decision latitude was measured using the mean of six items on
a four-point Likert scale (1, strongly disagree; 4, strongly agree).
Three items (allowed to make ones own decisions, decision free-
dom, and has lots of say) reflect the employees level of decision
authority, and three items (ability to learn new things, repetitive
work, and creativity required) reflect the employees level of skill
discretion. Higher scores indicated more decision latitude, and
scale reliability was calculated at a = 0.67.
Supervisor support for work and family issues was measured by
the mean of ten items on a four-point Likert scale (1, strongly
disagree; 4, strongly agree). Five items related to supervisor support
of work-related matters: keeps me informed, recognizes a good job,
has realistic expectations, supportive with work problems, and is
competent. Five items related to support for work-family issues: is
fair about personal/family needs, accommodates family/personal
business, understands personal/family issues, is comfortable
bringing up personal/family issues, cares about effects of work on
personal/family life. Higher scores indicated greater supervisor
support for work-family issues. Scale reliability was calculated at
a = 0.85.
Workplace flexibility, or the policies and practices that aid
employees in meeting their work, family, and personal responsi-
bilities [7, 9, 38] was measured using the mean of nine items that
assess temporal and spatial forms of flexibility. Three items mea-
sured general satisfaction with schedule on a four-point Likert scale
(1, strongly disagree; 4, strongly agree) and included: (a) control
over schedule, (b) satisfaction with schedule, and (c) difficulty
taking time off for personal/family issues. Six items were measured
dichotomously (1, yes; 0, no) and reflected access to flexible or
alternative work arrangements, including: (a) work from home, (b)
days off for sick child without losing pay or vacation time, (c)
choose starting and quitting times, (d) work a compressed work
week, (e) change schedule daily, and (f) decide when to take breaks.
Higher scores indicated more flexibility, and scale reliability for
these items was calculated at a = 0.63.
Co-worker support was measured using the mean of three items
on a four-point Likert scale (1, strongly disgree; 4, strongly agree).
These items included: (a) coworkers are friendly; (b) coworkers are
interested; and (c) coworkers work together. The scale reliability
was calculated at a = 0.75, and higher scores indicated more
coworker support.
Job insecurity was measured by five variables. Three were
dichotomous (1, no; 0, yes) and reflected the possibility of job loss
(recent and future layoffs and reduced work hours when work is
slow). Two were measured on a four-point Likert scale (1, strongly
disagree; 4, strongly agree) and reflected opportunities for
advancement (career possibilities and valuable skills). Higher
scores indicated more job security. Scale reliability was calculated
at a = 0.35 for the insecurity/job loss items and a = 0.59 for the
advancement items.
j Data analysis
We analyzed all data using STATA 9.0 (College Station, TX).
Sampling weights consistent with the NSCW were incorporated into
all analyses. STATA employs Taylor Series linearization as the
method of variance estimation for survey data. The linearization
accounts for non-linear estimates, which occur as a result of un-
equal selection possibilities, oversampling of subgroups, and non-
response. Since the variables of psychological demands, physical
demands, and job insecurity were reverse coded in the NSCW, prior
to analysis we multiplied these scores by )1 so the calculated odds
ratios would accurately reflect the direction of the relationship of
these variables to depressive symptoms. In all models categorical
variables were dummy coded (0, 1), and the reference categories are
noted in the tables of results. Odds ratios were considered signifi-
cant if the P value was 0.05 and the confidence interval did not
include 1.
First, we computed descriptive statistics for all respondents.
Second, for all respondents we ran a series of cross tabulations for
demographic variables and univariate logistic regression models
for psychosocial job characteristics relating each variable to
depressive symptoms. Third, to address our second research
question and because we found significant differences in depressive
symptoms based on working poor status, we ran three stepwise
multivariate logistic regression (MLR) models: one for all respon-
dents, one for working poor respondents, and one for working non-
poor respondents. For each MLR we entered the demographic and
health covariates that were significant in the bivariate analyses first,
and then entered the psychosocial job characteristic variables in the
following order until the most parsimonious model was achieved:
psychological demands, physical demands, decision latitude, flex-
ible work options, supervisor support for work and family issues,
coworker support, and job insecurity. This order was guided by
previous research on job quality consistent with the demand-con-
trol-support model [28], and P 0.05 was the basis for inclusion in
the model. Entering each psychosocial job characteristic in a
stepwise fashion also allowed us to assess possible mediating
relationships among the job characteristics. We report odds ratios
and associated 95% confidence intervals.
Results
j Sample description
Table 1 shows the frequencies for the sample distri-
bution. There were slightly more male (51.4%) than
female (48.6%) respondents. More than one-half of
respondents were between 26 and 49 years of age
(58%); 14.4% were between 18 and 25 years and
27.6% were 50 years or older. Nearly 42% of respon-
dents had a high school degree, equivalent or less,
while 29.6% had some postsecondary education and
28.6% had a 4-year degree or more. Two-thirds of the
sample were married (58.7%) or living with a partner
(6.7%), and 34.6% were single. The majority of
respondents identified as White (74.9%) versus non-
White (25.1%). Most lived in urban (55.4%) and
suburban (22.2%) areas as opposed to rural areas
(22.4%). Less than one-half of respondents had chil-
dren less than 18 years in the home (42.9%). The
majority worked full-time (81.1%) rather than part-
time (18.9%). Just over one-fourth (25.3%) of
respondents were working poor, or earning less than
250% of the federal poverty line, and 74.7% were
working non-poor, or earning 250% of poverty or
more (46,000 USD or 28,165 GBP1 for a family of four
in 2003). Most (82.4%) reported their health as good
or excellent; 17.6% reported their health as fair or
poor. The prevalence of depressive symptoms in the
sample was 16%.
1
The average exchange rate for 2003 was used to calculate this
figure.
 631

Table 1 Demographic characteristics for wage and salaried workers in the Table 2 Bivarate correlates of depressive symptoms for wage and salaried
NSCW (N = 2,584) workers in the NSCW

Variable Percent Variable Depressive Symptoms P value

Sex No (%) Yes (%)

Male 51.4
Female 48.6 Sex 0.21
Age (years) Male 43.7 7.7
1825 14.4 Female 40.4 8.3
2634 17.9 Age (years) 0.09
3549 40.1 1825 11.6 2.8
50 27.6 2634 14.6 3.3
Educational level 3549 33.9 6.2
High school/GED or less 41.8 50 24.0 3.7
Some post-secondary 29.6 Educational level <0.001
4-year degree or more 28.6 High school/GED or less 33.6 8.2
Marital status Some post-secondary 25.3 4.3
Married 58.7 4-year degree or more 25.2 3.4
Living with partner 6.7 Marital status <0.001
Singlea 34.6 Married 51.1 7.6
Ethnicity Living with partner 5.4 1.3
White 74.9 Single (includes unmarried, 27.6 7.0
Non-White 25.1 divorced/separated, widowed)
Urbanicity Ethnicity 0.22
Urban 55.4 White 63.5 11.5
Suburban 22.2 Non-White 20.6 4.5
Rural 22.4 Urbanicity 0.79
Children <18 years Urban 46.5 8.9
Yes 42.9 Suburban 18.5 3.7
No 57.1 Rural 19.1 3.4
Work status Children <18 years 0.67
Full-time 81.1 Yes 36.3 6.7
Part-time 18.9 No 47.8 9.3
Poverty level Work status 0.09
<250% FPL 25.3 Full-time 68.7 12.5
250% FPL 74.7 Part-time 15.3 3.6
Health status Poverty level <0.001
Good/excellent 82.4 <250% FPL 19.5 5.7
Fair/poor 17.6 250% FPL 64.6 10.2
Depressive symptoms Health status <0.001
Yes 16.0 Good/excellent 72.7 9.7
No 84.0 Fair/poor 11.4 6.3
a
Includes unmarried, divorced, separated and widowed respondents Psychosocial job characteristics OR 95% CI

Physical demands 1.25 1.121.40 <0.001

j Bivariate analyses Psychological demands 1.59 1.331.89 <0.001
Decision latitude 0.74 0.640.86 <0.001
Table 2 displays the results of the bivariate analyses Flexibility 0.19 0.110.32 <0.001
relating demographic covariates, health status, and Supervisor support for work and family 0.73 0.660.81 <0.001
Coworker support 0.58 0.480.69 <0.001
psychosocial job characteristics to depressive symp- Job insecurity 3.01 2.024.50 <0.001
toms. Among the demographic covariates, educa-
tional levels (P < 0.001), marital status (P < 0.001),
and working poor status (P < 0.001) were signifi- j Multivariate analyses
cantly different. The proportion of respondents
reporting depressive symptoms was greater for those Table 3 presents the results of the MLR models. For
with less education, single marital status, and earning the entire sample, psychological demands, coworker
less than 250% of the federal poverty line. Health support, and job insecurity were significantly associ-
status was also significant (P < 0.001); a greater pro- ated with depressive symptoms adjusting for educa-
portion of those with fair or poor health reported tion, marital status, flexibility and supervisor support.
depressive symptoms than those with good or excel- Workers who reported greater coworker support were
lent health. All psychosocial job characteristics dem- less likely to report depressive symptoms, while
onstrated significance at P < 0.001. Respondents with workers with more psychological demands and
fewer psychological and physical demands and greater job insecurity were more likely to report
greater decision latitude, flexibility, supervisor sup- depressive symptoms. Additionally, coworker support
port, coworker support, and job security were less was found to partially mediate the relationships be-
likely to report depressive symptoms. tween flexible work options and depressive symptoms
632

Table 3 Multivariable regression models examining psychosocial job characteristics associated with depressive symptoms among wage and salaried workers in the
NSCW

Variable Whole sample Working poor Working non-poor

OR 95% CI OR 95% CI OR 95% CI

Educational level
High school/GED or less 1.00 1.00 1.00
Some post-secondary 0.76 0.551.05 0.90 0.491.66 0.68 0.461.01
4-year degree or more 0.68* 0.490.96 0.84 0.381.88 0.64* 0.440.93
Marital status
Married 1.00 1.00 1.00
Living with partner 1.03 0.591.80 1.39 0.553.51 0.76 0.351.61
Single 1.60+ 1.192.15 1.26 0.642.48 1.55+ 1.122.14
Health 3.22# 2.354.43 3.62# 1.966.67 3.12# 2.174.49
Psychological demands 1.46# 1.201.78 1.41 0.982.03 1.51# 1.211.89
Physical demands Dropped Dropped Dropped
Decision authority Dropped Dropped Dropped
Flexibility 0.63 0.341.17 0.21 0.041.08 0.83 0.461.74
Supervisor support 0.78 0.621.00 Dropped 0.68+ 0.510.90
Coworker support 0.72+ 0.570.92 Dropped 0.63+ 0.480.84
Job insecurity 1.88+ 1.242.83 2.42* 1.194.92 Dropped
F 15.93 (10, 2416)# 5.33 (8, 515)# 14.49 (9, 1857)#

*Significant P < 0.05; +Significant P < 0.01; #Significant P < 0.001

and supervisor support and depressive symptoms, as
these previously significant relationships (data not
shown) were no longer significant once coworker
support was added to the model. These findings
suggest that coworker support buffers the effects of
limited flexibility and low supervisor support on
depressive symptoms.
Results indicated there were differences in signifi-
cant psychosocial job characteristics when the sample
was parceled into working poor and working non-
poor groups. For the working poor, job insecurity was
the single significant correlate of depressive symp-
toms after adjusting for education, marital status,
health, flexibility, and psychological demands. Fur-
ther, job insecurity partially mediated the relation-
ships between flexibility and depressive symptoms
and supervisor support and depressive symptoms, as
these relationships were no longer significant (data
not shown) when job insecurity was added to the
model. These findings suggest that working poor
respondents who reported job insecurity were more
likely to report depressive symptoms even in the
presence of flexibility and supervisor support. For
the working non-poor, psychological demands and
support from both supervisors and coworkers were
significant correlates of depressive symptoms after
adjusting for marital status, educational level, health,
and flexibility. Working non-poor respondents with
more psychological demands had increased odds of
reporting depressive symptoms, while respondents
with greater supervisor and coworker support had
decreased odds of reporting depressive symptoms.
Additionally, supervisor support partially mediated
the relationship between flexibility and depressive
symptoms, as the latter relationship was no longer
significant after adding supervisor support to the
model (data not shown). These findings suggest that
having a supportive supervisor may mitigate the ef-
fects of reduced flexibility on depression.
Discussion
Three important findings emerged from this analy-
sis. First, this study underscores other research [5, 6,
14, 20, 50, 55, 57] suggesting psychosocial job
characteristics are associated with employees mental
health, and specifically depressive symptoms. In the
current study, 16% of respondents reported depres-
sive symptoms. This is consistent with other studies
of depression in the workplace, which have docu-
mented a past month major depressive episode rate
of 8.5% in a Canadian sample [53] and a past month
depressive symptoms rate of 26.3% in a German
sample [14]. Additionally, a multinational epidemi-
ologic study revealed the lifetime prevalence of ma-
jor depressive episodes in the United States was
16.9%. Depressive symptoms are a significant public
health concern in the workplace, as they are asso-
ciated with absenteeism due to sickness [11, 37], lost
work hours [33], job retention [56], and reductions
in work performance [42]. Further, depressive
symptoms have been associated with poor health
behaviors such as cigarette smoking [31] and
comorbid health conditions that negatively affect
work productivity, including chronic fatigue, sleep
problems, and anxiety [35]. Given the deleterious
effects of depressive symptoms on work perfor-
mance, and given that employee health costs are the
single fastest growing expense in workplaces [45],
employers of low-wage workers may consider
investing in interventions to improve mental health,

including improving the psychosocial work envi-
ronment and increasing access to treatment. For
example, a recent randomized controlled trial
showed a depression outreach and treatment pro-
gram improved job retention and hours worked for
those treated compared to those not treated [56].
These analyses go beyond previous studies by
examining how the relationship between psychosocial
job characteristics and mental health differs for dif-
ferent categories of workers (i.e., working poor and
working non-poor), and by including the construct of
workplace flexibility in the model. We found the
relationships among psychosocial job characteristics
and depressive symptoms did differ based on working
poor status, and these differences were masked when
the whole group (working poor and working non-
poor) was analyzed together. This finding is impor-
tant, because it suggests that different categories of
jobs may have different effects on employee mental
health [36]. Indeed, among the two groups of workers
in this sample, 45.9% of working non-poor and 20.6%
of working poor respondents were employed in pro-
fessional, administrative, executive, and managerial
jobs, while 20.2% of working poor and 8.4% of
working non-poor respondents were employed in
service occupations (data not shown). Future research
should continue to investigate this line of inquiry,
specifically examining the effects of job type on em-
ployee mental health and how job characteristics
associated with mental health vary according to job
status. Researchers also should investigate strategies
for improving job characteristics within different
categories of workers in the labor force, especially
given research that shows low-wage workers are at
higher risk for mental disorders [1, 16, 24, 49].
A second important finding was the association
between psychosocial job characteristics and depres-
sive symptoms. The original demands-control-sup-
port model [2830] suggests high psychological job
demands in association with low decision authority
produce psychological strain. However, we found that
after controlling for demographic covariates, health
status, and psychological demands, decision latitude
was no longer a significant correlate of depressive
symptoms in any of the three models. This finding is
consistent with at least one other study [43], and it
may suggest that decision latitude is more closely tied
to physical health status, and the mental health effects
are a secondary outcome.
We found flexibility was an important correlate of
depressive symptoms that was mediated by other
psychosocial work factors. Other investigators have
identified flexibility as a job characteristic that mini-
mizes the conflict associated with managing work and
family demands [3, 4, 15, 22, 47]. In our analyses of
the whole sample, coworker support mediated flexi-
bility, suggesting coworkers may provide support
such as covering shifts or trading work responsibili-
ties in an environment where there is limited work-
633
place flexibility. For working non-poor individuals,
supervisor support mediated flexibility, similarly
suggesting that having a supportive supervisor mini-
mizes the stress that may be produced by a job with
inflexible scheduling. In the analyses of the working
poor sample, flexibility was an important independent
correlate of depressive symptoms that was subse-
quently mediated by job insecurity. To some extent,
this finding is not surprising. Jobs that pay lower
wages tend to be hourly, seasonal temporary, or
misclassified as contract work [40], and provide very
little job security. Moreover, because low-wage jobs
are less likely than higher paid jobs to offer oppor-
tunities for growth and benefits such as paid sick
time, health insurance or wage and hour guarantees,
workers may treat such jobs as a stopgap until they
find better employment. Any of these reasons may
contribute to job insecurity, stress, and related mental
health symptoms. This may be especially true if job
insecurity contributes to financial insecurity.
The third important finding is the association of
demographic covariates and depressive symptoms.
After adjusting for health status and psychosocial job
characteristics, workers with a four-year college de-
gree were significantly less likely to report depressive
symptoms, and workers who were single were sig-
nificantly more likely to report depressive symptoms.
Both findings are consistent with other research [6,
43]. Interestingly, we did not find gender differences
in depressive symptoms. This is contrary to some
research on psychosocial job characteristics and
mental health [2, 6, 43], but consistent with other
work [55].
A strength of this study is that we did not use cut-
off values to create high and low categories of job
characteristics in favor of continuous values that
permitted evaluation of these factors along a contin-
uum. In two previous studies, Wang [54, 55] noted the
methodological difficulty of defining high and low
work stress, and subsequently relating it to risk for
mental disorders, which he suggested may differ by
sociodemographic and occupational characteristics
across varying levels of stress. Given our interest in
examining workers across an important sociodemo-
graphic characteristicworking poor statuswe
thought it was especially important to utilize a con-
tinuous measure of psychosocial job characteristics,
so as not to misclassify these characteristics across the
two groups of workers. That is, what constitutes
high or low demands, decision latitude, support,
flexibility, etc. likely differs across different occupa-
tional categories and classes of workers, and cannot
be assumed to be the same for the working poor and
non-poor groups. Expectations for specific work
characteristics likely differ across occupational
groups and high-, medium-, and low-wage jobs, and
mismatched expectations may contribute to mental
health problems. An employee who expects more
flexibility than is afforded may experience greater
634
work stress and subsequently greater mental distress.
Future research should investigate the role of matched
or mismatched expectations for the work environ-
ment and how these may contribute to employee
health status.
Limitations
Although this is one of the first studies to examine
whether the job characteristics associated with
depressive symptoms differ between the working poor
and working non-poor, results should be understood
within the context of the study limitations. First, the
52% response rate is low compared to other national
studies (e.g., National Comorbidity SurveyReplica-
tion Response Rate [RR] = 76.1% [32]; National
Survey of Drug Use and Health RR = 78.6% [48]), so
findings may not be generalizable to all wage and
salaried workers in the US. Additionally, given this
was a telephone survey, working poor respondents
may be underrepresented due to difficulties with
maintaining a phone line resulting in selection bias.
Second, the NSCW data are cross-sectional. Thus,
these findings provide information about the nature
of the relationships between significant psychosocial
work characteristics and depressive symptoms, but no
causal claims may be made. Additional longitudinal
studies are warranted. Third, while this study uses a
two-item indicator of depressive symptoms that has
been shown to be reliable, fully structured interviews
to diagnose depression, such as that used in epide-
miologic studies (e.g., National Comorbidity Survey
[34]) or those carried out by clinicians, were not
conducted. Consequently, depressive symptoms may
be over- or under-reported in this sample.
Conclusions
The quality of the psychosocial work environment has
been associated with employee health and well-being
[19]. Our findings suggest that all jobs do not equally
affect depressive symptoms in the workplace. To
better assist low-income workers, more knowledge is
needed about the relationship between job charac-
teristics and mental health for these workers over
time. Although the demands-control-support model
[27, 28] is among the most widely tested of occupa-
tional health, many of these studies rely on tradi-
tionally male occupations, middle to higher income
occupations, or data collected before 1990 [12].
Additional research is needed to better understand
the relationships between job characteristics and
depressive symptoms among workers in distinctly
different job classifications and income categories.
Such investigations have the potential to inform em-
ployee-centered workplace policies and practices that
promote positive mental health.
j Acknowledgments This paper was a collaborative effort in
which both authors contributed equally. This project was sup-
ported with a grant from the University of Kentucky Center for
Poverty Research through the Department of Health and Human
Service, Office of the Assistant Secretary for Planning and Evalua-
tion, grant number 4 ASPE417-02 (PI Simmons). The opinions
expressed herein are solely those of the authors and should not be
construed as representing the opinions or policy of the UKCPR
or any agency of the U.S. federal government. Leigh Ann Simmons
is supported by the Building Interdisciplinary Research Careers
in Womens Health Program (NIH/NIDA grant number 5 K12
DA014040-07).
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