| Summary: | Background: Previous research has demonstrated a strong association between labour market status and minor psychiatric morbidity (MPM). This PhD thesis aims to uncover the role of mediating factors, and the extent to which the relationship varies over space and time. In addition, this research seeks to establish the direction of causality and to differentiate between secure and insecure employment, and between various forms of joblessness. Methods: MPM was measured using the General Health Questionnaire (GHQ-12). Analyses were undertaken using British Household Panel Survey (BHPS) data from 1992-2008. Firstly, unstratified and gender-stratified series of nested linear and logit autoregressive random effects models were run to assess the role of confounding and mediating factors in the relationship between labour market status and MPM. Secondly, three complementary multilevel modelling approaches were used to assess the extent to which independent variation in GHQ-12 scores existed at the Local Authority District (LAD) level, and whether area-level unemployment rate was independently predictive of MPM. Thirdly, unstratified and age-group stratified fixed effects models were run in order to assess the effects of labour market transitions on MPM and therefore to investigate causality and age effects. Results: Across both genders it was shown that after adjustment for a range of confounding factors: insecure employment, unemployment, permanent sickness and other inactivity were significantly predictive of MPM compared to secure employment. Transition analyses suggest that this relationship is causal. Virtually no independent variation in GHQ-12 scores was found at the LAD level, but unemployment was comparatively less distressing for those living in high unemployment areas. Age was found to moderate the relationship between labour market status and MPM to some degree. Conclusions: This research deepens our understanding of the causal processes underlying the relationship between labour market status and psychological wellbeing, whilst considering the roles of spatial, temporal and macroeconomic context.
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