Association of low-quality employment with the development of suicidal thought and suicide planning in workers: A longitudinal study in Korea

Abstract

Background: Employment quality stands as a crucial social determinant impacting workers' health. In this study, we investigate the association between low-quality employment and the emergence of suicidal thoughts and planning. Methods: We analyzed data from 7,797 Korean workers, amounting to 30,945 observations. Low-quality employment was characterized by three primary dimensions: employment insecurity, income inadequacy, and a lack of rights and protection. We employed a generalized estimating equation to probe the link between experiencing low-quality employment and the occurrence of suicidal thought and planning within the subsequent year. Odds ratios (OR) and 95% confidence intervals (CI) were estimated. Results: The overall incidence rates for suicidal thought and planning were 1.5% and 0.2%, respectively, across the observations. Workers with the lowest employment quality demonstrated higher propensities to develop both suicidal thought (OR: 2.05, 95% CI: 1.37-3.06) and planning (OR: 3.39, 95% CI: 1.08-10.64) at the following year, compared with workers with the highest overall employment quality. Specifically, daily employment exhibited associations with the onset of suicidal thought (OR: 1.64, 95% CI: 1.17-2.31) and suicide planning (OR: 3.49, 95% CI: 1.54-7.92) when compared to permanent employment. Additionally, individuals in the lowest monthly wage quartile displayed a heightened likelihood of developing suicidal thought (OR: 2.09, CI: 1.36-3.23) compared with those in the highest quartile. Conclusion: Our findings suggest that low-quality employment is associated with the onset of suicidal thought and suicide planning at follow-up. Therefore, employment quality is a critical social determinant of workers' mental health.