The Impact of Chronic Work Stress, Psychiatric Disorders and Chronic Physical Conditions on Disability Among Canadian Workers

Abstract

Background: The picture of the effects of chronic work stress, psychiatric disorders and chronic physical conditions on worker disability is becoming increasingly complicated. There appears to be a link between psychiatric disorders and work-related stress and also evidence that psychiatric disorders and physical conditions are linked. Yet, few studies have considered how these factors interact to impact disability in the working population.

Objectives: This study explores the relationships between disability with psychiatric disorders, chronic work stress, chronic physical conditions in the Canadian working population.

Methods: The study population (n=22,118) was drawn from the Canadian Community Health Survey 1.2 (CCHS), a national population-based survey that gathered cross-sectional data on health status from 37,000 respondents between May and December 2002. The sample included CCHS respondents aged 18-64 years old who indicated they were employed during the past year. Each respondent was given a structured diagnostic interview developed for the World Health Organization's World Mental Health Initiative 2000. The relationships between disability and chronic work stress, chronic physical conditions and psychiatric disorders were examined for working respondents using logistic regressions controlling for sociodemographic characteristics, province/region and occupation.

Results: Approximately, 30.6% of respondents experienced chronic work stress either alone or in combination with chronic physical condition and/or a psychiatric disorder. About 46.1% reported at least one chronic physical condition either alone or in combination. Finally, 10.7% had a psychiatric disorder. Compared to the group with none of the factors, increasing combinations were associated with increasing odds of disability after controlling for sociodemographics (i.e., age, sex, education, income, marital status, race/ethnicity), occupation and region.

Conclusions: The presence of chronic work stress seems to amplify effects of psychiatric disorders and chronic physical conditions on disability. In addition, psychiatric disorders comorbid with physical illness seem to be associated with significantly higher odds of disability.

Keywords: mental illness, work, disability

JEL Classification: I12