Psychosocial Work Environment and Mental Health among Restaurant Workers in San Francisco's Chinatown

Background and Objective: Adverse psychosocial working conditions pose numerous risks to workers’ health and wellbeing. In particular, situations of effort-reward imbalance (ERI), a mismatch of perceived workplace efforts and rewards, have been found to be associated with poor physical and mental health. To date, very few studies have examined the relationship between ERI and health among low wage or immigrant workers. Using data from our Community Based Participatory Research study of working conditions and health in San Francisco’s Chinatown, we examined the relationship between ERI and depression and anxiety among Chinese restaurant workers. Methods: We surveyed Chinese restaurant workers (n=405) about working conditions and health. Siegrist’s ERI scale was used to assess the psychosocial work environment and the Center for Epidemiologic Studies Depression Scale and the Hospital Anxiety and Depression Scale were used to screen for depression and anxiety, respectively. Additional worker characteristics and workplace factors were also measured. We conducted multivariate regression analyses to assess the relationship between ERI and the two outcomes. Results: Twenty-two percent of participants screened as depressed and 18% screened as anxious. ERI as well as the individual measures derived from Siegrist’s ERI model were strongly and significantly associated with both depression and anxiety. Conclusion: Results suggest a need for culturally-appropriate mental health and supportive services as well as interventions that improve the psychosocial work environment for Chinese restaurant workers. Further research is needed to elucidate the effects of the psychosocial work environment on health, particularly among low-wage, immigrant, and other vulnerable working populations.