Traits d’identité culturelle, travail et santé mentale : une étude dans la main-d’œuvre canadienne

The increased disability claims linked to mental health problems, the economic implications of mental illness in terms of costs for businesses, and the established link between work and mental health are some of the rising concerns explaining the growing interest in mental health interventions and programs in the workplace. In a context where the personalization of mental health interventions is further promoted, cultural identity traits could contribute to such a personalization. We define cultural identity traits as a tangible or intangible element of a cultural identity, inherited or not, considered as isolable and that could be subject of a specific analysis. To personalize mental health interventions according to cultural identity traits, it would require adapting these interventions to meet specific workplace situations in which cultural identity traits may act as important factors. This thesis is the beginning of an answer on whether such an approach is worth of interest. This thesis examines how cultural identity traits, such as ethnicity and immigration status, affect how work is related to mental health symptoms such as psychological distress symptoms and depressive symptoms in the Canadian workforce.  The limited attention paid to cultural identity traits by current models to analyze work stress, prevents a better understanding of the cultural identity traits role in the association linking work to mental health issues, while they are associated with both work and mental health. The composition of the Canadian population justifies the relevance of including cultural identity traits into a comprehensive analysis of work and mental health, as over 250 000 newcomers settle in Canada every year, with approximately 80% coming from Asia, Africa, and Latin America. Studies show that immigrants and those identified as visible minorities are more likely to end up in jobs where the working conditions are much more difficult. These two groups appear to have a higher prevalence of psychological distress symptoms and depressive symptoms.  In order to address the inherent limits of the current theoretical models explaining work stress in the literature, we use in this study a multilevel analysis approach of work stress inspired by the social stress theory, and sociological approaches discussed in the United States from a micro–macro perspective, and in Europe from an agency-structure perspective. Social stress theory allows us to understand the mechanisms linking some conditions of social organization to mental health. Micro-macro and agency-structure approaches are not only concerned with dividing social reality into levels, but also try to understand the direction between levels. Our theoretical model examines three main hypotheses in which work factors with the exception of overqualification are inspired by those found in the multilevel model: 1) a direct relationship between cultural identity traits (immigrant status and ethnicity) and mental health problems (psychological distress symptoms and depressive symptoms); 2) a moderating effect of cultural identity traits on the relation between work factors (overqualification, skill utilization, decision latitude, psychological demands, physical demands, social support at work, job insecurity, worked hours, irregular work scheduling) and mental health problems; 3) a mediating role of work factors on the relation between cultural identity trait and mental health problems. The mediating effect allows us to analyze if a differential exposure to work factors based on ethnicity and immigrant status exist.   The data for this study were collected from the nine cycles of the National Population Health Survey (NPHS) conducted by Statistics Canada over an 18-year period starting from 1994 and ending in 2012 after 9 cycles. Multilevel regression analyses were conducted on a sample of 6477 workers. The results of the analysis are presented in three articles representing the chapters 5 to 7 of this thesis.   Results suggest that ethnicity seems to influence the relationship between work and the two analyzed symptoms. Ethnicity (visible minority versus caucasian) seems to be associated with depressive symptoms, but not with psychological distress symptoms. Among the effects of moderating variables and the effects of mediating variables tested, only one variable is proven significant. The skill utilization plays a mediating role in the relationship between ethnicity and psychological distress symptoms. There seems to be a differential exposure to work factors based on ethnicity. Compared to caucasians, visible minorities are more exposed to overqualification and less to skill utilization and decision latitude. All analyses conducted with immigration status have led to inconclusive results. Many limitations related to our research strategy (measurement of ethnicity, job quality is not taken into account, immigrant categories are not distinguished, mostly long-term immigrants, confounding variables not reflecting many realities face by the migration and integration process, etc.) call to be caution when interpreting the results of this thesis.  The results of this thesis do not close debates on how cultural identity traits, such as ethnicity and immigration status affect the way work is related to mental health symptoms. However, they provide some insights into it. The results suggest that reducing risky working conditions and tackling differential exposure to work factors might provide two avenues for action against mental health problems in the Canadian workforce. Taking tangible steps on these two directions could also help lower cost related to mental health issues, which are continuously growing in Canada. One element that seems to stand out the most from this study is the need to look more closely at the issue of professional deskilling.

Keyphrases: Immigrant, Mental health, Psychological distress, Immigration, Canadian born, Visible minority, Ethnicity, Caucasian, Cultural identity traits, Differential reactions, Differential exposures, NPHS