Household Food Insufficiency, Financial Strain, Work-Family Spillover, and Depressive Symptoms in the Working Class: The Work, Family, and Health Network Study

Objectives. We evaluated the association of household-level stressors with depressive symptoms among low-wage nursing home employees. Methods. Data were collected in 2006 and 2007 from 452 multiethnic primary and nonprimary wage earners in 4 facilities in Massachusetts. We used logistic regression to estimate the association of depressive symptoms with household financial strain, food insufficiency, and work-family spillover (preoccupation with work-related concerns while at home and vice versa). Results. Depressive symptoms were significantly associated with household financial strain (odds ratio [OR]=1.82; 95% confidence interval [CI]=1.03, 3.21) and food insufficiency (OR=2.10; 95% CI=1.10, 4.18). Among primary earners, stratified analyses showed that food insufficiency was associated with depressive symptoms (OR=3.60; 95% CI=1.42, 9.11) but financial strain was not. Among nonprimary wage earners, depressive symptoms correlated with financial strain (OR=3.65; 95% CI=1.48, 9.01) and work-family spillover (OR=3.22; 95% CI=1.11, 9.35). Conclusions. Household financial strain, food insufficiency, and work-family spillover are pervasive problems for working populations, but associations vary by primary wage earner status. The prevalence of food insufficiency among full-time employees was striking and might have a detrimental influence on depressive symptoms and the health of working-class families. (Am J Public Health. 2012;102:126-133. doi:10.2105/AJPH.2011.300323)