Epidemiology

Background:Industrial blue-collar workers face multiple work-related stressors, but evidence regarding the burden of mental illness among today\u2019s blue-collar men and women remains limited.Methods:In this retrospective cohort study, we examined health and employment records for 37,183 blue- and white-collar workers employed by a single U.S. aluminum manufacturer from 2003 \u2013 2013. Using Cox proportional hazards regression, we modeled time to first episode of treated depression by gender and occupational class. Among cases, we modeled rates of depression-related service utilization with generalized gamma regression.Results:Compared with their white-collar counterparts, blue-collar men were more likely to be treated for depression (HR = 1.3, 95% CI 1.1 \u2013 1.4) as were blue-collar women (HR = 1.4, 1.2 \u2013 1.6). Blue-collar women were most likely to be treated for depression as compared with white-collar men (HR = 3.2, 95% CI 2.1 \u2013 5.0). However, blue-collar workers used depression-related services less frequently than their white-collar counterparts among both men (RR = 0.91, 95% CI 0.84 \u2013 0.98) and women (RR = 0.82, 95% CI 0.77 \u2013 0.88).Conclusion:Blue-collar women were most likely to be treated for depression compared with white-collar workers, and blue-collar women were most likely to be treated for depression compared with white-collar men. However, blue-collar men and women used depression-related healthcare services less frequently than white-collar workers. These findings underscore that blue-collar women may be uniquely susceptible to depression, and suggest that blue-collar workers may encounter barriers to care-seeking related mental illness other than their insurance status.20192020-05-01T00:00:00ZF31 MH112246/MH/NIMH NIH HHS/United StatesR01 AG026291/AG/NIA NIH HHS/United StatesR01 OH009939/OH/NIOSH CDC HHS/United States30964814PMC6461367797