Mental health, employment and gender. Cross-sectional evidence in a sample of refugees from Bosnia-Herzegovina living in two Swedish regions

Large regional differences regarding access to employment have been observed amongst persons from Bosnia-Herzegovina coming to Sweden in 1993-1994. This has led to questions about the role of mental health. To explore this further, postal survey questionnaires were distributed to a community sample (N=650) that was stratified and, within strata, randomly selected from a sampling frame of persons coming to Sweden from Bosnia-Herzegovina in 1993-1994. Four hundred and thirteen persons returned the questionnaire providing a response rate of 63.5%. The aim was to increase knowledge about the relationship between mental health and employment in the chosen population. The main mental health outcome measure was the Göteborg Quality of Life instrument from which 360 respondents were grouped according to low or high symptom levels. Data were cross tabulated ([chi]2-tested) against background variables such as age, gender and occupational status, and then tested using binary logistic regression. Binary logistic regression revealed unemployed men but not women, and women who had been working for longer periods during 1993-1999, to be associated with high levels of symptoms of poor mental health. Women living in the urban region were also overrepresented in the high symptom group. These findings indicate that, job occupancy is important to the health of men in the study. However, for the women, further understanding is needed, as job occupancy at some level as well as living in the urban region appear to be associated with poor mental health.