Occupational status as a determinant of mental health inequities in French young people: is fairness needed? Results of a cross-sectional multicentre observational survey.

Background: Employment conditions are associated with health inequities. In 2013, French young people had the highest unemployment rate and among those who worked as salaried workers most of them had temporary job. The purpose of the study was to assess mental health state of French young people through the prism of their occupational status and to measure whether occupational status is a determinant of health inequities.

Methods: A cross-sectional multicentre observational survey was performed in June and July 2010 in 115 French Local Social Centres and 74 Health Examination Centres, who were available to participate. The survey was based on an anonymous self-administrated questionnaire delivered by social workers or healthcare professionals to young people age from 16 to 25 years old. The questionnaire was composed of 54 items. Several health outcomes were measured: self-perceived health, mental health, addictions and to be victim of violence. The association of occupational status and mental health was assessed by adjusting results on age and gender and by introducing other explanatory variables such as social deprivation.

Results: A total of 4282 young people completed the questionnaire, a response rate of 83%, 1866 men and 2378 women, sex-ratio 0.79. French young people having a non-working occupational status or a non-permanent working status were more exposed to poor self-perceived health, poor mental health, addictions and violence. To be at school particularly secondary school was a protective factor for addiction.

Conclusions: Occupational status of French young people was a determinant of mental health inequities. Young people not at work and not studying reported greater vulnerability and should be targeted therefore by appropriate and specific social and medical services.