Home as workplace: Employment conditions, employer relationships, and mental health among migrant domestic workers in Macao, China.

BACKGROUND

Employment conditions are important social determinants of health among migrant domestic workers (MDW), yet most studies examine individual employment characteristics rather than multidimensional employment environments. This study examined how employment condition profiles and employer-employee relationships were associated with depressive and anxiety symptoms among MDWs in Macao, China.

METHODS

Cross-sectional data were drawn from 1769 completed surveys using respondent driven sampling and an analytic sample of 1743 female MDWs (Filipino, n = 1376; Indonesian, n = 367) were included in the analysis (2016-2017). Latent class analysis identified employment condition profiles across three domains: working environment, living environment, and compensation. Multivariable hierarchical linear regression models, stratified by nationality, examined associations between employment profiles, employer-employee relationship measures, and depressive and anxiety symptoms.

RESULTS

Two working environment profiles, three living environment profiles, and two compensation profiles were identified. Living environment profiles were most consistently associated with depressive and anxiety symptoms across both nationality groups. Compared with the favorable living environment profile, profiles characterized by living outside the employer's home and noisy residential conditions were associated with poorer mental health among Filipino MDWs. Working environment showed fewer adjusted associations, and compensation profiles were not independently associated with either mental health outcome. Fear of contract termination remained independently associated with poorer mental health, particularly among Filipino MDWs.

CONCLUSION

Living environment and perceived employment insecurity were the employment dimensions most consistently associated with MDW mental health. Policies that improve housing quality and protection against arbitrary contract termination may promote the mental health of MDWs.