Analysis of self-reported mental health problems among the self-employed compared with paid workers in the Republic of Korea.

Background: As self-employed workers are vulnerable to health problems, this study aimed to analyze mental health problems and sleep disturbances among self-employed workers compared with paid workers in Korea. Methods: A total of 34,750 workers (23,938 paid workers and 10,812 self-employed workers) were analyzed from the fifth Korean Working Condition Survey, which included 50,205 households collected by stratified sampling in 2017. To compare mental health problems and sleep disturbance among self-employed workers and paid workers, multivariate logistic regression analyses were performed. Results: The odds ratio in self-employed workers compared with paid workers was 1.25 (95% confidence interval [CI]: 1.09-1.42) for anxiety, 1.11 (95% CI: 1.04-1.17) for overall fatigue, 1.11 (95% CI: 1.04-1.20) for difficulty falling asleep, 1.10 (95% CI: 1.02-1.18) for difficulty maintaining sleep and 1.24 (95% CI: 1.16-1.32) for extreme fatigue after waking up. Conclusions: Self-employed workers in Korea have a higher risk of self-reported mental health problems and sleep disturbances than paid workers. Further studies with a longitudinal design and structured evaluation are required to investigate the causal relationship between health problems and self-employment.