Association between occupational health literacy and generalized anxiety disorder among couriers: A cross-sectional survey based in China

Background Occupational health literacy is crucial for the health of the working population. Couriers have more mental health problems compared to other populations. Objective This study aimed to examine the mediating effect of occupational stress and depressive symptoms between occupational health literacy and generalized anxiety disorder. Methods From March to October 2023, a cross-sectional survey was conducted on 1121 couriers in four districts of Chongqing. Common method bias was performed by Harman's single-factor test. We conducted the linear regression model and bootstrap analyses to test the mediating role of occupational stress and depressive symptoms in the relationship between occupational health literacy and generalized anxiety disorder. Results 16.4% of couriers had occupational health literacy. The detection rates of occupational stress, depressive symptoms, and generalized anxiety disorder were 39.4%, 27.6%, and 39.7%, respectively. After adjusting the confounders, occupational health literacy was significantly negatively correlated with generalized anxiety disorder( β = −0.088, p < 0.001). The mediation effect of occupational stress and depressive symptoms accounted for 51.24% of the total effect regarding occupational health literacy with generalized anxiety disorder. Conclusion Occupational health literacy not only directly influenced generalized anxiety disorder among couriers but also indirectly via occupational stress and depressive symptoms. Improving occupational health literacy and reducing occupational stress and depressive symptoms may be effective strategies to prevent generalized anxiety disorder among couriers.