Navigating Health at Sea: Work, Stress, and lifestyle as Drivers of Seafarers' Wellbeing and Self-Rated Health
Hayes Mejia, Rebecca LU
(2026)
In Lund University, Faculty of Medicine Doctoral Dissertation Series
- Abstract (Swedish)
- Background: Seafarers constitute a global workforce exposed to unique psychosocial, organisational, and environmental stressors. Despite growing attention to maritime wellbeing, empirical evidence on how these multi level determinants interact to shape mental and physical health remains limited. This thesis aims to identify key determinants of mental health, wellbeing, happiness, and self rated health (SRH) among international seafarers, and to assess how psychosocial work conditions, subjective work experiences, lifestyle behaviours, physical health conditions, and stress jointly influence health outcomes.
Methods: This thesis comprises three quantitative cross sectional studies using surveys conducted in 2022 and 2024, involving... (More) - Background: Seafarers constitute a global workforce exposed to unique psychosocial, organisational, and environmental stressors. Despite growing attention to maritime wellbeing, empirical evidence on how these multi level determinants interact to shape mental and physical health remains limited. This thesis aims to identify key determinants of mental health, wellbeing, happiness, and self rated health (SRH) among international seafarers, and to assess how psychosocial work conditions, subjective work experiences, lifestyle behaviours, physical health conditions, and stress jointly influence health outcomes.
Methods: This thesis comprises three quantitative cross sectional studies using surveys conducted in 2022 and 2024, involving 17,861; 13,008; and 22,432 international seafarers respectively. Validated instruments (PSS 10, GAD 7, PHQ 9, WHO 5, SHS) measured mental, psychological, and general health outcomes. Multivariate regression, stratified analyses, and interaction modelling (RERI) were used to assess associations and moderating effects.
Results: Paper I showed that COVID-19 disruptions, delayed crew changes, high workload, and poor communication significantly increased stress, anxiety, and depression, while strong safety culture and clear employer communication buffered these effects. Paper II demonstrated that wellbeing and happiness were strongly associated with positive work experiences (satisfaction, fairness, expectations, skills utilisation, and social climate), while high workload weakened these benefits. Paper III found that poor SRH was linked to chronic conditions, poor sleep, inactivity, smoking, loneliness, and high screen time, with stress acting as both an independent predictor and amplifier of other risk factors.
Conclusions: Seafarers’ health is shaped by interconnected regulatory, organisational, and individual determinants. Structural gaps in maritime governance, workload pressures, communication quality, leadership, and social cohesion onboard strongly influence mental and physical outcomes, while stress emerges as a central mechanism linking determinants across in particular Papers I and III. Effective health promotion requires coordinated multi level interventions spanning regulatory enforcement, organisational reforms, and support for individual health behaviours.
Implications: Strengthen the enforceability of regulatory frameworks, improve workload and communication practices, expand access to mental health support, and address loneliness and lifestyle risks essential to safeguarding seafarers’ wellbeing to build a resilient maritime workforce.
(Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/5e9250aa-155f-4494-b852-3b99d6c011f0
- author
- Hayes Mejia, Rebecca
LU
- supervisor
- opponent
-
- Professor Oldenburg, Marcus, Institute for Occupational Medicine, University Medical Center Hamburg-Eppendorf (UKE, Germany
- organization
- publishing date
- 2026
- type
- Thesis
- publication status
- published
- subject
- keywords
- Seafarers' health, Health and wellbeing, Psychosocial work environment, Maritime health
- in
- Lund University, Faculty of Medicine Doctoral Dissertation Series
- issue
- 2026:72
- pages
- 78 pages
- publisher
- Lund University, Faculty of Medicine
- defense location
- Agardh föreläsningssal, CRC, Jan Waldenströms gata 35, Skånes Universitetssjukhus i Malmö
- defense date
- 2026-05-13 13:15:00
- ISSN
- 1652-8220
- ISBN
- 978-91-8021-870-2
- language
- English
- LU publication?
- yes
- id
- 5e9250aa-155f-4494-b852-3b99d6c011f0
- date added to LUP
- 2026-04-10 10:10:05
- date last changed
- 2026-04-16 13:12:14
@phdthesis{5e9250aa-155f-4494-b852-3b99d6c011f0,
abstract = {{Background: Seafarers constitute a global workforce exposed to unique psychosocial, organisational, and environmental stressors. Despite growing attention to maritime wellbeing, empirical evidence on how these multi level determinants interact to shape mental and physical health remains limited. This thesis aims to identify key determinants of mental health, wellbeing, happiness, and self rated health (SRH) among international seafarers, and to assess how psychosocial work conditions, subjective work experiences, lifestyle behaviours, physical health conditions, and stress jointly influence health outcomes.<br/>Methods: This thesis comprises three quantitative cross sectional studies using surveys conducted in 2022 and 2024, involving 17,861; 13,008; and 22,432 international seafarers respectively. Validated instruments (PSS 10, GAD 7, PHQ 9, WHO 5, SHS) measured mental, psychological, and general health outcomes. Multivariate regression, stratified analyses, and interaction modelling (RERI) were used to assess associations and moderating effects.<br/>Results: Paper I showed that COVID-19 disruptions, delayed crew changes, high workload, and poor communication significantly increased stress, anxiety, and depression, while strong safety culture and clear employer communication buffered these effects. Paper II demonstrated that wellbeing and happiness were strongly associated with positive work experiences (satisfaction, fairness, expectations, skills utilisation, and social climate), while high workload weakened these benefits. Paper III found that poor SRH was linked to chronic conditions, poor sleep, inactivity, smoking, loneliness, and high screen time, with stress acting as both an independent predictor and amplifier of other risk factors.<br/>Conclusions: Seafarers’ health is shaped by interconnected regulatory, organisational, and individual determinants. Structural gaps in maritime governance, workload pressures, communication quality, leadership, and social cohesion onboard strongly influence mental and physical outcomes, while stress emerges as a central mechanism linking determinants across in particular Papers I and III. Effective health promotion requires coordinated multi level interventions spanning regulatory enforcement, organisational reforms, and support for individual health behaviours.<br/>Implications: Strengthen the enforceability of regulatory frameworks, improve workload and communication practices, expand access to mental health support, and address loneliness and lifestyle risks essential to safeguarding seafarers’ wellbeing to build a resilient maritime workforce.<br/>}},
author = {{Hayes Mejia, Rebecca}},
isbn = {{978-91-8021-870-2}},
issn = {{1652-8220}},
keywords = {{Seafarers' health; Health and wellbeing; Psychosocial work environment; Maritime health}},
language = {{eng}},
number = {{2026:72}},
publisher = {{Lund University, Faculty of Medicine}},
school = {{Lund University}},
series = {{Lund University, Faculty of Medicine Doctoral Dissertation Series}},
title = {{Navigating Health at Sea: Work, Stress, and lifestyle as Drivers of Seafarers' Wellbeing and Self-Rated Health}},
url = {{https://lup.lub.lu.se/search/files/247105938/e-spik_ex_rebecca_1_.pdf}},
year = {{2026}},
}