The portrayal of health as the greatest wealth of humans has unsurprisingly proven its worth having featured prominently as the third spine of the Sustainable Development Goals (SDGs 3), emphasizing healthy lives and the promotion of well-being for all at all ages (United Nations, 2023). The SDG 3.4’s accentuation and underscoring of mental health is a warning sign for global alertness (Tsang & Fong, 2022). Apparently, there has been an emerging interest in the mental health of young people among scholars and practitioners alike. Despite the high rate of mental health problems among the youth, discourses regarding the modus of help-seeking vis-à-vis the use of support resources to improve mental health have been relatively sparse (Simon-kumar & Gluckman, 2023; Westberg et al., 2022). The United Nations and its subsidiaries which categorized people between the ages of 15 to 24 as youth (United Nations, 2020), also disclose how mental health challenges are rife within this age group (United Nations Department of Economic and Social Affairs, 2014). On a global scale, one in seven adolescents of 10–19 years battle some form of mental disorder, which accounts for 13% of the global burden of disease in this age category. Suicide has therefore been ranked as the fourth cause of death among young people of 15–29 years (World Health Organization, 2023).
As UNICEF (Unicef, 2022) unveils, there is a wide gap between mental health funding and the mental health needs of young people. It emerged that governments allocate only 2.1% of their health expenditure to mental health and the economic price the global economy pays for this neglect is losing approximately USD387.2 billion of human potential that could have been invested in national economies annually. Gauging from the rapid proliferation of mental health problems within a teeming population of approximately 1.2 billion who identify as youth and the uncaptured ages of 25 to 29 (UNFPA, 2014), a sizeable fraction of the global population and a valuable asset to the global economy could be lost through this medical condition. Particularly in the context of COVID-19, there was also a massive global decline in youth mental health. The findings of Simon-kumar & Gluckman (2023) reveal that prior to the onset of the COVID-19 pandemic, there were rising rates of suicidal tendencies and behaviour as well as increasing rates of depression, and a general decline in emotional wellbeing among the youth. More acutely, the COVID-19 pandemic led to even higher levels of social isolation, anxiety and stress. The pandemic exacerbated youth mental health problems after having penetrated the constantly changing labour market, increasing unemployment and underemployment along with an upsurge in obscene occupations (International Labour Organisation, 2020). The pandemic aggravated the already numerous labour market challenges faced by young people. Over the period of 2019–2020, ILO reports a higher rate of job losses among the youth than adults (International Labour Organisation, 2020).
For employed youths, the considerable amount of manual dexterity and poor working environment are significant factors influencing the mental health of employed youths (Silva-Peñaherrera et al., 2022; World Health Organization, 2022). In 2019, 15% of workers worldwide experienced mental health issues, resulting in 12 billion lost working days and a cost of USD 1 trillion annually in lost productivity (World Health Organization, 2022). Distinctively, the environment and accompanying tasks for informal jobs are usually hazardous, and precarious along with meagre and unstable wages (ILO, 2003; International Labour Organisation, 2018). Additionally, these jobs typify the absence of social protection and compensatory benefits, such as pensions, health insurance, or leave (ILO, 2003; International Labour Organisation, 2018). Due to the porousness of informal jobs in the developing world, Silva-Penaherrera, Santia and Bernavides (Silva-Peñaherrera et al., 2022) find employees in informal jobs with a higher prevalence of poor mental health than their counterparts in formal jobs. Studies have shown a higher prevalence of poor mental health among informal job workers compared to those in formal employment (Huynh et al., 2022; Silva-Peñaherrera et al., 2022). In Africa, misconceptions about mental health and neglect of young people's emotional and psychological well-being contribute to a false perception of their overall health (Baum, 2016).
Perming the above with estimations that 77% of young people work in the informal sector (Oladosu et al., 2023; Sychareun et al., 2016), it is not out of place to draw conclusions that young informal workers are the most preyed by mental health problems (Atilola, 2012). This then begs the question, how do young informal workers improve their mental health? Scholars have demonstrated how young informal workers rely on the support of their social networks to meet their mental health needs (Pantic, 2014; Simon-kumar & Gluckman, 2023; Westberg et al., 2022). The extant studies theorize how young people rely on reciprocity in social networks to assist one another in improving their mental health (see for example, Jou & Fukada, 1996, 2002; Törrönen, 2021; Törrönen et al., 2017). These studies hypothesized young people as agents building intimacy and distanciation in which they are developing their own identity as well as reciprocal relationships with key people in their social milieu. Hence, young people with established relationships where social support is reciprocal are likely to report better mental health outcomes than their counterparts in less established reciprocal relationships (see for instance Törrönen, 2021; Jou & Fukada, 1996)). However, the prevailing literature that delves into how reciprocity in social networks improves the mental health of young informal workers has been inadequately discerned across the globe.
The existing literature on reciprocity within social networks has predominantly focused on developed countries, overlooking the intricate dynamics prevalent in the developing world, where labour informality is widespread. This study aims to bridge this gap by investigating the relationship between reciprocity and the mental well-being of young workers in Africa. It delves further into the exploration of diverse forms of reciprocity within social networks, which play a significant role in shaping the mental health outcomes of young informal workers in Africa. While prior research has characterized reciprocity as a direct exchange of social support between individuals, we argue that this direct person-to-person exchange may be imbalanced in the developing world context due to the substantial economic constraints faced by many young informal workers. Consequently, this imbalance can have adverse effects on their mental health. Thus, we propose that cultivating balanced reciprocal relationships among young informal workers would necessitate indirect channels such as active participation in groups with shared interests (such as, religious associations or trade unions), where resources are pooled together to support fellow members. By embracing this indirect reciprocal approach, rather than relying solely on direct person-to-person exchanges, we anticipate a positive impact on the mental health of young informal workers.
The significance of these geographical and theoretical questions demand that we draw data from Nigeria to provide empirical evidence from Africa to first test claims of a relationship between reciprocity in social networks and young informal workers’ mental health. Secondly and more importantly, we delve deeper to provide thick description and evidence of the kinds of reciprocity in social networks and their impact on the mental health of young informal workers. Nigeria, with a population of about 224 million (Worldometer, 2023), faces high youth unemployment rates ranging from 42.5–52.5% (Worldometer, 2023; National Bureau of Statistics, 2023). This has led to a significant rise in informal employment, which accounts for 92.9% of the country's workforce (ILO, 2018). Construction workers, in particular, face significant mental health challenges due to the hazardous and stressful nature of their jobs (Nwaogu, 2022). Therefore, it is essential to examine how reciprocity within social networks supports the mental health of young informal workers in Nigeria.
Policy wise we expect the results of this study to be significant for practitioners, particularly from the less developed countries interested in improving the mental health of young people. The rest of this paper will present the following sections/sub-sections: the conceptual relationship between reciprocity and health, the research method employed in this study, the data analysis, the results, the discussion of the findings, and the conclusion.
Silent Struggles: Unveiling the Mental Health Burden of Young Informal Construction Workers in Nigeria.
The construction industry in Nigeria is a significant employer of labour, engaging approximately 20% of the working population, with a majority of workers employed informally (NBS, 2018; Odediran & Babalola, 2013; Oni et al., 2022). Within this industry, formal workers, such as Engineers and Architects, primarily assume supervisory roles, while informal workers, commonly referred to as artisans, tradesmen, or labourers, carry out the labour-intensive tasks on construction sites (Omeje et al., 2021). Given the physical demands of construction work and the escalating youth unemployment rate in Nigeria, young people constitute a substantial portion of the workforce in this industry. Informal workers, in particular, make up the largest working population, accounting for approximately 55–89% of the industry’s workforce (Boschman et al., 2013; ILO, 2018).
In the bustling construction sites of Nigeria, where dreams of towering structures take shape, a silent battle rages within the hearts and minds of young informal construction workers. Despite the construction industry being the most hazardous among all sectors in Nigeria, responsible for approximately 40% of work-related accidents (Comaru & Werna, 2013; NSITF & ILO, 2016), the mental health challenges faced by these workers have largely remained overlooked. This section delves into the untold struggles of young informal construction workers, shedding light on the profound mental health challenges they endure in the demanding world of informal construction. From the lack of job security and economic hardships to unsafe working conditions and social marginalization, their struggles encompass a myriad of complex issues that deeply impact their well-being.
Many young construction workers in Nigeria find themselves trapped in the informal sector, devoid of the benefits and protections (like health insurance, pension, leave, formal contracts, and stable income) associated with formal employment. Their livelihoods hinge on day-to-day arrangements and short-term contracts, leaving them vulnerable to constant job insecurity and a perpetual cloud of uncertainty regarding their future income. This weight of this instability possibly seeps into their psyche, potentially amplifying issues of anxiety, stress, depression, and other mental health concerns. Additionally, within the realm of informal construction, meagre wages perpetuate a cycle of economic hardship for young workers. Their earnings often fall far below what is necessary to meet their basic needs, let alone access proper housing, healthcare, education, and other essential services. This financial strain becomes a constant companion, casting a shadow over their mental well-being and limiting their capacity to envision a brighter future.
Furthermore, the construction sites that serve as the backdrop for their toil are riddled with hazards and devoid of adequate safety measures (Holte & Kjestveit, 2012; ILO, 2015; Kolawole, 2018; Nwaogu, 2022). Young construction workers brave these perilous environments, lacking proper protective equipment, comprehensive training, and sufficient supervision. The constant exposure to accidents, injuries, and long-term health issues breeds a sense of fear and vulnerability, which may further exacerbate their mental health challenges (Duckworth et al., 2022; Nwaogu, 2022).
Again, construction work is an unyielding test of physical endurance, demanding long hours of labour-intensive tasks. Young workers, often sacrificing their well-being for survival, endure backbreaking labour, heavy lifting, repetitive motions, and exposure to extreme weather conditions. The toll on their bodies leads to fatigue, physical exhaustion, and heightened susceptibility to injuries, which, in turn, can burden their mental resilience. Despite all these, informal construction workers in Nigeria are deprived of critical social protection measures such as healthcare, retirement benefits, and unemployment benefits (Oladosu et al., 2023). This lack of support exacerbates their financial insecurity, making it even more challenging to cope with emergencies or unexpected events. The absence of a safety net intensifies their mental strain, which potentially leaves them disheartened and devoid of hope.
For many young informal construction workers, educational opportunities and skills training are elusive dreams. The absence of quality education and skill development programs hampers their ability to secure higher-paying and more stable employment in the future. This limited access stifles their potential, perpetuating a cycle of low wages and further curtailing their mental well-being.
In the light of all these, mental healthcare is still not a common phenomenon in Nigeria and is often associated with insanity (Aluh et al., 2018). For instance, it was only in January 2023 did a new mental health law in Nigeria change from the ‘lunacy ordinance’ to mental health act. This situation has led to increased stigma and isolation to the victims of mental problems in the country. Such stigmatization, perceptions and belief of mental health conditions make it difficult for young informal construction workers to report mental health cases or seek mental healthcare. It is only recently, particularly after the emergence of COVID-19 did mental health awareness increasingly gain popularity in the Nigerian context, particularly caused by the limitations on social interactions from social policies enacted by the government to reduce the spread of COVID19 (Anaduaka & Oladosu, 2023).
Furthermore, mental health services in Nigeria are limited in supply and often come at a high cost, rendering them accessible primarily to individuals of certain socioeconomic class who can afford it. Consequently, underprivileged groups such as young informal construction workers are effectively excluded from availing themselves of biomedical interventions for addressing mental health problems. This limitation underscores the need for a comprehensive approach to mental healthcare, as advocated by the World Health Organization (WHO) through its social determinants of health framework (Braveman & Gottlieb, 2014; Short & Mollborn, 2015; WHO, 2020). Recognizing the challenges posed by limited access to biomedical measures, the WHO has embraced a holistic approach to mental health, encompassing non-biomedical strategies that leverage social networks. In line with this perspective, the WHO has adopted the Comprehensive Mental Health Action Plan 2013–2020 (Saxena & Setoya, 2014). This plan recognizes the importance of integrating both biomedical and non-biomedical approaches in addressing mental health problems, particularly in low and middle-income countries (LMICs) like Nigeria. By embracing a diverse range of interventions, this approach aims to bridge the gaps in mental healthcare and promote equitable access to support for individuals across different socioeconomic backgrounds. Hence, the aim of this study to examine the impact of social support reciprocity on the mental health of young informal construction workers in Nigeria.
Reciprocity and Mental Health
Reciprocity refers to a “give-and-take” process that establishes stable social relationships in an individual’s life (Fyrand, 2010). It is considered the fundamental unit of social relationships, which involves responding to positive actions with positive actions, such as rewarding kind behaviour (Molm, 2010). In professional helping relationships, reciprocity is seen as a process of exchanging emotions or services and is widely recognized as a central aspect of human life (Molm, 2010; Von Dem Knesebeck & Siegrist, 2003). Reciprocity membership becomes balanced when individuals are satisfied with their contribution to the group, acknowledgment from other members, and benefits received from the group.
Researchers have linked reciprocity to mental health, suggesting that reciprocity in social relationships is generally associated with positive mental health. Sandhu et al. (Sandhu et al., 2015) in a systematic review found that incorporating reciprocity as a component of mental healthcare, with recurrent and observable processes may be harnessed to promote positive outcomes. Lack of reciprocity in social relationships was generally associated with negative effects and poor mental health. In a cross-sectional study, using the effort-reward balance model, von dem Knesebeck & Siegrist (Von Dem Knesebeck & Siegrist, 2003) investigated the potential imbalance between effort spent (investment in relationships) and rewards received (benefits from the relationship) among marital, parental, and unspecified relationships. The study comprised 1290 noninstitutionalized elderly men and women ≥ 60 years of age: 682 in Germany (mean age, 70.8) and 608 in the United States (mean age, 72.3). The study’s results revealed consistent associations of nonreciprocal social support with depressive symptoms for both genders (male and female) in both samples. The risk of depressive symptoms was about twice as high among elderly men and women who reported nonreciprocity in their social exchanges compared to subjects reporting reciprocal social exchange (Von Dem Knesebeck & Siegrist, 2003).
Furthermore, studies on the relationship between reciprocal social exchange for health and well-being tested the associations of different types of social activities (paid work, caring, and volunteering) and well-being (McMunn et al., 2009), and between social productivity (voluntary or charity work, caring for a sick or disabled adult, and provision of help to family, friends, or neighbours) and well-being (Wahrendorf et al., 2006). According to Siegrist et al. (Siegrist et al., 2004), socially-productive activities are based on the social norm of reciprocity, “…in which the effort of doing the activity is made in anticipation of an equivalent reward that reflects the value of the effort involved.” Data from a cross-sectional wave in 2004 of the English Longitudinal Study of Ageing (ELSA), of 5384 participants at post-state pension age (≥ 60 years for women and ≥ 65 years for men), were analysed to examine whether participation in social activities (i.e., caring for another person) was associated with higher levels of well-being (i.e., depression), and explained by “the reciprocal nature of these activities” (McMunn et al., 2009). The study showed that reciprocal exchange had a negative association with the degree of depression regarding the activity of caring (McMunn et al., 2009).
Similarly, the cross-sectional study of Wahrendorf et al. (Wahrendorf et al., 2006) also investigated the relationship between social activity (defined as social productivity, i.e., caring for a sick or disabled person and provision of help to family) and well-being (i.e., depression), focusing on the quality of the activity based on the notion of exchange reciprocity. The study was accomplished on 22 000 participants, ≥ 50 and from ten European countries—using data from the SHARE study (“Survey of Health Aging and Retirement in Europe”). The study uncovered that reciprocal activity was associated with lower scores on depression both for caring and informal help. Thus, all three studies (McMunn et al., 2009; Siegrist et al., 2004; Wahrendorf et al., 2006) are lending “…support to Siegrist's observations on the importance of reciprocal exchange in social relations for health and wellbeing” (McMunn et al., 2009).
However, most of the existing research have focused on middle-aged and older individuals, leaving a gap in understanding the association between reciprocity and mental health among young people. When it comes to young people, there are few studies that have examined the relationship between reciprocity and mental health, and all of them are in developed countries. For instance, in Finland, Tuominen & Haanpaa (Tuominen & Haanpää, 2022) used a cross-sectional design to explore the association between social capital (measured by reciprocity) of young people at 12–13 years and their subjective well-being using Finland’s sub-sample of the third wave of the International Survey of Children’s Well-Being. The study measured well-being with two context-free scales: a one-dimensional overall life satisfaction scale and a five-dimensional Student’s life satisfaction scale. The study found that norms of reciprocity was significantly associated with positive wellbeing among young people in Finland. Among the different social groups evaluated, reciprocity between family-related social networks had the greatest significance on young people’s wellbeing (Tuominen & Haanpää, 2022).
Another study conducted in England and Finland by Torronen (Törrönen, 2021) used participatory action research method to examine how young adults in England and Finland who have been in the care system evaluate their social relationships and mental health and how these are interconnected. The interview data explored young adults’ well-being during the transition period from care to independent living. The study found that young adults who have supportive social networks report better mental well-being and security than those who do not have such networks. In general, the study found that reciprocal social relationships are important for developing social skills, keeping physically and mentally well, and feeling a sense of security (Törrönen, 2021).
In Japan, Jou & Fukada (Jou & Fukada, 2002), examined the effects of reciprocity and sufficiency of social support on the mental and physical health of 488 Japanese university students with different levels of stressors. The authors examined the participants’ support relationships with others and found that reciprocity of support appeared to have both direct and buffering effects on health. The study found that lack of reciprocity of social support is associated with negative affect and poor health among Japanese university students. Reciprocity of support with family showed a direct effect on stress-related symptoms. Individuals in reciprocal relationships show better health than those in nonreciprocal relationships, whether stress is present or not. Overall, the article suggests that reciprocity and sufficiency of social support are important factors in maintaining good mental health among university students in Japan.
While the above studies highlight the importance of reciprocity on the mental health of young people, there remains significant lacunas in the reciprocity and mental health literature that requires immediate attention. First, all the studies cited above focused on young people in developed countries in Europe and Asia. This indicates a geographical/contextual gap in the understanding of the association between reciprocity and mental health among young people from developing countries, especially Sub-Saharan Africa (SSA), which is largely a youthful population. This is important because cultural and social norms of reciprocity, which may play a role in the mental health of young people from SSA, are very specific to the region and have not been studied in detail. Therefore, it is imperative to conduct further research in this area to understand how reciprocity and mental health are associated in this region. In light of this gap, this study aims to examine the relationship between social support reciprocity and the mental health of young informal construction workers in Nigeria. By focusing on this specific population, the study intends to contribute to the understanding of reciprocity and mental health in a developing country context and among underprivileged young people.
Study aims and hypotheses.
The following aims and hypotheses were framed for our study.
Aim 1. To evaluate the mental health-related quality of life of young informal construction workers in Nigeria.
Hypothesis 1
We expect that the mental health-related quality of life of young informal workers would be relatively low. In the absence of any previous studies evaluating the mental health of young informal construction workers in Nigeria, we wanted to examine the extent to which young informal construction would assess their mental health.
Aim 2. To investigate the extent to which and how reciprocity of social support occurs among young informal workers and their social networks despite their socioeconomic conditions.
Hypothesis 2
Following previous studies (Oladosu et al., 2023; Sychareun et al., 2016; Webber et al., 2012) that have found that young informal workers rely heavily on their social networks for health-related needs, we expect that the level of reciprocity among young informal construction workers in Nigeria would be high.
Aim 3. To investigate the relationship between reciprocity and the mental HRQoL of young informal construction workers in Nigeria.
Hypothesis 3
Following the outcomes of previous studies on reciprocity and mental health among young people, we expect that young informal construction workers with higher reciprocity scores will report better mental health than those in less reciprocal relationships.