Associations of Extrinsic and Intrinsic Components of Work Stress with Health: A Systematic Review of Evidence on the Effort-Reward Imbalance Model.

Johannes Siegrist,Jian Li

doi:10.3390/ijerph13040432

Abstract

Mainstream psychological stress theory claims that it is important to include information on people’s ways of coping with work stress when assessing the impact of stressful psychosocial work environments on health. Yet, some widely used respective theoretical models focus exclusively on extrinsic factors. The model of effort-reward imbalance (ERI) differs from them as it explicitly combines information on extrinsic and intrinsic factors in studying workers’ health. As a growing number of studies used the ERI model in recent past, we conducted a systematic review of available evidence, with a special focus on the distinct contribution of its intrinsic component, the coping pattern “over-commitment”, towards explaining health. Moreover, we explore whether the interaction of intrinsic and extrinsic components exceeds the size of effects on health attributable to single components. Results based on 51 reports document an independent explanatory role of “over-commitment” in explaining workers’ health in a majority of studies. However, support in favour of the interaction hypothesis is limited and requires further exploration. In conclusion, the findings of this review support the usefulness of a work stress model that combines extrinsic and intrinsic components in terms of scientific explanation and of designing more comprehensive worksite stress prevention programs.

Highlights

Major changes in the nature of work and employment have occurred in many countries, in high income ones, during the past several decades
The body of empirical research has been growing rapidly, and an updated summary of this evidence has not been published. Against this background we performed a systematic review of studies analyzing associations of effort-reward imbalance and over-commitment with health, with the following two objectives
Ambulatory blood pressure over the working day was increased among over-committed employees in one study, in combination with low occupational position [32], whereas ambulatory heart rate over the working day was increased in association with effort-reward imbalance (ERI), but not with OC in another study [33]

Summary

Introduction

Major changes in the nature of work and employment have occurred in many countries, in high income ones, during the past several decades. The following are noteworthy: first, employment sectors have shifted from industrial mass and lean production towards service delivery and information/communication technology-driven jobs; second, mainstream employment relations and job trajectories with long-standing continuity and security were increasingly replaced by more flexible arrangements, including mobility, retraining, de-standardization of employment contracts, and growth of job insecurity; third, with the advent of economic globalization, growing competition between transnational companies and the constraints of financial markets resulted in a sizeable increase of work pressure in many employment sectors, often in combination with decreasing job stability, in particular with the advent of the great financial crisis. Public Health 2016, 13, 432; doi:10.3390/ijerph13040432 www.mdpi.com/journal/ijerph

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