Let's study how worker health affects the psychosocial work environment.

Abstract

Over the last three decades, a large body of research has addressed the associations between the psy- chosocial work environment and work stress on the one hand, and worker health and well-being on the other (1-5). Although the evidence for associations between work characteristics (ie, stressors) and worker health and well-being (ie, strain) is considerably stronger in cross-sectional than in longitudinal studies (2, 3) and whereas the strength of these associations varies across different combinations of stressors and well-being/health indicators (3, 5), overall the current evidence supports the notion that work characteristics affect work outcomes, including worker health and well-being.Interestingly, the notion that the health and well-being of workers may also affect the (perceived and/ or objective) characteristics of their jobs has attracted considerably less attention. The assumption that people are not just passive recipients of environmental influences but also actively shape that environment is not particularly controversial (eg, 6-8). However, research that systematically tests for the "reversed" effects of the presumed "outcomes" of work (such as health and well-being) on the presumed "anteced- ents" of these outcomes (ie, work characteristics) has remained rare. Apparently, it is implicitly assumed that the effects of work on the outcomes thereof are practically more relevant and theoretically more interesting than the reverse effects. Whether this is indeed the case is subject to further scrutiny, though. Current theorizing considers to an increasing degree the possibility of reversed relationships (ie, effects from health and well-being on the work environment), and empirical research supports the existence of such strain-to-stressor effects (9), although the evidence is scattered and piecemeal.However, this issue of the Scandinavian Journal of Work, Environment and Health includes a major review (10) that fills this important void. Drawing on the results of ten high-quality longitudinal studies, Kenneth Tang shows that the evidence for a positive strain-to-stressor association is moderately strong in the case of job demands. For two other major work characteristics (job control and social support), no such evidence was present. His findings suggest that, whereas reciprocal stressor-strain relationships may exist for job demands, such relationships are considerably less likely to occur for other job characteristics.In this editorial we focus on the possible mechanisms underlying the reversed association between worker health and the psychosocial work environment and provide some recommendations for future research in this area.Although research on strain-to-stressor effects is scarce, it has been around for several decades. For example, already in the 1980s, it was shown that indicators of strain relate negatively to subsequent ratings of social support received from colleagues (11) and positively to subsequent experienced time pressure (12). Although an explicit theoretical framework for such strain-to-stressor effects is lacking, certain principles from existing psychological theories may shed light on this issue. For example, the Conservation of Resources theory assumes the existence of "loss spirals" (13), in which losing resources (ie, the "objects, personal characteristics, and energies that are either themselves valued for survival, directly or indirectly, or that serve as a means of achieving these resources"; p45) causes future resource loss. Pertaining to the strain-to-stressor association at work, a loss spiral refers to a process in which strained employees who have "lost" their resource of good health, are more likely to "lose" resources in their work, which in turn negatively affects their health, and so on. For example, a burned-out employee may be too exhausted to maintain enjoyable interactions with his/her colleagues and may consequently receive less social support at work, inducing even higher levels of burnout. …