Abstract
BackgroundUsing a 1-year prospective design, we examined the association of organizational justice (i.e., procedural justice and interactional justice) with refraining from seeking medical care (RSMC) among Japanese employees.MethodsWe surveyed 2695 employees (1994 men and 701 women) from two factories of a manufacturing company in Japan. A self-administered questionnaire comprising scales for measuring organizational justice (Organizational Justice Questionnaire) and potential confounders (i.e., demographic and socioeconomic characteristics as well as health-related behaviors) was administered at baseline (from April to June 2011). At 1-year follow-up (from April to June 2012), a single-item question was used to measure RSMC during the follow-up period. Multiple logistic regression analysis was conducted by gender.ResultsAfter adjusting for potential confounders, low procedural justice and low interactional justice at baseline were found to be significantly associated with higher odds of RSMC during the 1-year follow-up for male employees (odds ratio = 1.33 [95% confidence interval = 1.16–1.52], p < 0.001 and 1.15 [95% confidence interval = 1.02–1.29], p = 0.019, respectively). Similar patterns were observed for female employees (odds ratio = 1.37 [95% confidence interval = 1.08–1.74], p = 0.009 and 1.23 [95% confidence interval = 1.02–1.50], p = 0.035 for low procedural justice and low interactional justice, respectively).ConclusionsThe present study provided evidence that the lack of organizational justice is positively associated with RSMC among Japanese employees, independently of demographic and socioeconomic characteristics as well as of health-related behaviors.
Highlights
Access to medical care is a fundamental human right and an important determinant of health [1]
Several studies of community residents have reported that social class [9,10,11,12,13,14] as well as regional environmental factors [1, 15,16,17,18] have an effect on refraining from seeking medical care (RSMC)
After adjusting for demographic characteristics (Model 1), low procedural justice was significantly associated with higher odds of RSMC (p < 0.001) in that a one-point decrease in procedural justice led to a 1.34-fold increase in the odds of RSMC
Summary
Access to medical care is a fundamental human right and an important determinant of health [1]. 30%) [7], about one quarter of people have been reported to refrain from seeking medical care for the same reasons [8], which is the second-highest level among high-income countries following the USA [6]. Several studies of community residents have reported that social class (i.e., educational attainment, household income, and employment conditions) [9,10,11,12,13,14] as well as regional environmental factors (i.e., community size, having some means of transportation, non-familial support, and social capital in the neighborhood) [1, 15,16,17,18] have an effect on refraining from seeking medical care (RSMC).
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