Relationship between effort-reward imbalance, low social support and depressive state among Japanese male workers.

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The globalisation of the world economy is rapidly increasing. In response to such changes, work stress has gained increased concern all over the industrialized world, particularly in the Western countries. Siegrist recently highlighted work stress from the standpoint of the imbalance between high effort and low reward due to a lack of reciprocity at work. This effort-reward imbalance (ERI) model includes two components: (1) ERI, the ratio between extrinsic efforts (psychological and physical demands on the job) and low rewards (salary, esteem, and status control); and (2) overcommitment (OC), an intrinsic psychological coping style associated with the inability to withdraw from work obligations. It is posited that OC amplifies the adverse effects of ERI on health, because overcommited people exaggerate their efforts beyond the levels normally considered appropriate. The ERI model claims that the combination of high effort spent and low reward received at work induces an adverse effect on workers’ psychological and physical (particularly cardiovascular) health. In Japan, Tsutsumi et al. 9) developed the Japanese version of the ERI questionnaire, and reported that the ERI model is useful in studying current occupational stress and in evaluating the risk of depression among Japanese workers, but most of the previous studies did not investigate the complete individual effect of ERI (excluded OC) or OC (excluded ERI) on workers’ health. Apart from the ERI model, it has generally been proposed that social support should be considered as a buffering factor in determining the stress effect. There is much evidence that socially integrated individuals have lower illness and mortality rates than more socially isolated ones. In work stress models, such as the job strain model or the NIOSH general job stress model, social support plays a significant role as a stress buffering factor on health outcomes. We therefore hypothesized that social support also has an impact on the influence of the ERI model on workers’ health, but this issue has scarcely been investigated, particularly in countries outside of Europe. The present study was therefore conducted on Japanese male workers to confirm our hypothesis. We investigated how ERI, OC and social support were completely individually or combinedly associated with depressive states of workers. Subjects were limited to males, because the number of females in the corporation investigated was too small to conduct the following analyses. Additionally, we intended to exclude the influence of gender differences in the ERI model, which has been presented in previous studies.