Abstract
BackgroundIt has been argued that the association between job strain and health could be confounded by early life exposures, and studies have shown early adversity to increase individual vulnerability to later stress. We therefore investigated if early life exposure to adversity increases the individual's physiological vulnerability job strain in adulthood.Methodology/Principal FindingsIn a population-based cohort (343 women and 330 men, 83% of the eligible participants), we examined the association between on the one hand exposure to adversity in adolescence, measured at age 16, and job strain measured at age 43, and on the other hand allostatic load at age 43. Adversity was operationalised as an index comprising residential mobility and crowding, parental loss, parental unemployment, and parental physical and mental illness (including substance abuse). Allostatic load summarised body fat, blood pressure, inflammatory markers, glucose, blood lipids, and cortisol regulation. There was an interaction between adversity in adolescence and job strain (B = 0.09, 95% CI 0.02 to 0.16 after adjustment for socioeconomic status), particularly psychological demands, indicating that job strain was associated with increased allostatic load only among participants with adversity in adolescence. Job strain was associated with lower allostatic load in men (β = −0.20, 95% CI −0.35 to −0.06).Conclusions/SignificanceExposure to adversity in adolescence was associated with increased levels of biological stress among those reporting job strain in mid-life, indicating increased vulnerability to environmental stressors.
Highlights
Job strain, the combination of high demands and low control at work, has been shown to be associated with cardiovascular disease [1,2,3], depression [4], and a number of other health outcomes, especially among younger men [5]
A study of the 1958 British Birth Cohort showed that workplace factors such as low job control and night work were associated with cardiovascular risk factors, but that 30–50% of this relationship was explained by early life exposures [8], and another study found socioeconomic differences in cardiovascular risk factors already among 10-year-old children in Britain [9]
An analysis of young Finns concluded that pre-employment factors did not confound the association between job strain and atherosclerosis two decades later [10], and a similar conclusion was drawn in a recent paper based on the Whitehall II study [11]
Summary
The combination of high demands and low control at work, has been shown to be associated with cardiovascular disease [1,2,3], depression [4], and a number of other health outcomes, especially among younger men [5]. A large Swedish study showed that the relationship between low job control and myocardial infarction risk could be statistically explained by adverse circumstances during childhood [7]. A study of the 1958 British Birth Cohort showed that workplace factors such as low job control and night work were associated with cardiovascular risk factors, but that 30–50% of this relationship was explained by early life exposures [8], and another study found socioeconomic differences in cardiovascular risk factors already among 10-year-old children in Britain [9]. It has been argued that the association between job strain and health could be confounded by early life exposures, and studies have shown early adversity to increase individual vulnerability to later stress. We investigated if early life exposure to adversity increases the individual’s physiological vulnerability job strain in adulthood
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