High Effort-reward Imbalance Research Articles

Psychosocial work environment and mental health—a meta-analytic review

To clarify the associations between psychosocial work stressors and mental ill health, a meta-analysis of psychosocial work stressors and common mental disorders was undertaken using longitudinal studies identified through a systematic literature review. The review used a standardized search strategy and strict inclusion and quality criteria in seven databases in 1994-2005. Papers were identified from 24,939 citations covering social determinants of health, 50 relevant papers were identified, 38 fulfilled inclusion criteria, and 11 were suitable for a meta-analysis. The Comprehensive Meta-analysis Programme was used for decision authority, decision latitude, psychological demands, and work social support, components of the job-strain and iso-strain models, and the combination of effort and reward that makes up the effort-reward imbalance model and job insecurity. Cochran's Q statistic assessed the heterogeneity of the results, and the I2 statistic determined any inconsistency between studies. Job strain, low decision latitude, low social support, high psychological demands, effort-reward imbalance, and high job insecurity predicted common mental disorders despite the heterogeneity for psychological demands and social support among men. The strongest effects were found for job strain and effort-reward imbalance. This meta-analysis provides robust consistent evidence that (combinations of) high demands and low decision latitude and (combinations of) high efforts and low rewards are prospective risk factors for common mental disorders and suggests that the psychosocial work environment is important for mental health. The associations are not merely explained by response bias. The impact of work stressors on common mental disorders differs for women and men.

Path analysis of work conditions and work–family spillover as modifiable workplace factors associated with depressive symptomatology

AbstractBackground: Literature pertaining to the relationship between workplace factors and depression has been compartmentalized: work conditions, family conditions, and work–family balance have been studied separately as predictors of depressive symptoms but not concurrently.Objective: Work conditions and work–family spillover were considered concurrently as modifiable workplace factors associated with depressive symptomatology, while controlling for confounding socio‐economic factors.Methods: This cross‐sectional study involved 218 female health care workers who completed a survey assessing work conditions [Effort–Reward Imbalance (ERI) scale and Job Content Questionnaire (JCQ)], work–family balance (work–family spillover scale), sociodemographic information, and depressive symptoms [Center for Epidemiological Studies Depression (CES‐D) scale].Results: Path analysis supported the presence of a direct relationship between depressive symptoms and high effort–reward imbalance, high negative work–family spillover, low positive family‐to‐work spillover, and low education. The indirect effect of low support from work was mediated by negative work‐to‐family spillover and high effort–reward imbalance. The indirect effect of high effort–reward imbalance was mediated by increased negative work‐to‐family spillover. The indirect effect of having children 18 years or younger was mediated by decreased positive family‐to‐work spillover. An indirect effect of low education was mediated by high effort–reward imbalance and high negative work‐to‐family spillover.Conclusions: The association between work conditions and depressive symptomatology is mediated by increased negative work‐to‐family spillover. The impact of having young children is mediated by decreased positive family‐to‐work spillover. Copyright © 2006 John Wiley & Sons, Ltd.

Effort/reward imbalance and sedentary lifestyle: an observational study in a large occupational cohort

Objectives: To investigate the association between effort/reward imbalance (ERI) at work and sedentary lifestyle. Methods: Cross sectional data from the ongoing Finnish Public Sector Study related to 30 433 women...

Effort-reward imbalance at work and the co-occurrence of lifestyle risk factors: cross-sectional survey in a sample of 36,127 public sector employees.

BackgroundIn occupational life, a mismatch between high expenditure of effort and receiving few rewards may promote the co-occurrence of lifestyle risk factors, however, there is insufficient evidence to support or refute this hypothesis. The aim of this study is to examine the extent to which the dimensions of the Effort-Reward Imbalance (ERI) model – effort, rewards and ERI – are associated with the co-occurrence of lifestyle risk factors.MethodsBased on data from the Finnish Public Sector Study, cross-sectional analyses were performed for 28,894 women and 7233 men. ERI was conceptualized as a ratio of effort and rewards. To control for individual differences in response styles, such as a personal disposition to answer negatively to questionnaires, occupational and organizational -level ecological ERI scores were constructed in addition to individual-level ERI scores. Risk factors included current smoking, heavy drinking, body mass index ≥25 kg/m2, and physical inactivity. Multinomial logistic regression models were used to estimate the likelihood of having one risk factor, two risk factors, and three or four risk factors. The associations between ERI and single risk factors were explored using binary logistic regression models.ResultsAfter adjustment for age, socioeconomic position, marital status, and type of job contract, women and men with high ecological ERI were 40% more likely to have simultaneously ≥3 lifestyle risk factors (vs. 0 risk factors) compared with their counterparts with low ERI. When examined separately, both low ecological effort and low ecological rewards were also associated with an elevated prevalence of risk factor co-occurrence. The results obtained with the individual-level scores were in the same direction. The associations of ecological ERI with single risk factors were generally less marked than the associations with the co-occurrence of risk factors.ConclusionThis study suggests that a high ratio of occupational efforts relative to rewards may be associated with an elevated risk of having multiple lifestyle risk factors. However, an unexpected association between low effort and a higher likelihood of risk factor co-occurrence as well as the absence of data on overcommitment (and thereby a lack of full test of the ERI model) warrant caution in regard to the extent to which the entire ERI model is supported by our evidence.

Relationship Between Work Stress and Body Mass Index Among 45,810 Female and Male Employees

The proportion of overweight and obese people has grown rapidly, and obesity has now been widely recognized as an important public health problem. At the same time, stress has increased in working life. The 2 problems could be connected if work stress promotes unhealthy eating habits and sedentary behavior and thereby contributes to weight gain. This study explored the association between work stress and body mass index (BMI; kg/m2). We used cross-sectional questionnaire data obtained from 45,810 female and male employees participating in the ongoing Finnish Public Sector Cohort Study. We constructed individual-level scores, as well as occupational- and organizational-level aggregated scores for work stress, as indicated by the demand/control model and the effort-reward imbalance model. Linear regression analyses were stratified by sex and socioeconomic status (SES) and adjusted for age, marital status, job contract, smoking, alcohol consumption, physical activity, and negative affectivity. The results with the aggregated scores showed that lower job control, higher job strain, and higher effort-reward imbalance were associated with a higher BMI. In men, lower job demands were also associated with a higher BMI. These associations were not accounted for by SES, although an additional adjustment for SES attenuated the associations. The results obtained with the individual-level scores were in the same direction, but the relationships were weaker than those obtained with the aggregated scores. This study shows a weak association between work stress and BMI.

Job Strain, Effort???Reward Imbalance, and Heavy Drinking: A Study in 40,851 Employees

The objective of this study was to examine the relationship of the job strain model and the effort-reward imbalance model with heavy drinking. Questionnaire survey data were obtained from 32,352 women and 8499 men employed in the Finnish public sector (participation 67%). Logistic regression analyses for all employees and for separate subgroups were undertaken by sex, adjusted for age, education, occupational position, marital status, job contract, smoking, and negative affectivity. Different cutoff points of heavy drinking were used for men and women. High job strain and high effort-reward imbalance as global constructs were not associated with heavy drinking. However, some components of these models were associated with heavy drinking but the relationships were not all in the expected direction and they varied by sex, age, and occupational position. Stressful work conditions are not consistently associated with heavy drinking.

Effort–Reward Imbalance among Nurses in Stable Countries and in Countries in Transition

The effort-reward imbalance (ERI) model was used to analyze burnout and intention to leave the nursing profession (ITL) in nurses (n = 21,229) in seven European countries, as part of the NEXT-Study. Data were gathered using the short form of the ERI questionnaire. Burnout was assessed using the Copenhagen Burnout Inventory. Multivariate logistic regression analysis controlled for age and gender. ERI was very high in Poland, Germany, Italy, and Slovakia. High ERI was associated with burnout. Odds ratios (ORs) ranged from 2.6 to 13.2 for ERI and from 3.0 to 5.5 for overcommitment (OC). Nurses with high ERI also had high ORs for ITL (2.6-5.7). The association of OC and ITL was weaker (1.1-1.7). The strong and consistent associations of ERI model results with psychological health and with ITL support the relevance of the model for examining different outcome levels. Nurses in transitional countries, as expected, experienced high ERI. High ERI in stable countries suggests that their economic sectors, particularly health care, may be in transition.

Work stress and risk of cardiovascular mortality: prospective cohort study of industrial employees

Objective: To examine the association between work stress, according to the job strain model and the effort-reward imbalance model, and the risk of death from cardiovascular disease.Design: Prospective cohort study....

Vagal cardiac control throughout the day: the relative importance of effort–reward imbalance and within-day measurements of mood, demand and satisfaction

The effects of variables derived from a work stress theory (the effort–reward imbalance theory) on the power in the high frequency (HF_HRV) band of heart rate (0.14–0.40 Hz) throughout a work day, were determined using multilevel analysis. Explanatory variables were analysed at two levels: at the lowest level (within-day level), the effects of positive mood, negative mood, demand, satisfaction, demand-satisfaction ratio, and time of day were assessed. At the highest level (the subject level), the effects of sleep quality, effort, reward, effort–reward imbalance, need for control, type of work (profession), negative affectivity, gender and smoking on HF_HRV were assessed. Need for control has a negative effect on HF_HRV after controlling for time of day effects, i.e. subjects with a high need for control have a lower vagal control of the heart. In the long run, these subjects may be considered to be at increased health risk, because they have less of the health protective effects of vagal tone. The interaction between effort–reward imbalance and time of day has a positive effect on HF_HRV, i.e. the cardiac vagal control of subjects with a high effort–reward imbalance increases as the day progresses. It is discussed that this probably reflects reduced effort allocation, ensuing from disengagement from the work demands.

Work characteristics predict psychiatric disorder: prospective results from the Whitehall II Study.

OBJECTIVES: The impact of work on the risk of future psychiatric disorder has been examined in few longitudinal studies. This was examined prospectively in a large epidemiological study of civil...

Psychosocial Work Characteristics and Social Support as Predictors of SF-36 Health Functioning

To assess whether work characteristics and social support are predictors of physical, psychological, and social functioning. Work characteristics (Karasek and Siegrist models) and social support at baseline were used to predict health functioning measured by the SF-36 General Health Survey 5 years later in a prospective cohort study of 10,308 British male and female civil servants. Effort-reward imbalance and negative aspects of close relationships predicted poor physical, psychological, and social functioning after adjustment for the potential confounding effects of age, employment grade, baseline ill health, and negative affectivity. These psychosocial characteristics seem to act in a similar way in the healthy and those with existing illness. Psychological demands at work in women, and low confiding/emotional support in men, also predicted poor functioning. Etiologically. these effects are not mediated through health-related behaviors. Negative aspects of work (high demands and effort-reward imbalance) and negative aspects of close relationships are independent powerful predictors of poor health functioning. They may have an etiological role, which is independent of baseline illness.