Associations of psychosocial working conditions with self-rated general health and mental health among municipal employees

  • Mikko Laaksonen
  • Ossi Rahkonen
  • Pekka Martikainen
  • Eero Lahelma
Original Article

Abstract

Objectives: To examine associations of job demands and job control, procedural and relational organizational fairness, and physical work load with self-rated general health and mental health. In addition, the effect of occupational class on these associations is examined. Methods: The data were derived from the Helsinki Health Study baseline surveys in 2001–2002. Respondents to cross-sectional postal surveys were middle-aged employees of the City of Helsinki (n=5.829, response rate 67%). Associations of job demands and job control, organizational fairness and physical work load with less than good self-rated health and poor GHQ-12 mental health were examined. Results: Those with the poorest working conditions two to three times more, often reported poor general and mental health than those with the best working conditions. Adjustment for occupational class weakened the associations of low job control and physical work load with general health by one fifth, but even more strengthened that of high job demands. Adjustment for occupational class clearly strengthened the associations of job control and physical work load with mental health in men. Mutual adjustment for all working conditions notably weakened their associations with both health measures, except those of job control in men. All working conditions except relational organizational fairness remained independently associated with general and mental health. Conclusions: All studied working conditions were strongly associated with both general and mental health but the associations weakened after mutual adjustments. Of the two organizational fairness measures, procedural fairness remained independently associated with both health outcomes. Adjustment for occupational class had essentially different effects on the associations of different working conditions and different health outcomes.

Keywords

Job demands Job control Management styles Physical work load Occupational class Self-rated health Mental health 

References

  1. Allison PD (1999) Logistic regression using the SAS system: theory and application. SAS Institute Inc., Cary, NCGoogle Scholar
  2. Belkic KL, Landsbergis PA, Schnall PL, Baker D (2004) Is job strain a major source of cardiovascular disease risk? Scand J Work Environ Health 30:85–128PubMedGoogle Scholar
  3. Borg V, Kristensen TS (2000) Social class and self-rated health: can the gradient be explained by differences in life style or work environment? Soc Sci Med 51:1019–1030CrossRefPubMedGoogle Scholar
  4. Bosma H, Marmot MG, Hemingway H, Nicholson AC, Brunner E, Stansfeld SA (1997) Low job control and risk of coronary heart disease in Whitehall II (prospective cohort) study. BMJ 314:558–565PubMedGoogle Scholar
  5. Central Statistical Office of Finland. Classification of socio-economic groups. 1989. Helsinki, Central Statistical Office of Finland. Handbooks 17Google Scholar
  6. Cheng Y, Kawachi I, Coakley EH, Schwartz J, Colditz G (2000) Association between psychosocial work characteristics and health functioning in American women: prospective study. BMJ 320:1432–1436CrossRefPubMedGoogle Scholar
  7. de Jonge J, Bosma H, Peter R, Siegrist J (2000) Job strain, effort-reward imbalance and employee well-being: a large-scale cross-sectional study. Soc Sci Med 50:1317–1327CrossRefPubMedGoogle Scholar
  8. Elovainio M, Kivimäki M, Steen N, Vahtera J (2004) Job decision latitude, organizational justice and health: multilevel covariance structure analysis. Soc Sci Med 58:1659–1669CrossRefPubMedGoogle Scholar
  9. Elovainio M, Kivimäki M, Vahtera J (2002) Organizational justice: evidence of a new psychosocial predictor of health. Am J Public Health 92:105–108PubMedGoogle Scholar
  10. Frese M (2000) The changing nature of work. In: Chmiel N (ed) Introduction to work and organizational psychology: a European perspective. Blackwell Publishers, Berlin, pp 424–439Google Scholar
  11. Godin I, Kittel F (2004) Differential economic stability and psychosocial stress at work: associations with psychosomatic complaints and absenteeism. Soc Sci Med 58:1543–1553CrossRefPubMedGoogle Scholar
  12. Goldberg DP, Gater R, Sartorius N, Ustun TB, Piccinelli M, Gureje O, Rutter C (1997) The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med 27:191–197CrossRefPubMedGoogle Scholar
  13. Hallqvist J, Diderichsen F, Theorell T, Reuterwall C, Ahlbom A (1998) Is the effect of job strain on myocardial infarction risk due to interaction between high psychological demands and low decision latitude? Results from Stockholm Heart Epidemiology Program (SHEEP). Soc Sci Med 46:1405–1415CrossRefPubMedGoogle Scholar
  14. Ibrahim SA, Scott FE, Cole DC, Shannon HS, Eyles J (2001) Job strain and self-reported health among working women and men: an analysis of the 1994/5 Canadian national population health survey. Women Health 33:105–124CrossRefPubMedGoogle Scholar
  15. Idler EL, Benyamini Y (1997) Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 38:21–37PubMedGoogle Scholar
  16. Kaplan G, Baron-Epel O (2003) What lies behind the subjective evaluation of health status? Soc Sci Med 56:1669–1676CrossRefPubMedGoogle Scholar
  17. Karasek RA (1985) Job Content Questionnaire and User’s Guide. Revision 1.1. Department of Work Environment, University of Massachusetts, Lowell, MAGoogle Scholar
  18. Karasek RA (1979) Job demands, job decision latitude and mental strain: implications for job redesign. Admistrative Sci Quarterly 24:285–308Google Scholar
  19. Karasek RA, Theorell T (1990) Healthy work: stress, productivity, and the reconstruction of working life. Basic Books, New YorkGoogle Scholar
  20. Kasl SV (1996) The influence of the work environment on cardiovascular health: a historical, conceptual, and methodological perspective. J Occup Health Psychol 1:42–56CrossRefPubMedGoogle Scholar
  21. Kivimäki M, Elovainio M, Vahtera J, Ferrie JE (2003) Organisational justice and health of employees: prospective cohort study. Occup Environ Med 60:27–33CrossRefPubMedGoogle Scholar
  22. Kristensen TS (1995) The demand-control-support model: methodological challenges for future research. Stress Med 11:17–26Google Scholar
  23. Lahelma E, Martikainen P, Rahkonen O, Roos E, Saastamoinen P (2005) Occupational class inequalities across key domains of health: results from the Helsinki health study. Eur J Public Health 15:504–510CrossRefPubMedGoogle Scholar
  24. Lallukka T, Aittomäki A, Piha K, Roos E, Kivelä K, Silventoinen K (2002) Postikyselytutkimukseen vastanneiden edustavuus sosioekonomisten tekijöiden ja sairauspoissaolotietojen mukaan. Helsingin kaupungin henkilöstön terveystutkimus. Sosiaalilääketieteellinen Aikakauslehti 39:164–171Google Scholar
  25. Li CY, Sung FC (1999) A review of the healthy worker effect in occupational epidemiology. Occup Med (Lond) 49:225–229Google Scholar
  26. Manderbacka K (1998) Examining what self-rated health question is understood to mean by respondents. Scand J Soc Med 26:145–153PubMedGoogle Scholar
  27. Manderbacka K, Lahelma E, Martikainen P (1998) Examining the continuity of self-rated health. Int J Epidemiol 27:208–213CrossRefPubMedGoogle Scholar
  28. Manor O, Matthews S, Power C (2000) Dichotomous or categorical response? Analysing self-rated health and lifetime social class. Int J Epidemiol 29:149–157CrossRefPubMedGoogle Scholar
  29. Marmot MG, Bosma H, Hemingway H, Brunner E, Stansfeld S (1997) Contribution of job control and other risk factors to social variations in coronary heart disease incidence. Lancet 350:235–239CrossRefPubMedGoogle Scholar
  30. Martikainen P, Aromaa A, Heliövaara M, Klaukka T, Knekt P, Maatela J, Lahelma E (1999) Reliability of perceived health by sex and age. Soc Sci Med 48:1117–1122CrossRefPubMedGoogle Scholar
  31. Moorman RH (1991) Relationship between organizational justice and organizational citizenship behaviors: Do fairness perceptions influence employee citizenship? J Appl Psychol 76:845–855CrossRefGoogle Scholar
  32. Niedhammer I, Chea M (2003) Psychosocial factors at work and self reported health: comparative results of cross sectional and prospective analyses of the French GAZEL cohort. Occup Environ Med 60:509–515CrossRefPubMedGoogle Scholar
  33. North FM, Syme SL, Feeney A, Shipley M, Marmot M (1996) Psychosocial work environment and sickness absence among British civil servants: the Whitehall II study. Am J Public Health 86:332–340PubMedGoogle Scholar
  34. Peter R, Siegrist J, Hallqvist J, Reuterwall C, Theorell T (2002) Psychosocial work environment and myocardial infarction: improving risk estimation by combining two complementary job stress models in the SHEEP Study. J Epidemiol Community Health 56:294–300CrossRefPubMedGoogle Scholar
  35. Piirainen H, Hirvonen M, Elo A-L, Huuhtanen P, Kandolin I, Kauppinen K, Ketola R, Lindsröm K, Salminen S, Reijula K, Raila R, Toivanen M, Viluksela M, Virtanen S (2003) The work and health interview study 2003. Basic report. Finnish Institute of Occupational Health, HelsinkiGoogle Scholar
  36. Pikhart H, Bobak M, Siegrist J, Pajak A, Rywik S, Kyshegyi J, Gostautas A, Skodova Z, Marmot M (2001) Psychosocial work characteristics and self rated health in four post-communist countries. J Epidemiol Community Health 55:624–630CrossRefPubMedGoogle Scholar
  37. Rahkonen O, Laaksonen M, Martikainen P, Roos E, Lahelma E (2005) Job control, job demands or social class? The impact of working conditions on the relationship between socioeconomic status and health. J Epidemiol Community Health (in press)Google Scholar
  38. Rowan K (1994) Global questions and scores. In: Jenkinson C (ed) Measuring health and medical outcomes. University of Oxford Press, London, pp 54–76Google Scholar
  39. Schnall PL, Landsbergis PA, Baker D (1994) Job strain and cardiovascular disease. Annu Rev Public Health 15:381–411CrossRefPubMedGoogle Scholar
  40. Schrijvers CT, van de Mheen HD, Stronks K, Mackenbach JP (1998) Socioeconomic inequalities in health in the working population: the contribution of working conditions. Int J Epidemiol 27:1011–1018CrossRefPubMedGoogle Scholar
  41. Siegrist J (1996) Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol 1:27–41CrossRefPubMedGoogle Scholar
  42. Stansfeld SA, Bosma H, Hemingway H, Marmot MG (1998) Psychosocial work characteristics and social support as predictors of SF-36 health functioning: the Whitehall II study. Psychosom Med 60:247–255PubMedGoogle Scholar
  43. Stansfeld SA, Fuhrer R, Shipley MJ, Marmot MG (1999) Work characteristics predict psychiatric disorder: prospective results from the Whitehall II Study. Occup Environ Med 56:302–307PubMedGoogle Scholar
  44. Theorell T, Tsutsumi A, Hallqvist J, Reuterwall C, Hogstedt C, Fredlund P, Emlund N, Johnson JV (1998) Decision latitude, job strain, and myocardial infarction: a study of working men in Stockholm. The SHEEP Study Group. Stockholm Heart epidemiology Program. Am J Public Health 88:382–388PubMedGoogle Scholar
  45. van der Doef M, Maes S (1999) The Job Demand-Control(-Support) Model and psychological well-being: a review of 20 years of empirical research. Work Stress 13:87–114CrossRefGoogle Scholar
  46. Watson D (1988) Intraindividual and interindividual analyses of positive and negative affect: their relation to health complaints, perceived stress, and daily activities. J Pers Soc Psychol 54:1020–1030CrossRefPubMedGoogle Scholar
  47. White IR, Blane D, Morris JN, Mourouga P (1999) Educational attainment, deprivation-affluence and self reported health in Britain: a cross sectional study. J Epidemiol Community Health 53:535–541PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Mikko Laaksonen
    • 1
  • Ossi Rahkonen
    • 1
  • Pekka Martikainen
    • 2
  • Eero Lahelma
    • 1
  1. 1.Department of Public HealthUniversity of HelsinkiHelsinkiFinland
  2. 2.Population Research Unit, Department of SociologyUniversity of HelsinkiHelsinkiFinland

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