Lack of supportive leadership behavior predicts suboptimal self-rated health independent of job strain after 10 years of follow-up: findings from the population-based MONICA/KORA study

  • Burkhard SchmidtEmail author
  • Raphael M. Herr
  • Marc N. Jarczok
  • Jens Baumert
  • Karoline Lukaschek
  • Rebecca T. Emeny
  • Karl-Heinz Ladwig
  • for the KORA Investigators
Original Article



Emerging cross-sectional research has identified lack of supportive leadership behavior (SLB) as a risk factor for workforce health. However, prospective evidence is hitherto lacking. SLB denotes support in difficult situations, recognition and feedback on work tasks. This study aims to determine the effect of SLB on suboptimal self-rated health (SRH) after 10 years considering potential moderators such as ages, sex, occupation and job strain.


The sample included 884 employed participants drawn from the population-based prospective MONICA/KORA Study. SLB, SRH, as well as job strain were assessed by questionnaire. Logistic regressions estimated odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the effect of SLB at baseline on suboptimal SRH at follow-up. Analyses were adjusted for age, gender, lifestyle (alcohol, smoking, physical activity), socioeconomic status as well as for SRH and job strain at baseline.


Lack of SLB was associated with suboptimal SRH at baseline [OR 2.00, (95% CI 1.19–3.46)] and at follow-up [OR 2.33, (95% CI 1.40–3.89)]. Additional adjustment for job strain did not substantially alter this association [OR 2.06, (95% CI 1.20–3.52)]. However, interactions between SLB and job strain as well as gender became evident, indicating moderating influences on the association between SLB and SRH.


Lack of supportive leadership was associated with suboptimal SRH at 10 years’ follow-up in men, even if SRH at baseline and other risk factors were taken into account. This effect is likely to be moderated by job strain.


Leadership Self-rated health Work stress Workforce Cohort study 



The MONICA/KORA research platform is financed by the Helmholtz Zentrum München, German Research Centre for Environmental Health (GmbH), which is funded by the German Federal Ministry of Education and Research (BMBF) and by the State of Bavaria. The authors are grateful for the commitment and involvement of all study participants and for the work and dedication of the MONICA/KORA Augsburg study staff.

Compliance with ethical standards

Conflict of interest

All authors of this study declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For the MONICA/KORA studies approval was sought from the Bavarian commissioner for data protection and privacy (Bayerischer Datenschutzbeauftragter) for the baseline data in S3 and the Ethics Committee of the Bavarian Medical Association (Bayerische Landesärztekammer) for the follow-up data in F3.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

420_2018_1312_MOESM1_ESM.pptx (46 kb)
Supplementary material 1 (PPTX 45 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Burkhard Schmidt
    • 1
    • 2
    Email author
  • Raphael M. Herr
    • 1
  • Marc N. Jarczok
    • 1
  • Jens Baumert
    • 3
  • Karoline Lukaschek
    • 3
    • 5
  • Rebecca T. Emeny
    • 3
  • Karl-Heinz Ladwig
    • 3
    • 4
  • for the KORA Investigators
  1. 1.Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty MannheimHeidelberg UniversityMannheimGermany
  2. 2.Department of Business, Work and Organizational PsychologyApplied University FreseniusHeidelbergGermany
  3. 3.Institute of Epidemiology II, Helmholtz Zentrum MünchenGerman Research Center for Environmental HealthNeuherbergGermany
  4. 4.Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der IsarTechnische Universität MünchenMunichGermany
  5. 5.Institute of General Practice and Family MedicineUniversity Hospital of Ludwig-Maximilians-University MunichMunichGermany

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