General practitioner visits and physical activity with asthma—the role of job decision authority: a cross-sectional study

  • Katherina Heinrichs
  • Jian Li
  • Adrian LoerbroksEmail author
Original Article



Psychosocial working conditions—in terms of job decision authority, among others—may influence asthma self-management at work and in leisure time, as recent qualitative research has shown. We sought to statistically investigate potential relationships between job decision authority and two types of self-management behaviours: physical activity (PA) and visits to the general practitioner (GP).


We combined data from waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe (SHARE) for cross-sectional analyses. The sample was restricted to participants who were employed and reported asthma but no other chronic lung disease (n = 387). The three key variables were each measured by one item. We estimated the prevalence ratios of adequate PA (i.e., more than once a week) and regular GP visits (i.e., ≥ 4 per year) according to job decision authority (low vs. high) using Poisson regression with the robust variance.


We found no evidence of a relationship between job decision authority and PA. However, employees with low levels of job decision authority had a higher prevalence of reporting that they consulted their GP at least four times per year (prevalence ratio = 1.30; 95% confidence interval = 1.03–1.65).


This study was the first to quantitatively investigate the relationship between job decision authority and PA specifically among individuals with asthma. Our results contradict prior epidemiological studies among general working populations, which reported a positive relationship between job decision authority and PA. Our results concerning the association between low job decision authority and more GP visits are inconsistent with our qualitative findings but supported by epidemiological studies among general occupational samples.


Asthma Health care utilization Job decision authority Physical activity Self-management Survey of Health, Ageing and Retirement in Europe 



This paper uses data from SHARE Waves 1 and 2 (DOIs:,, see Börsch-Supan et al. (2013) for methodological details.


The SHARE data collection has been primarily funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), and FP7 (SHARE-PREP: No. 211909, SHARE-LEAP: No. 227822, SHARE M4: No. 261982). Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the U.S. National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C), and from various national funding sources is gratefully acknowledged (see Our work was supported by refonet—Rehabilitation Research Network of the German Pension Fund Rhineland, grant number 14006.

Compliance with ethical standards

Conflict of interest

The authors 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. Waves 1 and 2 received ethical approval by the ethics committee of the University of Mannheim, Germany.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of MedicineUniversity of DüsseldorfDüsseldorfGermany
  2. 2.Department of Environmental Health Sciences, Fielding School of Public Health, School of NursingUniversity of California Los AngelesLos AngelesUSA

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