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Work Stress and Cardiovascular Disease: Reviewing Research Evidence with a Focus on Effort-Reward Imbalance at Work

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Work Stress and Health in a Globalized Economy

Abstract

Cardiovascular disease is the leading cause of death globally and a significant source of disability and impairment of quality of life. Stress may influence the development of cardiovascular disease across the life course, affecting risk factors and the progression of atherosclerosis. In this chapter, we review evidence on work stress as a risk factor for coronary heart disease and stroke, with particular emphasis on the effort-reward imbalance (ERI) model. In addition to studies on ERI, our review covers research on long working hours and job insecurity as these factors represent proxy measures of the model’s main components, high efforts and low rewards at work. Findings from meta-analyses of cohort studies and international consortia suggest that individuals with ERI or job insecurity have an increased risk of coronary heart disease while those working long hours appear to be at an increased risk of stroke. The excess risk associated with ERI was not attributable to other well-established work stressors, such as job strain. Our review suggests that the aspects of ERI should be given attention in efforts to promote healthy work. At the same time, several methodological challenges need to be addressed by future research.

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Correspondence to Mika Kivimäki .

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Kivimäki, M., Siegrist, J. (2016). Work Stress and Cardiovascular Disease: Reviewing Research Evidence with a Focus on Effort-Reward Imbalance at Work. In: Siegrist, J., Wahrendorf, M. (eds) Work Stress and Health in a Globalized Economy. Aligning Perspectives on Health, Safety and Well-Being. Springer, Cham. https://doi.org/10.1007/978-3-319-32937-6_5

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