Documents Kuper, Hannah 3 results

"Objectives The aim of this study was to examine the association of the discrepancy between externally and self-assessed measures of work environment with long- and short-term sickness absence.Methods The study population included 6997 middle-aged men and women from the Whitehall II cohort, whose work characteristics were examined at baseline (1985–1988) through both an external evaluation and self-report, with a follow-up of up to 13 years of sickness absence reporting from administrative records. The primary exposure of interest was the discrepancy between measures of work stress for fast job pace, conflicting demands, and decision latitude.Results In mutually adjusted models, external measures of job characteristics were more strongly associated with higher rates of sickness absence compared with self-assessed measures, for both lower frequency of fast work pace and lower conflicting demands (ie “passive” levels). Individuals who self-reported higher frequencies of fast work pace and conflicting demands than were reported through external assessment had higher rates of short-term sickness absence [incident rate ratios (IRR) of 1.13 (95% confidence interval [95% CI] 1.11–1.15) and IRR 1.14 (95% CI 1.11–1.16), respectively]. There was no difference in rates of sickness absence found for decision latitude [IRR 1.02 (95% CI 1.00–1.04)].Conclusions Our findings demonstrate that the discrepancy between externally and self-assessed job demand measures have additional predictive power beyond each individual measure of job structure, which may be related to the extent of cognitive and emotional processing of assessment questions as compared to decision latitude measures."

"STUDY OBJECTIVES:
To investigate the association between job strain and components of the job strain model and coronary heart disease (CHD) risk.
DESIGN: Prospective cohort study (Whitehall II study). At the first phase of the study (1985-1988), data on self reported psychosocial work characteristics were collected from all participants. Participants were followed up until the end of phase 5 (1997-2000), with mean length of follow up of 11 years.
SETTING:
London based office staff in 20 civil service departments.
PARTICIPANTS:
6,895 male and 3,413 female civil servants aged 35-55.
OUTCOME MEASURES: Incident validated CHD.
MAIN RESULTS:
People with concurrent low decision latitude and high demands (job strain) were at the highest risk for CHD. High job demands, and, less consistently, low decision latitude, predicted CHD incidence. The effect of job strain on CHD incidence was strongest among younger workers, but there was no effect modification by social support at work, or employment grade.
CONCLUSIONS:
Job strain, high job demands, and, to some extent, low decision latitude, are associated with an increased risk of CHD among British civil servants."

"Although there has been considerable research on psychosocial working conditions and their effect on physical and mental health, there has been little research into the effects of psychosocial domestic conditions on health. The association between psychosocial working conditions (and control at work in particular) and coronary heart disease (CHD) is not as strong for women compared to men. Other research suggests that household and domestic factors may have an important effect on women's health. Some studies have shown that low control at home affects psychological well being. However, there has been little research into its effects on physical health. Furthermore, similar to results analysing low control at work, low control at home may form part of the pathways underlying social inequalities in health. The study investigates the meaning of control at home, the effect of control at home on incident CHD events and whether this explains some of the social inequalities in CHD events in men and women. Data from phases 3–5 of the Whitehall II study, London, UK, were analysed (N ? 7470). The results indicate that low control at home predicts CHD among women but not among men. Furthermore, low control at home may explain part of the association between household social position and CHD among women. There is some evidence suggesting that low control at home among women results from a lack of material and psychological resources to cope with excessive household and family demands. Psychosocial domestic conditions may have a greater effect on the health of women compared with men."