High Demands and Lack of Control on the Job Damage Health
HSPH researchers have confirmed what many workers may have long suspected--bad job strain can make you feel lousy.
Women in jobs with high work demands, low levels of job control and little workplace social support are more likely to suffer poor health--and see their health decline--than are women in more flexible jobs with reasonable demands and social support, according to a new study in the May 27 issue of the British Medical Journal.
"Some jobs are inherently stressful," said Ichiro Kawachi, associate professor of health and social behavior and director of the Harvard Center for Society and Health. "What we found is that regardless of how healthy or resilient a person is, the job stress can affect her health."
The researchers studied responses from more than 21,000 women involved in the Nurses' Health Study. The nurses completed surveys about jobs and health status in 1992 and 1996.
The
new study advanced previous research by linking job stress to broad, quality-of-life
health issues such as carrying out daily household chores and general
mental health. Whereas previous studies have linked job strain to hypertension,
cardiovascular disease, depression, and adverse birth outcomes, this study
showed that job stress has broader health effects that worsen as the strain
continues, said Kawachi.
"We looked at more daily activities such as the ability to socialize that affect almost everyone, unlike health events such as heart attacks that affect only a portion of people," said Kawachi.
The authors found that job strain can damage health as much as smoking and sedentary lifestyles.
"If we compare the effect of job strain on health to the effect of something like smoking, we see that people decline just as quickly," he said.
Everyone feels that his or her job is stressful, said Kawachi, but there is a difference between "good" and "bad" stress. The HSPH researchers were able to distinguish between the types of stress felt by managers and those experienced by workers. Managers and executives typically enjoy some freedom to prioritize and control their tasks, while workers may have little say over their duties.
"If you asked most people," said Kawachi, "they would say they are stressed in their jobs. That alone is not predictive. What is different in our study is that we conceptualized stress as to the number of job demands compared to control. That is where you really begin to separate the good from the bad stress."
Kawachi acknowledges that personality may play an unknown role in this kind of research. He says that some people who can't handle horrible jobs drop out of their fields while others may choose to stick to their employment, creating a pre-selected pool of workers before the study began. "We do not know the extent of these biases," said Kawachi. "We don't have a measure of their personalities and health before they started the jobs."
He added that although nurses--whose profession is the basis for the study--have particularly stressful jobs, he thinks the instrument the researchers used to conduct the study can be applied to other occupations.
The authors recommend that employers use the study's findings to restructure jobs to give employees more control over their workplace.
"If workers are able to participate in decision making and have some flexibility and control over their jobs," said Kawachi, "then employers would be rewarded with fewer sickness absences of employees and even lower health insurance rates."
See also:
Job Stress Taxes Health,
press release of May 26, 2000.
