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Yawen Cheng a Department of Health and Social Behavior,
Harvard School of Public Health, Boston, MA 02115, USA, b Harvard Center
for Society and Health, Harvard School of Public Health, c Department of Nutrition,
Harvard School of Public Health, d Department of Environmental Health,
Harvard School of Public Health, e Channing Laboratory, Department
of Medicine, Brigham and Women's Hospital, Boston MA 02115, USA
Correspondence to: I
Kawachi Ichiro.Kawachi{at}channing.harvard.edu
Objective:
To examine prospectively the relation
between psychosocial work characteristics and changes in health related quality of life over four years in a cohort of working women in the United States.
Design:
Longitudinal cohort study.
Setting:
United States.
Participants:
21 290 female registered nurses who
completed the Karasek's job content questionnaire and a modified
version of the short form 36 questionnaire (SF-36) as used for a survey of health status by the medical outcomes study.
Main outcome measures:
Seven dimensions of health
status: physical functioning, role limitations due to physical health
problems, bodily pain, vitality, social functioning, role limitations
due to emotional problems, and mental health.
Results:
Examined separately low job control, high job
demands, and low work related social support were associated with poor
health status at baseline as well as greater functional declines over
the four year follow up period. Examined in combination, women with low
job control, high job demands, and low work related social support
("iso-strain" jobs) had the greatest functional declines. These
associations could not be explained by age, body mass index, comorbid
disease status, alcohol consumption, smoking status, education level,
exercise level, employment status, marital status, or presence of a confidant.
Conclusions:
Adverse psychosocial work conditions are
important predictors of poor functional status and its decline over time.
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