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Association between psychosocial work characteristics and health functioning in American women: prospective study

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7247.1432 (Published 27 May 2000) Cite this as: BMJ 2000;320:1432
  1. Yawen Cheng, research fellowa,
  2. Ichiro Kawachi, director (Ichiro.Kawachi{at}channing.harvard.edu)b,
  3. Eugenie H Coakley, research fellowc,
  4. Joel Schwartz, associate professord,
  5. Graham Colditz, professore
  1. a Department of Health and Social Behavior, Harvard School of Public Health, Boston, MA 02115, USA
  2. b Harvard Center for Society and Health, Harvard School of Public Health
  3. c Department of Nutrition, Harvard School of Public Health
  4. d Department of Environmental Health, Harvard School of Public Health
  5. e Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston MA 02115, USA
  1. Correspondence to: I Kawachi
  • Accepted 7 February 2000

Abstract

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.

Footnotes

  • Funding This research was funded by a grant from the National Institute of Aging Research (R01-AG-12806). The nurses' health study is funded by a grant from the National Institutes of Health (R01-CA-40356). IK was supported by the MacArthur Foundation Network on Socioeconomic Status and Health and a career development award from the National Institutes of Health (HL03453).

  • Competing interests None declared.

  • Accepted 7 February 2000
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