ORIGINAL ARTICLE

Organisational justice and health of employees: prospective cohort study

M Kivimäki¹, M Elovainio², J Vahtera³, J E Ferrie⁴

¹ Department of Psychology, Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, FIN-00250 Helsinki, Finland
² Research and Development Centre for Health and Welfare, PO Box 220, FIN-00591 Helsinki, Finland
³ Finnish Institute of Occupational Health, Hämeenkatu 10, FIN-20500 Turku, Finland
⁴ Department of Epidemiology and Public Health, University College London Medical School, 1–19 Torrington Place, London WC1E 6BT, UK

Correspondence to:
Correspondence to:
Prof. M Kivimäki, Department of Psychology, Division of Applied Psychology, University of Helsinki, PO Box 13, FIN-00014, Finland;
mika.kivim\|[auml ]\|ki{at}occuphealth.fi

Aims: To examine the association between components of organisational justice (that is, justice of decision making procedures and interpersonal treatment) and health of employees.

Methods: The Poisson regression analyses of recorded all-cause sickness absences with medical certificate and the logistic regression analyses of minor psychiatric morbidity, as assessed by the General Health Questionnaire, and poor self rated health status were based on a cohort of 416 male and 3357 female employees working during 1998–2000 in 10 hospitals in Finland.

Results: Low versus high justice of decision making procedures was associated with a 41% higher risk of sickness absence in men (rate ratio (RR) 1.4, 95% confidence interval (CI) 1.1 to 1.8), and a 12% higher risk in women (RR 1.1, 95% CI 1.0 to 1.2) after adjustment for baseline characteristics. The corresponding odds ratios (OR) for minor psychiatric morbidity were 1.6 (95% CI 1.0 to 2.6) in men and 1.4 (95% CI 1.2 to 1.7) in women, and for self rated health 1.4 in both sexes. In interpersonal treatment, low justice increased the risk of sickness absence (RR 1.3 (95% CI 1.0 to 1.6) and RR 1.2 (95% CI 1.2 to 1.3) in men and women respectively), and minor psychiatric morbidity (OR 1.2 in both sexes). These figures largely persisted after control for other risk factors (for example, job control, workload, social support, and hostility) and they were replicated in initially healthy subcohorts. No evidence was found to support the hypothesis that organisational justice would represent a consequence of health (reversed causality).

Conclusions: This is the first longitudinal study to show that the extent to which people are treated with justice in workplaces independently predicts their health.

Keywords: organisational justice; health; cohort study

Abbreviations: CI, confidence interval; OR, odds ratio; RR, rate ratio

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COMMENTARY

T Theorell

National Institute for Psychosocial Factors and Health, Box 230, Stockholm S-171 77, Sweden; tores.theorell{at}ipm.ki.se

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