Injustice at work and health: causation or correlation?

Organisational justice has emerged in recent years as a determinant of workers’ health, joining the growing list of other psychosocial aspects of the work environment, including job strain, effort-reward imbalance, and job insecurity. In a series of studies carried out mainly among Finnish workers, perceptions of organisational justice have been linked to poor self-rated health, minor psychiatric disorders, and sickness absences.^1,2 In the July issue of this journal, Ferrie and colleagues provide an independent test of low organisational justice as a predictor of psychiatric morbidity within a well established cohort, the British Whitehall II study.³ What do these studies add to the literature on the psychosocial work environment, and do we have sufficient evidence to implicate organisational justice as a causal influence on workers’ health?

Initial studies in this area were cross-sectional and involved self-reported outcomes, so that reverse causation and common method bias could not be ruled out. In a longitudinal follow up of Finnish hospital workers, Kivimäki and colleagues² checked for the possibility of reverse causation by comparing the changes in perceptions of justice between initially healthy employees versus those with baseline health problems. Although the interaction term between time and baseline health was reported to be statistically non-significant, it was also evident that workers with health problems reported lower perceptions of justice compared to healthy co-workers …