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Injustice at work and incidence of psychiatric morbidity: the Whitehall II study
  1. J E Ferrie1,
  2. J Head1,
  3. M J Shipley1,
  4. J Vahtera2,
  5. M G Marmot1,
  6. M Kivimäki2
  1. 1International Centre for Health and Society, Department of Epidemiology and Public Health, University College London Medical School, UK
  2. 2Finnish Institute of Occupational Health and University of Helsinki, Finland
  1. Correspondence to:
 Dr J E Ferrie
 Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK; j.ferrie{at}


Background: Previous studies of organisational justice and mental health have mostly examined women and have not examined the effect of change in justice.

Aim: To examine effects of change in the treatment of employees by supervisors (the relational component of organisational justice) on minor psychiatric morbidity, using a cohort with a large proportion of men.

Methods: Data are from the Whitehall II study, a prospective cohort of 10 308 white-collar British civil servants (3143 women and 6895 men, aged 35–55 at baseline) (Phase 1, 1985–88). Employment grade, relational justice, job demands, job control, social support at work, effort–reward imbalance, physical illness, and psychiatric morbidity were measured at baseline. Relational justice was assessed again at Phase 2 (1989–90). The outcome was cases of psychiatric morbidity by Phases 2 and 3 (1991–93) among participants case-free at baseline.

Results: In analyses adjusted for age, grade, and baseline physical illness, women and men exposed to low relational justice at Phase 1 were at higher risk of psychiatric morbidity by Phases 2 and 3. Adjustment for other psychosocial work characteristics, particularly social support and effort–reward imbalance, partially attenuated these associations. A favourable change in justice between Phase 1 and Phase 2 reduced the immediate risk (Phase 2) of psychiatric morbidity, while an adverse change increased the immediate and longer term risk (Phase 3).

Conclusion: This study shows that unfair treatment by supervisors increases risk of poor mental health. It appears that the employers’ duty to ensure that employees are treated fairly at work also has benefits for health.

  • organisational justice
  • psychosocial work characteristics
  • minor psychiatric morbidity
  • GHQ
  • white collar
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  • Commentary

    by Kawachi, I

    Online First articles are available as unedited manuscripts* in downloadable PDF form. They are peer reviewed, accepted for publication and indexed by PubMed but not yet included in a journal issue.

    * edited, typeset versions may be added as they become available

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  • Published Online First 12 May 2006

  • Funding: The Whitehall II study has been supported by grants from the Medical Research Council; British Heart Foundation; Health and Safety Executive; Department of Health; National Heart Lung and Blood Institute (HL36310), US, NIH: National Institute on Aging (AG13196), US, NIH; Agency for Health Care Policy Research (HS06516); and the John D and Catherine T MacArthur Foundation Research Networks on Successful Midlife Development and Socio-economic Status and Health. MK, also working at the University of Helsinki, Finland, and JV were supported by the Academy of Finland (projects 77560, 104891, and 105195) and the Finnish Environment Fund, JEF is supported by the MRC (Grant number G8802774), MJS by a grant from the British Heart Foundation, and MGM by an MRC Research Professorship.

  • Competing interests: none

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