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Original Article
Association between childhood health, socioeconomic and school-related factors and effort-reward imbalance at work: a 25-year follow-up study
  1. Shuo Wang1,2,
  2. Kristy Sanderson1,3,
  3. Alison Venn1,
  4. Terence Dwyer1,4,
  5. Seana Gall1
  1. 1 Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
  2. 2 Anhui Medical University, Hefei, Anhui, China
  3. 3 School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, UK
  4. 4 The George Institute for Global Health, Oxford Martin School, University of Oxford, Oxford, UK
  1. Correspondence to Dr Seana Gall, Menzies Institute for Medical Research MS2, Medical Science Precinct 17 Liverpool St, Hobart, Tasmania 7000, Australia; seana.gall{at}


Objectives Stress pathways can have origins in childhood, but few early predictors have been explored in relation to adult job stress. This study examined whether childhood school, health or socioeconomic factors were associated with adult job stress.

Methods Data came from the Childhood Determinants of Adult Health study that began in 1985 with children aged 7–15 years who reported effortreward imbalance (ERI) scales at ages 31–41 years. Linear regression assessed the association between childhood factors and adult ERI adjusted for age and socioeconomic position (SEP) in childhood and adulthood.

Results There were between 999 and 1390 participants in each analysis. Lower adulthood ERI, indicating less job stress, was predicted by several school-related factors in men. For example, each higher category of learner self-concept was associated with a 19% (95% CI – 32% to 6%) reduction in adult ERI, and each unit increase in academic attainment was associated with a 15% (95% CI –28% to 3%) reduction in adult ERI. Childhood health was associated with adult ERI. For example, in women, overweight children had 14% (95% CI 5% to 22%) higher adult ERI scores compared with healthy weight children, and each unit of negative affect was associated with 2% (95% CI 1% to 4%) increase in adult ERI. Adult SEP had no effect on these associations for men but explained some of the effect in women. Childhood SEP had inconsistent associations with adult ERI.

Conclusion Our findings suggest that a range of childhood socioeconomic, school- and health-related factors might contribute to the development of job stress in adulthood.

  • effort-reward imbalance
  • childhood related factors

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  • Contributors All authors provided final approval for the work to be published and agree to be accountable for all aspects of the work. SW conducted analysis and interpretation of data and drafted the work; KS designed the work, interpreted data and revised it for intellectual content; AV designed the work, acquired data, interpreted data and revised it for intellectual content; TD designed the work, acquired data, interpreted data and revised it for intellectual content; and SG acquired the data, interpreted data and revised it for intellectual content.

  • Funding This study was supported by the National Health and Medical Research Council (Project Grant 211316, Senior Research Fellowship to AJV); the National Heart Foundation (Project Grant GOOH 0578, Fellowships PH 11H 6047 and FLF 100446 to SLG) and Veolia Environmental Services. The supporters had no role in the study design, conduct, analysis or reporting of results.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Southern Tasmanian Health and Medical Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.