Objective To examine the association between exposures to psychosocial work stressors and mortality in a nationally representative Australian working population sample.
Methods 18 000 participants from the Household, Income and Labour Dynamics in Australia survey with self-reported job demands, job control, job security and fair pay psychosocial work stressors exposures at baseline were followed for up to 15 waves. Cox proportional hazards regression models were used to examine the association between psychosocial work stressors and mortality. Models were serially adjusted for each subgroup of demographic, socioeconomic, health and behavioural risk factors.
Results Low job control was associated with a 39% increase in the risk of all-cause mortality (HR 1.39; 95% CI 1.04 to 1.85), controlling for demographic, socioeconomic, health and behavioural factors. A decreased risk of mortality was observed for workers with exposure to high job demands (HR 0.76; 95% CI 0.60 to 0.96, adjusted for gender and calendar), but the risk was attenuated after serially adjusting for socioeconomic status, health (HR=0.84; 95% CI 0.65 to 1.08) and behavioural (HR=0.79; 95% CI 0.60 to 1.04) factors. There did not appear to be an association between exposure to job insecurity (HR 1.03; 95% CI 0.79 to 1.33) and mortality, or unfair pay and mortality (HR 1.04; 95% CI 0.80 to 1.34).
Conclusions Low job control may be associated with an increased risk of all-cause mortality. Policy and practice interventions that reduce the adverse impact of low job control in stressful work environments could be considered to improve health and decrease risk of mortality.
- longitudinal studies
- mortality studies
Statistics from Altmetric.com
Deceased Dr Allison Milner died in a tragic accident on 12th August 2019
Contributors All authors contributed to the conception and design of the work. YT designed the study, performed the statistical analyses and drafted the manuscript. MJS and ADL contributed to the writing of the manuscript. AM provided logistic support at all stages of the study and contributed to the writing of the manuscript. The corresponding author attests that all listed authors meet the authorship criteria and that no others meeting the criteria have been omitted.
Funding This study was supported in part by an Australian Government Research Training Program Scholarship provided by the Australian Commonwealth Government. AM was funded by a Victorian Health and Medical Research Fellowship. MJS is a recipient of an Australian Research Council Future Fellowship (project number FT180100075) funded by the Australian Government. The funding sources had no role in the design or conduct of the study; collection, management, analysis and interpretation of the data; or preparation, review or approval of the manuscript, including the decision to submit for publication.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. The study received ethical approval from the Melbourne School of Population and Global Health’s Human Ethics Advisory Group (1750707.1). The HILDA survey is conducted by the Melbourne Institute of Applied Economic and Social Research at the University of Melbourne on behalf of the Australian Commonwealth Government Department of Social Services (DSS). All relevant ethical issues associated with this research project (including consent) were addressed by the Melbourne Institute of Applied Economic and Social Research at the University of Melbourne, which operates within the University’s Ethics Guidelines. All processes involving consent have been approved by both the University of Melbourne’s Human Research Ethics Committee and the Australian Institute of Health and Welfare’s Ethics Committee. All members of the group and researchers involved in the HILDA project must comply with the Privacy Act (1988). The authors were provided de-identified data by the organisational data custodian, the names and addresses of which have been removed.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data may be obtained from a third party and are not publicly available.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.