Low status control, high effort at work and ischemic heart disease: Prospective evidence from blue-collar men

doi:10.1016/0277-9536(90)90234-J

Social Science & Medicine

Volume 31, Issue 10, 1990, Pages 1127-1134

https://doi.org/10.1016/0277-9536(90)90234-J Get rights and content

Abstract

An inverse relation between socio-economic class and occurrence of ischemic heart disease (IHD) in advanced societies is an often replicated finding from empirical studies. Yet, the processes which produce these effects remain an open question. One promising explanation concerns the prevalence of stressful working life, especially of distinct ‘job strain’ occupations. Based on these considerations, we develop a refined concept of work-related socio-emotional distress which considers a mismatch between high workload and low control over occupational status (e.g. job insecurity, poor promotion prospects, status inconsistency) as crucial distress-provoking conditions. Moreover, we assume that the effect of this condition on IHD risk is substantially increased by the presence of a distinct individual pattern of coping with work demand (‘need for control’).

Based on data from a 6.5 years prospective study on IHD incidence (n = 21) in a cohort of 416 middle-aged blue-collar men this concept is tested using logistic regression analysis. Results indicate that status inconsistency [multivariate odds ratio (o.r.): 4.4], job insecurity (o.r. 3.4), work pressure (o.r. 3,4) and ‘need for control’ (o.r. 4,5) independently predict IHD occurrence after adjusting for major confounding somatic and behavioral coronary risk factors. In conclusion, a refined model of work-related socio-emotional distress substantially contributes to the explanation of high IHD incidence among blue-collar men.

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Low status control, high effort at work and ischemic heart disease: Prospective evidence from blue-collar men

Abstract

J. chron. Dis.

The Lancet

Atherosclerosis

Soc. Sci. Med.

J. Lip. Res.

Soc. Sci. Med.

Socio-economic status as a coronary risk factor: The Oslo Study

Acta med. scand.

Occupation and risk of death from coronary heart disease

J. Am. med. Ass.

Psychosocial influences on mortality after myocardial infarction

New Engl. J. Med.

Social class and cardiovascular disease: the contribution of work

Int. J. Hlth Serv.