A longitudinal study comparing the effort - reward imbalance and demand - control models using objective measures of physician utilization

Author:

Ostry Alec S.1,Hershler Ruth2,Chen Lisa2,Hertzman Clyde2

Affiliation:

1. Department of Health Care and Epidemiology, University of British Columbia, Canada,

2. Department of Health Care and Epidemiology, University of British Columbia, Canada

Abstract

Background: The objectives of this study were to compare the predictive validity of the demand - control and effort - reward imbalance models using objective measures of physician utilization. Methods: Self-reports for psychosocial work conditions were obtained in interviews with 1,028 workers using the demand - control and effort - reward imbalance models. Physician utilization outcomes were obtained through linkage to the British Columbia Linked Health Database. Outcomes were any visit to a physician for mental health reasons and 30 or more physician visits for any reason. The predictive validity of both models was compared in a longitudinal study using logistic regression. Results: Neither job strain nor effort - reward imbalance predicted either outcome. However, low esteem reward and low status control increased the risk for 30 or more physician visits by, respectively, approximately 60% and 30%. Conclusions: In a sample of middle-aged blue-collar current and ex-sawmill workers in Western Canada, followed prospectively, after controlling for sociodemographic and workplace confounders, and reducing the potential for adverse health selection into high-stress jobs, low esteem reward and low status control were associated with a significantly greater risk for 30 or more physician visits for any reason.

Publisher

SAGE Publications

Subject

Public Health, Environmental and Occupational Health,General Medicine

Reference22 articles.

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3. Psychosocial work environment and sickness absence among British civil servants: the Whitehall II study.

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

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