Stress and high effort/low reward work doubles men’s heart disease risk
A study of white-collar workers has found that men who experience work stress coupled with a job that requires high effort for low reward are at double the risk of developing heart disease, having a similar impact on heart health as obesity.
A number of well-known lifestyle-related risk factors have been identified as relevant targets for preventing cardiovascular disease (CVD). This includes psychosocial factors such as work strain, and an imbalance between the effort required by a job and the reward received. Here, ‘reward’ refers not only to salary but also to recognition and job security.
While previous studies have considered how these two factors separately affect heart disease risk, few have looked at them in combination. Now, a new study has examined the combined impact of job strain and effort-reward imbalance (ERI) and found that men are particularly affected.
“Considering the significant amount of time people spend at work, understanding the relationship between work stressors and cardiovascular health is crucial for public health and workforce well-being,” said Mathilde Lavigne-Robichaud, lead and corresponding author of the study. “Our study highlights the pressing need to proactively address stressful working conditions, to create healthier work environments that benefit employees and employers.”
The study included 3,118 men and 3,347 women, all Canadian white-collar workers, who were followed for a median period of 18.7 years. Jobs included senior management, professional, technical and office worker roles. Over the course of the study, the researchers measured the incidence of CVD and job strain.
“Job strain refers to work environments where employees face a combination of high job demands and low control over their work,” said Lavigne-Robichaud. “High demands can include a heavy workload, tight deadlines and numerous responsibilities, while low control means the employee has little to say in decision-making and how they perform their tasks.”
The researchers also measured work effort and reward and used the sum of both measures to calculate the ERI ratio.
“Effort-reward imbalance occurs when employees invest high effort into their work, but they perceive the rewards they receive in return – such as salary, recognition or job security – as insufficient or unequal to the effort,” Lavigne-Robichaud said. “For instance, if you’re always going above and beyond, but you feel like you’re not getting the credit or rewards you deserve, that’s called effort-reward imbalance.”
They found that men who reported either job strain or ERI had a 49% increase in heart disease risk compared to men who didn’t report those stressors. Men who reported both job strain and ERI were at twice the risk (103%) of heart disease compared with men who didn’t. The researchers found that the impact of job strain and ERI combined was similar to the impact obesity has on heart disease risk. Interestingly, they found that the impact of work stress on women’s health was inconclusive.
“Our results suggest that interventions aimed at reducing stressors from the work environment could be particularly effective for men and could also have positive implications for women, as these stress factors are associated with other prevalent health issues such as depression,” Lavigne-Robichaud said. “The study’s inability to establish a direct link between psychosocial job stressors and coronary heart disease in women signals the need for further investigation into the complex interplay of various stressors and women’s heart health.”
The researchers recognize that a limitation of their study was that it was confined to Canadian white-collar workers. However, they say, the results may still be comparable to white-collar workers in the US and other high-income countries with similar job structures.
The study was published in the journal Circulation: Cardiovascular Quality and Outcomes.
Source: American Heart Association