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Psychosomatic Medicine, Vol 60, Issue 3 247-255, Copyright © 1998 by American Psychosomatic Society
ORIGINAL ARTICLES |
SA Stansfeld, H Bosma, H Hemingway and MG Marmot
International Centre for Health and Society, Department of Epidemiology and Public Health, University College London Medical School, England.
OBJECTIVE: To assess whether work characteristics and social support are predictors of physical, psychological, and social functioning. METHOD: Work characteristics (Karasek and Siegrist models) and social support at baseline were used to predict health functioning measured by the SF-36 General Health Survey 5 years later in a prospective cohort study of 10,308 British male and female civil servants. RESULTS: Effort-reward imbalance and negative aspects of close relationships predicted poor physical, psychological, and social functioning after adjustment for the potential confounding effects of age, employment grade, baseline ill health, and negative affectivity. These psychosocial characteristics seem to act in a similar way in the healthy and those with existing illness. Psychological demands at work in women, and low confiding/emotional support in men, also predicted poor functioning. Etiologically. these effects are not mediated through health-related behaviors. CONCLUSIONS: Negative aspects of work (high demands and effort-reward imbalance) and negative aspects of close relationships are independent powerful predictors of poor health functioning. They may have an etiological role, which is independent of baseline illness.
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