Effort-reward imbalance, procedural injustice and relational injustice as psychosocial predictors of health: complementary or redundant models?

Full Abstract

OBJECTIVE:
Effort-reward imbalance at work is an established psychosocial risk factor but there are also newer conceptualisations, such as procedural injustice (decisions at work lack consistency, openness and input from all affected parties) and relational injustice (problems in considerate and fair treatment of employees by supervisors). The authors examined whether procedural injustice and relational injustice are associated with employee health in addition to, and in combination with, effort-reward imbalance.

METHODS:
Prospective survey data from two cohorts related to public-sector employees:
the 10-Town study (n = 18 066 (78% women, age range 19-62) and the Finnish Hospital Personnel study (n = 4833, 89% women, age range 20-60). Self-rated poor health, minor psychiatric morbidity and doctor-diagnosed depression were assessed at baseline (2000-2) and at follow-up (2004). To determine incident morbidity, baseline cases were excluded.

RESULTS:
In multivariate models including age, sex, occupational status and all three psychosocial factors as predictors, high effort-reward imbalance and either high procedural injustice or high relational injustice were associated with increased morbidity at follow-up in both cohorts. After combining procedural and relational injustice into a single measure of organisational injustice, high effort-reward imbalance and high injustice were both independently associated with health. For all outcome measures, a combination of high effort-reward imbalance and high organisational injustice was related to a greater health risk than high effort-reward imbalance or injustice alone.

CONCLUSION:
Evidence from two independent occupational cohorts suggests that procedural and relational components of injustice, as a combined index, and effort-reward imbalance are complementary risk factors.

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Author information

Author/s: Kivimäki, Mika (M); Vahtera, Jussi (J); Elovainio, Marko (M); Virtanen, Marianna (M); Siegrist, Johannes (J);

Affiliation: International Institute for Health and Society, Department of Epidemiology and Public Health, University College London, UK. m.kivimaki(-atsign-)ucl.ac.uk

Journal and publication information

Publication Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't

Journal: Occupational and environmental medicine (Occup Environ Med), published in England. (Language: eng)

Reference: 2007-Oct; vol 64 (issue 10) : pp 659-65

Dates: Created 2007/09/20; Completed 2007/10/18;

PMID: 17259167, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Occup Environ Med. 2007 Oct;64(10):640-1. (PMID: 17881469)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Age Distribution
Causality
Cohort Studies
Europe - epidemiology
Female
Follow-Up Studies
Health Status
Health Surveys
Humans
Male

Mental Disorders - epidemiology; psychology
Middle Aged
Models, Psychological
Multivariate Analysis
Occupational Diseases - epidemiology; psychology
Odds Ratio
Prospective Studies
Reward
Sex Distribution
Social Justice - psychology
Workload - psychology

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