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Effects from job stress on self-rated health transitions over time: the ELSA-Brasil cohort study
Thaís Lopes de Oliveira1, Raquel de Vasconcellos Carvalhaes de Oliveira2, Rosane Harter Griep3
1Department of Epidemiology and Quantitative Methods in Health, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
Abstract:
This study aimed to analyze the effects of job stressors on self-rated health transitions in more than ten years of follow-up of participants of The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Longitudinal design, including individuals from ELSA-Brasil, aged 35-74 years at baseline. Our outcome was transition intensities between self-rated health states, a time-varying variable, categorized into three states (good, fair, and poor). Our exposure, measured at the baseline, was job stressors assessed by the Demand-Control-Support Questionnaire. The effects of job stressors on changes in self-rated health were analyzed using longitudinal models adjusted for age, sex, and education. In total, we analyzed information from 9776 individuals. Participants with active jobs (Hazard Ratio - HR = 0.81, 95% Confidence Interval - CI = 0.72 - 0.91), passive jobs (HR = 0.78, CI = 0.70 - 0.86), and high job strain (HR = 0.75, CI = 0.68 - 0.84) had a lower risk of transitioning from fair to good self-rated health. Participants with low social support had a higher risk of transitioning from good to fair self-rated health (HR = 1.12, CI = 1.04 - 1.21) and a lower risk of transitioning from poor to good self-rated health (HR = 0.10, CI = 0.02 - 0.50). Job stressors were associated with a decline in self-rated health within our population. The risks varied depending on the participants' current state of self-rated health. It is essential to improve job control and social support to prevent the negative consequences of poor health states.
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