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Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men
Insights
A demanding job and limited control over work increase the risk of cardiovascular disease (CVD) and coronary heart disease (CHD) symptoms in men. These factors contribute to premature death, even after accounting for lifestyle choices.
Area of Science:
- Occupational Health
- Cardiovascular Epidemiology
- Psychosocial Factors in Medicine
Background:
- Job characteristics are increasingly recognized as significant determinants of employee health.
- Previous research suggests a link between work stress and cardiovascular outcomes, but specific mechanisms require further elucidation.
- Understanding the impact of job demands and control on cardiovascular health is crucial for public health interventions.
Purpose of the Study:
- To investigate the association between specific job characteristics and the development of cardiovascular disease (CVD) and coronary heart disease (CHD) in a male working population.
- To analyze the risk of developing CHD symptoms and signs and premature CHD-CVD death based on job demands and decision latitude.
- To validate the predictive accuracy of CHD symptoms and signs in relation to mortality.
Main Methods:
- A large-scale prospective study utilizing a random sample of the male working Swedish population.
- Multivariate logistic regression analysis to assess the prospective development of CHD symptoms and signs.
- Case-controlled study design to analyze CHD-CVD deaths over a six-year follow-up period.
- Statistical controls for age, education, smoking, and overweight were applied.
Main Results:
- A hectic and psychologically demanding job was associated with an increased risk of developing CHD symptoms and signs (standardized odds ratio [SOR] 1.29) and premature CHD-CVD death (relative risk [RR] 4.0).
- Low decision latitude, specifically low intellectual discretion, predicted the development of CHD symptoms and signs (SOR 1.44).
- Low personal schedule freedom, particularly among workers with minimal education, significantly increased the risk of CHD-CVD death (RR 6.6).
Conclusions:
- Hectic and psychologically demanding work environments are significant risk factors for cardiovascular disease.
- Limited control over one's work, characterized by low intellectual discretion and schedule freedom, contributes to increased cardiovascular morbidity and mortality.
- These findings highlight the importance of addressing psychosocial job factors in occupational health strategies to prevent cardiovascular disease.
Abstract:
The association between specific job characteristics and subsequent cardiovascular disease was tested using a large random sample of the male working Swedish population. The prospective development of coronary heart disease (CHD) symptoms and signs was analyzed using a multivariate logistic regression technique. Additionally, a case-controlled study was used to analyze all cardiovascular-cerebrovascular (CHD-CVD) deaths during a six-year follow-up. The indicator of CHD symptoms and signs was validated in a six-year prospective study of CHD deaths (standardized mortality ratio 5.0; p less than or equal to .001). A hectic and psychologically demanding job increases the risk of developing CHD symptoms and signs (standardized odds ratio 1.29, p less than 0.25) and premature CHD-CVD death (relative risk 4.0, p less than .01). Low decision latitude-expressed as low intellectual discretion and low personal schedule freedom-is also associated with increased risk of cardiovascular disease. Low intellectual discretion predicts the development of CHD symptoms and signs (SOR 1.44, p less than .01), while low personal schedule freedom among the majority of workers with the minimum statutory education increases the risk of CHD-CVD death (RR 6.6, p less than .0002). The associations exist after controlling for age, education, smoking, and overweight.