Emotions and health in occupational life: new scientific findings and policy implications

A large number of patients suffer from cardiovascular (CV) risk and disease. While many of them have experienced chronic emotional distress at work or at home as a subjectively important risk factor, clinical medicine has so far often disregarded the role of emotional distress in the pathogenesis of CV disease. However, new findings show striking associations. This paper summarizes the evidence from 3 epidemiologic studies on work-related distress and CV risk in middle-aged male populations. The empirical work is based on a theoretical model termed effort-reward imbalance. Workers who exhibit high effort in combination with low reward, and especially with low job security or promotion prospects, suffer from a 3- to 4-fold increased risk of CV disease, and they exhibit higher blood pressure, blood lipids and fibrinogen. Implications of these findings for prevention and intervention are discussed.