Effort-reward studies

John D. and Catherine T. MacArthur
Research Network on Socioeconomic Status and Health

Table 3 - Adverse Health Outcomes of Effort-Reward Imbalance at Work

Author, year, country	Total sample (% women)	Type of study	Exposure	Health measure	Adjustment	Relative risk	Summary
Bosma et al. 1998) UK	10,308 (33) civil servants	Prospective mean 5.3 years	high effort, low reward (proxy measures)	angina, doctor diagnosed ischemia	age, smoking, blood pressure, cholesterol, BMI, employment grade, negative affectivity, job control	2.15	+
(Siegrist et al. 1990) Germany	416 (0) blue-collars	Prospective mean 6.5 years	high effort, low reward	Incident fatal or non-fatal coronary heart disease	age, smoking, blood pressure, cholesterol, BMI	6.15	+
(Peter et al. 1998a) Sweden	5,720 (44)	Prospective (baseline data)	high effort, low reward (ratio and score over-commitment)	Hypertension, total cholesterol, LDL and HDL cholesterol	age, smoking BMI, physical exercise	1.62 for hypertension (ratio in men) 1.39 for LDL cholesterol (overcommitment in women)	+ (partial) + (partial)
(Siegrist et al. 1997) Germany	179 middle managers	cross-sectional	high effort, low reward	Hypertension, LDL cholesterol	age, BMI, exercise, smoking, alcohol	5.77 3.57	+ +
(Stansfeld et al. 1998) UK	10,308 (33) civil servants	Prospective mean 5.3 years	high effort, low reward (proxy measures)	new reports of psychiatric disorders subjective health functioning	age, employment grade, baseline mental health age, employment grade, baseline ill health, negative affectivity	2.57 for men 1.67 for women all significant ranging from 1.44 to 2.33	+ +
(Peter et al. 1998b) Germany	1,337 (12) transport workers	cross-sectional	high effort, low reward (proxy measures)	level of reported symptoms	reported health, physically demanding work, occupational hazards	ranging from 1.99 to 3.06	+
(Joksimovic et al. 1998) Germany	106 (0) coronary patients	follow-up 1 year	high effort, low reward	Coronary restenosis, based on angiographic measures	age, cholesterol, hypertension, smoking, multivesseldisease	2.86	(partial)

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