1
|
Riopel C, Trudel X, Milot A, Laurin D, Gilbert-Ouimet M, Brisson C. Effort-reward imbalance at work assessed at midlife and prediabetes prevalence assessed 18 years later in a prospective cohort of white-collar workers. Ann Work Expo Health 2024:wxae071. [PMID: 39312482 DOI: 10.1093/annweh/wxae071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/20/2024] [Indexed: 09/25/2024] Open
Abstract
OBJECTIVES Evidence suggests that workers exposed to psychosocial stressors at work from the effort-reward imbalance (ERI) model are at increased risk for type 2 diabetes mellitus (T2DM). However, evidence about the effect of ERI on prediabetes is scarce. This study aimed to examine the association between effort-reward imbalance at work, glycated hemoglobin level and the prevalence of prediabetes in women and men from a prospective cohort study. METHODS This study was conducted among 1354 white-collar workers followed for an average of 18 years. Effort-reward imbalance at work was measured in 1999 to 2001 using a validated instrument. Glycated hemoglobin was assessed at follow-up (2015 to 2018). Differences in mean glycated hemoglobin levels were estimated with linear models. Prediabetes prevalence ratios (PRs) were computed using robust Poisson regression models. RESULTS In women, those exposed to effort-reward imbalance at work at baseline had a higher prevalence of prediabetes (PR = 1.60, 95% confidence interval: 1.02-2.49) at follow-up following adjustment for sociodemographic, lifestyle-related, clinical, and other occupational risk factors. There was no difference in mean glycated hemoglobin levels. CONCLUSION Among women, effort-reward imbalance at work at midlife was associated with the prevalence of prediabetes, at older age. Preventive workplace interventions aiming to reduce the prevalence of effort-reward imbalance at work may be effective to reduce the prevalence of prediabetes among women.
Collapse
Affiliation(s)
- Camille Riopel
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, 1050 Av. de la Médecine, Québec, QC G1V 0A6, Canada
- Centre de recherche du CHU de Québec-Université Laval, 1050 Ch Ste-Foy, Québec, QC G1S 4L8, Canada
| | - Xavier Trudel
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, 1050 Av. de la Médecine, Québec, QC G1V 0A6, Canada
- Centre de recherche du CHU de Québec-Université Laval, 1050 Ch Ste-Foy, Québec, QC G1S 4L8, Canada
| | - Alain Milot
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, 1050 Av. de la Médecine, Québec, QC G1V 0A6, Canada
- Centre de recherche du CHU de Québec-Université Laval, 1050 Ch Ste-Foy, Québec, QC G1S 4L8, Canada
| | - Danielle Laurin
- Centre de recherche du CHU de Québec-Université Laval, 1050 Ch Ste-Foy, Québec, QC G1S 4L8, Canada
- Centre d'excellence sur le vieillissement de Québec, Centre de recherche VITAM en santé durable, CIUSSS-Capitale Nationale, 2480, chemin de la Canardière, Québec, QC G1J 2G1, Canada
- Faculty of Pharmacy, Université Laval, 1050 Av. de la Médecine, Québec, QC G1V 0A6, Canada
| | - Mahée Gilbert-Ouimet
- Centre de recherche du CHU de Québec-Université Laval, 1050 Ch Ste-Foy, Québec, QC G1S 4L8, Canada
- Health Sciences Department, Université du Québec à Rimouski Campus de Lévis, 1595 Bd Alphonse-Desjardins, Lévis, QC G6V 0A6, Canada
- Canada Research Chair in Sex and Gender in Occupational Health, Université du Québec à Rimouski Campus de Lévis, 1595 Bd Alphonse-Desjardins, Lévis, QC G6V 0A6, Canada
| | - Chantal Brisson
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, 1050 Av. de la Médecine, Québec, QC G1V 0A6, Canada
- Centre de recherche du CHU de Québec-Université Laval, 1050 Ch Ste-Foy, Québec, QC G1S 4L8, Canada
- Centre d'excellence sur le vieillissement de Québec, Centre de recherche VITAM en santé durable, CIUSSS-Capitale Nationale, 2480, chemin de la Canardière, Québec, QC G1J 2G1, Canada
| |
Collapse
|
2
|
Mi J, Han X, Cao M, Cheng H, Pan Z, Guo J, Sun W, Liu Y, Zheng C, Wang X, Cao X, Hu Z, Tian Y, Wang Z, Guan T. The impact of retirement on blood pressure: evidence from a nationwide survey in China. BMC Public Health 2024; 24:1565. [PMID: 38862990 PMCID: PMC11165730 DOI: 10.1186/s12889-024-18422-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/24/2024] [Indexed: 06/13/2024] Open
Abstract
INTRODUCTION The health impact of retirement is controversial. Most previous studies have been based on self-reported health indicators or the endpoints of some chronic diseases (e.g., morbidity or mortality), but objective physiological indicators (e.g., blood pressure) have rarely been used. The objective of this study is to elucidate the health effects of retirement on blood pressure, thereby offering empirical evidence to facilitate the health of retirees and to optimize retirement policies. METHODS From 2012 to 2015, 84,696 participants of the Chinese Hypertension Survey (CHS) were included in this study. We applied the fuzzy regression discontinuity design (FRDD) to identify retirement's causal effect on systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure. We also explored the heterogeneity in the effects of retirement across different sex and education level groups. RESULTS Based on the fully adjusted model, we estimated that retirement increased SBP by 5.047 mm Hg (95% CI: -2.628-12.723, P value: 0.197), DBP by 0.614 mm Hg (95% CI: -3.879-5.108, P value: 0.789) and pulse pressure by 4.433 mm Hg (95% CI: -0.985-9.851, P value: 0.109). We found that retirement led to a significant increase in male participants' SBP and pulse pressure as well as a possible decrease in female participants' blood pressure. Additionally, the blood pressure levels of low-educated participants were more vulnerable to the shock of retirement. CONCLUSION Retirement is associated with an increase in blood pressure level. There is a causal relationship between the increase in blood pressure levels of men and retirement. Policy-makers should pay extra attention to the health status of men and less educated people when adjusting retirement policies in the future.
Collapse
Affiliation(s)
- Jiarun Mi
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongdansantiao, Dongcheng district, Beijing, 100730, China
| | - Xueyan Han
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongdansantiao, Dongcheng district, Beijing, 100730, China
| | - Man Cao
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongdansantiao, Dongcheng district, Beijing, 100730, China
| | - Hanchao Cheng
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongdansantiao, Dongcheng district, Beijing, 100730, China
| | - Zhaoyang Pan
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongdansantiao, Dongcheng district, Beijing, 100730, China
| | - Jian Guo
- Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Wei Sun
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongdansantiao, Dongcheng district, Beijing, 100730, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongdansantiao, Dongcheng district, Beijing, 100730, China
| | - Congyi Zheng
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular, Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Xin Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular, Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Xue Cao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular, Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Zhen Hu
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular, Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yixin Tian
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular, Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular, Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
| | - Tianjia Guan
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongdansantiao, Dongcheng district, Beijing, 100730, China.
| |
Collapse
|
3
|
Lewis TT, Parker R, Erving CL, Udaipuria S, Murden RJ, Fields ND, Booker B, Moore RH, Vaccarino V. Financial responsibility, financial context, and ambulatory blood pressure in early middle-aged African-American women. Soc Sci Med 2024; 345:116699. [PMID: 38412624 PMCID: PMC11014723 DOI: 10.1016/j.socscimed.2024.116699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 01/06/2024] [Accepted: 02/15/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND African-American women have excess rates of elevated blood pressure (BP) and hypertension compared to women of all other racial/ethnic backgrounds. Several researchers have speculated that race and gender-related socioeconomic status (SES) stressors might play a role. OBJECTIVE To examine the association between a novel SES-related stressor highly salient among African-American women, financial responsibility for one's household, and 48-h ambulatory BP. We further examined whether aspects related to African-American women's financial context (e.g., single parenthood, household income, marital status) played a role. METHODS Participants were N = 345 employed, healthy African-American women aged 30-46 from diverse SES backgrounds who underwent 48-h ambulatory BP monitoring. Linear regression analyses were conducted to examine associations between self-reported financial responsibility and daytime and nighttime BP, adjusting for age, SES and other sociodemographics, cardiovascular risk factors, financial strain and depressive symptoms. Interactions between financial responsibility and single parenthood, household income, and marital/partnered status were tested. RESULTS In age-adjusted analyses, reporting financial responsibility was associated with higher daytime systolic (β = 4.42, S.E. = 1.36, p = 0.0013), and diastolic (β = 2.82, S.E. = 0.98, p = 0.004) BP. Associations persisted in fully adjusted models. Significant associations were also observed for nighttime systolic and diastolic BP. There were no significant interactions with single parenthood, household income, nor marital/partnered status. CONCLUSION Having primary responsibility for one's household may be an important driver of BP in early middle-aged African-American women, independent of SES, financial strain, and across a range of financial contexts. Future studies examining prospective associations are needed, and policy interventions targeting structural factors contributing to financial responsibility in African-American women may be warranted.
Collapse
Affiliation(s)
- Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Rachel Parker
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Christy L Erving
- Department of Sociology, The University of Texas at Austin, Austin, TX, USA
| | - Shivika Udaipuria
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Raphiel J Murden
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Nicole D Fields
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Bianca Booker
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Reneé H Moore
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology and Biostatistics, Drexel University, Dornsife School of Public Health, Philadelphia, PA, USA
| |
Collapse
|
4
|
Adulthood Psychosocial Disadvantages and Risk of Hypertension in U.S. Workers: Effect Modification by Adverse Childhood Experiences. Life (Basel) 2022; 12:life12101507. [PMID: 36294941 PMCID: PMC9604677 DOI: 10.3390/life12101507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/22/2022] [Accepted: 09/24/2022] [Indexed: 11/16/2022] Open
Abstract
Hypertension is a key driver of cardiovascular diseases. However, how stressors contribute to the development of hypertension remains unclear. The objective of this study was to examine prospective associations of adverse childhood experiences (ACEs) and adulthood psychosocial disadvantages (APDs) with incident hypertension. Data were from the Mid-life in the United States (MIDUS) study, a national, population-based, prospective cohort study. ACEs were examined via retrospective reports, and APDs including work stress and social isolation were assessed using survey measures. Incident hypertension was defined based on self-reported physician diagnosis. Baseline data were collected in 1995, with follow-up in 2004-2006 and 2013-2014. Cox proportional hazards regression was applied to assess prospective associations of ACEs and APDs with incident hypertension in 2568 workers free from hypertension at baseline. After adjustment for covariates, baseline APDs were associated with increased incident hypertension (aHR and 95% CI = 1.48 [1.09, 2.01]) during a 20-year follow-up, whereas ACEs showed null associations. Moreover, a moderating effect by ACEs was observed-the effect of APDs on risk of hypertension was stronger when ACEs were present (aHR and 95% CI = 1.83 [1.17, 2.86]). These findings underscore the importance of psychosocial stressors as nontraditional risk factors of cardiometabolic disorders.
Collapse
|
5
|
Truchon M, Gilbert-Ouimet M, Zahiriharsini A, Beaulieu M, Daigle G, Langlois L. Occupational Health and Well-being Questionnaire (OHWQ): an instrument to assess psychosocial risk and protective factors in the workplace. Public Health 2022; 210:48-57. [PMID: 35870321 DOI: 10.1016/j.puhe.2022.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 05/12/2022] [Accepted: 06/13/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Psychosocial stressors at work have been identified as significant risk factors for several mental and physical health problems. These stressors must be compensated by psychosocial resources to prevent or reduce adverse effects on health. Questionnaires measuring these stressors and resources already exist, but none integrate digital stress, ethical culture, and psychosocial safety climate; factors that are increasingly linked to workers' health. This study aims to develop and establish the psychometric properties of one of the most comprehensive instruments measuring the psychosocial work environment to date: the Occupational Health and Well-being Questionnaire (OHWQ). STUDY DESIGN A cross-sectional validation study is proposed to develop the OHWQ and document its psychometric properties. METHODS The OHWQ was developed from validated instruments to which new items were added. The questionnaire includes psychosocial dimensions, along with indicators of psychological distress, musculoskeletal disorders, and well-being. It was administered to a sample of 2770 participants from a population working in the academic field. Exploratory and confirmatory factor analyses and the calculation of Cronbach's α coefficient were used to identify the variables, items, and, dimensions of the OHWQ and to document its main psychometric properties. RESULTS The acceptability of the measurement model was evaluated by the reliability of the items, internal consistency between the items, and the convergent and discriminant validity. Construct validity was assessed using exploratory and confirmatory factor analyses. Using factor analyses and cut-off rules, the new instrument has 124 items grouped into 22 dimensions. The OHWQ demonstrated satisfactory reliability and validity, as well as reasonable fit indices. The internal consistency of the scales was also good (Cronbach's α = 0.68-0.96, median = 0.85). CONCLUSION The OHWQ demonstrated good psychometric properties. It could be useful for both research purposes and for workplaces interested in developing concrete action plans aimed at improving the balance between psychosocial work stressors and resources.
Collapse
Affiliation(s)
- M Truchon
- School of Psychology, Laval University, Quebec City, QC G1V 0A6, Canada; Centre de recherche interdisciplinaire en réadaptation et intégration sociale (CIRRIS), Quebec City, QC G1M 2S8, Canada.
| | - M Gilbert-Ouimet
- Department of Health Sciences, Université du Québec à Rimouski, 1595 Boulevard Alphonse-Desjardins, Lévis, QC G6V 0A6, Canada; CHU de Québec-Laval University Research Center, 1050 Chemin Ste-Foy, Quebec City, QC G1S 4L8, Canada
| | - A Zahiriharsini
- Department of Health Sciences, Université du Québec à Rimouski, 1595 Boulevard Alphonse-Desjardins, Lévis, QC G6V 0A6, Canada; CHU de Québec-Laval University Research Center, 1050 Chemin Ste-Foy, Quebec City, QC G1S 4L8, Canada.
| | - M Beaulieu
- Nursing Faculty, Laval University, Quebec City, QC G1V 0A6, Canada
| | - G Daigle
- Laval University, Quebec City, QC G1V 0A6, Canada
| | - L Langlois
- Laval University, Quebec City, QC G1V 0A6, Canada
| |
Collapse
|
6
|
Spikes T, Murden R, McKinnon II, Bromfield S, Van Dyke ME, Moore RH, Rahbari-Oskoui FF, Quyummi A, Vaccarino V, Lewis TT. Association of Net Worth and Ambulatory Blood Pressure in Early Middle-aged African American Women. JAMA Netw Open 2022; 5:e220331. [PMID: 35201307 PMCID: PMC8874347 DOI: 10.1001/jamanetworkopen.2022.0331] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
IMPORTANCE Low socioeconomic status (SES) in the form of educational level and income has been linked to greater cardiovascular risk across cohorts; however, associations have been inconsistent for African American individuals. Net worth, a measure of overall assets, may be a more relevant metric, especially for African American women, because it captures longer-term financial stability and economic reserve. OBJECTIVE To examine whether net worth is associated with increased ambulatory blood pressure (ABP), a marker of cardiovascular disease (CVD) risk, independent of educational level and income, in young to middle-aged African American women. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional, community-based study conducted in the southeastern US was performed using 48-hour ambulatory BP monitoring. Participants included 384 African American women aged 30 to 46 years without clinical CVD recruited between December 16, 2016, and March 21, 2019; data analysis was performed from September 2020 to December 2021. EXPOSURES Self-reported net worth (total financial assets minus debts), self-reported educational level, and self-reported income. MAIN OUTCOMES AND MEASURES Mean daytime and nighttime BP levels, assessed via 48-hour ABP monitoring and sustained hypertension (ABP daytime and clinic BP ≥130/80 mm Hg). RESULTS The 384 African American women in this study represented a range of SES backgrounds; mean (SD) age was 38.0 (4.3) years. Excluding 66 women who were not receiving antihypertensive medications, in linear regression models adjusted for age, marital status, educational level, family income, and family size, women reporting a negative net worth (debt) had higher levels of daytime (β = 6.7; SE = 1.5; P < .001) and nighttime (β = 6.4; SE = 1.4; P < .001) systolic BP, compared with women reporting a positive net worth. Similar associations were observed with sustained hypertension: women reporting a negative net worth had 150% higher odds (odds ratio, 2.5; 95% CI, 1.3-4.7) of sustained hypertension than those reporting a positive net worth. Associations remained significant after additional adjustments for smoking, body mass index, psychosocial stress due to debt, and depressive symptoms and were similar, although attenuated, when women receiving antihypertensive medications were included and treatment was controlled for in all analyses. CONCLUSIONS AND RELEVANCE In this cross-sectional study, having a negative net worth (ie, debt) was associated with elevated BP in African American women, independent of traditional indicators of SES. This finding suggests that limited assets or a lack of economic reserve may be associated with poor CVD outcomes in this at-risk group.
Collapse
Affiliation(s)
- Telisa Spikes
- School of Nursing, Emory University, Atlanta, Georgia
| | - Raphiel Murden
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Izraelle I. McKinnon
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | | | - Miriam E. Van Dyke
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Renee H. Moore
- Department of Epidemiology and Biostatistics, Drexel University, Dornsife School of Public Health, Philadelphia, Pennsylvania
| | | | - Arshed Quyummi
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Tené T. Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| |
Collapse
|
7
|
Job Strain, Overweight, and Diabetes: A 13-Year Prospective Study Among 12,896 Men and Women in Ontario. Psychosom Med 2021; 83:187-195. [PMID: 33337590 DOI: 10.1097/psy.0000000000000898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The American Diabetes Association recently called for research on social and environmental determinants of diabetes to intensify primary prevention. Recent epidemiological evidence suggests that frequent and modifiable psychosocial stressors at work might contribute to the development of diabetes, but more prospective studies are needed. We evaluated the relationship between job strain and diabetes incidence in 12,896 workers followed up over a 13-year period in Ontario, Canada. We also examined the modifying effect of body mass index in this relationship. METHODS Data from Ontario respondents (35-74 years of age) to the 2000-2001, 2002, and 2003 cycles of the Canadian Community Health Survey were prospectively linked to the Ontario Health Insurance Plan database for physician services and the Canadian Institute for Health Information Discharge Abstract Database for hospital admissions. The sample consisted of actively employed participants with no previous diagnosis for diabetes. Cox proportional hazard regression models were performed to evaluate the relationship between job strain, obesity, and the incidence of diabetes. RESULTS Overall, job strain was not associated with the incidence of diabetes (hazard ratio [HR] = 1.05; 95% confidence interval [CI] = 0.83-1.34). Among women, job strain was associated with an elevated risk of diabetes, although this finding did not reach statistical significance (HR = 1.36; 95% CI = 0.94-1.96). Among men, no association was observed (HR = 0.89; 95% CI = 0.65-1.22). Also, job strain increased the risk of diabetes among women with obesity (HR = 1.88; 95% CI = 1.14-3.08), whereas these stressors reduced the risk among men with obesity (HR = 0.58; 95% CI = 0.36-0.95). CONCLUSIONS The current study suggests that lowering job strain might be an effective strategy for preventing diabetes among women, especially the high-risk group comprising women with obesity.
Collapse
|
8
|
Birk JL, Cornelius T, Edmondson D, Schwartz JE. Duration of Perseverative Thinking as Related to Perceived Stress and Blood Pressure: An Ambulatory Monitoring Study. Psychosom Med 2019; 81:603-611. [PMID: 31274822 PMCID: PMC6713609 DOI: 10.1097/psy.0000000000000727] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Psychological distress may be intensified and prolonged by perseverative thinking (e.g., rumination, worry). The tendency to engage frequently in perseverative thinking has been linked to increased blood pressure (BP). Research is needed to investigate the physiological consequences of time spent perseverating by testing the momentary association between the duration of perseverative thinking and BP. The present study examines the extent to which the duration of perseverative thinking is associated with momentary perceived stress and ambulatory BP elevations during daily life. METHODS Participants (N = 373) drawn from a larger project on BP and cardiovascular health completed 24-hour ambulatory BP monitoring accompanied by ecological momentary assessments of their perseverative thoughts and feelings. Multilevel models tested associations among perseveration duration, momentary perceived stress, and systolic and diastolic BP, adjusting for person-level and momentary covariates. RESULTS Higher within-subject perseveration duration was associated with higher stress (B = 0.29; 95% confidence interval [CI] = 0.24-0.33; p < .001). Although higher perseveration duration was not associated with substantially higher systolic (B = 0.16 mm Hg; 95% CI = 0.00-0.33 mm Hg; p = .056) or diastolic (B = 0.07 mm Hg; 95% CI = -0.05 to 0.19 mm Hg; p = .25) BP, the associations between higher perseveration duration and higher systolic (p = .032) and diastolic (p = .036) BP were significantly mediated by a higher intensity of momentary perceived stress. CONCLUSIONS Findings support the clinically important notion that physiological consequences of perceived stress can be maintained and even heightened by maladaptively prolonged mental activity.
Collapse
Affiliation(s)
- Jeffrey L Birk
- From the Center for Behavioral Cardiovascular Health, Columbia University Medical Center (Birk, Cornelius, Edmondson, Schwartz), New York, New York
| | | | | | | |
Collapse
|
9
|
Job strain and the prevalence of uncontrolled hypertension among white-collar workers. Hypertens Res 2019; 42:1616-1623. [PMID: 31171842 DOI: 10.1038/s41440-019-0278-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 04/04/2019] [Accepted: 04/30/2019] [Indexed: 01/11/2023]
Abstract
To determine whether white-collar workers treated for hypertension who are exposed to psychosocial stressors at work have a higher prevalence of uncontrolled hypertension than unexposed workers, this study conducted three waves of data collection over a 5-year period (repeated cross-sectional design). The study sample was composed of 464 white-collar workers treated for hypertension. At each collection time, ambulatory blood pressure (ABP) was measured every 15 min during the workday. Uncontrolled hypertension was defined as a mean daytime systolic ABP ≥135 mmHg and/or diastolic ABP ≥85 mmHg for non-diabetic participants and systolic ABP ≥125 mmHg and/or diastolic ABP ≥75 mmHg for diabetic participants. Job strain was evaluated with Karasek's demand-latitude model using validated scales for psychological demands and decision latitude. Prevalence ratios (PR) and 95% confidence intervals (CI) were estimated using generalized estimating equations, adjusting for sociodemographic and lifestyle-related risk factors. Men with job strain (high demands and low latitude) and active jobs (high demands and high latitude) had a higher prevalence of uncontrolled hypertension (PR job strain = 1.46, 95% CI: 1.07-1.98 and PR active = 1.47, 95% CI: 1.12-1.94). When considered separately, high demands were associated with a higher prevalence of uncontrolled hypertension in both men (PR highest tertile = 1.60, 95% CI: 1.25-2.06) and women (PR highest tertile = 1.60, 95% CI: 1.03-2.47). Workers exposed to psychosocial stressors at work according to the demand-latitude model had a higher prevalence of uncontrolled hypertension. Reducing these frequent exposures could help to reduce the burden of uncontrolled hypertension.
Collapse
|
10
|
Ambulatory Blood Pressure Reactivity as a Moderator in the Association Between Daily Life Psychosocial Stress and Carotid Artery Atherosclerosis. Psychosom Med 2018; 80:774-782. [PMID: 30020145 PMCID: PMC7523702 DOI: 10.1097/psy.0000000000000627] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We examined whether associations between daily psychosocial stressor exposures and carotid artery intima-medial thickness (IMT) may be stronger among those showing larger stress-related cardiovascular reactivity (CVR) during the course of daily living. METHODS A total of 474 healthy working adults (ages 30-54 years) collected ambulatory blood pressure and recorded their daily experiences, using electronic diaries, during two 2-day periods for a week. Measures of mean momentary task strain and social conflict were used as indices of stressor exposure, and partial regression coefficients linking momentary strain and conflict with ambulatory blood pressure fluctuations were used as measures of CVR. IMT was assessed in the carotid arteries using B-mode ultrasound. RESULTS After covariate adjustment, associations between mean task strain exposure and IMT were significant among those high in CVR to strain (for systolic blood pressure, p = .006, for diastolic blood pressure, p = .011) but not among those low in strain CVR. Similarly, associations involving mean conflict exposure were significant among those high in CVR to social conflict (p < .001 for systolic blood pressure, p = .001 for diastolic blood pressure) but not among low social conflict reactors. Significant moderation effects were more consistently shown for task strain than for social conflict, but the overall pattern of results was robust across two different types of statistical modeling procedures. CONCLUSIONS Individual differences in CVR may moderate the effects of daily psychosocial stress on subclinical CVD among healthy employed adults. Using ecological momentary assessment to measure stress exposure as well as stress reactivity may facilitate our ability to detect these effects.
Collapse
|
11
|
Trudel X, Gilbert-Ouimet M, Milot A, Duchaine CS, Vézina M, Laurin D, Sultan-Taïeb H, Brisson C. Cohort Profile: The PROspective Québec (PROQ) Study on Work and Health. Int J Epidemiol 2018. [PMID: 29534180 DOI: 10.1093/ije/dyy026] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Xavier Trudel
- Department of Social and Preventive Medicine, Laval University, Québec, Canada.,Population Health and Optimal Health Practices Research Unit, CHU de Québec-Université Laval Research Center, Québec, Canada
| | - Mahée Gilbert-Ouimet
- Population Health and Optimal Health Practices Research Unit, CHU de Québec-Université Laval Research Center, Québec, Canada
| | - Alain Milot
- Population Health and Optimal Health Practices Research Unit, CHU de Québec-Université Laval Research Center, Québec, Canada.,Department of Medicine, Laval University, Québec, Canada
| | - Caroline S Duchaine
- Department of Social and Preventive Medicine, Laval University, Québec, Canada.,Population Health and Optimal Health Practices Research Unit, CHU de Québec-Université Laval Research Center, Québec, Canada
| | - Michel Vézina
- National Institute of Public Health of Québec (INSPQ), Québec, Canada
| | - Danielle Laurin
- Population Health and Optimal Health Practices Research Unit, CHU de Québec-Université Laval Research Center, Québec, Canada.,Faculty of Pharmacy, Laval University, Québec, Canada
| | - Hélène Sultan-Taïeb
- Université du Québec à Montréal (UQÀM), School of Management, Montréal, ON, Canada
| | - Chantal Brisson
- Department of Social and Preventive Medicine, Laval University, Québec, Canada.,Population Health and Optimal Health Practices Research Unit, CHU de Québec-Université Laval Research Center, Québec, Canada
| | | | | | | |
Collapse
|
12
|
Siegrist J, Li J. Work Stress and Altered Biomarkers: A Synthesis of Findings Based on the Effort-Reward Imbalance Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1373. [PMID: 29125555 PMCID: PMC5708012 DOI: 10.3390/ijerph14111373] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 10/26/2017] [Accepted: 11/07/2017] [Indexed: 12/20/2022]
Abstract
While epidemiological studies provide statistical evidence on associations of exposures such as stressful work with elevated risks of stress-related disorders (e.g., coronary heart disease or depression), additional information on biological pathways and biomarkers underlying these associations is required. In this contribution, we summarize the current state of the art on research findings linking stressful work, in terms of an established theoretical model-effort-reward imbalance-with a broad range of biomarkers. Based on structured electronic literature search and recent available systematic reviews, our synthesis of findings indicates that associations of work stress with heart rate variability, altered blood lipids, and risk of metabolic syndrome are rather consistent and robust. Significant relationships with blood pressure, heart rate, altered immune function and inflammation, cortisol release, and haemostatic biomarkers were also observed, but due to conflicting findings additional data will be needed to reach a firm conclusion. This narrative review of empirical evidence supports the argument that the biomarkers under study can act as mediators of epidemiologically established associations of work stress, as measured by effort-reward imbalance, with incident stress-related disorders.
Collapse
Affiliation(s)
- Johannes Siegrist
- Life Science Centre, University of Düsseldorf, Merowingerplatz 1a, 40225 Düsseldorf, Germany.
| | - Jian Li
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstrasse 1, 40225 Düsseldorf, Germany.
| |
Collapse
|