Chronic stress and chronic disease in life and work: Conceptual and methodological issues
TL;DR: The lack of strong prospective evidence linking occupational and social stress to chronic disease stems from the failure of research designs to attend sufficiently to the aetiological chronicity of such diseases as discussed by the authors.
Abstract: This paper argues that the lack of strong prospective evidence linking occupational and social stress to chronic disease stems from the failure of research designs to attend sufficiently to the aetiological chronicity of such diseases. Studies of both supposedly acute stress (life events) and chronic stress in life or work must increasingly be designed to distinguish between stress which is sustained or chronic over a period of yean or even decades, and hence capable of causing a serious chronic disease, and brief or transient stress, which may produce transient or brief psychological or physiological disturbances but cannot generate major chronic disease. Prospective studies are needed which collect measures of both stress and health or disease at multiple points over an extended period of time. Measures of stress should focus more on affect (for example, feelings of pressure and tension) than on cognition (for example feelings of satisfaction). Limited existing evidence is consistent with these...
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TL;DR: Cross-sectional data from two national surveys of adults aged 25 years and over show that age and socioeconomic status (SES) are significant predictors of self-reported physical health and that the relation of age to health varies with SES features.
Abstract: Analysts dispute what roles biomedical, psychosocial, and other factors play in determining the duration of morbidity and disability over the life course. Cross-sectional data from two national surveys of adults aged 25 years and over not only show, however, that age and socioeconomic status (SES) are significant predictors of self-reported physical health; they also demonstrate that the relation of age to health varies with SES features. Longitudinal research is needed to test the finding that enduring functional limitations in terms of time are actually compressed in higher SES groups. To improve well-being in our society, moreover, requires specifying why SES differences occur, and perhaps ultimately reducing socioeconomic inequality itself.
812 citations
TL;DR: In this article, the Allostatic Load model is used as an organizing framework for reviewing the vast literature that has considered health outcomes that are associated with exposure to psychosocial stressors at work.
662 citations
TL;DR: Results suggest that even after adjustment for numerous social background characteristics and baseline health, involuntary job loss is associated with significantly poorer overall self-rated health and more depressive symptoms.
Abstract: Previous research has shown that involuntary job loss may have negative health consequences, but existing analyses have not adequately adjusted for health selection or other confounding factors that could reveal the association to be spurious. Using two large, population-based longitudinal samples of U.S. workers from the Americans’ Changing Lives Study and the Wisconsin Longitudinal Study, this analysis goes further by using respondents’ self-reports of the reasons for job loss and information about the timing of job losses and acute negative health shocks to distinguish health-related job losses from other involuntary job losses. Results suggest that even after adjustment for numerous social background characteristics and baseline health, involuntary job loss is associated with significantly poorer overall self-rated health and more depressive symptoms. More nuanced analyses reveal that among involuntary job losers, those who lose their jobs for health-related reasons have, not surprisingly, the most precipitous declines in health. Job losses for other reasons have substantive and statistically significant effects on depressive symptoms, while effects on self-rated poor health are relatively small.
297 citations
TL;DR: Education, being determined early in life and influencing psychosocial mechanisms throughout life, may have a greater impact on prevention of activity and functional disorders.
Abstract: Background Although a robust association between socioeconomic status and health has been shown in past research, the processes that explain the connection are not well understood. This paper seeks to advance such understanding in two ways, first by attending to the distinction between onset of a functional health problem and its progression, and second by addressing whether and how education and income relate differently to the onset versus progression of functional health problems. Methods Data come from the Americans' Changing Lives survey (n = 3617). The baseline was conducted in 1986 and outcome status measured in 1994. Activity limitations are categorized into none, mild, moderate, severe. Onset is defined as having no limitation at origin and a limitation at outcome. Progression is defined as limitation of a particular severity at origin and improving, staying the same, or getting worse with respect to the severity. Multinomial regressions determine transition probabilities related to onset and progression. Results Those with higher income and education are less likely to experience an onset. Only income associates with progression. Those with the highest income are most likely to improve and least likely to get worse in comparison to those with the lowest income. Conclusions Education, being determined early in life and influencing psychosocial mechanisms throughout life, may have a greater impact on prevention of activity and functional disorders. Income's role may be both as a prevention factor and as a mechanism for management of health problems.
160 citations
TL;DR: A framework by which positive psychological states may influence physical health is presented and methodological issues associated with this relatively new area of inquiry are discussed.
158 citations
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TL;DR: This report defines a method which achieves etiologic significance as a necessary but not sufficient cause of illness and accounts in part for the time of onset of disease and provides a quantitative basis for new epidemiological studies of diseases.
10,629 citations
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01 Jan 1956
TL;DR: In this paper, the discovery of stress, the dissection of stress the disease of adaptation sketch for a unified theory implications and applications is described, and the authors propose a unified framework for adaptation.
Abstract: The discovery of stress the dissection of stress the disease of adaptation sketch for a unified theory implications and applications.
5,551 citations
TL;DR: The findings show that people who lacked social and community ties were more likely to die in the follow-up period than those with more extensive contacts.
Abstract: The relationship between social and community ties and mortality was assessed using the 1965 Human Population Laboratory survey of a random sample of 6928 adults in Alameda County, California and a subsequent nine-year mortality follow-up. The findings show that people who lacked social and community ties were more likely to die in the follow-up period than those with more extensive contacts. The age-adjusted relative risks for those most isolated when compared to those with the most social contacts were 2.3 for men and 2.8 for women. The association between social ties and mortality was found to be independent of self-reported physical health status at the time of the 1965 survey, year of death, socioeconomic status, and health practices such as smoking, alcoholic beverage consumption, obesity, physical activity, and utilization of preventive health services as well as a cumulative index of health practices.
4,882 citations
TL;DR: The association between specific job characteristics and subsequent cardiovascular disease was tested using a large random sample of the male working Swedish population and the prospective development of coronary heart disease symptoms and signs was analyzed using a multivariate logistic regression technique.
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.
1,506 citations
TL;DR: Men reporting a higher levels of social relationships and activities in 1967-1969 were significantly less likely to die during the follow-up period and trends for women were similar, but generally nonsignificant once age and other risk factors were controlled.
Abstract: The prospective association of social relationships and activities reported during a round of interviews and medical examinations in 1967-1969 with mortality over the succeeding nine to 12 years was examined for a cohort of 2754 adult (aged 35-69 years as of 1967-1969) men and women in the Tecumseh Community Health Study. After adjustments for age and a variety of risk factors for mortality, men reporting a higher levels of social relationships and activities in 1967-1969 were significantly less likely to die during the follow-up period. Trends for women were similar, but generally nonsignificant once age and other risk factors were controlled. These results were invariant across age, occupational, and health status groups. No association was observed between mortality and satisfaction with social relationships or activities. How and why social relationships and activities predict mortality are discussed and identified as important foci for future research.
1,380 citations