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An examination of the long-term impact of job strain on mental health and wellbeing over a 12-year period

DOI:10.1007/s00127-016-1192-9
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Richard Andrew Burns at Australian National University
Richard Andrew Burns
Peter Butterworth
Peter Butterworth
Peter Butterworth
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Kaarin J. Anstey at UNSW Sydney
Kaarin J. Anstey
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Abstract

Objectives: Job strain has been implicated in a range of employee health outcomes including psychiatric health. Much of the literature is drawn from studies that utilise cross-sectional designs, whilst the long-term follow-up of participants is limited. We examine the short and long-term risks of job strain for depression and wellbeing over a 12-year period. In particular, we utilise measures of wellbeing to emphasise the importance of discriminating between indices of subjective and psychological wellbeing that complement measures of mental health. Methods: Participants (n = 2530) were aged between 40 and 44 years at baseline and were drawn from the Personality and Total Health (PATH) Through Life Project. Participants were observed once every 4 years for 12 years. Results: A high strain job was associated with an increased risk of reporting sub-syndromal [RRR = 1.66 (95 % CI 1.23; 2.25), p < 0.001], minor [RRR = 1.92 (95 % CI 1.19; 3.10), p < 0.001] and major depression [RRR = 2.19 (95 % CI 1.30; 3.67), p < 0.001], but strain was not a long-term risk for depression 4 years later. In contrast, strain was a risk for both cross-sectional and longitudinal wellbeing outcomes. Moving into a high strain job was a risk for developing depression [RRR = 1.81 (95 % CI 1.26; 2.59), p < 0.001], but the cumulative exposure to a high strain job was not associated with poorer outcomes in adjusted models. Conclusions: Overall, our results emphasise the importance of current job strain, and the risk of moving into a high strain job, on adverse mental health and wellbeing outcomes. Effects were not consistent between indices of mental health, subjective or psychological wellbeing, supporting the need to dedifferentiate between wellbeing and mental health.
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ORIGINAL PAPER
An examination of the long-term impact of job strain on mental
health and wellbeing over a 12-year period
Richard A. Burns
1
•Peter Butterworth
1,2,3
•Kaarin J. Anstey
1
Received: 3 September 2015 / Accepted: 1 February 2016 / Published online: 13 February 2016
ÓSpringer-Verlag Berlin Heidelberg 2016
Abstract
Objectives Job strain has been implicated in a range of
employee health outcomes including psychiatric health.
Much of the literature is drawn from studies that utilise
cross-sectional designs, whilst the long-term follow-up of
participants is limited. We examine the short and long-term
risks of job strain for depression and wellbeing over a
12-year period. In particular, we utilise measures of well-
being to emphasise the importance of discriminating
between indices of subjective and psychological wellbeing
that complement measures of mental health.
Methods Participants (n=2530) were aged between 40
and 44 years at baseline and were drawn from the Per-
sonality and Total Health (PATH) Through Life Project.
Participants were observed once every 4 years for 12 years.
Results A high strain job was associated with an
increased risk of reporting sub-syndromal [RRR =1.66
(95 % CI 1.23; 2.25), p\0.001], minor [RRR =1.92
(95 % CI 1.19; 3.10), p\0.001] and major depression
[RRR =2.19 (95 % CI 1.30; 3.67), p\0.001], but strain
was not a long-term risk for depression 4 years later. In
contrast, strain was a risk for both cross-sectional and
longitudinal wellbeing outcomes. Moving into a high strain
job was a risk for developing depression [RRR =1.81
(95 % CI 1.26; 2.59), p\0.001], but the cumulative
exposure to a high strain job was not associated with poorer
outcomes in adjusted models.
Conclusions Overall, our results emphasise the impor-
tance of current job strain, and the risk of moving into a
high strain job, on adverse mental health and wellbeing
outcomes. Effects were not consistent between indices of
mental health, subjective or psychological wellbeing, sup-
porting the need to dedifferentiate between wellbeing and
mental health.
Keywords Job strain Mental health Wellbeing
Introduction
Job strain is frequently defined as the balance between
workplace demands and the degree of control or decision
latitude an employee has to execute those work demands
[1]. The job strain literature has focused particularly on
those conditions reflected by high levels of demands and
low levels of control (high strain). Other forms of job strain
include conditions reflected by low levels of demand and
control (passive jobs), low levels of demand with high
control (low strain), or high levels of both demands and
control (active jobs). Job strain can have adverse effects on
individuals, organisations and society. For individuals, job
strain has been implicated in the aetiology of a number of
high burden disease states including cardio-vascular dis-
ease, diabetes, obesity, poor mental health and increased
risk of poor health behaviours (e.g. smoking and physical
inactivity) [1–12]. For organisations, the adverse impact of
job strain is reflected by rates of sickness-related absence
&Richard A. Burns
richard.burns@anu.edu.au
1
Centre for Research on Ageing, Health and Wellbeing,
The Research School of Population Health, The Australian
National University, Building 54, Mills Road, Canberra,
ACT 0200, Australia
2
Centre for Mental Health, Melbourne School of Population
and Global Health, University of Melbourne, Melbourne,
Australia
3
Melbourne Institute of Applied Economic and Social
Research, Faculty of Business and Economics, University of
Melbourne, Melbourne, Australia
123
Soc Psychiatry Psychiatr Epidemiol (2016) 51:725–733
DOI 10.1007/s00127-016-1192-9
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