S Levine’s research while affiliated with Tufts Medical Center and other places

Although evidence suggests that social networks reduce the risk of mortality and are negatively associated with severe mental disability, little is known about their relationship to everyday functioning and health-related quality of life (HRQoL). In addition, the importance of social networks in the presence of chronic stress remains unclear. We examined the association between social networks and aspects of mental functioning (mental health, vitality and role-emotional functioning) and the relationship between social networks and mental functioning in the presence of stressors. Multiple linear and logistic regression models were used to examine data in 47,912 middle-aged and older healthy women. The Medical Outcomes Study Shortform Health Survey measured dimensions of quality of life. We observed strong associations between levels of social networks and multivariate-adjusted quality of life scores, particularly in potentially high stress situations. Compared to the most socially integrated, women who were socially isolated had reductions in mental health and vitality scores of 6.5 and 7.4 points, respectively and a 60% increased risk of limitation in role-emotional functioning. Social networks are positively associated with mental functioning in women. This association is strongest for women reporting high levels of home and work stressors.

This study examined the relationships of job strain and iso-strain psychosocial work-environment exposures to health status in a cohort of working women in the United States. In a cross-sectional survey, 33689 women responded to the Karasek job content and the MOS SF-36 health status questionnaires. The psychosocial work-environment exposures were characterized using the job strain and iso-strain frameworks. Health status was assessed with the following 6 scales: physical functioning, vitality, freedom from pain, mental health, role limitations due to physical health, and role limitations due to emotional health. When compared with active work, high-strain work (high job demands and low job control) was associated with lower vitality, mental health, higher pain, and increased risks of both physical and emotional role limitations. Iso-strain work (high strain and low work-related social support) increased the risks further. Job insecurity was also associated with lower health status. The analyses supported the hypothesis that the psychosocial work environment is an important determinant of health status among working women. The findings suggest that incorporating social conditions at work into the measurement of psychosocial work-environment exposure improves the identification of high-risk work arrangements.

Studies of the health effects of job strain have focused on morbidity and mortality as outcomes. This is the first study to examine the relationship of job strain to more comprehensive health status measures that encompass health-related quality of life. In a national cross-sectional survey, 1319 working men and women, aged 18 through 64 years, completed a modified version of the Job Content Questionnaire that classified workers' jobs into four categories: high strain, passive, low strain, and active. Subjects also completed the Medical Outcomes Study Short-Form Health Survey and a health distress scale. Logistic regression analyses were employed that controlled for age, race/ethnicity, gender, and education. Both work and nonwork variables were included. Job strain was significantly associated with five of nine components of health-related quality of life: physical functioning, role functioning related to physical health, vitality, social functioning, and mental health. Job strain made a modest yet statistically significant contribution beyond the effects of chronic illness and psychosocial variables. The results provide justification for further investigating the role of job strain as an independent risk factor for health-related quality of life.