Mikael Rostila1. 1. Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institute, Stockholm, Sweden. mikael.rostila@chess.su.se
Abstract
BACKGROUND: The economic recession in Sweden in the 1990s influenced several aspects of the labour market, including the psychosocial work environment. This study examined psychosocial working conditions in relation to self-reported ill-health in the 1990s by means of the job strain model. METHODS: The study was based on two representative cross-sectional samples of Swedish employed men and women in 1991 (n=3,292) and 2000 (n=3,010), together with a panel of employees who were included for both years (n=1,953). The main outcome measures were psychological distress and self-rated poor health. The primary method used was logistic regression. RESULTS: The results suggested that although adverse psychosocial conditions increased during the 1990s, the association with health weakened. However, further analyses showed that poor health increased in most groups with various types of psychosocial conditions, and that reduced relative differences in poor health were discernible. Finally, a longitudinal analysis showed that long-term exposure to and experience of deteriorating psychosocial conditions was most detrimental for health at the end of the 1990s, once health status at baseline had been adjusted for. CONCLUSIONS: The increased prevalence of health problems among most groups with various psychosocial conditions during the 1990s, together with reduced relative differences in poor health, might make it more difficult for employers and policy-makers to direct health policies towards specific groups of employees, as the "healthy'' job seems to have disappeared. Another important inference of the results is that psychosocial working conditions seem to be causally related to health.
BACKGROUND: The economic recession in Sweden in the 1990s influenced several aspects of the labour market, including the psychosocial work environment. This study examined psychosocial working conditions in relation to self-reported ill-health in the 1990s by means of the job strain model. METHODS: The study was based on two representative cross-sectional samples of Swedish employed men and women in 1991 (n=3,292) and 2000 (n=3,010), together with a panel of employees who were included for both years (n=1,953). The main outcome measures were psychological distress and self-rated poor health. The primary method used was logistic regression. RESULTS: The results suggested that although adverse psychosocial conditions increased during the 1990s, the association with health weakened. However, further analyses showed that poor health increased in most groups with various types of psychosocial conditions, and that reduced relative differences in poor health were discernible. Finally, a longitudinal analysis showed that long-term exposure to and experience of deteriorating psychosocial conditions was most detrimental for health at the end of the 1990s, once health status at baseline had been adjusted for. CONCLUSIONS: The increased prevalence of health problems among most groups with various psychosocial conditions during the 1990s, together with reduced relative differences in poor health, might make it more difficult for employers and policy-makers to direct health policies towards specific groups of employees, as the "healthy'' job seems to have disappeared. Another important inference of the results is that psychosocial working conditions seem to be causally related to health.