RESEARCH REPORTS

Examining the relationships between job control and health status: a path analysis approach

P M Smith^1,2, J W Frank^1,3,4, C A Mustard^1,3, S J Bondy^3,5

¹ Institute for Work & Health, Toronto, Canada
² Institute for Medical Science, University of Toronto, Toronto, Canada
³ Department of Public Health Sciences, University of Toronto, Toronto, Canada
⁴ Canadian Institutes for Health Research, Institute of Population and Public Health, Toronto, Canada
⁵ Institute for Clinical Evaluative Sciences, Toronto, Canada

Correspondence to:
Peter Smith, Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON, Canada M5G 2E9; psmith{at}iwh.on.ca

Objective: To examine the pathways through which job control affects health status; to examine if the effects of job control on health status are attenuated by including other measures associated with lower socioeconomic status, and to examine if the relationship between job control and health status is consistent across socioeconomic status groups.

Design: A prospective observational cohort study over eight years (1994–2002).

Participants: 4886 Respondents aged 25–60 years, who were non-self-employed labour force participants, working more than 20 hours per week, without physical or mental limitations restricting the type or amount of work they could do at baseline. After longitudinal attrition, the remaining study sample was 3411 (87% of the original study sample who did not die or become pregnant during the survey period).

Main results: Low job control in 1994 was associated with worse than expected self-rated health in 2002, both directly and indirectly via a lower physical activity level in 1996. Adjustment for other factors associated with low socioeconomic status did not attenuate these relationships to a large extent. No differences were found in the effects of job control on physical activity or health status between socioeconomic groups (high and low education and high and low household income).

Conclusions: The inclusion of other factors associated with lower socioeconomic status did not attenuate the direct and indirect effects of job control on health status. The finding that low job control is associated with lower physical activity levels deserves further investigation, given the increasing concern about rising levels of obesity in the developed world.

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