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J Epidemiol Community Health 57:849-854 doi:10.1136/jech.57.11.849
  • Evidence based public health policy and practice

Work and health in a contemporary society: demands, control, and insecurity

  1. R M D’Souza1,
  2. L Strazdins1,
  3. L L-Y Lim1,
  4. D H Broom1,
  5. B Rodgers2
  1. 1National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
  2. 2Centre for Mental Health Research, Australian National University
  1. Correspondence to:
 Dr R M D’Souza, National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT 0200, Australia; 
 rennie.dsouzaanu.edu.au
  • Accepted 13 April 2003

Abstract

Objective: To examine independent associations of job strain (high demands and low control) and job insecurity with mental and physical health outcomes.

Design: Cross sectional general population study conducted in 2000 using a self completed questionnaire.

Setting: Two adjoining cities in south east Australia.

Subjects: 1188 employed professionals, aged 40–44 years, 55% (n = 655) male.

Main outcome measures: Depression, anxiety, physical, and self rated health (SRH).

Results: Adverse job conditions were relatively prevalent as 23% of the sample reported high job strain, while 7.3% and 23% reported high and moderate job insecurity respectively. Associations between job conditions and health persisted after adjustment for gender, education, marital status, employment status, major life events, and negative affectivity (personality). When adjusted for job strain, high job insecurity was independently associated with a greater than threefold increase in odds for poor SRH, depression and anxiety (OR (95% confidence intervals) poor SRH: 3.72 (1.97 to 7.04) depression: 3.49 (1.90 to 6.41), anxiety: 3.29 (1.71 to 6.33)), and a twofold increase for physical health 2.19 (1.21 to 3.95). High job strain also showed significant independent associations with depression: 2.54 (1.34 to.4.75) and anxiety: 3.15 (1.48 to 6.70).

Conclusion: In this relatively privileged socioeconomic group, insecure employment and high job strain showed independent, consistent, and strong associations with physical and mental health. These adverse job conditions are on the increase, particularly insecure employment, and the influence of these two work conditions are an important focus for future public health research and their prevalence and impact should be examined in other occupations.

Footnotes

  • * Australian electoral rolls provide virtually complete lists of voting age adults, excepting those of unsound mind, serving a prison sentence of five years or more, or convicted of treason or treachery

  • Funding: funding for this study was provided by a unit grant (no 973302) and new program grant (no 179805) from the National Health and Medical Research Council, and additional support from the Australian Rotary Health Research Fund and the Australian Brewers’ Foundation Medical Research Grant Scheme.