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Organisational justice and change in justice as predictors of employee health: the Whitehall II study
  1. Mika Kivimäki1,
  2. Jane E Ferrie2,
  3. Jenny Head2,
  4. Martin J Shipley2,
  5. Jussi Vahtera1,
  6. Michael G Marmot2
  1. 1Finnish Institute of Occupational Health and University of Helsinki, Finland
  2. 2International Centre for Health and Society, Department of Epidemiology and Public Health, University College London Medical School, UK
  1. Correspondence to:
 Professor M Kivimaki
 Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, FIN-00250 Helsinki, Finland;


Objective: Organisational justice has been proposed as a new way to examine the impact of psychosocial work environment on employee health. This article studied the justice of interpersonal treatment by supervisors (the relational component of organisational justice) as a predictor of health.

Design: Prospective cohort study. Phase 1 (1985–88) measured relational justice, job demands, job control, social support at work, effort-reward imbalance, and self rated health. Relational justice was assessed again at phase 2 (1989–90) and self rated health at phase 2 and phase 3 (1991–93).

Setting: 20 civil service departments originally located in London.

Participants: 10 308 civil servants (6895 men, 3413 women) aged 35–55.

Outcome measure: Self rated health.

Main results: Men exposed to low justice at phase 1 or adverse change in justice between phase 1 and phase 2 were at higher risk of poor health at phase 2 and phase 3. A favourable change in justice was associated with reduced risk. Adjustment for other stress indicators had little effect on results. In women, low justice at phase 1 predicted poor health at phase 2 and phase 3 before but not after adjustment for other stress indicators. Adverse change in justice was associated with worse health prospects irrespective of adjustments.

Conclusions: The extent to which people are treated with justice in workplaces seems to predict their health independently of established stressors at work. Evidence on reduced health risk after favourable change in organisational justice implies a promising area for health interventions at workplace.

  • organisational justice
  • job control
  • job demands
  • social support at work
  • effort-reward imbalance
  • psychosocial factors
  • occupational stress
  • self rated health

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  • Funding: the Whitehall II study has been supported by grants from the Medical Research Council; British Heart Foundation; Health and Safety Executive; Department of Health; National Heart Lung and Blood Institute (HL36310), US, NIH: National Institute on Aging (AG13196), US, NIH; Agency for Health Care Policy Research (HS06516); and the John D and Catherine T MacArthur Foundation Research Networks on Successful Midlife Development and Socio-economic Status and Health. MK, also working at the University of Helsinki, Finland, and JV were supported by the Academy of Finland (projects 77560, 104891, and 105195) and the Finnish Environment Fund, JEF is supported by the MRC (Grant number 47413), MJS by a grant from the British Heart Foundation, and MGM by an MRC Research Professorship.

  • Conflicts of interest: none declared.

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