Sense of coherence and psychiatric morbidity: a 19-year register-based prospective study.

BACKGROUND: Most prospective studies on the relationship between sense of coherence (SOC) and mental health have been conducted using subjective health indicators and short-term follow-ups. The objective of this prospective occupational cohort study was to examine whether a strong sense of coherence is a protective factor against psychiatric disorders over a long period of time. METHODS: The study was conducted in a multinational forest industry corporation with domicile in Finland. Participants were 8029 Finnish industrial employees aged 18-65 at baseline (1986). Questionnaire survey data on SOC and other factors were collected at baseline; records of hospital admissions for psychiatric disorders and suicide attempt were derived from the National Hospital Discharge Register, while records of deaths due to suicide were derived from the National Death Registry up until 2006. RESULTS: During the 19-year follow-up, 406 participants with no prior admissions were admitted to hospital for psychiatric disorders (n=351) or suicide attempt (n=25) or committed a suicide (n=30). A strong SOC was associated with about 40% decreased risk of psychiatric disorder. This association was not accounted for by mental health-related baseline characteristics, such as sex, age, marital status, education, occupational status, work environment, risk behaviours or psychological distress. The result was replicated in a subcohort of participants who did not report an elevated level of psychological distress at baseline (hazard ratio=0.59, 95% CI 0.40 to 0.86). CONCLUSIONS: A strong SOC is associated with reduced risk of psychiatric disorders during a long time period.

Low workplace social capital as a predictor of depression: the Finnish Public Sector Study.

In a prospective cohort study of Finnish public sector employees, the authors examined the association between workplace social capital and depression. Data were obtained from 33,577 employees, who had no recent history of antidepressant treatment and who reported no history of physician-diagnosed depression at baseline in 2000-2002. Their risk of depression was measured with two indicators: recorded purchases of antidepressants until December 31, 2005, and self-reports of new-onset depression diagnosed by a physician in the follow-up survey in 2004-2005. Multilevel logistic regression analysis was used to explore whether self-reported and aggregate-level workplace social capital predicted indicators of depression at follow-up. The odds for antidepressant treatment and physician-diagnosed depression were 20-50% higher for employees with low self-reported social capital than for those reporting high social capital. These associations were not accounted for by sex, age, marital status, socioeconomic position, place of work, smoking, alcohol use, physical activity, and body mass index. The association between social capital and self-reported depression attenuated but remained significant after further adjustment for baseline psychological distress (a proxy for undiagnosed mental health problems). Aggregate-level social capital was not associated with subsequent depression.

Organisational justice and smoking: the Finnish Public Sector Study.

OBJECTIVE: To examine the extent to which the justice of decision-making procedures and interpersonal relationships is associated with smoking. SETTING: 10 municipalities and 21 hospitals in Finland. DESIGN AND PARTICIPANTS: Cross-sectional data derived from the Finnish Public Sector Study were analysed with logistic regression analysis models with generalised estimating equations. Analyses of smoking status were based on data provided by 34,021 employees. Separate models for heavy smoking (> or = 20 cigarettes/day) were calculated for 6295 current smokers. RESULTS: After adjustment for age, education, socioeconomic position, marital status, job contract and negative affectivity, smokers who reported low procedural justice were about 1.4 times more likely to smoke > or = 20 cigarettes/day compared with their counterparts who reported high levels of justice. In a similar way, after adjustments, low levels of justice in interpersonal treatment was significantly associated with an increased prevalence of heavy smoking (OR 1.35, 95% CI 1.03 to 1.77 for men and OR 1.41, 95% CI 1.09 to 1.83 for women). Further adjustment for job strain and effort-reward imbalance had little effect on these results. No associations were observed between justice components and smoking status or ex-smoking. CONCLUSIONS: The extent to which employees are treated with justice in the workplace seems to be associated with smoking intensity independently of established stressors at work.

Psychometric evaluation of a short measure of social capital at work.

BACKGROUND: Prior studies on social capital and health have assessed social capital in residential neighbourhoods and communities, but the question whether the concept should also be applicable in workplaces has been raised. The present study reports on the psychometric properties of an 8-item measure of social capital at work. METHODS: Data were derived from the Finnish Public Sector Study (N = 48,592) collected in 2000-2002. Based on face validity, an expert unfamiliar with the data selected 8 questionnaire items from the available items for a scale of social capital. Reliability analysis included tests of internal consistency, item-total correlations, and within-unit (interrater) agreement by rwg index. The associations with theoretically related and unrelated constructs were examined to assess convergent and divergent validity (construct validity). Criterion-related validity was explored with respect to self-rated health using multilevel logistic regression models. The effects of individual level and work unit level social capital were modelled on self-rated health. RESULTS: The internal consistency of the scale was good (Cronbach's alpha = 0.88). The rwg index was 0.88, which indicates a significant within-unit agreement. The scale was associated with, but not redundant to, conceptually close constructs such as procedural justice, job control, and effort-reward imbalance. Its associations with conceptually more distant concepts, such as trait anxiety and magnitude of change in work, were weaker. In multilevel models, significantly elevated age adjusted odds ratios (ORs) of poor self-rated health (OR = 2.42, 95% confidence interval (CI): 2.24-2.61 for the women and OR = 2.99, 95% CI: 2.56-3.50 for the men) were observed for the employees in the lowest vs. highest quartile of individual level social capital. In addition, low social capital at the work unit level was associated with a higher likelihood of poor self-rated health. CONCLUSION: Psychometric techniques show our 8-item measure of social capital to be a valid tool reflecting the construct and displaying the postulated links with other variables.

Relationship between work stress and body mass index among 45,810 female and male employees.

OBJECTIVE: The proportion of overweight and obese people has grown rapidly, and obesity has now been widely recognized as an important public health problem. At the same time, stress has increased in working life. The 2 problems could be connected if work stress promotes unhealthy eating habits and sedentary behavior and thereby contributes to weight gain. This study explored the association between work stress and body mass index (BMI; kg/m2). METHODS: We used cross-sectional questionnaire data obtained from 45,810 female and male employees participating in the ongoing Finnish Public Sector Cohort Study. We constructed individual-level scores, as well as occupational- and organizational-level aggregated scores for work stress, as indicated by the demand/control model and the effort-reward imbalance model. Linear regression analyses were stratified by sex and socioeconomic status (SES) and adjusted for age, marital status, job contract, smoking, alcohol consumption, physical activity, and negative affectivity. RESULTS: The results with the aggregated scores showed that lower job control, higher job strain, and higher effort-reward imbalance were associated with a higher BMI. In men, lower job demands were also associated with a higher BMI. These associations were not accounted for by SES, although an additional adjustment for SES attenuated the associations. The results obtained with the individual-level scores were in the same direction, but the relationships were weaker than those obtained with the aggregated scores. CONCLUSIONS: This study shows a weak association between work stress and BMI.

Job strain, effort-reward imbalance, and heavy drinking: a study in 40,851 employees.

OBJECTIVE: The objective of this study was to examine the relationship of the job strain model and the effort-reward imbalance model with heavy drinking. METHODS: Questionnaire survey data were obtained from 32,352 women and 8499 men employed in the Finnish public sector (participation 67%). Logistic regression analyses for all employees and for separate subgroups were undertaken by sex, adjusted for age, education, occupational position, marital status, job contract, smoking, and negative affectivity. Different cutoff points of heavy drinking were used for men and women. RESULTS: High job strain and high effort-reward imbalance as global constructs were not associated with heavy drinking. However, some components of these models were associated with heavy drinking but the relationships were not all in the expected direction and they varied by sex, age, and occupational position. CONCLUSIONS: Stressful work conditions are not consistently associated with heavy drinking.