Dual source support and control at work in relation to poor health

Abstract

Background and aim: Social support and decision authority in relation to health has been examined in extensive research. However, research on the role of different constellations of support sources is conspicuously lacking. The aim of the present study is to describe the health of employees in eight contrasting situations that differ with regard to support from superiors and from workmates and with regard to decision authority. Men and women were studied separately. Study sample and methods: A large sample of Swedish employees (n=53,371, after exclusion of supervisors) who participated in a national work environment survey was utilized. In addition prospective long-term sick leave data (60 days or more during the 12 months after questionnaire completion) were collected from the national insurance register. Results: Employees who reported below median decision authority had higher prevalence of pains after work and general physical symptoms as well as a higher incidence of long-term sick leave than those with higher decision authority in all subgroups. Those with good support from both workmates and superiors had lower symptom prevalence and long-term sick leave incidence than those with poor support. The groups with either poor support from superiors or from workmates were in an intermediate category with regard to symptom prevalence. The group with good support from superiors but weak support from workmates, however, had as high long-term sick leave incidence as the group with poor support from both superiors and workmates. The patterns were similar for men and women. Conclusion: Long-term sick leave was related mainly to poor support from workmates. Prevalence of symptoms, on the other hand, was related to both sources of support and absence of both sources was associated with particularly high prevalence of physical symptoms. This illustrates that it is meaningful to separate the social support sources.

Keywords

Decision authority gender pain physical symptoms social support sick leave

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References

House JS , Well JA Occupational stress, social support and health. In: McLean A, Black G, Colligan M, editors. Reducing occupational stress: Proceedings of a conference. Washington, DC: US Department of Health, Education and Welfare; 1978.

La Rocco JM , Hoouse JS , French JRP Social support, occupational stress and health. J Health Soc Behav 1980;21:202.

Johnson J. , Hall EM Job strain, workplace social support, and cardiovascular disease: A cross-sectional study of a random sample of the Swedish working population. Am J Public Health 1988;78:1336—42.

Johnson J. Collective control: Strategies for survival in the workplace. Int J Health Serv 1989;19:469—80.

Karasek R. , Theorell T. Healthy work: Stress, productivity, and the reconstruction of working life . New York: Basic Books; 1990.

Viswesvaran C. , Sanchez J. , Fisher J. The role of social support in the process of work stress: A meta-analysis. J Vocat Behav 1999;54:314—34.

Elfering A. , Semmer NK , Schade V. , Grund S. , Boos N. Supportive colleague, unsupportive supervisor: The role of provider-specific constellations of social support at work in the development of low back pain. J Occup Health Psych 2002;7:130—40.

Gardell B. Work participation and autonomy: A multilevel approach to democracy at the workplace. Int J Health Serv 1982;12:527—58.

Theorell T. , Oxenstierna G. , Westerlund H. , Ferrie J. , Hagberg J. , Alfredsson L. Downsizing of staff is associated with lowered medically certified sick leave in female employees. Occup Environ Med 2003;60:E9.

10.

Kristensen TS , Bjorner JB , Christensen KB , Borg V. How to measure quantitative demands at work? Results from a national Danish study (submitted).

11.

Belkic KL , Landsbergis PA , Schnall PL , Baker D.

Is job strain a major source of cardiovascular disease risk?

Scand J Work Environ Health 2004;30:85—128.

12.

De Lange AH , Taris TW , Kompier MA , Houtman IL , Bongers PM ``The very best of the millennium'': Longitudinal research and the demand—control— (support) model. J Occup Health Psychol 2003 Oct;8: 282—305.

13.

North FM , Syme SL , Feeney A. , Shipley M. , Marmot M. Psychosocial work environment and sickness absence among British civil servants: The Whitehall II study. Am J Public Health 1996;86:332—40.

14.

Arbetsmiljön 1999 [The work Environment 1999.]. Statistiska meddelanden AM 68 SM 0001 . Stockholm: Arbetarskyddsstyrelsen, Statistics Sweden ; 2001.

15.

Svar, bortfall och representativitet i Arbetsmiljöundersökningen 1999. [Answers, drop-out and representativity in the Work Environment Survey 1999.] Bakgrudsfakta till Arbetsmarknads- och Utbildningsstatistiken, 2001 :6. Stockholm : Statistics Sweden; 2001.

16.

Norusis MJ SPSS 11.0: Guide to data analysis. London: Prentice Hall; 2002.

17.

Vahtera J. , Kivimaki M. , Pentti J. , Theorell T. Effect of change in the psychosocial work environment on sickness absence: A seven year follow up of initially healthy employees. J Epidemiol Community Health 2000 ;54:484—93.

18.

Radcliffe-Brown A. On social structure. J Roy Anthropol Soc Great Britain and Ireland 1940;70:1—2.

19.

Simmel G. The web of group affiliations. In: Simmel G , editor. Conflicts and the web of group affiliations (R. Bendix, trans.). New York: Free Press; 1955. pp 125—95.