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      The Association between Education and Work Stress: Does the Policy Context Matter?

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          Abstract

          Objectives

          Several studies report socioeconomic differences in work stress, where people in lower socioeconomic positions (SEP) are more likely to experience this burden. In the current study, we analyse associations between education and work stress in a large sample of workers from 16 European countries. In addition we explore whether distinct national labour market policies are related to smaller inequalities in work stress according to educational attainment.

          Methods

          We use data collected in 2010/11 in two comparative studies (‘Survey of Health, Ageing and Retirement in Europe’ and the ‘English Longitudinal Study of Ageing’; N = 13695), with samples of men and women aged 50 to 64 from 16 European countries. We measure highest educational degree according to the international standard classification of education (ISCED) and assess work stress in terms of the demand-control and the effort-reward imbalance model. National labour market policies are measured on the basis of policy indicators which are divided into (1) ‘protective’ policies offering financial compensation to those excluded from the labour market (e.g. replacement rate), and (2) ‘integrative’ policies supporting disadvantaged individuals on the labour market (e.g. investments into active labour market policies or possibilities for further qualification in later life). In addition to country-specific analyses, we estimate multilevel models and test for interactions between the indicators of national policies and individual education.

          Results

          Main findings demonstrate consistent associations between lower education and higher levels of work stress in all countries. The strength of this association, however, varies across countries and is comparatively small in countries offering pronounced ‘integrative’ policies, in terms of high investments into measures of an active labor market policy and high participation rates in lifelong learning activities.

          Conclusions

          Our results point to different types of policies that may help to reduce educational differences in work stress, in particular policies supporting those who are disadvantaged on the labour market.

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          Most cited references17

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          Data Resource Profile: the Survey of Health, Ageing and Retirement in Europe (SHARE).

          SHARE is a unique panel database of micro data on health, socio-economic status and social and family networks covering most of the European Union and Israel. To date, SHARE has collected three panel waves (2004, 2006, 2010) of current living circumstances and retrospective life histories (2008, SHARELIFE); 6 additional waves are planned until 2024. The more than 150 000 interviews give a broad picture of life after the age of 50 years, measuring physical and mental health, economic and non-economic activities, income and wealth, transfers of time and money within and outside the family as well as life satisfaction and well-being. The data are available to the scientific community free of charge at www.share-project.org after registration. SHARE is harmonized with the US Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA) and has become a role model for several ageing surveys worldwide. SHARE's scientific power is based on its panel design that grasps the dynamic character of the ageing process, its multidisciplinary approach that delivers the full picture of individual and societal ageing, and its cross-nationally ex-ante harmonized design that permits international comparisons of health, economic and social outcomes in Europe and the USA.
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            Adverse health effects of high-effort/low-reward conditions.

            J Siegrist (1996)
            In addition to the person-environment fit model (J. R. French, R. D. Caplan, & R. V. Harrison, 1982) and the demand-control model (R. A. Karasek & T. Theorell, 1990), a third theoretical concept is proposed to assess adverse health effects of stressful experience at work: the effort-reward imbalance model. The focus of this model is on reciprocity of exchange in occupational life where high-cost/low-gain conditions are considered particularly stressful. Variables measuring low reward in terms of low status control (e.g., lack of promotion prospects, job insecurity) in association with high extrinsic (e.g., work pressure) or intrinsic (personal coping pattern, e.g., high need for control) effort independently predict new cardiovascular events in a prospective study on blue-collar men. Furthermore, these variables partly explain prevalence of cardiovascular risk factors (hypertension, atherogenic lipids) in 2 independent studies. Studying adverse health effects of high-effort/low-reward conditions seems well justified, especially in view of recent developments of the labor market.
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              Psychosocial work environment and stress-related disorders, a systematic review.

              Knowledge on the impact of the psychosocial work environment on the occurrence of stress-related disorders (SRDs) can assist occupational physicians in the assessment of the work-relatedness of these disorders. To systematically review the contribution of work-related psychosocial risk factors to SRDs. A systematic review of the literature was carried out by searching Medline, PsycINFO and Embase for studies published up until October 2008. Studies eligible for inclusion were prospective cohort studies or patient-control studies of workers at risk for SRDs. Studies were included in the review when data on the association between exposure to psychosocial work factors and the occurrence of SRDs were presented. Where possible, meta-analysis was conducted to obtain summary odds ratios of the association. The strength of the evidence was assessed using four levels of evidence. From the 2426 studies identified, seven prospective studies were included in this review. Strong evidence was found that high job demands, low job control, low co-worker support, low supervisor support, low procedural justice, low relational justice and a high effort-reward imbalance predicted the incidence of SRDs. This systematic review points to the potential of preventing SRDs by improving the psychosocial work environment. However, more prospective studies are needed on the remaining factors, exposure assessment and the relative contributions of single factors, in order to enable consistent assessment of the work-relatedness of SRDs by occupational physicians.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                26 March 2015
                2015
                : 10
                : 3
                : e0121573
                Affiliations
                [1 ]Centre for Health and Society, Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
                [2 ]Senior Professorship on Work Stress Research, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
                Indiana University, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Analyzed the data: TL MW. Wrote the paper: TL JS ND MW.

                Article
                PONE-D-14-20639
                10.1371/journal.pone.0121573
                4374794
                25812142
                e1ff7226-2430-41a6-8f54-c9274141fe5b
                Copyright @ 2015

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                History
                : 14 May 2014
                : 18 February 2015
                Page count
                Figures: 4, Tables: 4, Pages: 17
                Funding
                This research was funded as part of the DRIVERS project by the European Community (FP7 2007-2013; grant agreement no 278350 ( www.health-gradient.eu). Additional grant support was provided by the Hans-Boeckler-Foundation ( http://www.boeckler.de), Duesseldorf, Germany (project number: S-2009-311-4). MW was additionally supported by a post-doc fellowship from the German Research Foundation (Deutsche Forschungsgemeinschaft, project number: WA 3065/1-1). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Custom metadata
                Data are available from the UK Data Service (ELSA) and from the SHARE Research Data Center for researchers who meet the criteria for access to confidential data.

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