Chapter 6-Health and the Psychosocial Environment at Work.docx

Chapter 6 – Health and the Psychosocial Environment at Work INTRODUCTION  It is likely that work makes a greater contribution to disease and ill health not thought of as occupational  Diseases have been related to psychological conditions in the workplace, most notably coronary heart disease, musculoskeletal disorders and mental illness C HANGES IN THE D ISTRIBUTION OF CORONARY H EART D ISEASE  There have been 2 major changes in the epidemiology of CHD over recent years: o 1. A changing social class distribution of the disease o 2. A rise and fall in CHD in different countries  CHD became a mess disease, it rose first in higher socio-economic groups and, subsequently in lower- higher rates as the social hierarchy is descended  Recently, the decline in CHD morality is mostly in higher socio-economic groups- which widens the social gap  Theory is that CHD is related to job stress EXPLANATIONS OF THE SOCIAL D ISTRIBUTION OF C ORONARY H EART D ISEASE  Risk factors for CHD include high levels of blood pressure, raised plasma cholesterol and smoking  Also need to examine social and economic organizations in society like the work place The Changing Nature of Work  Work plays an important role for health and well being in adult life  A job is a prerequisite for income and employment determines SES (socio-economic status)  Occupation is also important for socialization  It provides opportunities for personal growth and development and participation in social networks beyond primary groups  Work can be physically, mentally and emotionally demanding  The nature of work has changed in that jobs in mass production are decreasing and employment in the service sector is rising  Computer based information processing is a part of many jobs now  Changes of type of work means changes in the labour market- women and older people comprise a growing proportion of the work force and flexibility of work has increased Social Inequalities in the Quality of Work and Health  The benefits and costs of working life are unequally distributed across society and for the health burden of working life  Midlife is the time when social differences in morality are most pronounced THEORETICAL M ODELS OF PSYCHOSOCIAL W ORK E NVIRONMENT WITH R ELEVANCE TO H EALTH General Theoretical Background  2 models of psychosocial work related stress: (1) demand control model (2) effort reward imbalance model  A psychosocial work environment is defined by the interaction between a person’s cognitions, emotions and behaviours, and the material and social work context  Psychosocial environment is defined as the socio-structural range of opportunities that is available to an individual person to meet his or her needs of well being, productivity and positive self- experience  2 aspects of positive self experience for well being and health is self efficacy and self esteem  Self efficacy: the belief a person has in his ability to accomplish tasks. This belief is based on a favourable evaluation of one’s competence and of expected outcomes  A psychosocial environment that that offers options of experiencing self efficacy produces favourable effects on health and well being  Self esteem strengthens feelings of belonging, approval and success and a psychosocial environment that prevents a person form experiencing this results in frustration The Demand-Control Model  Contains 2 dimensions, a high level of psychological demand combined with a low level of decision latitude is predicted to increase the risk of stressful experience and physical illness (in particular CHD)  If a situation is uncontrollable it is likely to induce negative expectancy in the process of coping with the demands- therefore high demands and low control (job strain) = CHD  The original demand control concept was modified to include social support at work as a third dimension and assess work control in a life course perspective – ‘total job control exposure’  In summary: job profiles defined by high quantitative demands in combination with low control over task performance limit the experience of self efficacy among workers and elicit stressful experience with adverse long term consequences on health, these effects are enhanced is social support in the workplace is lacking. The Effort-Reward Imbalance Model  Builds on the notion of social reciprocity: mutual co-operative investments based on the norm of return expectancy. Where efforts are assumed to be equalized by respective rewards  Failed reciprocity, resulting from a violation of this norm, elicits strong negative emotions and sustained stress responses because it operates against this fundamental principle  The model of effort- reward imbalance is based on the assumption that efforts spent at work are not reciprocated by equitable rewards under specific conditions- rewards include money, esteem, job security  An imbalance of costs and gains results from the fact that social exchange between employee