Behaviour, Depression, Heart, General, Mental Health | May 31, 2016 | Author: The Super Pharmacist
Life expectancy varies considerably from country to country. In Australia, for example, people live 36 years longer on average than they do in Rwanda.1
This may be expected given differences in access to medicine, legal stability, violent conflict, and sanitation between countries. However, life expectancy can vary greatly within the same country for different lifestyle conditions. Depending on where someone lives in the United States, their racial background, their socioeconomic status, life expectancy can differ by over three decades.2
Over the last two decades, this life expectancy gap is growing among Western nations.3,4 New research is emerging that sheds light on the cause of this life expectancy gap, namely workplace stress.5 In fact, between 10 and 38% of the difference in life expectancy across various groups may be directly related to different job conditions.
Researchers identified seven new job conditions—all inherently stressful—that directly contributed to reduced life expectancy
Obviously, socioeconomic status complicates this analysis.
We have known for a long time that socioeconomic status affects longevity (i.e. people in lower socioeconomic level do not live as long as those at a higher level). Indeed, life expectancy was considerably worse among people with 12 or fewer years of education compared to those of 17 or more years of education.5 However, even people at higher educational and income levels (who generally live longer because of their socioeconomic status) have decreased life expectancy when their job demands are high and they have little control over their jobs. As much as 10% of early mortality was due to a stressful workplace while as little as 12% was due to educational attainment. In other words, stress at work appears to be an independent risk factor for a shorter life.
Chronic job stress is defined as -
This is becming as a substantial and growing problem.
Over the short term, job stress may lead to increased alcohol consumption, elevated blood pressure, and depressive symptoms.
Chronic job stress may cause or contribute to alcoholism, hypertension, and major depression.6
In the face of a severe stressor, virtually everyone will develop at least a transient post-traumatic stress reaction.7 These may resolve or they may result in a prolonged condition called post-traumatic stress disorder or PTSD.8,9
Workplace PTSD can occur in virtually any work environment, but is more likely among some professions including healthcare professionals, journalists, soldiers, sailors, emergency medical workers, police officers, fighter fires (i.e. first responders).7
Employees who have encountered armed robbery, violence, or disasters within the workplace a much more likely develop workplace PTSD than those who have not been exposed to the stressors.
Work-related stressors have been linked to the development of ischemic heart disease, such as unstable angina and heart attack. Specifically, jobs with high psychological demands and a lack of social support heavily influence the development of ischemic heart disease.10,11,12
Job strain and lack of job control are independently associated with insomnia which has it own array of health complications.13,14
Psychological job stress increases the risk of developing or worsening depression.14
Moreover, lack of decision-making ability, job strain, and workplace bullying, significantly increase the risk of depressive symptoms and major depressive disorder.15
A review of 16 studies including 63,000 employees identified job stress as a significant factor in developing major depressive disorder, more than doubling a person’s inherent risk of developing the condition.16
People with depression live shorter lives.17 This could be related to increased risk of cardiac disease and related health problems. While it is more difficult to discuss, there is direct evidence to show that workplace stress and depression are directly tied to increased suicide rates among affected employees.18 Higher rates of suicide can certainly explain at least part of reduced average life expectancy.
Unemployment and the fear of losing one’s job is a severe stressor. These factors account for up to 6% of reduced life expectancy among working age individuals.5 In a study population of nearly 8,000, researchers found a significant association with high rates of unemployment and later life disability. Likewise, unemployment was associated with lower life expectancy.19 Importantly, these results still held after accounting for age, sex, race/ethnicity, education, health status at baseline and throughout work life, and social support.
While it is impossible to eliminate workplace stress or all episodes of workplace violence, the work environment can be made safer. Some managers are taking these risks to employees seriously and implementing new programs to reduce workplace stressors.20 Some data suggest these efforts are at least partially helpful.21,22
More than a dozen workplace suicide prevention programs have been developed for various high risk professions.23
Importantly, those affected by workplace stress can and should receive timely treatment.
While heart disease, insomnia, and major depressive disorder can be treated directly, employees at risk for workplace stress disorders can receive pre-emptive or preventative support to reduce their reactions to workplace stress.
Groundbreaking work is being done on vulnerability and resiliency.24 While the field is relatively new, some interventions can be used to decrease the former and bolster the latter.25,26,27 In this way, people who are predisposed to workplace stress or who work in particularly stressful fields can be “stress inoculated” to become more resilient in the face of future workplace stressors.
1 World Health Organization. The World Health Report 2004. 2004; http://www.who.int/whr/2004/en/report04_en.pdf.
2 Murray CJL, Kulkarni SC, Michaud C, et al. Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States. PLoS Med. 2006;3(9):e260. doi:10.1371/journal.pmed.0030260
3 Olshansky SJ, Antonucci T, Berkman L, et al. Differences in life expectancy due to race and educational differences are widening, and many may not catch up. Health Aff (Millwood). Aug 2012;31(8):1803-1813. doi:10.1377/hlthaff.2011.0746
4 Beard JR, Officer A, de Carvalho IA, et al. The World report on ageing and health: a policy framework for healthy ageing. Lancet. Oct 28 2015. doi:10.1016/s0140-6736(15)00516-4
5 Goh J, Pfeffer J, Zenios S. Exposure To Harmful Workplace Practices Could Account For Inequality In Life Spans Across Different Demographic Groups. Health Affairs. October 1, 2015 2015;34(10):1761-1768. doi:10.1377/hlthaff.2015.0022
6 Nakao M. Work-related stress and psychosomatic medicine. Biopsychosoc Med. 2010;4(1):4. doi:10.1186/1751-0759-4-4
7 Skogstad M, Skorstad M, Lie A, Conradi HS, Heir T, Weisaeth L. Work-related post-traumatic stress disorder. Occup Med (Lond). Apr 2013;63(3):175-182. doi:10.1093/occmed/kqt003
8 Strauser DR. Trauma symptomatology: implications for return to work. Work. 2008;31(2):245-252.
9 Asmundson GJ, Norton GR, Allerdings MD, Norton PJ, Larsen DK. Posttraumatic stress disorder and work-related injury. J Anxiety Disord. Jan-Feb 1998;12(1):57-69.
10 Johnson JV, Hall EM. Job strain, work place social support, and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population. Am J Public Health. Oct 1988;78(10):1336-1342.
11 Eller NH, Netterstrom B, Gyntelberg F, et al. Work-related psychosocial factors and the development of ischemic heart disease: a systematic review. Cardiol Rev. Mar-Apr 2009;17(2):83-97. doi:10.1097/CRD.0b013e318198c8e9
12 Netterstrom B, Kristensen TS, Sjol A. Psychological job demands increase the risk of ischaemic heart disease: a 14-year cohort study of employed Danish men. Eur J Cardiovasc Prev Rehabil. Jun 2006;13(3):414-420.
13 Nomura K, Nakao M, Takeuchi T, Yano E. Associations of insomnia with job strain, control, and support among male Japanese workers. Sleep Med. Jun 2009;10(6):626-629. doi:10.1016/j.sleep.2008.06.010
14 Nishitani N, Sakakibara H. Job stress factors, stress response, and social support in association with insomnia of Japanese male workers. Ind Health. 2010;48(2):178-184.
15 Theorell T, Hammarstrom A, Aronsson G, et al. A systematic review including meta-analysis of work environment and depressive symptoms. BMC Public Health. 2015;15:738. doi:10.1186/s12889-015-1954-4
16 Bonde JPE. Psychosocial factors at work and risk of depression: a systematic review of the epidemiological evidence. Occupational and Environmental Medicine. July 1, 2008 2008;65(7):438-445. doi:10.1136/oem.2007.038430
17 Zivin K, Ilgen MA, Pfeiffer PN, et al. Early mortality and years of potential life lost among Veterans Affairs patients with depression. Psychiatr Serv. Aug 2012;63(8):823-826. doi:10.1176/appi.ps.201100317
18 Woo JM, Postolache TT. The impact of work environment on mood disorders and suicide: Evidence and implications. Int J Disabil Hum Dev. 2008;7(2):185-200.
19 Laditka JN, Laditka SB. Unemployment, disability and life expectancy in the United States: A life course study. Disabil Health J. Jan 2016;9(1):46-53. doi:10.1016/j.dhjo.2015.08.003
20 Colvin G. The new trend? Reducing stress in the workplace-by order of management. Fortune. Aug 11 2014;170(2):42.
21 Yandrick RM. Stress and the workplace. Conflict management can prevent behavioral health problems. Behav Healthc Tomorrow. Jun 1999;8(3):23, 26-27.
22 Haraway DL, Haraway WM, 3rd. Analysis of the effect of conflict-management and resolution training on employee stress at a healthcare organization. Hosp Top. Fall 2005;83(4):11-17. doi:10.3200/htps.83.4.11-18
23 Milner A, Page K, Spencer-Thomas S, Lamotagne AD. Workplace suicide prevention: a systematic review of published and unpublished activities. Health Promotion International. March 1, 2015 2015;30(1):29-37. doi:10.1093/heapro/dau085
24 McEwen BS, Gianaros PJ. Central role of the brain in stress and adaptation: links to socioeconomic status, health, and disease. Ann N Y Acad Sci. Feb 2010;1186:190-222. doi:10.1111/j.1749-6632.2009.05331.x
25 Jackson D, Firtko A, Edenborough M. Personal resilience as a strategy for surviving and thriving in the face of workplace adversity: a literature review. J Adv Nurs. Oct 2007;60(1):1-9. doi:10.1111/j.1365-2648.2007.04412.x
26 Walters L, Laurence CO, Dollard J, Elliott T, Eley DS. Exploring resilience in rural GP registrars--implications for training. BMC Med Educ. 2015;15:110. doi:10.1186/s12909-015-0399-x
27 Edward KL. The phenomenon of resilience in crisis care mental health clinicians. Int J Ment Health Nurs. Jun 2005;14(2):142-148. doi:10.1111/j.1440-0979.2005.00371.x