Skip to main content
PMC home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1997 Apr;87(4):617–622. doi: 10.2105/ajph.87.4.617

Workplace conditions, socioeconomic status, and the risk of mortality and acute myocardial infarction: the Kuopio Ischemic Heart Disease Risk Factor Study.

J Lynch 1, N Krause 1, G A Kaplan 1, J Tuomilehto 1, J T Salonen 1
PMCID: PMC1380842  PMID: 9146441

Abstract

OBJECTIVES: This study investigated whether the association between workplace conditions and the risk of all-cause and cardiovascular mortality and acute myocardial infarction differed by socioeconomic status. METHODS: Prospective data were used to examine these associations in 2297 Finnish men, with adjustment for prevalent diseases and biological, behavioral, and psychosocial covariates, and stratified by employment status and workplace social support. RESULTS: Elevated age-adjusted relative hazards for all-cause mortality were found for men who reported high demands, low resources, and low income; high demands, high resources, and low income; and low demands, high resources, and low income. Similar patterns were found for cardiovascular mortality. In contrast, elevated age-adjusted relative hazards for acute myocardial infarction were observed only in men who reported high demands, low resources, and low income. These results did not differ by level of workplace social support or employment status. CONCLUSIONS: The negative effects of workplace conditions on mortality and of myocardial infarction risk depended on income level and were largely mediated by known risk factors.

Full text

PDF
617

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alterman T., Shekelle R. B., Vernon S. W., Burau K. D. Decision latitude, psychologic demand, job strain, and coronary heart disease in the Western Electric Study. Am J Epidemiol. 1994 Mar 15;139(6):620–627. doi: 10.1093/oxfordjournals.aje.a117051. [DOI] [PubMed] [Google Scholar]
  2. Everson S. A., Goldberg D. E., Kaplan G. A., Cohen R. D., Pukkala E., Tuomilehto J., Salonen J. T. Hopelessness and risk of mortality and incidence of myocardial infarction and cancer. Psychosom Med. 1996 Mar-Apr;58(2):113–121. doi: 10.1097/00006842-199603000-00003. [DOI] [PubMed] [Google Scholar]
  3. Falk A., Hanson B. S., Isacsson S. O., Ostergren P. O. Job strain and mortality in elderly men: social network, support, and influence as buffers. Am J Public Health. 1992 Aug;82(8):1136–1139. doi: 10.2105/ajph.82.8.1136. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Fenwick R., Tausig M. The macroeconomic context of job stress. J Health Soc Behav. 1994 Sep;35(3):266–282. [PubMed] [Google Scholar]
  5. Greenlund K. J., Liu K., Knox S., McCreath H., Dyer A. R., Gardin J. Psychosocial work characteristics and cardiovascular disease risk factors in young adults: the CARDIA study. Coronary Artery Risk Disease in Young Adults. Soc Sci Med. 1995 Sep;41(5):717–723. doi: 10.1016/0277-9536(94)00385-7. [DOI] [PubMed] [Google Scholar]
  6. Haan M. N. Job strain and ischaemic heart disease: an epidemiologic study of metal workers. Ann Clin Res. 1988;20(1-2):143–145. [PubMed] [Google Scholar]
  7. Johnson J. V., Hall E. M., Theorell T. Combined effects of job strain and social isolation on cardiovascular disease morbidity and mortality in a random sample of the Swedish male working population. Scand J Work Environ Health. 1989 Aug;15(4):271–279. doi: 10.5271/sjweh.1852. [DOI] [PubMed] [Google Scholar]
  8. Karasek R. A., Theorell T., Schwartz J. E., Schnall P. L., Pieper C. F., Michela J. L. Job characteristics in relation to the prevalence of myocardial infarction in the US Health Examination Survey (HES) and the Health and Nutrition Examination Survey (HANES). Am J Public Health. 1988 Aug;78(8):910–918. doi: 10.2105/ajph.78.8.910. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Karasek R., Baker D., Marxer F., Ahlbom A., Theorell T. Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men. Am J Public Health. 1981 Jul;71(7):694–705. doi: 10.2105/ajph.71.7.694. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Lakka T. A., Salonen J. T. Physical activity and serum lipids: a cross-sectional population study in eastern Finnish men. Am J Epidemiol. 1992 Oct 1;136(7):806–818. doi: 10.1093/aje/136.7.806. [DOI] [PubMed] [Google Scholar]
  11. Lakka T. A., Venäläinen J. M., Rauramaa R., Salonen R., Tuomilehto J., Salonen J. T. Relation of leisure-time physical activity and cardiorespiratory fitness to the risk of acute myocardial infarction. N Engl J Med. 1994 Jun 2;330(22):1549–1554. doi: 10.1056/NEJM199406023302201. [DOI] [PubMed] [Google Scholar]
  12. Lynch J. W., Kaplan G. A., Cohen R. D., Kauhanen J., Wilson T. W., Smith N. L., Salonen J. T. Childhood and adult socioeconomic status as predictors of mortality in Finland. Lancet. 1994 Feb 26;343(8896):524–527. doi: 10.1016/s0140-6736(94)91468-0. [DOI] [PubMed] [Google Scholar]
  13. Lynch J. W., Kaplan G. A., Cohen R. D., Tuomilehto J., Salonen J. T. Do cardiovascular risk factors explain the relation between socioeconomic status, risk of all-cause mortality, cardiovascular mortality, and acute myocardial infarction? Am J Epidemiol. 1996 Nov 15;144(10):934–942. doi: 10.1093/oxfordjournals.aje.a008863. [DOI] [PubMed] [Google Scholar]
  14. Lynch J. W., Kaplan G. A., Salonen J. T. Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse. Soc Sci Med. 1997 Mar;44(6):809–819. doi: 10.1016/s0277-9536(96)00191-8. [DOI] [PubMed] [Google Scholar]
  15. Lynch J., Kaplan G. A., Salonen R., Cohen R. D., Salonen J. T. Socioeconomic status and carotid atherosclerosis. Circulation. 1995 Oct 1;92(7):1786–1792. doi: 10.1161/01.cir.92.7.1786. [DOI] [PubMed] [Google Scholar]
  16. Marmot M., Theorell T. Social class and cardiovascular disease: the contribution of work. Int J Health Serv. 1988;18(4):659–674. doi: 10.2190/KTC1-N5LK-J1PM-9GRQ. [DOI] [PubMed] [Google Scholar]
  17. Muntaner C., O'Campo P. J. A critical appraisal of the demand/control model of the psychosocial work environment: epistemological, social, behavioral and class considerations. Soc Sci Med. 1993 Jun;36(11):1509–1517. doi: 10.1016/0277-9536(93)90393-i. [DOI] [PubMed] [Google Scholar]
  18. Notkola V. J., Husman K. R., Laukkanen V. J. Mortality among male farmers in Finland during 1979-1983. Scand J Work Environ Health. 1987 Apr;13(2):124–128. doi: 10.5271/sjweh.2071. [DOI] [PubMed] [Google Scholar]
  19. Reed D. M., LaCroix A. Z., Karasek R. A., Miller D., MacLean C. A. Occupational strain and the incidence of coronary heart disease. Am J Epidemiol. 1989 Mar;129(3):495–502. doi: 10.1093/oxfordjournals.aje.a115160. [DOI] [PubMed] [Google Scholar]
  20. Salonen J. T. Is there a continuing need for longitudinal epidemiologic research? The Kuopio Ischaemic Heart Disease Risk Factor Study. Ann Clin Res. 1988;20(1-2):46–50. [PubMed] [Google Scholar]
  21. Salonen J. T., Nyyssönen K., Korpela H., Tuomilehto J., Seppänen R., Salonen R. High stored iron levels are associated with excess risk of myocardial infarction in eastern Finnish men. Circulation. 1992 Sep;86(3):803–811. doi: 10.1161/01.cir.86.3.803. [DOI] [PubMed] [Google Scholar]
  22. Salonen J. T., Salonen R., Korpela H., Suntioinen S., Tuomilehto J. Serum copper and the risk of acute myocardial infarction: a prospective population study in men in eastern Finland. Am J Epidemiol. 1991 Aug 1;134(3):268–276. doi: 10.1093/oxfordjournals.aje.a116080. [DOI] [PubMed] [Google Scholar]
  23. Salonen J. T., Salonen R., Seppänen K., Rauramaa R., Tuomilehto J. HDL, HDL2, and HDL3 subfractions, and the risk of acute myocardial infarction. A prospective population study in eastern Finnish men. Circulation. 1991 Jul;84(1):129–139. doi: 10.1161/01.cir.84.1.129. [DOI] [PubMed] [Google Scholar]
  24. Salonen J. T., Seppänen K., Nyyssönen K., Korpela H., Kauhanen J., Kantola M., Tuomilehto J., Esterbauer H., Tatzber F., Salonen R. Intake of mercury from fish, lipid peroxidation, and the risk of myocardial infarction and coronary, cardiovascular, and any death in eastern Finnish men. Circulation. 1995 Feb 1;91(3):645–655. doi: 10.1161/01.cir.91.3.645. [DOI] [PubMed] [Google Scholar]
  25. Schnall P. L., Landsbergis P. A., Baker D. Job strain and cardiovascular disease. Annu Rev Public Health. 1994;15:381–411. doi: 10.1146/annurev.pu.15.050194.002121. [DOI] [PubMed] [Google Scholar]
  26. Siegrist J. Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol. 1996 Jan;1(1):27–41. doi: 10.1037//1076-8998.1.1.27. [DOI] [PubMed] [Google Scholar]
  27. Siegrist J., Peter R., Junge A., Cremer P., Seidel D. Low status control, high effort at work and ischemic heart disease: prospective evidence from blue-collar men. Soc Sci Med. 1990;31(10):1127–1134. doi: 10.1016/0277-9536(90)90234-j. [DOI] [PubMed] [Google Scholar]
  28. Theorell T., Hamsten A., de Faire U., Orth-Gomér K., Perski A. Psychosocial work conditions before myocardial infarction in young men. Int J Cardiol. 1987 Apr;15(1):33–46. doi: 10.1016/0167-5273(87)90290-7. [DOI] [PubMed] [Google Scholar]
  29. Tuomilehto J., Arstila M., Kaarsalo E., Kankaanpä J., Ketonen M., Kuulasmaa K., Lehto S., Miettinen H., Mustaniemi H., Palomäki P. Acute myocardial infarction (AMI) in Finland--baseline data from the FINMONICA AMI register in 1983-1985. Eur Heart J. 1992 May;13(5):577–587. doi: 10.1093/oxfordjournals.eurheartj.a060219. [DOI] [PubMed] [Google Scholar]
  30. Wilson T. W., Kaplan G. A., Kauhanen J., Cohen R. D., Wu M., Salonen R., Salonen J. T. Association between plasma fibrinogen concentration and five socioeconomic indices in the Kuopio Ischemic Heart Disease Risk Factor Study. Am J Epidemiol. 1993 Feb 1;137(3):292–300. doi: 10.1093/oxfordjournals.aje.a116676. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES