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Objectives. We evaluated whether cumulative exposure to job strain increases blood pressure. Methods. A prospective study of 8395 white-collar workers was initiated during 1991 to 1993. At follow-up, 7.5 years later, 84% of the participants were reassessed to estimate cumulative exposure to job strain. Results. Compared with men who had never been exposed, men with cumulative exposure and those who became exposed during follow-up showed significant systolic blood pressure increments of 1.8 mm Hg (95% confidence interval [CI]=0.1, 3.5) and 1.5 mm Hg (95% CI=0.2, 2.8), respectively, and relative risks of blood pressure increases in the highest quintile group of 1.33 (95% CI= 1.01, 1.76) and 1.40 (95% CI= 1.14, 1.73). Effect magnitudes were smaller among women. Effects tended to be more pronounced among men and women with low levels of social support at work. Conclusions. Among these white-collar workers, exposure to cumulative job strain had a modest but significant effect on systolic blood pressure among men. The risk was of comparable magnitude to that observed for age and sedentary behavior. Men and women with low levels of social support at work appeared to be at higher risk for increases in blood pressure.

Ryff's Psychological Well-being scales cover six dimensions of psychological well-being (Self-acceptance, Environmental mastery, Positive relations with others, Personal growth, Purpose in life, and Autonomy) and have been suggested as an adequate measure of positive psychological functioning. Apart from translating the scales to Swedish and examining the psychometric properties of the measure, the present study aimed to explore the relationships between the Ryff scales and the General Health Questionnaire, negative affectivity, and physical symptoms using self-ratings from 91 full-time employed women and men. Given low internal consistency for the different dimensions of the Ryff scales, correlational analyses were based on a composite index. Analysis indicated negative relations between the Ryff index and other measures and are in line with prior findings showing that the index taps positive psychological functioning while other indices focus on negative functioning.

Objectives. This study examined changes in the health status of civil servants whose employment security was threatened. Methods. Data were derived from a longitudinal cohort of 10308 men and women, office staff in 20 British civil service departments. Physiological measurements, self-reported morbidity, and health-related behaviors for 530 members of the department under threat were compared with those of 19 other departments, during the period of uncertainty and during stable employment 5 years earlier. Results: From a position of advantage or no difference at baseline, self-reported morbidity and physiological risk factors tended to increase among respondents from the threatened department compared with those from other departments. For both sexes, increases were significant for body mass index (P [is less than] .001) and sleeping 9 or more hours (odds ratio [OR]: 1.88; 95% confidence interval [CI]= 1.3, 2.8; P [is less than] .01); modest but significant increases were seen in ischemia (OR = 1.45; 95% CI: 1.0, 2.1) and cholesterol concentration (0.08 mmol/L; 95% CI: 0.01, 0.14). Among women only, a significant relative increase in blood pressure (P [is less than] .01) was recorded. Over the same period health-related behaviors changed little. Conclusions. Threats to employment security have adverse consequences for health status that are unexplained by health selection or health-related behaviors. (Am J Public Health. 1998;88:1030-1036)

Since August 1988 an increasing proportion of the executive functions of government in the United Kingdom have been devolved to executive agencies. Transfer to an executive agency involves a period of uncertainty during which the options of elimination or transfer to the private sector are considered, followed by a marked change in management style and further periods of uncertainty when the agency's function is reconsidered for transfer to the private sector. This paper examines the effects of this major organisational change and consequent job insecurity on the health status of a cohort of 7419 white-collar civil servants by comparing groups either exposed to or anticipating exposure to this stressor, with controls experiencing no change. Compared with controls, men both already working in and anticipating transfer to an executive agency experienced significant increases in health self-rated as 'average or worse', longstanding illness, adverse sleep patterns, mean number of symptoms in the fortnight before questionnaire completion, and minor psychiatric morbidity. Significant relative increases in body mass index were seen in both exposure groups while exposure to agency status was also associated with significant relative increases in blood pressure. Health-related behaviours, where they differed between exposure and control groups, tended to favour those in the exposure groups. Compared with controls, women in both exposure groups reported small increases in most self-reported morbidity measures and most clinical measurements, accompanied by slight beneficial changes in some health-related behaviours and small adverse changes in others. Significant relative increases were seen in mean number of symptoms, and ischaemia among women anticipating exposure and in body mass index among those exposed to agency status. Policy makers should be aware of the wider consequences of job insecurity when considering the efficiency of changes in employment policy. Key words - job insecurity, health, white-collar, longitudinal

I argue that the shift from manual to white-collar jobs and reduced exposure to infectious disease were important determinants of declines in chronic disease rates among older men from the early 1900s to the 1970s and 1980s. The average decline in chronic respiratory problems, valvular heart disease, arteriosclerosis, and joint and back problems was about 66%. Occupational shifts accounted for 29% of the decline; the decreased prevalence of infectious disease accounted for 18%; the remainder are unexplained. The duration of chronic conditions has remained unchanged since the early 1900s, but when disability is measured by difficulty in walking, men with chronic conditions are less disabled now than they were in the past.

A national cohort of 380,000 individuals aged between 25 and 64 obtained from the National Longitudinal Mortality Study was used to compare mortality differences across several categories of occupations. Using relative risk measures from Cox proportional-hazards model analyses, it was shown that higher risk could be observed when moving across the occupational spectrum from technical, highly skilled profession to generally more labor-intensive occupations. The high-risk occupations identified include longshoremen and cooks while the low-risk occupations include scientists and teachers.