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Effort-reward imbalance, procedural injustice and relational injustice as psychosocial predictors of health: complementary or redundant models?
Open accessAbstract
Objective: Effort-reward imbalance at work is an established psychosocial risk factor but there are also newer conceptualisations, such as procedural injustice (decisions at work lack consistency, openness and input from all affected parties) and relational injustice (problems in considerate and fair treatment of employees by supervisors). The authors examined whether procedural injustice and relational injustice are associated with employee health in addition to, and in combination with, effort-reward imbalance. Methods: Prospective survey data from two cohorts related to public-sector employees: the 10-Town study (n = 18 066 (78% women, age range 19–62) and the Finnish Hospital Personnel study (n = 4833, 89% women, age range 20–60). Self-rated poor health, minor psychiatric morbidity and doctor-diagnosed depression were assessed at baseline (2000–2) and at follow-up (2004). To determine incident morbidity, baseline cases were excluded. Results: In multivariate models including age, sex, occupational status and all three psychosocial factors as predictors, high effort-reward imbalance and either high procedural injustice or high relational injustice were associated with increased morbidity at follow-up in both cohorts. After combining procedural and relational injustice into a single measure of organisational injustice, high effort-reward imbalance and high injustice were both independently associated with health. For all outcome measures, a combination of high effort-reward imbalance and high organisational injustice was related to a greater health risk than high effort-reward imbalance or injustice alone. Conclusion: Evidence from two independent occupational cohorts suggests that procedural and relational components of injustice, as a combined index, and effort-reward imbalance are complementary risk factors.
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“Six cohort studies16 18 19 24 25 demonstrate that there is moderate-quality evidence that effort-reward imbalance increases the incidence of SRD, with a pooled OR of 1.91 (95% CI 1.70 to 2.15) (see table 3 and figure 2).”
From Work-related psychosocial risk factors for stress-related mental disorders: an updated systematic review and meta-analysis (2020) · cites this paper as [19]
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In the citing paper
“Five cohort studies3 19 22 25 demonstrate that there is moderate-quality evidence that low procedural justice with a pooled OR of 1.73 (95% CI 1.61 to 1.86) and low relational justice with a pooled OR of 1.55 (95%CI 1.44 to 1.67) increase the incidence of SRD (see table 3 and figure 3).”
From Work-related psychosocial risk factors for stress-related mental disorders: an updated systematic review and meta-analysis (2020) · cites this paper as [19]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Five cohort studies3 19 22 25 demonstrate that there is moderate-quality evidence that low procedural justice with a pooled OR of 1.73 (95% CI 1.61 to 1.86) and low relational justice with a pooled OR of 1.55 (95%CI 1.44 to 1.67) increase the incidence of SRD (see table 3 and figure 3).”
From Work-related psychosocial risk factors for stress-related mental disorders: an updated systematic review and meta-analysis (2020) · cites this paper as [19]
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“Six studies also controlled for other work-related psychosocial risk factors in various models.3 19 20 22 27”
From Work-related psychosocial risk factors for stress-related mental disorders: an updated systematic review and meta-analysis (2020) · cites this paper as [19]
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Metadata
- Authors
- Kivimäki, M., Vahtera, J., Elovainio, M., Virtanen, M., & Siegrist, J.
- Affiliations
- Finnish Institute of Occupational Health (FI)
- Venue
- Occupational and Environmental Medicine
- Publisher
- BMJ
- Published
- 2007-01-25
- Volume
- 64
- Issue
- 10
- Pages
- 659-665
- ISSN
- 0007-1072 (ISSN-L)
- 1351-0711
- 1470-7926
- PMC
- PMC2078405
- OpenAlex
- W2087147136
- Cited by
- 245
- References
- 29
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 11 · 2023: 8 · 2022: 8 · 2021: 10 · 2020: 14 · 2019: 18 · 2018: 17 · 2017: 13 · 2016: 15 · 2015: 18 · 2014: 13 · 2013: 9 · 2012: 25
- FWCI
- 30.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Occupational and Environmental Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Workplace Health and Well-being
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Employment and Welfare Studies
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Job Satisfaction and Organizational Behavior
- Keywords
- effort-reward imbalance, procedural injustice, psychosocial risk factors, employee health, psychiatric morbidity, depression, public sector employees, occupational health
- MeSH terms
- Adult, Mental Disorders, Europe, Female, Follow-Up Studies, Health Status, Health Surveys, Humans, Male, Middle Aged, Models, Psychological, Occupational Diseases, Prospective Studies, Reward, Social Justice, Cohort Studies, Causality, Multivariate Analysis, Odds Ratio, Workload, Age Distribution, Sex Distribution
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