The contribution of work and lifestyle factors to socioeconomic inequalities in self-rated health ‒ a systematic review

Amy C. M. Dieker, Wilhelmina Ijzelenberg, Karin I. Proper, Alex Burdorf, Johannes C. F. Ket, Allard J. van der Beek, Gerben Hulsegge

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Objective This study aimed to systematically review the literature on the contribution of work and lifestyle factors to socioeconomic inequalities in self-rated health among workers. Methods A search for cross-sectional and longitudinal studies assessing the contribution of work and/or lifestyle factors to socioeconomic inequalities in self-rated health among workers was performed in PubMed, PsycINFO, and Web of Science in March 2017. Two independent reviewers performed eligibility and risk of bias assessment. The median change in odds ratio between models without and with adjustment for work or lifestyle factors across studies was calculated to quantify the contribution of work and lifestyle factors to health inequalities. A best-evidence synthesis was performed. Results Of those reviewed, 3 high-quality longitudinal and 17 cross-sectional studies consistently reported work factors to explain part (about one-third) of the socioeconomic health inequalities among workers (grade: strong evidence). Most studies separately investigated physical and psychosocial work factors. In contrast with the 12 cross-sectional studies, 2 longitudinal studies reported no separate contribution of physical workload and physical work environment to health inequalities. Regarding psychosocial work factors, lack of job resources (eg, less autonomy) seemed to contribute to health inequalities, whereas job demands (eg, job overload) might not. Furthermore, 2 longitudinal and 4 cross-sectional studies showed that lifestyle factors explain part (about one-fifth) of the health inequalities (grade: strong evidence). Conclusions The large contribution of work factors to socioeconomic health inequalities emphasizes the need for future longitudinal studies to assess which specific work factors contribute to health inequalities.
Original languageEnglish
Pages (from-to)114-125
JournalScandinavian Journal of Work, Environment and Health
Volume45
Issue number2
DOIs
Publication statusPublished - 1 Jan 2019

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