Unfairness and health: Evidence from the Whitehall II Study

Roberto De Vogli, Jane E. Ferrie, Tarani Chandola, Mika Kivimäki, Michael G. Marmot

Research output: Contribution to journalArticle

123 Scopus citations

Abstract

Objective: To examine the effects of unfairness on incident coronary events and health functioning. Design: Prospective cohort study. Unfairness, sociodemographics, established coronary risk factors (high serum cholesterol, hypertension, obesity, exercise, smoking and alcohol consumption) and other psychosocial work characteristics (job strain, effort-reward imbalance and organisational justice) were measured at baseline. Associations between unfairness and incident coronary events and health functioning were determined over an average follow-up of 10.9 years. Participants: 5726 men and 2572 women from 20 civil service departments in London (the Whitehall II Study). Main outcome measures: Incident fatal coronary heart disease, non-fatal myocardial infarction and angina (528 events) and health functioning. Results: Low employment grade is strongly associated with unfairness. Participants reporting higher levels of unfairness are more likely to experience an incident coronary event (HR 1.55, 95% CI 1.11 to 2.17), after adjustment for age, gender, employment grade, established coronary risk factors and other work-related psychosocial characteristics. Unfairness is also associated with poor physical (OR 1.46, 95% CI 1.20 to 1.77) and mental (OR 1.54, 95% CI 1.19 to 1.99) functioning at follow-up, controlling for all other factors and health functioning at baseline. Conclusions: Unfairness is an independent predictor of increased coronary events and impaired health functioning. Further research is needed to disentangle the effects of unfairness from other psychosocial constructs and to investigate the societal, relational and biological mechanisms that may underlie its associations with health and heart disease.

Original languageEnglish (US)
Pages (from-to)513-518
Number of pages6
JournalJournal of Epidemiology and Community Health
Volume61
Issue number6
DOIs
StatePublished - Jun 2007
Externally publishedYes

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ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

De Vogli, R., Ferrie, J. E., Chandola, T., Kivimäki, M., & Marmot, M. G. (2007). Unfairness and health: Evidence from the Whitehall II Study. Journal of Epidemiology and Community Health, 61(6), 513-518. https://doi.org/10.1136/jech.2006.052563