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Canadian Journal of Public Health

, Volume 104, Issue 1, pp e82–e86 | Cite as

Comparing the Risk Associated With Psychosocial Work Conditions and Health Behaviours on Incident Hypertension Over a Nine-year Period in Ontario, Canada

  • Peter M. SmithEmail author
  • Cameron A. Mustard
  • Hong Lu
  • Richard H. Glazier
Quantitative Research
  • 1 Downloads

Abstract

OBJECTIVES: Hypertension is an increasingly important health concern in Canada. This paper examines the risks associated with psychosocial working conditions compared to health behaviours on the risk of hypertension over a 9-year period in Ontario, Canada.

METHODS: We used data from Ontario respondents to the 2000–01 Canadian Community Health Survey linked to the Ontario Health Information Plan database covering physician services and the Canadian Institute for Health Information database for hospital admissions. We focused on labour market participants aged 35 to 60, who had not been previously diagnosed with hypertension, were not self-employed, and were working more than 10 hours per week, more than 20 weeks in the previous 12 months (N = 6,611). Subjects were followed for a nine-year period to ascertain incidence of hypertension.

RESULTS: Low job control was associated with an increased risk of hypertension among men, but not among women. The population attributable fraction associated with low job control among males was 11.8% in our fully adjusted model. There was no consistent pattern of increased risk of hypertension across different levels of health behaviours.

CONCLUSION: Primary prevention efforts to reduce the incidence of hypertension predominantly target modifiable health behaviours. Evidence from this longitudinal cohort suggests that modifiable characteristics of the work environment should also be considered in the design of cardiovascular disease prevention programs, in particular for male labour market participants.

Key words

Hypertension psychosocial factors work gender 

Résumé

OBJECTIFS: L’hypertension artérielle est un problème de santé qui gagne en importance au Canada. Nous avons comparé sur une période de neuf ans les risques d’hypertension associés aux conditions de travail psychosociales et ceux associés aux habitudes de santé en Ontario, au Canada.

MÉTHODE: Nous avons utilisé les données fournies par les répondants ontariens de l’Enquête sur la santé dans les collectivités canadiennes de 2000–2001 et nous les avons reliées à la base de données de l’Assurance-santé de l’Ontario, qui couvre les services médicaux, et à la base de données de l’Institut canadien d’information sur la santé pour ce qui est des hospitalisations. Nous nous sommes limités aux actifs de 35 à 60 ans n’ayant jamais reçu de diagnostic d’hypertension, n’étant pas travailleurs autonomes et ayant travaillé plus de 10 heures par semaine pendant plus de 20 semaines au cours des 12 mois précédents (N = 6 611). Les sujets ont été suivis sur une période de neuf ans pour vérifier leur incidence d’hypertension.

RÉSULTATS: Le faible contrôle sur le travail était associé à un risque accru d’hypertension chez les hommes, mais pas chez les femmes. Chez les hommes, la fraction attribuable dans la population associée au faible contrôle sur le travail était de 11,8 % dans notre modèle entièrement ajusté. Nous n’avons pas observé de hausse systématique du risque d’hypertension entre les différents niveaux d’habitudes de santé.

CONCLUSION: Les efforts de prévention primaire qui visent à réduire l’incidence de l’hypertension ciblent surtout les habitudes de santé modifiables. Selon les preuves de cette étude de cohorte longitudinale, les caractéristiques modifiables du milieu de travail devraient aussi être prises en considération lorsqu’on conçoit des programmes de prévention des maladies cardiovasculaires, en particulier pour les actifs de sexe masculin.

Mots clés

hypertension artérielle facteurs psychosociaux travail sexe 

References

  1. 1.
    Tu K, Chen ZL, Lipscombe LL. Prevalence and incidence of hypertension from 1995 to 2005: A population-based study. CMAJ 2008;178:1429–35.CrossRefGoogle Scholar
  2. 2.
    Katzmarzyk PT, Mason C. Prevalence of class I, II and III obesity in Canada. CMAJ 2006;174:156–57.CrossRefGoogle Scholar
  3. 3.
    Smith P, Frank J, Mustard C. The monitoring and surveillance of the psychosocial work environment in Canada: A forgotten determinant of health. Can J Public Health 2008;99:475–77.PubMedGoogle Scholar
  4. 4.
    Steptoe A, Cropley M, Joekes K. Job strain, blood pressure and response to uncontrollable stress. J Hypertension 1999;17:193–200.CrossRefGoogle Scholar
  5. 5.
    Steptoe A, Siegrist J, Kirschbaum C, Marmot M. Effort-reward imbalance, overcommitment, and measures of cortisol and blood pressure over the working day. Psychosomatic Med 2004;66:323–29.Google Scholar
  6. 6.
    Hemingway H, Marmot MG. Psychosocial factors in the aetiology and prognosis of coronary heart disease: Systematic review of prospective cohort studies. BMJ 1999;318:1460–67.CrossRefGoogle Scholar
  7. 7.
    Bourbonnais R, Brisson C, Vinet A, Vezina M, Abdous B, Gaudet M. Effectiveness of a participative intervention on psychosocial work factors to prevent mental health problems in a hospital setting. Occup Environ Med 2006;63:335–42.CrossRefGoogle Scholar
  8. 8.
    Gilbert-Ouimet M, Brisson C, Vezina M, Trudel L, Bourbonnais R, Masse B, et al. An intervention study on psychosocial work factors and mental health and musculoskeletal outcomes. Healthcare Papers 2011;11(Sp):47–66.CrossRefGoogle Scholar
  9. 9.
    Brisson C, Laflamme N, Moisan J, Milot A, Masse B, Vezina M. Effect of family responsibilities and job strain on ambulatory blood pressure among white-collar women. Psychosom Med 1999;61:205–13.CrossRefGoogle Scholar
  10. 10.
    Laflamme N, Brisson C, Moisan J, Milot A, Masse B, Vezina M. Job strain and ambulatory blood pressure among female white-collar workers. Scand J Work Environ Health 1998;24:334–43.CrossRefGoogle Scholar
  11. 11.
    Guimont C, Brisson C, Dagenais GR, Milot A, Vézina M, Mâsse B, et al. Effects of job strain on blood pressure: A prospective study of male and female white-collar workers. Am J Public Health 2006;96:1436–43.CrossRefGoogle Scholar
  12. 12.
    Tu K, Campbell NRC, Chen ZL, Cauch-Dudek J, McAlister FA. Accuracy of administrative databases in identifying patients with hypertension. Open Med 2007;1:E18–26.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Karasek R, Theorell T. Healthy Work: Stress Productivity and the Reconstruction of Working Life. New York, NY: Basic Books Inc., 1990.Google Scholar
  14. 14.
    Yeo D, Mantel H, Liu TP. Bootstrap variance estimation for the National Population Health Survey. American Statistical Association Conference, Baltimore, MD, 1999;778–83.Google Scholar
  15. 15.
    The SAS Institute. The SAS System for Windows, Release 9.2. 2010.Google Scholar
  16. 16.
    Hennekens CH, Buring JE. Measures of disease frequency and association. In: Mayrent SL (Ed.), Epidemiology in Medicine. Toronto, ON: Little, Brown and Company, 1987;54–98.Google Scholar
  17. 17.
    Belkic KL, Landsbergis PA, Schnall PL, Baker D. Is job strain a major source of cardiovascular disease risk? Scand J Work Environ Health 2004;30:85–128.CrossRefGoogle Scholar
  18. 18.
    Bosma H, Marmot MG, Hemingway H, Nicholson AC, Brunner E, Stansfeld SA. Low job control and risk of coronary heart disease in Whitehall II (prospective cohort) study. BMJ 1997;314:558–65.CrossRefGoogle Scholar
  19. 19.
    Probert AW, Tremblay MS, Gorber SC. Desk potatoes: The importance of occupational physical activity on health. Can J Public Health 2008;99:311–18.PubMedGoogle Scholar
  20. 20.
    Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc 2009;41:998–1005.CrossRefGoogle Scholar
  21. 21.
    Smith PM, Frank JW, Mustard CA, Bondy S. Examining the relationships between job control and health status: A path analysis approach. J Epidemiol Community Health 2008;62:54–61.CrossRefGoogle Scholar
  22. 22.
    Roos NP, Mustard CA. Variation in health and health care use by socio-economic status in Winnipeg, Canada: Does the system work well? Yes and no. Milbank Q 1997;75:89–111.CrossRefGoogle Scholar
  23. 23.
    Glazier RH, Agha MM, Moineddin R, Sibley LM. Universal health insurance and equity in primary care and specialist office visits: A population-based study. Ann Fam Med 2009;7:396–405.CrossRefGoogle Scholar
  24. 24.
    Stringhini S, Sabia S, Shipley M, Brunner E, Nabi H, Kivimaki M, Singh-Manoux A. Association of socioeconomic position with health behaviors and mortality. JAMA 2010;303:1159–66.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 2012

Authors and Affiliations

  • Peter M. Smith
    • 1
    • 2
    • 3
    Email author
  • Cameron A. Mustard
    • 1
    • 2
  • Hong Lu
    • 4
  • Richard H. Glazier
    • 2
    • 4
    • 5
    • 6
  1. 1.Institute for Work & HealthTorontoCanada
  2. 2.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  3. 3.School of Public Health and Preventive MedicineMonash UniversityVictoriaAustralia
  4. 4.Institute for Clinical Evaluative SciencesTorontoCanada
  5. 5.Centre for Research on Inner City HealthSt. Michael’s HospitalTorontoCanada
  6. 6.Department of Family and Community Medicine, St. Michael’s Hospital and University of TorontoTorontoCanada

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