title: Exploring the interplay between work stress and socioeconomic position in relation to common health complaints: the role of interaction.
abstract: BACKGROUND
  This study explored the interplay between work stress and socioeconomic position and investigated if the interaction of work stress and low socioeconomic position is associated with poorer health.
  
  
  METHODS
  A representative sample of the Swedish working population, including 2,613 employees (48.7% women) aged 19-64 years, was analyzed. The health outcomes were poor self-rated health, psychological distress, and musculoskeletal pain. Work stress was operationalized as job strain and effort-reward imbalance, and socioeconomic position as occupational class. Interaction analysis was based on departure from additivity as criterion, and a synergy index (SI) was applied, using odds ratios (ORs) from logistic regressions for women and men.
  
  
  CONCLUSIONS
  In fully adjusted models, work stress, and in a lesser extent also socioeconomic position, was associated with higher odds for the three health complaints. The prevalence of poorer health was highest among those individuals jointly exposed to high work stress and low occupational class, with ORs ranging from 1.94 to 6.77 (95%CI 1.01-18.65) for poor self-rated health, 2.42-8.44 (95%CI 1.28-27.06) for psychological distress and 1.93-3.93 (95%CI 1.11-6.78) for musculoskeletal pain. The joint influence of work stress and low socioeconomic position on health was additive rather than multiplicative.
authors.affiliation: Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institute, Sweden. susanna.toivanen@chess.su.se
authors.forename: Susanna
authors.initials: S
authors.lastname: Toivanen
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000453:epidemiology*; D016273:Occupational Exposure; D016017:Odds Ratio; D015995:Prevalence; D012201:Reward; D057566:Self Report; D012737:Sex Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology; D016526:Workload / Q000523:psychology; D017132:Workplace / Q000523:psychology; D055815:Young Adult