title: Differential associations of job control components with mortality: a cohort study, 1986-2005.
abstract: Inconsistent evidence of the hypothesized favorable effects of high job control on health may have resulted from a failure to treat job control as a multifactor concept. The authors studied whether the 2 components of job control, decision authority and skill discretion, were differentially associated with cause-specific mortality in 13,510 Finnish forest company employees with no history of severe illness. Surveys on work characteristics were carried out in 1986 and 1996, and the respondents were followed up until the end of 2005 by use of the Statistics Finland National Death Registry. During a mean follow-up of 15.5 years, 981 participants died. In the analyses adjusted for confounders, employees with high and intermediate levels of skill discretion had a lower all-cause mortality risk than those with low skill discretion, with hazard ratios of 0.84 (95% confidence interval (CI): 0.69, 1.02) and 0.81 (95% CI: 0.69, 0.96), respectively. In contrast, high decision authority was associated with elevated risks of all-cause, cardiovascular, and alcohol-related mortality, with hazard ratios of 1.28 (95% CI: 1.06, 1.54), 1.49 (95% CI: 1.11, 2.02), and 2.03 (95% CI: 1.03, 4.00), respectively. The results suggest that job control is not an unequivocal concept in relation to mortality; decision authority and skill discretion show different and to some extent opposite associations.
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, Helsinki, Finland.matti.joensuu@ttl.fi
authors.forename: Matti
authors.initials: M
authors.lastname: Joensuu
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
authors.forename: Aki
authors.initials: A
authors.lastname: Koskinen
authors.forename: Anne
authors.initials: A
authors.lastname: Kouvonen
authors.forename: Laura
authors.initials: L
authors.lastname: Pulkki-Råback
authors.forename: Jussi
authors.initials: J
authors.lastname: Vahtera
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
authors.forename: Ari
authors.initials: A
authors.lastname: Väänänen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004651:Employment / Q000523:psychology*; D005260:Female; D005387:Finland; D016468:Forestry / Q000706:statistics & numerical data; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009026:Mortality; D016016:Proportional Hazards Models; D011584:Psychology; D055815:Young Adult