New Research Details How Workplace Stress Contributes to Cardiovascular Disease

Sep 15, 2016

Study Authors Recommend Policies to Lessen Stressful Employment Conditions


Brooklyn, NY; Irvine, Calif. – Researchers at SUNY Downstate Health Sciences University and the University of California, Irvine (UCI), have created a model illustrating how economic globalization may create stressful employment factors in high income countries contributing to the worldwide epidemic of cardiovascular disease (CVD).

Their findings are published online in the current edition of the International Journal of Health Services in an article entitled, “Globalization, Work, and Cardiovascular Disease,” [doi: 10.1177/0020731416664687].

Cardiovascular disease, a global epidemic, is responsible for about 30 percent of all deaths worldwide. While mortality rates from CVD have been mostly declining in the advanced industrialized nations, some CVD risk factors – including hypertension, obesity and diabetes – have been on the increase everywhere. Researchers investigating the social causes of CVD have produced a robust body of evidence documenting the relationships between the work environment and CVD, including through the mechanisms of psychosocial work stressors.

In their study, the researchers reviewed the empirical evidence linking work, psychosocial stressors and CVD. These work stressors can produce chronic biologic responses and promote unhealthy behaviors, which increases CVD risk. The researchers also offer a theoretical model that illustrates how economic globalization influences the labor market and work organization in high-income countries, which, in turn, exacerbates job characteristics, such as demands, low job control, effort-reward imbalance, job insecurity and long work hours.

Co-author Paul Landsbergis, PhD, EdD, MPH, said, “Given the high costs of medical treatment and the economic costs to employers and society of ill health, lost productivity, and sickness absence, it is in the interest of all to seriously consider improving work organization.” Dr. Landsbergis is associate professor in the Department of Environmental and Occupational Health Sciences in the School of Public Health at SUNY Downstate.

The authors make the following recommendations:

  • Implementing national surveillance of occupations, industries and workplaces to identify elevated levels of hazardous work characteristics;
  • Passage of regulations and laws limiting psychosocial stressors at the workplace;
  • Establishing upper limits of weekly and yearly work hours (to reduce CVD risk);
  • Mandating vacation time for all workers to facilitate recovery;
  • Passing regulations to mandate a “living wage” that provide sufficient support so that workers are not forced to work excessively long hours;
  • and passing legislation that increases the economic security of precarious workers.

"We conclude from more than 30 years of epidemiological research that CVD is a disease of modern industrial society and not the natural result of aging,” said Peter Schnall, MD, MPH, of UCI’s Center for Occupational and Environmental Health. “It is related to forms of production that emerged with industrialization and that have expanded with economic globalization: long work hours, repetitive work, high demands, lack of control, long hours, and job insecurity.” Schnall is a clinical professor of medicine and public health at UCI.

Dr. Landsbergis concludes, “If there is a silver lining to our findings that working conditions play an important role in the etiology of CVD, it is that preventing these outcomes will require creating healthier workplaces and healthier jobs in general for all working people, with the dual consequences of improved well-being and a reduced burden of chronic disease later in life, not just CVD.”

Marnie Dobson, PhD, with UCI also contributed to the study. Dr. Dobson said, “Neoliberal global economic policies and the rise of the new ‘flexible labor market’ have seen an increase in ‘precarious’ employment in advanced industrialized countries, which includes increased job insecurity and increased exposure to psychosocial work stressors, such as higher workloads, lower job control and lower work-related social support. These work stressors in turn contribute to CVD risk factors such as obesity, diabetes and high blood pressure.” The article is currently available online at: