Department of Medical Sociology, Vrije Universiteit, Brussels, Laarbeeklaan 103, 1090 Brussels, Belgium.
J Epidemiol Community Health. 2010 Oct;64(10):866-73. doi: 10.1136/jech.2009.087122. Epub 2009 Oct 11.
In this article, the link between (1) psychosocial working conditions (job demands, job autonomy, task variation, social support), (2) self-reported health (persistent fatigue, musculoskeletal complaints, emotional well-being) and (3) socioeconomic position (skill levels, occupational status) is explored. The two theoretical pathways linking the psychosocial work environment to socioeconomic differences in health are explored: differential exposure and differential vulnerability. Previously, the focus has often been on social inequalities in exposure to the stressors. The pathway of differential vulnerability in different socioeconomic positions is often neglected.
In a representative cross-sectional sample of 11,099 Flemish (Belgian) wage earners, 16-65 years of age (47.5% women), logit modelling is applied.
Higher exposure to psychosocial occupational stressors is associated with a higher prevalence of adverse health outcomes. Lower skill levels and subordinate occupational positions show a higher prevalence of musculoskeletal complaints, but not of persistent fatigue or emotional well-being. High demands, job strain and iso-strain are more common in higher-skilled, supervisory and managerial positions, but have the strongest health-damaging effects in lower socioeconomic positions. Low control is more prevalent in lower-skilled and subordinate positions, while having stronger adverse health effects in higher socioeconomic positions-the same holds for social support, although it has no clear socioeconomic distribution.
Differential exposure and differential vulnerability constitute two counteracting forces in constituting the association between the psychosocial work environment and socioeconomic differences in self-reported health complaints among wage earners.
本文探讨了（1）心理社会工作条件（工作要求、工作自主性、任务变化、社会支持）、（2）自我报告的健康状况（持续疲劳、肌肉骨骼投诉、情绪健康）和（3）社会经济地位（技能水平、职业地位）之间的联系。探索了将心理社会工作环境与健康的社会经济差异联系起来的两个理论途径：差异暴露和差异脆弱性。以前，重点通常是社会不平等的压力源暴露。不同社会经济地位的差异脆弱性途径往往被忽视。
在 11099 名佛兰芒（比利时）工薪阶层的代表性横断面样本中（47.5%为女性），年龄在 16-65 岁之间，应用逻辑回归模型。
较高的心理社会职业压力源暴露与不良健康结果的患病率较高相关。较低的技能水平和从属职业地位与肌肉骨骼投诉的患病率较高相关，但与持续疲劳或情绪健康无关。高要求、工作压力和同型压力在技能较高、监督和管理职位中更为常见，但在较低社会经济地位中对健康的损害作用最强。低控制在技能较低和从属职位中更为普遍，而在较高社会经济地位中对健康的不利影响更强——社会支持也是如此，尽管它没有明确的社会经济分布。
差异暴露和差异脆弱性构成了心理社会工作环境与自我报告的工薪族健康抱怨的社会经济差异之间关联的两个相互抵消的力量。
