Job stress in the childhood determinants of adult health study : an examination of childhood predictors and associations with adult health risk behaviours

Background Few studies have investigated the role of childhood factors in adult job stress or the association of job stress and multiple health behaviours in one cohort. The aims of this thesis were to: 1) examine whether a range of childhood factors were associated with adult job stress and 2) examine the association between job stress and health risk behaviours, including their co-occurrence. Methods Participants (aged 31-41 years) with completed effort-reward imbalance (ERI) scales (n=1,481) came from the Childhood Determinants of Adult Health study. This study began in 1985 with children aged 7 to 15 and had follow-up for 25 years (2009-11). Childhood measures included socioeconomic position (SEP), health- and school-related factors. Adulthood measures included the ERI scale and health risk behaviours (e.g., smoking, alcohol, physical activity, dietary behaviours, obesity and sitting time). Log binomial, log multinomial and linear regression with adjustment for potential confounders assessed: 1) the associations between childhood factors and adult job stress and 2) the associations between job stress and health risk behaviours (separately and together in a 'Healthy Lifestyle Score' to assess co-occurrence). Results Lower adulthood ERI and lower effort, indicating less job stress, were predicted in men by better learner self-concept and better academic attainment in childhood. Higher reward, indicating less job stress, was predicted in men by better academic attainment and enjoyment of physical activity. Greater adulthood ERI, indicating higher job stress, was predicted in men by worse self-rated fitness compared to peers, poorer self-rated health and doing less physical activity in childhood and was predicted in women by being overweight, drinking alcohol, smoking and higher negative affect in childhood. Higher effort was predicted in men by worse self-rated fitness compared to peers, drinking alcohol and doing less physical activity and was predicted in women by being overweight, drinking alcohol and smoking in childhood. Higher reward was predicted in men by lower negative affect and doing more physical activity and was predicted in women by being overweight and less negative affect in childhood. Childhood SEP had inconsistent associations with adult ERI and its components. For analyses of the cross-sectional association between adult job stress and health risk behaviours, there were independent associations with both individual and co-occurring health risk behaviours. Higher ERI was associated with less often having a higher healthy lifestyle score, eating more serves of extra foods per day, doing less minutes of leisure time physical activity per week and spending more minutes of sitting at the weekend in men. In women, higher ERI was associated with doing less minutes of transport related physical activity, taking more steps per day, more often being a current smoker and consuming takeaway food twice a week or more. In terms of the components of the ERI scale, higher effort was associated with eating more serves of extra foods per day and spending more minutes of sitting at the weekend in men and was associated with doing more minutes of physical activity in the workplace, doing less minutes of transport-related physical activity, more often being a current smoker and consuming take away food twice a week or more in women. Higher reward was associated with meeting more dietary guidelines on the Dietary Guideline Index, eating less serves of extra food per day and spending less minutes of sitting time at the weekend in men. Conclusion Childhood factors including SEP, but also school- and health-related factors predicted adult ERI. Future studies of job stress and health should consider the effect of pre-employment factors including those from early in life. Job stress at work may lead to more unhealthy behaviours, such as poor eating habits, smoking, excess sitting and a lack of exercise in either men or women.