Stressful Work, Self-Experience, and Cardiovascular Disease Prevention
Johannes Siegrist Institute of Medical Sociology, University of Dusseldorf
There are at least four important reasons that account for the centrality of work and occupation in advanced industrialized societies. First, having a job is a principal prerequisite for continuous income opportunities. Level of income determines a wide range of life chances. Second, training for a job and achievement of occupational status are the most important goals of primary and secondary socialization. It is through education, job training, and status acquisition that personal growth and development are realized, that a core social identity outside the family is acquired, and that intentional, goal-directed activity in human life is shaped. Third, occupation defines a most important criterion of social stratification in advanced societies. Amount of esteem and social approval in interpersonal life largely depend on type of job, professional training, and level of occupational achievement. Furthermore, type and quality of occupation, and especially the degree of self-direction at work, strongly influence personal attitudes and behavioral patterns in areas that are not directly related to work, such as leisure, family life, education, and political activity ( 1) Finally, occupational settings produce the most pervasive and continuous demands during one's lifetime, and they absorb the largest amount of active time in adult life. Exposure to adverse job conditions carries the risk of ill health by virtue of the amount of time spent and the quality of demands faced at the workplace. At the same time, occupational settings provide unique options to experience reward, esteem, success, and satisfaction.
To understand the impact of working life on health in general, and on cardiovascular health in particular, it is important to realize that major changes in