A Comprehensive Review: Work Stress and its Impact on Public Health

This report examines the impact of work-related stress on various health issues, including hypertension and cardiovascular diseases. It references studies that demonstrate a positive relationship between work stress and hypertension, highlighting the role of job strain in causing high blood pressure and increasing the risk of coronary heart disease. The analysis incorporates models like DCS and ERI to assess the psychological demands and effort-reward imbalance experienced by working individuals. The report concludes that work stress is a significant risk factor for mortality, especially in individuals with pre-existing cardio-metabolic diseases, emphasizing the need for managing work-related stress to maintain overall health and well-being. The report draws upon various cohort studies conducted in different countries to support its findings.

Work stress is a potential killer
Introduction
In today’s world, the employment sector has transformed completely in many countries,
particularly in the developed countries. Most employment sectors have transformed from
industrial mass and lean production to more information technology driven jobs. Also due to the
increasing globalization in economies, there has been an increase in competition among many
transnational companies thereby increasing work-related stress. Also due to the increasing
constraints of financial markets, this also lead to a significant increase in work –related pressure
too and this is often occurring in combination with decrease in job stability. In this context, the
work-related stress and pressure have been increasing greatly over time in many parts of the
world (Jian et al., 2016). Nowadays most adults spend about half their waking hours at the
workplace, meaning that the workplace setting is an essential part of our daily lives. There has
been an ongoing debate on whether the work stress poses as a potential risk factor in our daily
lives and whether they are responsible for causing issues like chronic diseases, hypertension
and blood pressure. Many researchers argue that work stress is the factor responsible for such
problems in our daily lives while some remain skeptical about this and have argued that work
stress effect on such problems is either negligible or confounded (Kawachi and Kivimaki, 2015).
The aim of this report is to review and study various findings regarding work stress’s effect on
our daily problems that we face and determine whether work stress poses itself as a threat to
our daily lives.
Body
A study by Babu et al.(2013) aimed at determining the relationship between work – related
stress and hypertension among working adults. In order to study this, an extensive and in depth
meta-analysis was carried out. For assessing this meta-analysis, multiple studies and reviews
were evaluated. The cross-sectional studies were excluded for this analysis while the cohort
and case-control studies were considered. This was because cross-sectional studies tend to be
easily influenced by biases. The pooled estimate from most of the studies was successful in
showing a positive relationship between work-related stress and hypertension. This study
concluded that there needs to be an increasing emphasis for the need to conduct research on
work-related stress and many other factors that are responsible for causing this stress which is
also able to increase morbidity among the working class population. The huge size of the
working population and the relatively high impact that stress has on many adults today are more
reasons for the need to conduct research on work related stress and hence analyze the health
profiles of working adults. The meta-analysis also concluded that researchers need to study the
effects of job related stress and health outcomes so as to obtain more clear scientific guidance
and knowledge that will be helpful in improving the health outcomes among the working class
population.
Gilbert et al.(2014) in his article, studied the impact that work-related stress has on blood
pressure. Having high blood pressure is a major threat to our lives as it is the leading risk factor
for causing cardiovascular diseases. Cardiovascular diseases being the leading cause of death
worldwide and causing about one third of male and female deaths in Canada is a very

dangerous disease to have and is also part of the costliest group of health problems in regards
to hospitalization. In order to assess the effect that work-related stress has on blood pressure,
DCS and ERI models have been used. The demand control support (DCS) model was able to
prove that working adults that were experiencing high psychological demands and very low
control over job were very likely to experience stress related issues in health. Psychological
demands mean stuff like excessive workload or very complex tasks that require to be completed
in impossible time frame. With today’s increase in economy, the workplace demands a lot of
these psychological demands implying that more and more people today are developing stress-
related health problems. The ERI model determines the degree of imbalance between effort and
the corresponding rewards (Siegrist et al., 2004). When evaluating the ERI models for working
individuals, an imbalance is evident showing that the excessive efforts done by them aren’t
being rewarded adequately. This sort of imbalance is detrimental to the health as it can cause
stress-related issues in the individual. As mentioned here in the DCS and ERI models, people
have been experiencing a lot of stress. When an individual’s body is stressed out, the body is
able to develop a gush of hormones. These hormones eventually cause the blood pressure to
rise for a short period of time. This results in faster heart beating and narrowing of blood
vessels. Although there’s no proof that stress by itself is able to cause long-term blood pressure,
reacting to stress can potentially increase the risk of high blood pressure which can then result
in cardiovascular diseases (Mayoclinic, 2019). In order to determine whether stress had an
impact on blood pressure, a total of 74 studies were evaluated in this article. Out of these, 64
were the DCS models while 12 of them looked at the ERI models. Two of the studies
considered both the models. From this sample of 74 studies, it was concluded that about half
the studies showed a significant impact of work-related stress on blood pressure elevation. It
was also observed that it had a greater impact on men than women. Hence it can be concluded
that psychological work factors have a consistent effect on both men and women in regards to
blood pressure elevation which is a major risk factor in causing cardiovascular diseases.
According to Netterstorm (2013), his article on ‘Job strain and hypertension’ highlights the fact
that people who are being treated with high blood pressure, the cause for such a high blood
pressure could be cause of work-related stress or working conditions.
Work-related stress is also a factor that is able to result in causing coronary heart disease
(CHD) (Chandola et al, 2007). It is able to affect the possibility of coronary heart disease directly
as a result of activation of neuroendocrine responses to stressors and able to affect indirectly as
a result of unhealthy lifestyle activities such as smoking, excessive alcohol consumption or even
lack of exercise. Job strain and work–related stress are also responsible for causing
cardiovascular disease (CVD) risk factors such as smoking, obesity, dietary fat intake and
inactivity or lack of exercise and this has a negative effect on overall long-term health too
(Hellerstedt and Jeffrey, 1997).
In order to prevent cardiovascular diseases, the prevention guidelines have recommended to
manage and control work – related stress especially for patients with cardio metabolic disease.
However, the evidence regarding the importance of controlling work-related stress is weak.
Pentti et al(2018) was able to clarify this importance of controlling work related stress. It showed
the association of job strain with mortality in both men and women. The study consisted of
people with and without pre-existing cardio metabolic disease. They collected and gathered

information from seven different cohort studies in the IPD-Work consortium. These cohort
studies included data between the years 1985 and 2002 from countries like the UK, Sweden,
Finland and France. The article concluded that for men with cardio metabolic disease, work-
related stress was a major risk factor for causing death and was independent of other
conventional risk factors.
Conclusion
Babu et al (2013) in their article on studying the relationship between work-related stress and
hypertension was successful in concluding that there is a positive relationship between work –
related stress and hypertension. The study also implied that hypertension’s leading cause was
because of work-related stress. Gilbert et al(2014) also with their study on the impact that work-
related stress has on blood pressure successfully concluded that job strain is able to result in
high blood pressure. High blood pressure is itself lethal as it is the leading factor that causes
cardiovascular disease. They used the help of DCS and ERI models in order to come to this
conclusion. According to Chandola et al (2007), the article highlighted on the fact that job strain
is able to cause coronary heart disease (CHD). Job strain and work–related stress are also
responsible for causing cardiovascular disease (CVD) risk factors such as smoking, obesity,
dietary fat intake and inactivity or lack of exercise and this has a negative effect on overall long-
term health too. Pentti et al(2018) was able to clarify this importance of controlling work related
stress. It showed the association of job strain with mortality in both men and women. The study
consisted of people with and without pre-existing cardio metabolic disease. They collected and
gathered information from seven different cohort studies in the IPD-Work consortium. These
cohort studies included data between the years 1985 and 2002 from countries like the UK,
Sweden, Finland and France. The article concluded that for men with cardio metabolic disease,
work-related stress was a major risk factor for causing death and was independent of other
conventional risk factors. As a result, work stress is responsible for causing many life-
threatening diseases and can have a negative impact on maintaining a healthy and well-
balanced life.