The Effort-reward Imbalance Model: Experience in Japanese Working Population

The model for effort-reward imbalance (ERI) at work, originally formulated by Siegrist’s group on European samples, has been receiving considerable attention in occupational health research because of its predictive power for adverse health outcomes . This model defines stressful experiences at work as an imbalance between high effort expended and low reward received. ‘Effort’ is evaluated by measuring work demands. Three transmitters are considered to be sources of a ‘reward’: money, esteem, and career opportunities. Considering current labor market developments in a global economy— fragmented job careers, job instability, redundancy, and forced occupational mobility, the importance of career opportunities is emphasized. Another unique feature of the ERI model concerns the inclusion of a personal component into an otherwise situational model of job stress. A distinct personal pattern of coping with job demands, termed ‘overcommitment’, in which a set of attitudes, behavior and emotions reflecting excessive endeavors combined with a strong desire for approval and esteem are defined. People characterized by overcommitment exaggerate their efforts beyond levels normally considered appropriate. It has been hypothesized that not only is this coping critical enough to result in emotional exhaustion, it amplifies the ill effects of the effort-reward imbalance. Abstract: The Effort-reward Imbalance Model: Experience in Japanese Working Population: Akizumi TSUTSUMI, et al. Okayama University Graduate School of Medicine and Dentistry—The validity of Siegrist’s effort-reward imbalance model was examined in Japanese workers: 105 dental technicians, 902 employees of production companies, and 2,827 selected from staff of hospitals. After controlling for possible confounders, levels of the two stress m e a s u r e s , ‘ e f f o r t r e w a r d i m b a l a n c e ’ a n d ‘overcommitment’, were similar for both genders. The effort-reward imbalance was most prevalent in the 25– 30 age employees and then decreased with age, but the level of overcommitment increased with age. Those with lower educational attainment and others who reported working long hours were more often exposed to effort-reward imbalance and those in the private sector reported higher overcommitment levels than their respective counterparts. Hospital staff (predominantly nurses) had almost twice as high a level of effort-reward imbalance as production workers. A review of empirical studies confirmed validity of the criterion with respect to a self-reported health outcome and the responsiveness of the measures to organizational changes. Nevertheless, the low prevalence of an effort-reward imbalance (originally formulated by Siegrist’s group on European samples) in Japanese employees seemed to reduce the statistical power of these tests. A subsequent change in exposure prevalence by defining the top quintile of the distribution of the logarithmic-transformed effortreward ratio resulted in an improvement in the statistical fit. The Japanese evidence indicates promising