Association between effort-reward imbalance and self-reported diabetes mellitus in older U.S. workers

Miriam Mutambudzi, Johannes Siegrist, John D. Meyer, Jian Li

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Objective Studies assessing the effects of work stress on health in older adults in the U.S. labor force are scarce. We examined the longitudinal association between work stress as measured by effort-reward imbalance (ERI) and incident diabetes over a 7-year period in U.S. working adults aged 50 years and older. Methods We used longitudinal data from the 2006–2012 waves of the Health and Retirement Study (n = 1932). Cox proportional hazard regression was used to examine whether ERI significantly predicted diabetes incidence in older adults who were diabetes-free at baseline. Results High stress level at work (ERI ratio > 1.0) was found in participants who worked 55 h or more a week (37.3%), had no insurance coverage (35.9%), and those working in blue collar jobs (34.4%). Participants with high ERI had a significantly higher risk of diabetes (HR = 1.33, 95%CI = 1.04–1.69) relative to those with low ERI, after adjustment for known predictors of adult-onset diabetes. Conclusion Effort-reward imbalance was associated with increased risk of diabetes incidence after controlling for other known predictive factors, which suggests an independent non-mediated effect of work stressors. More research is required to better understand the effects of work stress in aging populations and how psychosocial disequilibrium in the work environment may impact susceptibility to chronic conditions, and in particular how change in self-assessed reward might vary toward the end of a working lifetime.

Original languageEnglish (US)
Pages (from-to)61-64
Number of pages4
JournalJournal of Psychosomatic Research
StatePublished - Jan 2018
Externally publishedYes


  • Aging workforce
  • Diabetes
  • Effort-reward imbalance
  • Work-related stress

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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