This study capitalizes on the availability of two unique and powerful epidemiological data sets to advance knowledge on the impact of work on women's health and quality of life over the adult life course. We propose to examine prospectively how the psychosocial work environment affects both health-related quality of life (HRQL) and total mortality in a sizeable sample of nurses who are free of major illness at baseline. We will control for important factors outside the workplace that may contribute to HRQL: biomedical covariates, morbidity, health risk behavior. and stresses and burdens in the home and family sphere. Through cross-sectional and prospective analyses, we will test the hypothesis that work characterized by job strain (high psychological demands, together with low control) and social isolation (""""""""iso-strain work""""""""), will diminish women's health-related quality of life, even after taking account of other factors. We expect biomedical parameters, chronic illnesses, and health behaviors to predict women's HRQL, and partially to mediate the influence of iso-strain work on HRQL, and we anticipate that factors in the home and family will moderate the relationship. But our overriding goal is to map the direct and independent relations between characteristics of work itself and women's health-related quality of life. In addition, relating psychosocial work environment to total mortality and cause specific mortality will complete our understanding of the impact of work on womens' health. The investigation will be carried out in two ongoing large prospective cohort studies together comprising roughly 123,000 actively working female nurses, aged 29-72 years. Nursing work is particularly well-suited for this research. -As a female-dominated and socially-important occupation, nursing is emblematic of the expanding service sector of the American economy where most growth in women's employment continues to occur. Nurses work in an industry -- health care -- that is facing economic and political constraints and dislocations. In some but by no means all settings, nursing is a highly stressful work. The scope and demands of nursing are diverse and heterogeneous enough to permit the pursuit of fundamental questions in a study of nurses about job strain and women's health and quality of life. This research promises to advance the field in five new directions: (1) it brings a very large, continuing, prospective cohort study of women to a research area that has largely been dominated by smaller cross- sectional surveys of men; (2) it adds validated biomedical health indicators to the self-reports more typical of the field and controls for the possible impact on health of selection in and out of high-strain work; (3) it applies state-of-the-art measurement of the key independent variable, iso-strain (isolated, high-strain) work; (4) it considers women's work in conjunction with home and family life roles and strains that typically vary at different stages of life; (5) it introduces into job strain research a new and potentially illuminating dependent variable--health-related quality of life--using a well-validated instrument (the SF-36) that taps positive and negative indicators of health, role functioning, and well-being.
| Lee, Sunmin; Colditz, Graham A; Berkman, Lisa F et al. (2004) Prospective study of job insecurity and coronary heart disease in US women. Ann Epidemiol 14:24-30 |
| Cannuscio, Carolyn C; Colditz, Graham A; Rimm, Eric B et al. (2004) Employment status, social ties, and caregivers' mental health. Soc Sci Med 58:1247-56 |
| Lee, Sunmin; Colditz, Graham; Berkman, Lisa et al. (2003) Caregiving to children and grandchildren and risk of coronary heart disease in women. Am J Public Health 93:1939-44 |
| Lee, Sunmin; Colditz, Graham A; Berkman, Lisa F et al. (2003) Caregiving and risk of coronary heart disease in U.S. women: a prospective study. Am J Prev Med 24:113-9 |
| Lee, Sunmin; Colditz, Graham; Berkman, Lisa et al. (2002) A prospective study of job strain and coronary heart disease in US women. Int J Epidemiol 31:1147-53; discussion 1154 |
| Michael, Yvonne L; Berkman, Lisa F; Colditz, Graham A et al. (2002) Social networks and health-related quality of life in breast cancer survivors: a prospective study. J Psychosom Res 52:285-93 |
| Achat, H; Kawachi, I; Byrne, C et al. (2000) A prospective study of job strain and risk of breast cancer. Int J Epidemiol 29:622-8 |
| Cheng, Y; Kawachi, I; Coakley, E H et al. (2000) Association between psychosocial work characteristics and health functioning in American women: prospective study. BMJ 320:1432-6 |
| Fine, J T; Colditz, G A; Coakley, E H et al. (1999) A prospective study of weight change and health-related quality of life in women. JAMA 282:2136-42 |
| Amick 3rd, B C; Kawachi, I; Coakley, E H et al. (1998) Relationship of job strain and iso-strain to health status in a cohort of women in the United States. Scand J Work Environ Health 24:54-61 |
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