| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
RESEARCH AND PRACTICE |
Marko Elovainio is with the National Research and Development Center for Welfare and Health, Helsinki, Finland. Mika Kivimäki is with the Department of Psychology, University of Helsinki, Helsinki, Finland. Marko Elovainio and Mika Kivimäki are also with the Department of Psychology, Finnish Institute of Occupational Health, Helsinki. Jussi Vahtera is with the Finnish Institute of Occupational Health, Turku, Finland.
Correspondence: Requests for reprints should be sent to Marko Elovainio, National Research and Development Center for Welfare and Health, PO Box 220, FIN-00531 Helsinki, Finland (e-mail: marko.elovainio{at}stakes.fi).
 |
ABSTRACT |
|---|
 TOP ABSTRACT INTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
|---|
Objectives. This study examined the justice of decision-making procedures and interpersonal relations as a psychosocial predictor of health.
Methods. Regression analyses were used to examine the relationship between levels of perceived justice and self-rated health, minor psychiatric disorders, and recorded absences due to sickness in a cohort of 506 male and 3570 female hospital employees aged 19 to 63 years.
Results. The odds ratios of poor self-rated health and minor psychiatric disorders associated with low vs high levels of perceived justice ranged from 1.7 to 2.4. The rates of absence due to sickness among those perceiving low justice were 1.2 to 1.9 times higher than among those perceiving high justice. These associations remained significant after adjustment for behavioral risks, workload, job control, and social support.
Conclusions. Low organizational justice is a risk to the health of employees.
|
INTRODUCTION |
|---|
|
TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
|---|
|
METHODS |
|---|
|
TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
|---|
Measures
Scales of procedural justice (7 items; range of scale = 1–5; mean score of responses = 2.8; SD = 0.7; 
= .90) and relational justice (6 items; range of scale = 1–5; mean score of responses = 3.5; SD = 0.9; = .81) were adopted from Moorman7 (Figure 1
). Both scales have been associated with organizational commitment, job satisfaction, and retaliation,6,8,9 and they were moderately interrelated (r = 0.30).
|
= .80); cases were those that scored 4 or higher on the questionnaire (n = 920).13–15 Self-certified and medically certified sick leaves in 1997 and 1998 were obtained from employers' registers. Self-certified sickness absences were 3 days or less, while medically certified absences, for which a physician' examination and a medical certificate were always required, were more than 3 days.16–18
We measured covariates by using the following standard criteria: age, sex, income, smoking status (never smoker, n = 2797; former smoker, n = 557; current smoker, n = 582), alcohol consumption19 (low consumption: 40 g or less of pure alcohol per week, n = 3090; high consumption: more than 280 g for men and more than 190 g for women, n = 396), sedentary lifestyle (less than half an hour of fast walking per week; n = 2135),20 and body mass index (<25 kg/m2, n = 3813; 25–30 kg/m2, n = 1179; >30 kg/m2, n = 350). Psychosocial factors were workload21,22 (4 items; range = 1–5; mean = 3.5; SD = 0.9; = .85), job control23 (9 items; range = 1–5; mean = 3.6; SD = 0.7; = .84), and social support24 (6 items; range = 0–30; mean = 12.0; SD = 5.3; = .79).
Statistical Analysis
Justice and other psychosocial measures were divided into quartiles and treated as categorical variables. Associations of justice variables with self-rated health and minor psychiatric morbidity, determined by logistic regression analysis, were expressed as odds ratios. We studied associations of justice variables with sickness absences by using Poisson regression and rate ratios. Ninety-five-percent confidence intervals were calculated and adjustments were made for demographics, behavioral risks, and established psychosocial factors.
|
RESULTS |
|---|
|
TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
|---|
23 = 46.10; P < .001).
Among men, low procedural justice was associated with a 2-fold risk of poor self-rated health and an almost 4-fold risk of minor psychiatric disorders, but the associations were not significant after adjustment for other psychosocial factors. Among women, associations between procedural justice, self-rated health, and minor psychiatric disorders were significant irrespective of adjustments (Table 1).
|
).
Procedural justice and relational justice were significantly associated with selfcertified and medically certified sickness absence. The association of relational justice with medically certified sickness absence was significantly stronger among men than among women (P < .01). There were no interactions between sex and procedural justice (Table 2).
|
|
DISCUSSION |
|---|
|
TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
|---|
Relational justice was a stronger predictor of sickness absence for men than for women. This difference, however, might reflect not only a difference between the sexes but also the fact that hospital occupations are gender related. For example, over 50% of the physicians were men, whereas over 93% of the nurses were women. Organizational justice may have different meanings for members of highly ranked occupations related to management than for shop-floor employees.25 The size differences between the male and female samples may also have affected the detected differences in significance between sexes.
Our results may shed light on the effects of other psychosocial models of organizational behavior. Hemingway and Marmot2 concluded that only about half of the studies they reviewed supported the role of workload and job control or social support in predicting coronary heart disease. Although organizational justice partly overlaps with these psychosocial factors, it also seems to tap additive elements associated with employee health18,26,27—for example, organizational consistency, accuracy, ethicality, managerial decision making, procedures used, and discrimination in organizations.28–30
The model of effort–reward imbalance31 suggests that high effort spent at work combined with low reward in terms of salary, esteem, or job security defines a state of distress that increases health problems. Our findings on procedural justice show that people seem to be affected not only by rewards as such but also by the procedures used to determine how they will be distributed.
Replications with prospective data and with other kinds of organizations and occupational groups are still needed to assess the causality and generalizability of the association between organizational justice and employee health.
|
Acknowledgments |
|---|
|
Footnotes |
|---|
Accepted for publication October 23, 2000.
|
References |
|---|
|
TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
|---|
2.
Hemingway H, Marmot M. Psychosocial factors in the aetiology and prognosis of coronary heart disease: systematic review of a prospective cohort study. BMJ. 1999;318:1460–1467.
3. Bies RJ, Moag JS. Interactional justice: communication criteria of fairness. In: Lewicki RJ, Sheppard BH, Bazerman MZ, eds. Research on Negotiations in Organizations. Greenwich, Conn: JAI Press; 1986:43–55.
4. Kramer RM, Tyler TR. Trust in Organizations: Frontiers of Theory and Research. London, England: Sage; 1996.
5. Shapiro DL, Brett JM. Comparing three processes underlying judgements of procedural justice: a field study of mediation and arbitration. J Pers Soc Psychol. 1993;65:1167–1177.
6. Greenberg J. Organizational justice: yesterday, today, and tomorrow. J Manage. 1990;16:399–432.
7. Moorman RH. Relationship between organizational justice and organizational citizenship behaviors: do fairness perceptions influence employee citizenship? J Appl Psychol. 1991;76:845–855.
8. Elovainio M, Kivimäki M, Helkama K. Organizational justice evaluations, job control and occupational strain. J Appl Psychol. 2001;86:418–424.[Medline]
9. Scarlicki DP, Folger R. Retaliation in the workplace: the roles of distributive, procedural and interactional justice. J Appl Psychol. 1997;82:434–443.
10.
Idler EL, Angel RJ. Self-rated health and mortality in the NHANES-I epidemiological follow-up study. Am J Public Health. 1990;80:446–452.
11. Marmot MG, Smith GD, Stansfeld S, et al. Health inequalities among British civil servants: the Whitehall II study. Lancet. 1991;337:1387–1393.[Medline]
12. Miilunpalo S, Vuori I, Oja P, Pasanen M, Urponen H. Self-rated health as a health measure: the predictive value of self-reported health status on the use of physician services and on mortality in the working-age population. J Clin Epidemiol. 1997;50:517–528.[Medline]
13. Goldberg D. The Detection of Psychiatric Illness by Questionnaire. London, England: Oxford University Press; 1972.
14. Goldberg DP, Gater R, Sartorius N, Puccinelli M, Gureje O, Rutter C. The validity of the two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997;27:191–197.[Medline]
15. Goldberg D, Williams P. A User' Guide to the General Health Questionnaire. Berkshire, United Kingdom: NFER–Nelson Publishing Co; 1988.
16. Kivimäki M, Vahtera J, Thomson L, Griffiths A, Cox T, Pentti J. Psychosocial factors predicting employee sickness absence during economic decline. J Appl Psychol. 1997;82:858–872.[Medline]
17. Vahtera J, Kivimäki M, Pentti J. Effect of organizational downsizing on health of employees. Lancet. 1997;350:1124–1128.[Medline]
18.
Kivimäki M, Vahtera J, Pentti J, Ferrie JE. Factors underlying the effect of organisational downsizing on health of employees: longitudinal cohort study. BMJ. 2000;320:971–975.
19. Kaprio J, Koskenvuo M, Langinvainio H, Romanov K, Sarna S, Rose RJ. Genetic influences on use and abuse of alcohol: a study of 5638 adult Finnish twin brothers. Alcohol Clin Exp Res. 1987;11:349–356.[Medline]
20.
Kujala UM, Kaprio J, Sarna S, Koskenvuo M. Relationship of leisure-time physical activity and mortality. JAMA. 1998;279:440–444.
21. Harris PE. The Nurse Stress Index. Work Stress. 1989;3:335–345.
22. Cooper CL, Mitchell S. Nurses under stress: a reliability and validity study of the NSI. Stress Med. 1990;6:21–24.
23. Karasek RA. Job Content Questionnaire and User' Guide, Revision 1.1. Los Angeles: University of Southern California; 1985.
24. Sarason IG, Sarason BR, Shearin EN, Pierce GR. A brief measure of social support: practical and theoretical implications. J Soc Personal Relationships. 1987;4:497–510.[Abstract]
25. Kaplan GA. People and places: contrasting perspectives on the association between social class and health. Int J Health Serv. 1996;26:507–519.[Medline]
26.
Bosma H, Marmot MG, Hemingway H, Nicholson AC, Brunner E, Stansfeld SA. Low job control and risk of coronary heart disease in the Whitehall II (prospective cohort) study. BMJ. 1997;314:558–564.
27.
Johnson JV, Stewart W, Hall EM, Fredlund P, Theorell T. Long-term psychosocial work environment and cardiovascular mortality among Swedish men. Am J Public Health. 1996;86:324–331.
28. Firth-Cozens J. Sources of stress in women junior house officers. BMJ. 1990;301:89–91.
29. Kessler RC, Mickelson KD, Williams DR. The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. J Health Soc Behav. 1999;9:70–80.
30. Krieger N. Embodying inequity: a review of concepts, measures, and methods for studying health consequences of discrimination. Int J Health Serv. 1999;29:19–32.
31. Siegrist J. Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol. 1996;1:27–41.[Medline]
This article has been cited by other articles:
|
|
 |
|
  P. M. Lindfors, O. A. Meretoja, R. A. Luukkonen, M. J. Elovainio, and T. J. Leino Attitudes to job turnover among Finnish anaesthetists Occup. Med., January 7, 2009; (2009) kqn173v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A Nyberg, L Alfredsson, T Theorell, H Westerlund, J Vahtera, and M Kivimaki Managerial leadership and ischaemic heart disease among employees: the Swedish WOLF study Occup. Environ. Med., January 1, 2009; 66(1): 51 - 55. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Heponiemi, A. Kouvonen, J. Vanska, H. Halila, T. Sinervo, M. Kivimaki, and M. Elovainio Health, psychosocial factors and retirement intentions among Finnish physicians Occup. Med., September 1, 2008; 58(6): 406 - 412. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Josephson, P. Lindberg, M. Voss, L. Alfredsson, and E. Vingard The same factors influence job turnover and long spells of sick leave--a 3-year follow-up of Swedish nurses Eur J Public Health, August 1, 2008; 18(4): 380 - 385. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Kouvonen, M. Kivimaki, M. Elovainio, A. Vaananen, R. De Vogli, T. Heponiemi, A. Linna, J. Pentti, and J. Vahtera Low organisational justice and heavy drinking: a prospective cohort study Occup. Environ. Med., January 1, 2008; 65(1): 44 - 50. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Kivimaki, J. E. Ferrie, M. Shipley, D. Gimeno, M. Elovainio, R. de Vogli, J. Vahtera, M. G. Marmot, and J. Head Effects on Blood Pressure Do Not Explain the Association Between Organizational Justice and Coronary Heart Disease in the Whitehall II Study Psychosom Med, January 1, 2008; 70(1): 1 - 6. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Melchior, T. E. Moffitt, B. J. Milne, R. Poulton, and A. Caspi Why Do Children from Socioeconomically Disadvantaged Families Suffer from Poor Health When They Reach Adulthood? A Life-Course Study Am. J. Epidemiol., October 15, 2007; 166(8): 966 - 974. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kivimaki, J. Vahtera, M. Elovainio, M. Virtanen, and J. Siegrist Effort-reward imbalance, procedural injustice and relational injustice as psychosocial predictors of health: complementary or redundant models? Occup. Environ. Med., October 1, 2007; 64(10): 659 - 665. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E Ferrie, J. A Head, M. J Shipley, J. Vahtera, M. G Marmot, and M. Kivimaki Injustice at work and health: causation, correlation or cause for action? Occup. Environ. Med., June 1, 2007; 64(6): 428 - 428. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Kouvonen, J. Vahtera, M. Elovainio, S. J Cox, T. Cox, A. Linna, M. Virtanen, and M. Kivimaki Organisational justice and smoking: the Finnish public sector study J Epidemiol Community Health, May 1, 2007; 61(5): 427 - 433. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C Muntaner, J Benach, W C Hadden, D Gimeno, and F G Benavides A glossary for the social epidemiology of work organisation: part 2 Terms from the sociology of work and organisations. J Epidemiol Community Health, December 1, 2006; 60(12): 1010 - 1012. [Full Text] [PDF]
|
|
|
|
|
|
I Kawachi Injustice at work and health: causation or correlation? Occup. Environ. Med., September 1, 2006; 63(9): 578 - 579. [Full Text] [PDF]
|
|
|
|
|
|
J E Ferrie, J Head, M J Shipley, J Vahtera, M G Marmot, and M Kivimaki Injustice at work and incidence of psychiatric morbidity: the Whitehall II study Occup. Environ. Med., July 1, 2006; 63(7): 443 - 450. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Elovainio, M Kivimaki, S Puttonen, H Lindholm, T Pohjonen, and T Sinervo Organisational injustice and impaired cardiovascular regulation among female employees Occup. Environ. Med., February 1, 2006; 63(2): 141 - 144. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Kivimaki, J. E. Ferrie, E. Brunner, J. Head, M. J. Shipley, J. Vahtera, and M. G. Marmot Justice at Work and Reduced Risk of Coronary Heart Disease Among Employees: The Whitehall II Study Arch Intern Med, October 24, 2005; 165(19): 2245 - 2251. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Vaananen, R. Kalimo, S. Toppinen-Tanner, P. Mutanen, J. M. Peiro, M. Kivimaki, and J. Vahtera Role clarity, fairness, and organizational climate as predictors of sickness absence: A prospective study in the private sector Scand J Public Health, December 1, 2004; 32(6): 426 - 434. [Abstract] [PDF]
|
|
|
|
|
|
M. Kivimaki, J. E Ferrie, J. Head, M. J Shipley, J. Vahtera, and M. G Marmot Organisational justice and change in justice as predictors of employee health: the Whitehall II study J Epidemiol Community Health, November 1, 2004; 58(11): 931 - 937. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J Vahtera, J Pentti, and M Kivimaki Sickness absence as a predictor of mortality among male and female employees J Epidemiol Community Health, April 1, 2004; 58(4): 321 - 326. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Kivimaki, M Elovainio, J Vahtera, J E Ferrie, and T Theorell Organisational justice and health of employees: prospective cohort study * COMMENTARY Occup. Environ. Med., January 1, 2003; 60(1): 27 - 34. [Abstract] [Full Text] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
