This study is the first to investigate the joint effects of job strain and informal caregiving on long-term sickness absence. The main finding was that informal caregiving responsibilities and/or high job strain predicted long-term sickness absence among women.
The present paper contributes to the understanding of the role of early life stress in health across the life span and of the mechanisms by which adverse childhood environments impact health as children emerge into early adulthood. This knowledge will have implications for early intervention efforts.
Objective
Studies investigating health effects of work and family stress usually consider these factors in isolation. The present study investigated prospective interactive effects of job strain and informal caregiving on allostatic load (AL), a multisystem indicator of physiological dysregulation.
Methods
Subjects were 7,007 British civil servants from the Whitehall II cohort study. Phase 3 (1991-1994) served as the baseline, Phases 5 (1997-1999) and 7 (2002-2004) as follow-ups. Job strain (high job demands combined with low control) and caregiving (providing care to aged or disabled relatives) were assessed at baseline. AL index (possible range 0-9) was assessed at baseline and both follow-ups based on 9 cardiovascular, metabolic and immune biomarkers. Linear mixed effect models were used to examine the association of job strain and caregiving with AL.
Results
High caregiving burden (above the sample median weekly hours of providing care) predicted higher AL levels, with the effect strongest in those also reporting job strain [b = 0.36, 95% CI: 0.01– 0.71)]; however, the interaction between job strain and caregiving was not significant (p = 0.56). Regardless of job strain, participants with low caregiving burden (below sample median) had lower subsequent AL levels than non-caregivers [b = 0.22, 95% CI: 0.06–0.37].
Conclusions
The study provides some evidence for adverse effects of stress at work combined with family demands on physiological functioning. However, providing care to others may also have health protective effects if it does not involve excessive time commitment.
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