Put workers in control to cut disease

HEALTH

Giving workers more control over what they do in their jobs may be the most effective way of cutting deaths from heart disease, researchers believe.

Findings from one of the most comprehensive studies of the effect of work on health show that workers who have little control over what they do in their jobs are at higher risk of a heart attack than their bosses.

The finding, which confirms observations made over the last 20 years, suggests that the quickest way to reduce the health gap between the rich and poor may be to change the way people work. Death rates from heart disease are three times higher in social class V than in social class I and the gap has widened sharply in the last 25 years.

Professor Michael Marmot and colleagues of the department of public health at University College, London, who have followed the lives of over 10,000 civil servants since the 1970s, showed over a decade ago that workers in the lowest clerical grades had higher rates of heart disease than those in the higher administrative grades. The traditional risk factors of diet, exercise and smoking accounted for less than half the difference.

Now, in a further analysis published in the Lancet, Professor Marmot has shown that workplace control accounts for most of the rest of the difference. "Greater attention to the design of work environments may be one important way to reduce inequalities in health," he says.