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Work characteristics, socioeconomic position and health: a systematic review of mediation and moderation effects in prospective studies.

Hoven H, Siegrist J - Occup Environ Med (2013)

Bottom Line: Moderate support was found for the mediation hypothesis where OR or HR of health according to socioeconomic position (SEP) were reduced in a majority of analyses after introducing work characteristics in multivariate models.Evidence in favour of the moderation hypothesis was found in some studies, demonstrating stronger effects of adverse work on health among people with low SEP.Policy recommendations would benefit from a higher degree of consistency of respective research evidence.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Life-Science Center, Düsseldorf, Germany.

ABSTRACT
Social inequalities in health persist in modern societies. The contribution of adverse work and employment conditions towards their explanation is analysed by two approaches, mediation and moderation. Yet the relative significance of each approach remains unclear in respective research. We set out to study this question by conducting a systematic literature review. We included all original papers based on prospective observational studies of employed cohorts that were published between January 1980 and October 2012 meeting our search criteria, by using major databases and by observing established quality criteria. 26 reports were included after quality assessment. 17 studies examined the mediation hypothesis and nine studies tested the moderation hypothesis. Moderate support was found for the mediation hypothesis where OR or HR of health according to socioeconomic position (SEP) were reduced in a majority of analyses after introducing work characteristics in multivariate models. Evidence in favour of the moderation hypothesis was found in some studies, demonstrating stronger effects of adverse work on health among people with low SEP. Despite some support in favour of the two hypotheses future research should aim at reducing the heterogeneity in defining and measuring core variables and at applying advanced statistical analyses. Policy recommendations would benefit from a higher degree of consistency of respective research evidence.

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Related in: MedlinePlus

Selection process for identification of studies.
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OEMED2012101331F1: Selection process for identification of studies.

Mentions: In a first stage, all records were judged by the first author on the basis of titles and abstracts. In difficult cases, full texts were consulted, and ambiguities were discussed between the authors (see flowchart figure 1). In a second stage both authors examined the remaining papers independently and searched for studies analysing the mediation or moderation hypothesis. To this aim, full texts were available, and the two independent ratings were compared. The few discordant cases were resolved by in-depth discussion. Data were extracted in a standardised format, according to categories indicated in supplementary tables S1 and S2 (available online only).


Work characteristics, socioeconomic position and health: a systematic review of mediation and moderation effects in prospective studies.

Hoven H, Siegrist J - Occup Environ Med (2013)

Selection process for identification of studies.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3756612&req=5

OEMED2012101331F1: Selection process for identification of studies.
Mentions: In a first stage, all records were judged by the first author on the basis of titles and abstracts. In difficult cases, full texts were consulted, and ambiguities were discussed between the authors (see flowchart figure 1). In a second stage both authors examined the remaining papers independently and searched for studies analysing the mediation or moderation hypothesis. To this aim, full texts were available, and the two independent ratings were compared. The few discordant cases were resolved by in-depth discussion. Data were extracted in a standardised format, according to categories indicated in supplementary tables S1 and S2 (available online only).

Bottom Line: Moderate support was found for the mediation hypothesis where OR or HR of health according to socioeconomic position (SEP) were reduced in a majority of analyses after introducing work characteristics in multivariate models.Evidence in favour of the moderation hypothesis was found in some studies, demonstrating stronger effects of adverse work on health among people with low SEP.Policy recommendations would benefit from a higher degree of consistency of respective research evidence.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Life-Science Center, Düsseldorf, Germany.

ABSTRACT
Social inequalities in health persist in modern societies. The contribution of adverse work and employment conditions towards their explanation is analysed by two approaches, mediation and moderation. Yet the relative significance of each approach remains unclear in respective research. We set out to study this question by conducting a systematic literature review. We included all original papers based on prospective observational studies of employed cohorts that were published between January 1980 and October 2012 meeting our search criteria, by using major databases and by observing established quality criteria. 26 reports were included after quality assessment. 17 studies examined the mediation hypothesis and nine studies tested the moderation hypothesis. Moderate support was found for the mediation hypothesis where OR or HR of health according to socioeconomic position (SEP) were reduced in a majority of analyses after introducing work characteristics in multivariate models. Evidence in favour of the moderation hypothesis was found in some studies, demonstrating stronger effects of adverse work on health among people with low SEP. Despite some support in favour of the two hypotheses future research should aim at reducing the heterogeneity in defining and measuring core variables and at applying advanced statistical analyses. Policy recommendations would benefit from a higher degree of consistency of respective research evidence.

Show MeSH
Related in: MedlinePlus