Workplace factors boost diabetes risk


Middle-aged men who work hard for poor rewards are three times more likely to develop diabetes as those higher up the office food-chain, according to a long-running research project.

Although stress, low social support and depression are known risk factors in the development of coronary heart disease, the research led by Professor Sir Michael Marmot at University College London is the first to establish a link between these factors and diabetes.

Other studies have shown that bad management can drive up their employees' blood pressure, increasing their long-term risks of a heart attack or stroke, while Finish researchers have found a strong correlation between organisational justice - described as 'justice of decision making procedures and interpersonal treatment' - and the health of employees.

The University College researchers have been tracking the health of 10,000 civil servants since 1985 and correlating the incidence of diabetes with individual's grade within the civil service.

During the subsequent years, four percent of those tracked were diagnosed with diabetes. But nine percent of the men and seven percent of the women in clerical and office support grades developed diabetes, compared with three percent of men and two percent of women in administrative grades.

Overall, those at the bottom of the civil service hierarchy were found to 2.9 times as likely to develop diabetes if they are men and 1.7 times more likely to do so if they are women.

The researchers said that the different incidence of the disease in women could be explained by the fact that the lower-grade civil servants lead less healthy lives.

But the same could not be said for men. Here, the relationship between diabetes and employment grade remained significant even after accounting for other risk factors, such as ethnicity, family history, physical activity and blood pressure.

The higher risk in men was due to a higher "effort-reward imbalance," the researchers said, where high efforts were defined as competitiveness and work-related over-commitment or hostility, and low rewards were defined as poor promotion prospects or a blocked career.

The relationship between effort-reward imbalance was "robust" even after additional cardiovascular risk factors were considered, making it unlikely that it was influenced by changes in behaviours, such as diet or exercise, they added.