Work environment may put women at risk of diabetes: ICES study

Women with low job control are twice as likely to develop diabetes compared to women with high job control according to a new nine-year study by researchers at the Institute for Clinical Evaluative Sciences (ICES) and the Institute for Work & Health.

Job control can be defined as an individual’s ability to use their skills and the authority to make decisions over the way they work. Given the increasing prevalence of diabetes in Canada, low job control might be an important modifiable risk factor to reduce the occurrence of diabetes among the female population.

Peter Smith, lead author on the study and researcher with the Institute for Work & Health, said, “Increasing levels of job control for women at work – such as providing autonomy over the way they do their jobs – along with improving health behaviours, should be considered as part of a comprehensive diabetes prevention strategy."

The two primary pathways linking high psychosocial work stress to diabetes risk are:

• Via disruptions to neuroendocrine and immune system functioning and increased or prolonged cortisol and sympathetic hormone release in reaction to stress.
• Through changes in health behaviour patterns, particularly those related to diet and energy expenditure, possibly as coping mechanisms.

While there has been a large amount of work examining the relationship between the psychosocial work environment and hypertension and heart disease, to date there have been relatively few studies examining the relationship between psychosocial work conditions and diabetes.

“Given the increasing prevalence of diabetes in Canada it is important to identify modifiable factors the might increase or decrease the risk of this disease in women. While our study shows that high body mass index is probably the most important risk factor, low job control among women also played an important role in diabetes risk,” said Rick Glazier, co-author and senior ICES Scientist.

The study, which was funded by the Canadian Institutes of Health Research, followed 7,443 actively employed Ontario labour market participants with no previous diagnoses for diabetes for a nine year period. The study used data from the 2000-01 Canadian Community Health Survey linked to the Ontario Health Insurance Plan database (OHIP) for physician services and the Canadian Institute for Health Information Discharge Abstract Database (CIHI-DAD) for hospital admissions. The proportion of cases of diabetes in women that could be attributed to low job control, at 19 per cent, was higher than that for other health behaviours (smoking, drinking, physical activity and fruit and vegetable consumption), but lower than for obesity.

Diabetes is a growing public health concern. In Ontario, Canada, the prevalence of diabetes in 2005 had already surpassed the predicted global rate for the year 2030, almost doubling between 1995 and 2005.

The article, “The psychosocial work environment and incident diabetes in Ontario, Canada,” was published today in the Journal of Occupational Medicine.

Author block: Peter M Smith, Richard H Glazier, Hong Lu, Cameron A Mustard

The Institute for Work & Health is an independent, not-for-profit organization. Our mission is to conduct and share research that protects and improves the health of working people and is valued by policy-makers, workers and workplaces, clinicians, and health & safety professionals.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

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