Objectives To synthesize evidence on neurobiological mechanisms, clinical outcomes, and policy interventions related to occupational and socioeconomic stress as primary health determinants. Methods A narrative review was conducted synthesizing evidence from PubMed, MEDLINE, and Cochrane databases (1990-2024) focusing on meta-analyses and systematic reviews. Search terms included allostatic load, occupational stress, job strain, work-related disease, cardiovascular outcomes, and mental health. Meta-analytic evidence was prioritized for robust effect estimates. Results Allostatic load demonstrates dose-dependent associations with health outcomes. Meta-analyses of >600, 000 participants show job strain is associated with 23% increased coronary heart disease risk. Long working hours (≥55 hours/week) are linked to 33% increased stroke risk and 13% increased coronary heart disease risk. Chronic stress correlates with hippocampal atrophy, impaired prefrontal function, elevated inflammatory markers, and 2. 5-fold increased depression risk. Work-related stress is associated with over 300 billion annually in U. S. healthcare costs and lost productivity. Conclusions Occupational and socioeconomic stressors demonstrate robust associations with adverse health outcomes through well-characterized neurobiological pathways. Effect sizes rival traditional risk factors. Evidence-based interventions from international comparisons suggest potential effectiveness of structural workplace modifications.
Bertrand C. Liang (Fri,) studied this question.