Effects from job stress on self-rated health transitions over time: the ELSA-Brasil cohort study

This study aimed to analyze the effects of job stressors on self-rated health transitions in more than ten years of follow-up of participants of The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Longitudinal design, including individuals from ELSA-Brasil, aged 35-74 years at baseline. Our outcome was transition intensities between self-rated health states, a time-varying variable, categorized into three states (good, fair, and poor). Our exposure, measured at the baseline, was job stressors assessed by the Demand-Control-Support Questionnaire. The effects of job stressors on changes in self-rated health were analyzed using longitudinal models adjusted for age, sex, and education. In total, we analyzed information from 9776 individuals. Participants with active jobs (Hazard Ratio - HR = 0.81, 95% Confidence Interval - CI = 0.72 - 0.91), passive jobs (HR = 0.78, CI = 0.70 - 0.86), and high job strain (HR = 0.75, CI = 0.68 - 0.84) had a lower risk of transitioning from fair to good self-rated health. Participants with low social support had a higher risk of transitioning from good to fair self-rated health (HR = 1.12, CI = 1.04 - 1.21) and a lower risk of transitioning from poor to good self-rated health (HR = 0.10, CI = 0.02 - 0.50). Job stressors were associated with a decline in self-rated health within our population. The risks varied depending on the participants' current state of self-rated health. It is essential to improve job control and social support to prevent the negative consequences of poor health states.