American Diabetes Association
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Characteristics of Workplace Psychosocial Resources and Risk of Diabetes: A Prospective Cohort Study

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posted on 2021-11-05, 16:06 authored by Tianwei Xu, Alice J Clark, Jaana Pentti, Reiner Rugulies, Theis Lange, Jussi Vahtera, Linda L Magnusson Hanson, Hugo Westerlund, Mika Kivimäki, Naja H Rod

To examine whether characteristics of workplace psychosocial resources are associated with the risk of type 2 diabetes among employees.

Research Design and Methods

Participants were 49,835 employees (77% women, aged 40-65 and diabetes-free at baseline) from the Finnish Public Sector cohort study. Characteristics of horizontal (culture of collaboration and support from colleagues) and vertical (leadership quality and organizational procedural justice) psychosocial resources were self-reported. Incident type 2 diabetes (n=2148) was ascertained via linkage to electronic health records from national registers. We used latent-class modeling to assess the clustering of resource characteristics. Cox proportional hazard models were used to examine the association between the identified clusters and risk of type 2 diabetes during 10.9 years of follow-up, adjusting for age, sex, marital status, educational level, type of employment contract, comorbidity and diagnosed mental disorders.


We identified four patterns of workplace psychosocial resources: ‘unfavorable’; ‘favorable vertical’; ‘favorable horizontal’; and ‘favorable vertical and horizontal.’ Compared with the ‘unfavorable’, ‘favorable vertical’ (HR=0.87 95%CI 0.78;0.97), ‘favorable horizontal’ (HR=0.77 95%CI 0.67;0.88), and ‘favorable vertical and horizontal’ (HR=0.77 95%CI 0.68;0.86) resources were associated with a lower risk of type 2 diabetes, with the strongest associations seen in employees at age 55 or older (Pinteraction=0.03). These associations were robust to multivariable adjustments and were not explained by reverse causation.


Employees working in a favorable level of culture of collaboration, support from colleagues, leadership quality, and organizational procedural justice have a lower risk of developing type 2 diabetes than those without such favorable workplace psychosocial resources.


This project is supported by the Danish Working Environment Research Fund (grant 13-2015-09). TX was supported by a grant from the Swedish Research Council for Health, Working Life and Welfare (#2020-00040). RR was supported by research grands from NordForsk (grant 70521) and the Danish Working Environment Research Fund (grant 10-2016-03). JV was supported by the Academy of Finland (grant 321409 and 329240) and NordForsk (75021). LMH was supported by a grant from the Swedish Research Council for Health, Working Life and Welfare (#2019-01318). MK was supported by research grants from NordForsk (grant 70521, the Nordic Research Programme on Health and Welfare), the Academy of Finland (329202), and Finnish Work Environment Fund (190424) and, outside this work, by research grants from the UK Medical Research Council (grant MRC S011676) and the US National Institute on Aging (NIA) (grant R01AG056477). AJC moved to Novo Nordisk at the end of the project. Her current employer has no role in the study design, analyses and results interpretation.


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