A review of empirical studies on the model of effort-reward imbalance at work: reducing occupational stress by implementing a new theory

Soc Sci Med. 2004 Dec;59(11):2335-59. doi: 10.1016/j.socscimed.2004.03.030.


The present study reviews empirical studies of a new occupational stress model of effort-reward imbalance at work to examine its validity as an occupational stress measure and the theory-based intervention approach to occupational stress reduction. The effort-reward imbalance model is valid for demonstrating a stressful work environment that reflects the current labor market and predicts health conditions among a wide range of working populations. The stressful aspects of work measured by the effort-reward imbalance model are different from those shown in the job demand-control model, and the adverse health effects are independent of each other, which suggests that the two models are complementary. The evidence indicates that it is efficient to select psychosomatic symptoms as short-range target outcomes and sick leave as a medium-range target outcome of the theory-based intervention. In addition, it would be preferable to simultaneously measure job satisfaction, morale, motivation, and performance as organizational level outcomes. Although employees engaged in diverse occupations can be target populations, high effectiveness is expected, particularly in service occupations that work shifts. Studies are necessary to determine how long and how intensely interventions are implemented. Target work environments are selected from the perspective of securing or improving employees' sense of fairness and reciprocity by approaching them. Since the theory-based intervention depends largely on organizational changes that are beyond the individual employees' ability, the cooperation of employers is necessary.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Humans
  • Models, Theoretical
  • Occupational Health*
  • Reward*
  • Stress, Psychological / prevention & control*
  • Surveys and Questionnaires
  • Work*