The heart and justice

Justice is not often the object of study in a medical journal.

Kivimäki and colleagues just published a study on the health effects of justice at work. In a study of 6442 male British civil servants, aged 35 to 55 years and no heart disease at the beginning of the study, they demonstrated that justice at work is associated with reduced risk of heart disease. When adjusted for age and employment grade, data showed that employees who experienced a high level of justice at work had a 30% lower risk of new heart disease compared with employees who experienced a low or an intermediate level of justice.

According to the study’s authors, “An indicator of justice at work is whether people believe that their supervisor considers their viewpoints, shares information concerning decision-making, and treats individuals fairly and in a truthful manner.”

The level of justice in the workplace was assessed by a self-report questionnaire that asked the following questions (using a scale of 1 to 4, with 1 being “never” and 4 being “often”):
(1) Do you ever get criticized unfairly (reverse scored)?
(2) Do you get consistent information from line management (your superior)?
(3) Do you get sufficient information from line management (your superior)?
(4) How often is your superior willing to listen to your problems?
(5) Do you ever get praised for your work?

Job strain and effort-reward imbalance were also measured, using self-reported job demands, job control, efforts, and rewards. Higher job strain, and, to a lesser extent, higher effort-reward imbalance, were also associated with higher risk of new heart disease but the justice factor is unique among psychosocial work factors in that it is directly focused on managerial treatment and procedure.

The authors offer this conclusion:

Most people care deeply about just treatment by authorities. Just treatment may communicate status and value, whereas lack of justice may be a source of oppression, deprivation, and stress. Justice, equity, and altruism have been the drivers of benign developments in human societies according to a wide range of studies across a broad spectrum of disciplines. Our findings on [coronary heart disease], the leading cause of death in all Western societies, suggest that organizational justice is also a topic worthy of consideration in health research.

The study was published in the October 25 issue of Archives of Internal Medicine. You can read the article in full here.