Effort-reward imbalance and problem drinking among workers: Differences in gender and the gender composition of industries and main job activities in a prospective cohort study from Sweden

Effort-reward imbalance (ERI) is a form of psychosocial work stress known to contribute to health problems among working populations. Given that men and women tend to work in different industries and job activities, the labour market remains gender segregated. This study investigated the relationships between effort, reward, ERI, overcommitment and problem drinking in a sample of the Swedish working population over time and simultaneously explored whether these relationships differ by gender and the gender composition of industries and main job activities. Data were drawn from the Swedish Longitudinal Occupational Survey of Health, collected biennially from 2010 to 2022, comprising 18 017 workers. Work stress and problem drinking were measured with the ERI questionnaire and the Cut-down-Annoyed-Guilty-Eye opener instrument, respectively. A logistic-generalised estimating equation was used to perform the analysis. The results showed that higher scores of all the components of the ERI–model are significantly associated with problem drinking (p<0.01). However, these associations did not significantly differ by gender and the gender composition of industries and main job activities (p>0.10). Also, overcommitment did not significantly moderate the association between ERI and problem drinking (p>0.10). Our findings demonstrated that all the components of the ERI–model contribute to problem drinking in working populations and highlight the need for organisations and stakeholders to consider gender as a social structure when developing strategies and interventions aimed at improving work stress and reducing problem drinking.