IDEAS home Printed from
   My bibliography  Save this article

Impact of occupational stress on stroke across occupational classes and genders


  • Tsutsumi, Akizumi
  • Kayaba, Kazunori
  • Ishikawa, Shizukiyo


The aims of the present study were to analyze the association between incident stroke, occupational class and stress and to examine whether the association is found in both men and women in a prospective study of Japanese male and female workers. A total of 3190 male and 3363 female Japanese community-dwelling workers aged 65 or under with no history of cardiovascular disease were followed. Occupational stress was evaluated using a demand-control questionnaire. The impact on stroke was examined in stratified analyses of occupational classes. We identified 147 incident strokes (91 in men and 56 in women) during the 11-year follow-up period. Men with high strain jobs (combination of high job demand and low job control) were nearly three times more likely to suffer from a stroke than men with low strain jobs (combination of low job demand and high job control). Among male workers in low occupational classes (blue-collar and non-managerial work), job strain was associated with a higher risk of stroke. In contrast, there was no association between job strain and incident stroke among male workers in high occupational classes (white-collar and managerial work). No statistically significant differences were found for stroke incidence among the job characteristic categories in all the female participants. However, significant, over five-fold excess risks were found among white-collar and managerial female workers exposed to high job strain, compared with their counterparts with low strain jobs. Our study of Japanese workers provided supportive evidence for vulnerability to occupational stress among lower occupational class workers in males but not in females.

Suggested Citation

  • Tsutsumi, Akizumi & Kayaba, Kazunori & Ishikawa, Shizukiyo, 2011. "Impact of occupational stress on stroke across occupational classes and genders," Social Science & Medicine, Elsevier, vol. 72(10), pages 1652-1658, May.
  • Handle: RePEc:eee:socmed:v:72:y:2011:i:10:p:1652-1658

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. repec:aph:ajpbhl:1997:87:4:617-622_5 is not listed on IDEAS
    2. Elovainio, Marko & van den Bos, Kees & Linna, Anne & Kivimäki, Mika & Ala-Mursula, Leena & Pentti, Jaana & Vahtera, Jussi, 2005. "Combined effects of uncertainty and organizational justice on employee health: Testing the uncertainty management model of fairness judgments among Finnish public sector employees," Social Science & Medicine, Elsevier, vol. 61(12), pages 2501-2512, December.
    3. Hallqvist, Johan & Diderichsen, Finn & Theorell, Töres & Reuterwall, Christina & Ahlbom, Anders, 1998. "Is the effect of job strain on myocardial infarction risk due to interaction between high psychological demands and low decision latitude? Results from Stockholm Heart Epidemiology Program (SHEEP)," Social Science & Medicine, Elsevier, vol. 46(11), pages 1405-1415, January.
    4. repec:aph:ajpbhl:1998:88:3:382-388_4 is not listed on IDEAS
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Hiyoshi, Ayako & Fukuda, Yoshiharu & Shipley, Martin J. & Bartley, Mel & Brunner, Eric J., 2013. "A new theory-based social classification in Japan and its validation using historically collected information," Social Science & Medicine, Elsevier, vol. 87(C), pages 84-92.


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:72:y:2011:i:10:p:1652-1658. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.