Ignite Creation Date:
2024-05-05 @ 10:23 AM
Last Modification Date:
2024-10-26 @ 9:05 AM
Study NCT ID:
NCT00005680
Status:
COMPLETED
Last Update Posted:
2016-07-29
First Post:
2000-05-25
Brief Title:
Whitehall II - Social and Occupational Influences On Health and Illness
Sponsor:
National Heart Lung and Blood Institute NHLBI
Organization:
National Heart Lung and Blood Institute NHLBI
Study Overview
Official Title:
None
Status:
COMPLETED
Status Verified Date:
2008-01
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
To examine the effect on health and disease of the work environment psychological workload control over work pacing and content opportunity for use of skills social support at work the moderating effect on these relationships of social supports and the interaction between these psychosocial factors and other established risk factors in the etiology of chronic disease
Detailed Description:
BACKGROUND
One of the major health problems facing industrialized countries is the persisting social class differences in the rate of occurrence of the major chronic diseases It is true in the United States as it is in the United Kingdom Scandinavia Japan and other countries The advantage of investigating these social differences in the United Kingdom is that they have been most extensively documented but findings are likely to be generalizable The Black Report comprehensively reviewed the persisting social inequalities in health and concluded that the reasons were not completely understood The Whitehall Study of the British civil service confirms the social gradient in mortality
In the British civil service studies as in the country as a whole social class is defined on the basis of occupation This raises the question as to whether the observed differences in morbidity and mortality are due to factors related to occupation or the general way of life In many countries there are well documented social class differences in aspects of life-style smoking leisure-time physical activity obesity diet Such differences were confirmed in civil servants studies but these were insufficient to account for differences in mortality There are thus two types of question what accounts for the differences in smoking and other aspects of life style among men and women in different occupations and to what extent may the unexplained social differences in disease rates be related to factors associated with work as distinct from way of life
DESIGN NARRATIVE
There was a cross-sectional study and a short-term longitudinal study linking baseline data with morbidity based on sickness-absence records collected over an eighteen month period Each subject was screened in an on-site work clinic Questions were included on birthdate civil service grade marital status family history of cardiovascular disease occupation car and house ownership ethnicity medical history of cardiovascular and respiratory problems smoking coffee and alcohol use dietary intake physical activity work characteristics social support life satisfaction life events and mental illness Type A behavior was assessed by the Framingham Type A Scale A separately funded physical exam was conducted and included data on blood pressure height weight pulse ECG blood clotting factors and serum cholesterol Initial analysis included calculation of prevalence rates of ischemic heart disease by age sex and social class as measured by employment grade Dependent variables were crosstabulated for various categories of independent variables The independent variables consisted of measures of psychosocial stress arising from work and personal situations
The study was renewed in 1993 and again in 1997 to continue the follow-up of the cohort and collect further outcome data This was achieved by 1 continued collection of sickness absence data 2 obtaining information from GPs regarding long spells of absence 3 obtaining death certificates and cancer registrations and 4 a repeat questionnaire to all 10314 participants to ensure completeness of outcome data With additional outcome data the investigators used their extensive exposure database to explain the socio-economic gradient in health encompassing both external influences and biomedical mechanisms The main focus of the analysis was the role of work stress and social supports and networks both in explaining differences in health between socio-economic groups and individual differences in health The analysis of these individual differences in health paid particular attention to women and ethnic minorities
The study was renewed in 2002 to 1 determine the extent to which socio-economic position and psychosocial factors influence pathophysiological responses and sub-clinical vascular disease directly and via health related behaviors 2 examine psychosocial explanations for socio-economic differences in coronary health in an occupational cohort moving out of work 3 determine in our aging population the relationships between socio-economic position coronary disease and health functioning and disability
One of the major health problems facing industrialized countries is the persisting social class differences in the rate of occurrence of the major chronic diseases It is true in the United States as it is in the United Kingdom Scandinavia Japan and other countries The advantage of investigating these social differences in the United Kingdom is that they have been most extensively documented but findings are likely to be generalizable The Black Report comprehensively reviewed the persisting social inequalities in health and concluded that the reasons were not completely understood The Whitehall Study of the British civil service confirms the social gradient in mortality
In the British civil service studies as in the country as a whole social class is defined on the basis of occupation This raises the question as to whether the observed differences in morbidity and mortality are due to factors related to occupation or the general way of life In many countries there are well documented social class differences in aspects of life-style smoking leisure-time physical activity obesity diet Such differences were confirmed in civil servants studies but these were insufficient to account for differences in mortality There are thus two types of question what accounts for the differences in smoking and other aspects of life style among men and women in different occupations and to what extent may the unexplained social differences in disease rates be related to factors associated with work as distinct from way of life
DESIGN NARRATIVE
There was a cross-sectional study and a short-term longitudinal study linking baseline data with morbidity based on sickness-absence records collected over an eighteen month period Each subject was screened in an on-site work clinic Questions were included on birthdate civil service grade marital status family history of cardiovascular disease occupation car and house ownership ethnicity medical history of cardiovascular and respiratory problems smoking coffee and alcohol use dietary intake physical activity work characteristics social support life satisfaction life events and mental illness Type A behavior was assessed by the Framingham Type A Scale A separately funded physical exam was conducted and included data on blood pressure height weight pulse ECG blood clotting factors and serum cholesterol Initial analysis included calculation of prevalence rates of ischemic heart disease by age sex and social class as measured by employment grade Dependent variables were crosstabulated for various categories of independent variables The independent variables consisted of measures of psychosocial stress arising from work and personal situations
The study was renewed in 1993 and again in 1997 to continue the follow-up of the cohort and collect further outcome data This was achieved by 1 continued collection of sickness absence data 2 obtaining information from GPs regarding long spells of absence 3 obtaining death certificates and cancer registrations and 4 a repeat questionnaire to all 10314 participants to ensure completeness of outcome data With additional outcome data the investigators used their extensive exposure database to explain the socio-economic gradient in health encompassing both external influences and biomedical mechanisms The main focus of the analysis was the role of work stress and social supports and networks both in explaining differences in health between socio-economic groups and individual differences in health The analysis of these individual differences in health paid particular attention to women and ethnic minorities
The study was renewed in 2002 to 1 determine the extent to which socio-economic position and psychosocial factors influence pathophysiological responses and sub-clinical vascular disease directly and via health related behaviors 2 examine psychosocial explanations for socio-economic differences in coronary health in an occupational cohort moving out of work 3 determine in our aging population the relationships between socio-economic position coronary disease and health functioning and disability
Study Oversight
Has Oversight DMC:
Is a FDA Regulated Drug?:
Is a FDA Regulated Device?:
Is an Unapproved Device?:
Is a PPSD?:
Is a US Export?:
Is an FDA AA801 Violation?:
Secondary IDs
| Secondary ID | Type | Domain | Link |
|---|---|---|---|
| R01HL036310 | NIH | None | httpsreporternihgovquickSearchR01HL036310 |