Explaining employees' health care costs: A prospective examination of stressful job demands, personal control, and physiological reactivity

The authors tested the ability of stressful demands and personal control in the workplace to predict employees' subsequent health care costs in a samp le of 105 full-time nurses, Both subjective and objective measures of workl oad demands interacted with personal control perceptions in predicting the cumulative health care costs over the ensuing 5-year period. Tonic elevatio ns in salivary cortisol, moreover, mediated the effects of demands and cont rol on health care costs. Neither the job demands variables nor physiologic al reactivity measures, however, explained subsequent mental health. The re sults support findings from the epidemiological literature that demonstrate an important role for employees' control in explaining occupational inequa lities in coronary heart disease and mortality. The authors argue that the results also encourage control-enhancing job design interventions by sugges ting that their outcomes can benefit both organizations and their members.