Organizational Justice and Long-term Metabolic Trajectories: A 25-Year Follow-up of the Whitehall II Cohort

Abstract

Context: Organizational justice has been linked to lower risk of several chronic conditions among employees, but less is known about the long-term mechanisms underlying this risk reduction. Objective: To assess whether self-reported organizational justice is associated with individual and composite long-term metabolic trajectories. Design: Twenty-five-year follow-up of the Whitehall II prospective cohort study. Setting: Middle-aged public servants from the United Kingdom. Participants: Data on 8182 participants were used. Main Outcome Measures: Levels of 11 anthropometric, glycemic, lipid, and blood pressure biomarkers were measured at 5 timepoints (1991-2013). We used generalized estimating equations and group-based trajectory modeling to investigate the relationship between organizational justice and biomarker trajectories. Results: High vs low organizational justice were associated with lower waist (-1.7 cm) and hip (-1 cm) circumference, body mass index (-0.6 kg/m2), triglycerides (-1.07 mmol/L), and fasting insulin (-1.08 μIU/mL) trajectories. Two latent metabolic trajectory clusters were identified: a high- and a low-risk cluster. High organizational justice (vs low) were associated with belonging to the low-risk cluster (pooled odds ratio = 1.47). The low-risk cluster demonstrated lower baseline levels of most biomarkers and better glycemic control, whereas the high-risk cluster showed higher baseline levels of most biomarkers, glycemic deterioration, but also greater improvements in lipid levels over time. Conclusions: People with high organizational justice had more favorable long-term cardiometabolic biomarker patterns than those with low organizational justice, indicating a potential mechanism contributing to the lower risk of chronic diseases in the first group. Further intervention studies are warranted to determine whether improvement of organizational justice might improve long-term health.