Work as a social determinant of health on cardiovascular and musculoskeletal diseases: A literature review

Abstract

Background: Work, a social determinant of health (SDOH) can both affect and be affected by health. Objective: To examine literature related to work as a SDOH on cardiovascular and musculoskeletal disease among U.S. workers. Methods: A literature review was conducted. All studies investigating work-related SDOH on the following cardiovascular (stroke, hypertension) and musculoskeletal disease (arm and leg limbs, pain). Epigenetic influences were also evaluated, as it relates to these diseases. Results: The core concept of “work” as a SDOH on cardiovascular and musculoskeletal disease has yielded the “bio-ecological work” model, comprised of four main levels of influence: Work Environment, Interpersonal, Psychological, and Intrapersonal. The Work Environmental dimension includes: The health effects of unemployment and job insecurity, the impact of shift work schedules on health, balance between work effort and reward, the psychosocial work environment, the influence of control at work, demands, and decision latitude on worker's health, the link between health and the physical risks and hazards of work. The Interpersonal level consists of: The health implications of balancing work and family responsibilities and social support at work. The Psychological dimension includes perceived discrimination in the workplace and acute work-related stress and chronic disease. And the Intrapersonal level consists of workplace exposures on epigenetics, telomere length, and microRNA molecules. Conclusion: This work is important to inspire capacity building and research in occupational health, to prevent cardiovascular and musculoskeletal disorders in order to preserve a productive life for the ageing population.