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An inverse relationship exists between social position and incidence of diabetes that is partly explained by health behaviors and other risk factors. Effort-reward imbalance, which is reportedly associated with coronary heart disease, is also associated with type 2 diabetes.

Objective-To describe and explain the socioeconomic gradient in sickness absence.Design-Analysis of questionnaire and sickness absence data collected from the first phase of the Whitehall II study. Grade of employment was used as a measure ofsocioeconomic status.Setting-20 civil service departments in London. Subjects-6900 male and 3414 female civil servants aged 35-55 years.Main outcome measures-Rates of short spells (<7 days) and long spells (>7 days) of sickness absence.Results-A strong inverse relation between grade of employment and sickness absence was evident. Men in the lowest grade had rates of short and long spells of absence 6-1 (95% confidence interval 5*3 to 6.9) and 6-1 (4-8 to 7 9) times higher than those in the highest grade. For women the corresponding rate ratios were 3 0 (2.3 to 3.9) and 4-2 (2.5 to 6 8) respectively. Several risk factors were identified, including health related behaviours (smoking and frequent alcohol consumption), work characteristics (low levels of control, variety and use of skills, work pace, and support at work), low levels of job satisfaction, and adverse social circumstances outside work (financial difficulties and negative support). These risk factors accounted for about one third of the grade differences in sickness absence.Conclusion-Large grade differences in sickness absence parallel socioeconomic differences in morbidity and mortality found in other studies.

Objective: Previous research has focused on overall associations between work stress and body mass index (BMI) ignoring the possibility that stress may cause some people to eat less and lose weight and others to eat more. Using longitudinal data, we studied whether work stress induced weight loss in lean individuals and weight gain in overweight individuals. Design: Prospective cohort study. Subjects: A total of 7965 British civil servants (5547 men and 2418 women) aged 35-55 at study entry (The Whitehall II study). Measurements: Work stress, indicated by the job strain model and measured as job control, job demands and job strain, was assessed at baseline and BMI at baseline and at 5-year follow-up. Results: In men, the effect of job strain on weight gain and weight loss was dependent on baseline BMI (Pp0.03). In the leanest quintile (BMIo22 kg/m 2 ) at baseline, high job strain and low job control were associated with weight loss by follow-up, whereas among those in the highest BMI quintile (427 kg/m 2 ), these stress indicators were associated with subsequent weight gain. No corresponding interaction was seen among women. Conclusion: Inconsistent findings reported by previous studies of stress and BMI have generally been interpreted to indicate the absence of an association. In light of our results, the possibility of differential effects of work stress should also be taken into account.

Employers and employees should be aware of the potential harmful effects caused by sickness presenteeism.

Background. Previous research suggests that children are a high risk group vulnerable to the effects of chronic noise exposure. However, questions remain about the nature of the noise effects and the underlying causal mechanisms. This study addresses the effects of aircraft noise exposure on children around London Heathrow airport, in terms of stress responses, mental health and cognitive performance. The research also focuses on the underlying causal mechanisms contributing to the cognitive effects and potential confounding factors.Methods. The cognitive performance and health of 340 children aged 8–11 years attending four schools in high aircraft noise areas (16h outdoor Leq>66dBA) was compared with children attending four matched control schools exposed to lower levels of aircraft noise (16h outdoor Leq<57dBA). Mental health and cognitive tests were group administered to the children in the schools. Salivary cortisol was measured in a subsample of children.Results. Chronic aircraft noise exposure was associated with higher levels of noise annoyance and poorer reading comprehension measured by standardized scales with adjustments for age, deprivation and main language spoken. Chronic aircraft noise was not associated with mental health problems and raised cortisol secretion. The association between aircraft noise exposure and reading comprehension could not be accounted for by the mediating role of annoyance, confounding by social class, deprivation, main language or acute noise exposure.Conclusions.These results suggest that chronic aircraft noise exposure is associated with impaired reading comprehension and high levels of noise annoyance but not mental health problems in children.

This paper investigates the extent to which social support can have a buffering effect against the potentially adverse consequences of bullying on school achievement and mental health. It uses a representative multiethnic sample of adolescents attending East London secondary schools in three boroughs. Bullied adolescents were less likely to achieve the appropriate academic achievement benchmark for their age group and bullied boys (but not girls) were more likely to exhibit depressive symptoms compared to those not bullied. High levels of social support from family were important in promoting good mental health. There was evidence that high levels of support from friends and moderate (but not high) family support was able to protect bullied adolescents from poor academic achievement. Support from friends and family was not sufficient to protect adolescents against mental health difficulties that they might face as a result of being bullied. More active intervention from schools is recommended.