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Open Access Open Badges Research article

Proximal and distal determinants of stressful work: framework and analysis of retrospective European data

Morten Wahrendorf1* and Johannes Siegrist2

Author Affiliations

1 Centre for Health and Society, Institute for Medical Sociology, University of Düsseldorf, 40225 Düsseldorf, Germany

2 Senior Professorship on Work Stress Research, Faculty of Medicine, University of Duesseldorf, 40225 Düsseldorf, Germany

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BMC Public Health 2014, 14:849  doi:10.1186/1471-2458-14-849

Published: 15 August 2014



While robust evidence on associations of stressful work with health exists, less research is available on determinants of stressful work in terms of respondents' characteristics (proximal factors) and in terms of national labour market policies (distal factors). In this article we analyse proximal (childhood circumstances and labour market disadvantage) and distal determinants (national compensation and integration policies) of stressful work in a comprehensive framework.


We use data from the third wave of the Survey of Health, Ageing and Retirement in Europe (SHARE), with retrospective information on individual life courses collected among 11181 retired men and women in 13 European countries (2008–2009). To test our hypotheses we estimate multilevel regression models.


Results show that stressful work is related to disadvantaged circumstances during childhood. To some extent this association is explained by labour market disadvantage during adulthood. Additionally, well developed labour market integration policies are related to lower overall levels of stressful work at national level.


This analysis provides first evidence of important determinants of stressful work, both in terms of pre-employment conditions (childhood circumstances) and in terms of contextual macro-social policies.