The relationship between psychosocial risk factors and health outcomes of chronic diseases: a review of the evidence for cancer and cardiovascular diseases

Abstract

This report summarizes the best available evidence for a link between psychosocial factors and cardiovascular and cancer morbidity and mortality in Europe. A total of 1822 Medline and PubMed articles published in English since January 2000 were searched, identifying 37 systematic reviews and meta-analyses. Among the psychosocial factors repeatedly identified as related to chronic diseases, in and outside work, were high job demand, low autonomy, low control or high effort–reward imbalance, interpersonal conflicts, and low social support or low trust. The evidence suggests that multiple adverse psychosocial factors are independently associated with a range of adverse chronic diseases throughout adulthood. In addition, the social gradient in health observed throughout adulthood may partly operate through psychosocial factors on the pathway between socioeconomic characteristics and health. Psychosocial factors, therefore, might become part of complex total risk-reducing interventions focusing on multiple risk factors.