Effort-reward imbalance at work and health

All major contracts in social life, including the work contract, are based on the principle of reciprocity. A fair balance between the costs invested in cooperative activities and the gains received in turn is a prerequisite of a trustful social exchange and individual well being. Conversely, failed reciprocity in terms of high cost and low gain elicits strong negative emotions and associated stress responses. The model of effort-reward imbalance has been developed to identify conditions of failed reciprocity in social contracts, with a particular focus on work, and to predict reduced well being and increased illness susceptibility as a consequence of this exposure. This chapter describes the theoretical foundation of this model and its measurement. Moreover it summarizes empirical evidence on adverse effects on health derived from epidemiological and laboratory investigations. Finally, some policy implications of this new evidence are discussed.