What is the Origin of Effort-Reward Imbalance?

This model was developed by sociologist Johannes Siegrist in the 1990s as a framework for understanding the detrimental health effects of adverse social and psychological work environments. The theoretical origin is rooted in occupational health psychology and sociology, seeking to quantify the link between social reciprocity failures in the workplace and objective health outcomes. Its relevance to clinical practice stems from its ability to predict disease risk independent of traditional biological factors.

What is the Mechanism of Effort-Reward Imbalance?

The mechanism of action is mediated by the sustained neuroendocrine response to perceived injustice or threat, which the imbalance represents. The chronic mobilization of stress hormones, primarily cortisol and catecholamines, shifts the body into a catabolic state, promoting visceral adiposity, insulin resistance, and systemic inflammation. This continuous physiological alarm state, driven by the psychosocial environment, eventually exhausts the body's regulatory systems, accelerating cellular aging and contributing to the onset of metabolic syndrome and other endocrine disorders.

Effort-Reward Imbalance

Meaning

Effort-Reward Imbalance is a psychosocial stress model that posits that high effort expenditure in the workplace, coupled with low perceived rewards—including low salary, lack of esteem, or poor job security—leads to sustained psychological and physiological distress. From an endocrinology perspective, this chronic stress exposure drives prolonged activation of the hypothalamic-pituitary-adrenal (HPA) axis, resulting in dysregulated cortisol secretion and a heightened allostatic load. This imbalance is a critical factor in the pathogenesis of stress-related metabolic and cardiovascular dysfunction.