Effort–reward imbalance and overcommitment for municipality employees

Norwegian local authority workers took part in a study to validate a Norwegian version of the Effort–Reward Imbalance Questionnaire which examined variables such as self-reported general health, psychological distress, musculoskeletal complaints and work-related burnout. People with high effort–reward and overcommitment scores had less favourable health scores, and those with low effort–reward and overcommitment scores had more favourable health scores.


According to the effort–reward imbalance (ERI) model (see Siegrist et al, 2004), effort at work is reciprocated by adequate reward as part of a social contract. Rewards are transmitted in the following three ways:

  • esteem;
  • career opportunities;
  • job security.

Research has found that a failure to achieve reciprocation between effort and reward at work may enhance the activation of the autonomic nervous system (that is, the part of the nervous system that controls involuntary actions) and influence the risk of coronary heart disease (Siegrist, 1984, 1996; Siegrist and Peter, 1996).

The ERI model has been found to be related to:

  • self-reported health (Godin and Kittel, 2004);
  • poor well-being (de Jonge et al, 2000);
  • depression (Pikhart et al, 2004).
  • to the ERI model, adverse health effects can also be triggered by an individual’s exhaustive coping style; this is referred to as ‘overcommitment’.

As the ERI model had never been systematically examined in Norway, a study by Bjørn Lau published in April 2008 sought to validate a Norwegian version of the Effort–Reward Imbalance Questionnaire (ERI-Q). The study’s aims included:

  • examining the factors covered by the ERI-Q and its components;
  • investigating the differences in the average values of the model’s components according to gender, age, education and occupation;
  • testing the ERI, overcommitment and interaction hypotheses in relation to self-reported health, psychological distress, musculoskeletal complaints and work-related burnout.

About the survey

All employees in a middle-sized municipality in Norway were invited to participate in a study of their psychosocial workplace environment based on a web-based questionnaire. The standardised ERI-Q (Siegrist et al, 2004) was translated into Norwegian and data were collected during a three-week period in spring 2007; 1,803 of the municipality’s 2,712 employees participated, giving a response rate of 66%.

Results and discussion

When adjusted for differences in the number of items on the scales (that is, the effort–reward ratio), the numbers of people having higher scores on the effort scale than on the reward scale did not significantly differ according to gender, age, education or occupational group. However, some differences were found in the different components of the ERI model.

  • The youngest employees were more likely to have low effort values compared with employees in their fifties.
  • High-skilled white-collar workers reported higher scores on the effort dimension than all other occupation groups.
  • High-skilled white-collar workers had higher levels of overcommitment than low-skilled blue-collar workers and low-skilled white-collar workers.

When the effort–reward ratio was associated with all the health-related variables in logistic regression analyses, the strongest associations were found with work-related burnout and psychological distress. Weaker associations were found with musculoskeletal complaints and self-rated poor health.

Overcommitment was also associated with all the health-related variables. The ERI and overcommitment hypotheses were also supported in the linear regression analyses. The results also indicate that the dependence of the health scores on the effort–reward ratio changed as a function of the level of overcommitment.

In this first study to investigate the psychometric properties of a Norwegian version of the ERI-Q, satisfactory psychometric properties were found for most of the factors in this model when used in a study of employees in a medium-sized Norwegian municipality. The earlier finding that employees with lower socioeconomic positions most frequently report higher ERI at work (Siegrist and Marmot, 2004) was not supported in this study where the effort–reward ratio and the continuous ERI score were consistent according to gender, age, education, and occupational groups.

In contrast to other studies, the results also showed a tendency towards higher reported levels of effort with increasing age, indicating increased perceived strain associated with work.

Both the ERI and overcommitment hypotheses were supported in the multivariate logistic regression analyses and in the linear regression analyses in this study.

The study’s findings suggest it would be worthwhile exploring health conditions among employees with different combinations of high and low scores for effort–reward and overcommitment. Employees could be classified into such a study in four different groups:

  • relaxed employees;
  • struggling employees;
  • exaggerating employees;
  • despairing employees.


de Jonge, J., Bosma, H., Peter, R. and Siegrist, J., ‘Job strain, effort-reward imbalance and employee well-being: a large-scale cross-sectional study’, Social Science and Medicine, Vol. 50, No. 9, 2000, pp. 1317–1327.

Godin, I. and Kittel, F., ‘Differential economic stability and psychosocial stress at work: associations with psychosomatic complaints and absenteeism’, Social Science and Medicine, Vol. 58, No. 8, 2004, pp. 1543–1553.

Lau, B., Effort–reward imbalance and overcommitment in employees in a Norwegian municipality: a cross sectional study, Journal of Occupational Medicine and Toxicology, Vol. 3, Open Access Paper 9, 2008.

Pikhart, H., Bobak, M., Pajak, A., Malyutina, S., Kubinova, R., Topor, R., Sebakova, H., Nikitin, Y. and Marmot, M., ‘Psychosocial factors at work and depression in three countries of Central and Eastern Europe’, Social Science and Medicine, Vol. 58, No. 8, 2004, pp. 1475–1482.

Siegrist, J., ‘Adverse health effects of high-effort/low-reward conditions’, Journal of Occupational Health and Psychology, Vol. 1, 1996, pp. 27–41.

Siegrist, J., ‘Reducing social inequalities in health: work-related strategies’, Scandinavian Journal of Public Health. Supplement, Vol. 59, 2002, pp. 49–53.

Siegrist, J. and Peter, R., ‘Threat to occupational status control and cardiovascular risk’, Israel Journal of Medical Sciences, Vol. 32, No. 3–4, 1996, pp. 179–184.

Siegrist, J. and Marmot, M., ‘Health inequalities and the psychosocial environment: two scientific challenges’, Social Science and Medicine, Vol. 58, No. 8, 2004, pp. 1463–1473.

Siegrist, J., Starke, D., Chandola, T., Godin, I., Marmot, M., Niedhammer, I. and Peter, R., ‘The measurement of effort-reward imbalance at work: European comparisons’, Social Science and Medicine, Vol. 58, No. 8, 2004, pp. 1483–1499.

Bjørn Tore Langeland, National Institute of Occupational Health, Department of Occupational Health Surveillance

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