[The Load of Injustice: A Longitudinal Analysis of the Impact of Subjectively Perceived Income Injustice on the Risk of Stress-Associated Diseases Based on the German Socio-Economic Panel Study].

BACKGROUND: Income injustice is regarded as a psychosocial strain and associated with an increased risk of stress-related diseases. The physiological stress response is thereby considered as a central link. The aim of the study is to reveal the influence of subjectively perceived income injustice on stress-associated diseases, taking into consideration the load duration.

METHOD: Based on the German Socio-Economic Panel Study, data on 5,657 workers in the survey years 2005-2013 were analyzed. The dependent variable reflect the doctor's diagnosed new cases of diabetes, asthma, cardiopathy, stroke, hypertension and depression in the years 2009-2013 as an index. Key predictor is the injustice perception of one's income. In order to operationalize the duration of the injustice perception, the values of the variable for the years 2005, 2007 and 2009 were accumulated. Using logit models, stratified for gender and volume of employment, factors were identified that affect the probability of stress-related diseases.

RESULTS: If income was perceived as unjust for over 5 years, the odds of stress-related diseases were strongly enhanced for women (OR 1.64; 95% CI 1.17-2.30). Women working full-time seemed to be particularly affected (OR 2.43; 95% CI 1.54-3.84). Men working full-time perceiving their income as unjust also showed an increased risk for stress diseases (OR 1.43; CI 1.03-1.98). The more often income was assessed as unjust, the higher was the probability of stress-related diseases.

CONCLUSIONS: Perceived income injustice seems to be a significant risk factor for stress-related diseases within a dose-response relationship with increasing duration of exposure. Findings of stress research indicate that this represents the 'allostatic load'. Gender-specific differences in stress reaction as well as in the appraisal of the stressors can be associated with gender-specific work and life conditions and therefore provide explanatory approaches for the revealed effects.