4. The degree of control that employees exercise over their work influences health.

Many scientists have focused research on different working conditions and their effects on health and mental health. These include, for example, workload and pace, work schedule, job complexity, role ambiguity, career security factors, interpersonal relations and job content.¹⁹ Robert Karasek and Töres Theorell have spearheaded a fruitful area of research focused on two important dimensions of working conditions: the amount of work employees are expected to accomplish ("job demands") and the extent of their decision-making authority over how to complete the work ("decision latitude"). Studies researching the interplay of these factors have found that workers who have high demands and low decision latitude, which they term "job strain," are at risk for a number of poor health outcomes. Job strain has been found to be particularly associated with cardiovascular disease.^{20, 21} Other research has identified relationships between job strain and all-cause mortality,^{22, 23} exhaustion and depression,²⁴ poor perceived health,²⁵ poor mental health and physical functioning,²⁶ and alcohol abuse.²⁷ Some research has suggested that unemployment rates result in poorer health even among those who are working because high unemployment causes changes in job structures that reduce decision latitude and increase job demands for those who are working.²⁸