Testing global and specific indicators of rewards in the Effort-Reward Imbalance Model: Does it make any difference?

The aim of the present study was to investigate relationships between Effort-Reward Imbalance (ERI) and employee adverse health (i.e., psychosomatic complaints, physical symptoms, and exhaustion). The Effort-Reward Imbalance Model was extended by discriminating three specific rewards separately (i.e., salary, esteem, and job security). A sample of 167 health-care workers was used to test the relationship between ERI (i.e., high effort accompanied with low reward) and employee adverse health with multiple univariate logistic regression analyses. Separate analyses were carried out with a composite reward scale and with each of the three specific reward scales as independent variables. The results indicate that the health outcomes of ERI vary depending on the specific reward that was used. Generally, the most adverse health effects were found for employees who reported both high efforts and low rewards, thus supporting the ERI Model. Moreover, the strongest effects of ERI on employee health were found when esteem was used as a reward indicator. Job security also appeared to be an important reward in this respect, whereas salary did not have strong effects as a result of ERI. Although the ERI Model was merely supported by the results, current findings also indicate it is important to separate different kinds of rewards, especially in health-care work in order to capture the complexity of working with clients as well.