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Supplemento B, Psicologia 2010; Vol. 32, N. 3: B5-B9 ISSN 1592-7830

Marko Elovainio1, Tarja Heponiemi1, Timo Sinervo1, Nicola Magnavita2

Organizational justice and health; review of evidence


National Institute for Health and Welfare, Helsinki, Finland 2 Institute of Occupational Medicine, Catholic University, Rome, Italy

ABSTRACT. Organizational justice is a construct defining the quality of social interaction at work. Organizational justice can be divided into three categories: procedural justice (fairness of the decision-making procedures), distributive justice (fairness of outcomes) and relational justice (equity and fairness in the interpersonal treatment of employees by their supervisors). Organizational justice is related to employees’ health and well-being. Low perceived justice has been shown to be associated with experienced stress reactions and related physiological and behavioral reactions, such as inflammation, sleeping problems, cardiovascular regulation and cognitive impairments, and with a high rate of work absenteeism. This paper is a review of the literature on organizational justice and its impact on workers’ health. Key words: work organization, fairness, health, well-being.

Major theoretical models of organizational justice Organizational justice is a construct defining the quality of social interaction at work (1-3). Organizational justice theorists have identified at least three different categories of events that can be evaluated in terms of justice. These categories are outcomes, processes, and interpersonal interactions. Following these categories, justice evaluations regarding to outcomes are specified as distributive justice, evaluations regarding to fairness of processes are named procedural justice, and justice regarding to interpersonal interactions are judged in terms of interactional or relational justice (4-5). The initial interest in the area of organizational justice considered distributive justice and perceptions of equity (6), but more recent research has emphasized procedural and relational justice (7). Procedural justice refers to the extent to which decision-making procedures are applied consistently, free from bias, accurate, correctable, ethical, and representative of all concerns (8). Relational justice refers to the quality of treatments employees experience in their interpersonal interactions during the completion of organizational processes; specifically, to polite and considerate treatments received from their supervisors (9).

RIASSUNTO. EFFETTI DELLA GIUSTIZIA ORGANIZZATIVA SULLA SALUTE: UNA REVISIONE DELL’EVIDENZA SCIENTIFICA. Il concetto di giustizia organizzativa definisce la qualità dell’integrazione sociale sul lavoro. La giustizia organizzativa si articola in tre categorie: giustizia procedurale (correttezza percepita del processo decisionale), giustizia distributiva (percezione dei risultati del processo decisionale) e giustizia relazionale (percezione di ricevere un trattamento franco e corretto da parte dei superiori). La giustizia organizzativa si correla con la salute e il benessere dei lavoratori. È stato osservato che un basso livello di giustizia si associa con la comparsa di reazioni fisiologiche e comportamentali allo stress, come flogosi, disturbi del sonno, alterazioni dell’omeostasi cardiovascolare e compromissione cognitiva, e con un alto tasso di assenteismo lavorativo. In questo lavoro viene riportata una revisione della letteratura riguardante la giustizia organizzativa e le sue ripercussioni sulla salute dei lavoratori. Parole chiave: organizzazione del lavoro, giustizia, salute, benessere.

The health effects of organizational justice Organizational justice has been related to emotional reactions (10), and low perceived justice has been shown to play an important role in the health and well-being of employees (11-13). It has been associated with job dissatisfaction, retaliation, workplace aggression, lower work commitment and withdrawal (14-17). Previous research also suggests that factors associated with justice perceptions, such as discrimination may be related to factors that influence susceptibility to illness, such as elevated unfavorable serum lipids and negative feelings (18-19). Low justice has also been shown to increase risk of mental distress, psychiatric disorders, sickness absence, and poor self-rated health status (20-22). In addition, epidemiological studies suggest that low organizational justice may also contribute to serious health problems, such as cardiovascular disease (23) and cardiovascular death (24).

fsm. As a consequence. Furthermore. we tried to specify this somewhat and. (27) showed that perceived unfair treatment at workplace is associated with increased risk of poor sleep quality in men and women. proposing that perception of injustice is caused by discrepancy between efforts and Mechanisms linking organizational justice to health outcomes Potential mechanisms underlying the associations between low perceived organizational justice and health outcomes have also been studied. According to a more generalized uncertainty management model of fairness judgments. such as coronary heart disease and some respiratory and musculoskeletal diseases. The tension between the benefits of interdependence on the one hand and the risks associated with interdependence on the other has been termed the fundamental social dilemma (34). that when people do not have information about authority’s trustworthiness.8 times higher in employees with low justice than in employees with high justice (26). body mass index and depressive symptoms. this theory also suggests that when people do have direct.8 to 5. Elovainio et al. a plausible mechanism through which perceived organizational injustice may affect health is prolonged stress. behavioural risks. Uncertainty. fairness heuristic theory suggest. The key element is the salience of either the unpredictability of future events or the inconsistency between important cognitions. Furthermore.33) suggesting that people especially need fairness judgments when they are concerned about potential problems associated with social interdependence and socially-based identity processes. already in midlife (29). inductive reasoning and vocabulary. According to fairness heuristic theory. It has also been found. According to the results of Elovainio et al. or behaviors. A recent explanation for the strong effects of experiences of organizational justice on human reactions was offered by van den Bos. hypertension and job strain. According to van den Bos and Lind’s uncertainty management model (37). on the basis of previous literature. As for many other psychosocial factors at work. that the risk for increased lowfrequency band systolic arterial pressure variability was 3. In previous conceptions of the uncertainty management model. the range of uncertainty-provoking. Prolonged (chronic) inflammation is part of the atherosclerotic process and is a predictor of chronic conditions. In the current paper. firmly constructed fairness judgments either remove uncertainty or alleviate much of the discomfort that uncertainty would otherwise generate. Suppl B. According to the uncertainty management model. unpredictable situations was very broad. employment grade. This dilemma is concerned with the question of whether one can trust others (35). such as age. This results was based on the prospective Whitehall II cohort study of nearly 5000 British civil servants aged 35-55 years at study entry. depression. explicit information about authority’s trustworthiness they are less in need of procedural fairness as a heuristic substitute and less strong fair process effects should occur.(25). or confusion provide the stimulus for seeking and using fairness judgments. it is reasonable to assume that perceived injustice in an uncertain situation represents a greater health risk than in a more certain and predictable situation. Following this. Solid. but this association was not statistically significant. that provoke feelings of uncertainty. which is suggested to be a common indicator of prolonged negative emotional states and related physiological changes. organisational injustice is associated with increased long-term levels of inflammatory markers. Sleep represents the daily process of physiological restitution and recovery and lack of sleep has effects on immune system and metabolism. situations. whether social or not. 32:3. Disturbed sleep is another marker of prolonged stress. using the Whitehall II cohort. cardiovascular regulation and cognitive impairments. people become especially attentive to the information they need to form fairness judgments when they find themselves in unclear or unpredictable situations (36-38). Low perceived justice was also related to an 80% excess risk of reduced high-frequency heart rate variability compared to high perceived justice. because it helps them to deal with uncertainty. It has also been found. when forming fairness judgments people make predictable leaps of judgment to resolve uncertainties they encounter within the fairness judgment process. such as interleukin-6 and C-reactive protein. such as memory. it has been found that one potential mechanism through which justice at work may affect health is poor sleep quality (28).B6 G Ital Med Lav Erg 2010. These findings suggest that cardiac disregulation is one stress mechanism through which a low perceived justice of decision-making procedures and interpersonal treatment increases the risk of health problems. argue for . sleeping problems. who proposed that fairness matters to people. These associations were independent of covariates. such as age. re- sembles assumptions behind most of the classic occupational stress theories (30). occupational grade. experiences. and Lind (31). if people do not have information about the authority’s trustworthiness. they will react more positively towards the outcome they received from the authority when they believe that the authority had been employing fair as opposed to unfair procedures. On the other hand. such as inflammation. Perceived injustice has been shown to be associated with experienced stress reactions (12) and related physiological and behavioral reactions. and organizational justice The idea. This uncertainty model is based on the previous theory called fairness heuristic theory (32. fairness is important for people because fairness judgments are an effective and readily available device for handling the various uncertainties they face. doubt. Psicol http://gimle. procedural fairness serves as a heuristic substitute in the process of deciding how to judge the trustworthiness. that low long-term levels of perceived organisational justice are associated with impaired cognitive functions. Wilke. The long term associations were largely independent of covariates. job control.

attenuate or remove the source of threat. that is autonomy with regard to worktime (worker control over the duration. and procedural justice. there are results suggesting that unfair treatment may intensify health effects of other environmental stressors and that working in a high justice work environment may protect employee from health problems. besides health. According to the results.e. Important sources of uncertainty in modern work life include continuous and rapid changes.42). income. Competent decisions that enable the individual to control a potentially threatening situation are fundamental aspects of homeostasis. there is rapidly growing body of evidence suggesting that organizational justice is associated with wide variety of health outcomes of employees. procedural and interactional dimensions of organizational justice. negative changes in the psychosocial work environment have detrimental effects on the health of employees. quality of care in nursing homes (49) employees’ possibilities to connect work and family live (50) and attitudes towards retirement (51). We also extended previous research in studying whether working in high justice work place would protect from health effects following environmental stressors outside work (47). and negative changes at work) and organizational justice (i. Furthermore. A form of control that has been shown to relate with health at work is control over working times. and maintained the theoretical subdivision of the original questionnaire into sub-scales concerning relational. proposed by Jason A. The instrument showed very good reliability (Cronbach’s alpha= 0. organizational justice is important. distributive. Thus. which may be reduced in stress situations. these associations were dependent on experienced work-time control and perceived changes at work (46). and recent negatively experienced changes at work. was associated with the greatest risk of subsequent illness. and that these mechanisms are related to prolonged stress followed unfair treatment. We suggest that perceived negative changes in the work environment reflect a state in which employees are not able to affect things in predictable ways and. and distribution of his/her worktime) (40-42). In accordance with the uncertainty management model. In addition. thus increasing predictability and reducing uncertainty. It has been observed that the questionnaire may be useful and stimulating to enlarge the existing stress models and capturing new aspects of the psychosocial work environment (54). A recent cross sectional study showed an association between perceived low worktime control and poor health among women.083 male and 24. the dimension of work-time control is located at the work/nonwork interface.fsm. In sum. control over the beginning and end of a workday. control implies the power to reverse. such as predictability of the work environment or possibilities for participation in decision making. has been recently translated into Italian and validated (53). Italian studies We have also previously shown that.92). The Justice Measure 20-items questionnaire (JM20). Compared to other forms of job control 43). for the productivity of the organization (48). Colquitt (52). position. Studies about organizational justice are currently performed in Italy. We examined whether the combination of uncertainty (lack of work-time control. we studied the relationships between organizational justice and sickness-related absences both before and after a major life event among 25459 public sector employees working in 2551 work units. negative changes constitute one source of uncertainty at work. Using a prospective longitudinal design. and health behaviors low procedural and interactional justice were related to long sickness-absence spells. Low work-time control may hamper the successful combination of work-life demands with unavoidable nonwork responsibilities. Results of hierarchical regression models on 7. Controlling aversive situations make individuals believe that the consequence is created by their own response (39). in this way. among those who perceived the management practices in their work unit to be relatively unfair. Other outcomes of organizational justice. and are likely to reduce feelings of uncertainty. Their results showed that a combination of poor psychosocial work characteristics and an adverse change in some other psychosocial B7 operationalizing the work-related uncertainty through two sources: lack of control over working times. which refers to multiple dimensions of control within work (opportunities to participate and use skills). According to the findings of Vahtera and co-workers (45). A meta analysis has linked flexible scheduling. Low control of worktime at the occupational level has been linked with an increased risk of hospitalization and cardiovascular disease (41. .317 female Finnish public sector employees showed that after adjustment for age. the increase in sickness absences after the event was bigger and stayed at a higher level even 30 months after the event. Suppl B. The different dimensions of control may bear a varying relevance on health across individuals and across time. The concept of control refers to power or mastery of the environment as a means for maintaining homeostasis. Psicol http://gimle.G Ital Med Lav Erg 2010. with lower absenteeism (44). Sickness absences covered the period from 36 months prior to the event until 30 months after the event. 32:3. but not among men (40). thus creating a sense of uncertainty and unpredictability reaching beyond a working day. Similar patterns were found for each of the distributive. organizational justice may help to buffer the negative effects of poor health (51). justice of decisionmaking procedures and interpersonal treatment) contributes to sickness absence.. that there are plausible behavioral and physiological mechanisms linking justice perceptions to health outcomes. for example.

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