Work and its impact on health. The model Work and its repercussions on health. The effort-reward imbalance model

All major contracts in social life, including work contracts, are based on the principle of reciprocity between the efforts invested in cooperative activities and the gains received in return. Failed reciprocity in terms of high effort and low gain elicits strong negative emotions and associated stress responses. The model of Effort-Reward Imbalance (ERI) has been developed to identify conditions of failed reciprocity in social contracts, with a particular focus on work, and to predict reduced well being and increased susceptibility to illness as a consequence of this imbalance. The present article describes the theoretical foundation of this model and its measurement. Empirical evidence on the adverse effects on health of IRE is summarized and the implications for healthcare of this new evidence are discussed.