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Whitehall II - Social and Occupational Influences On Health and Illness

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00005680
Recruitment Status : Completed
First Posted : May 26, 2000
Last Update Posted : July 29, 2016
Information provided by:
National Heart, Lung, and Blood Institute (NHLBI)

Tracking Information
First Submitted Date May 25, 2000
First Posted Date May 26, 2000
Last Update Posted Date July 29, 2016
Study Start Date September 1993
Actual Primary Completion Date August 2007   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures Not Provided
Original Primary Outcome Measures Not Provided
Change History Complete list of historical versions of study NCT00005680 on Archive Site
Current Secondary Outcome Measures Not Provided
Original Secondary Outcome Measures Not Provided
Current Other Outcome Measures Not Provided
Original Other Outcome Measures Not Provided
Descriptive Information
Brief Title Whitehall II - Social and Occupational Influences On Health and Illness
Official Title Not Provided
Brief Summary To examine the effect on health and disease of the work environment, psychological workload, control over work pacing and content, opportunity for use of skills, social support at work; the moderating effect on these relationships of social supports; and, the interaction between these psychosocial factors and other established risk factors in the etiology of chronic disease.
Detailed Description


One of the major health problems facing industrialized countries is the persisting social class differences in the rate of occurrence of the major chronic diseases. It is true in the United States as it is in the United Kingdom, Scandinavia, Japan, and other countries. The advantage of investigating these social differences in the United Kingdom is that they have been most extensively documented, but findings are likely to be generalizable. The Black Report comprehensively reviewed the persisting social inequalities in health and concluded that the reasons were not completely understood. The Whitehall Study of the British civil service confirms the social gradient in mortality.

In the British civil service studies, as in the country as a whole, social class is defined on the basis of occupation. This raises the question as to whether the observed differences in morbidity and mortality are due to factors related to occupation or the general way of life. In many countries there are well documented social class differences in aspects of life-style: smoking, leisure-time physical activity, obesity, diet. Such differences were confirmed in civil servants studies, but these were insufficient to account for differences in mortality. There are thus two types of question: what accounts for the differences in smoking and other aspects of life style among men and women in different occupations? and; to what extent may the unexplained social differences in disease rates be related to factors associated with work as distinct from way of life?


There was a cross-sectional study and a short-term longitudinal study linking baseline data with morbidity based on sickness-absence records collected over an eighteen month period. Each subject was screened in an on-site work clinic. Questions were included on birthdate, civil service grade, marital status, family history of cardiovascular disease, occupation, car and house ownership, ethnicity, medical history of cardiovascular and respiratory problems, smoking, coffee and alcohol use, dietary intake, physical activity, work characteristics, social support, life satisfaction, life events, and mental illness. Type A behavior was assessed by the Framingham Type A Scale. A separately funded physical exam was conducted and included data on blood pressure, height, weight, pulse, ECG, blood clotting factors, and serum cholesterol. Initial analysis included calculation of prevalence rates of ischemic heart disease by age, sex, and social class as measured by employment grade. Dependent variables were crosstabulated for various categories of independent variables. The independent variables consisted of measures of psychosocial stress arising from work and personal situations.

The study was renewed in 1993 and again in 1997 to continue the follow-up of the cohort and collect further outcome data. This was achieved by 1) continued collection of sickness absence data; 2) obtaining information from GP's regarding long spells of absence; 3) obtaining death certificates and cancer registrations; and 4) a repeat questionnaire to all 10,314 participants to ensure completeness of outcome data. With additional outcome data the investigators used their extensive exposure database to explain the socio-economic gradient in health, encompassing both external influences and biomedical mechanisms. The main focus of the analysis was the role of work stress and social supports and networks both in explaining differences in health between socio-economic groups and individual differences in health. The analysis of these individual differences in health paid particular attention to women and ethnic minorities.

The study was renewed in 2002 to :(1) determine the extent to which socio-economic position and psychosocial factors influence pathophysiological responses and sub-clinical vascular disease directly and via health related behaviors, (2) examine psychosocial explanations for socio-economic differences in coronary health in an occupational cohort moving out of work, (3) determine, in our aging population, the relationships between socio-economic position, coronary disease and health functioning and disability.

Study Type Observational
Study Design Not Provided
Target Follow-Up Duration Not Provided
Biospecimen Not Provided
Sampling Method Not Provided
Study Population Not Provided
  • Cardiovascular Diseases
  • Heart Diseases
  • Coronary Disease
  • Myocardial Ischemia
  • Hypertension
Intervention Not Provided
Study Groups/Cohorts Not Provided
Publications *

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
Recruitment Information
Recruitment Status Completed
Enrollment Not Provided
Original Enrollment Not Provided
Actual Study Completion Date August 2007
Actual Primary Completion Date August 2007   (Final data collection date for primary outcome measure)
Eligibility Criteria No eligibility criteria
Sexes Eligible for Study: All
Ages up to 100 Years   (Child, Adult, Older Adult)
Accepts Healthy Volunteers No
Contacts Contact information is only displayed when the study is recruiting subjects
Listed Location Countries Not Provided
Removed Location Countries  
Administrative Information
NCT Number NCT00005680
Other Study ID Numbers 1070
R01HL036310 ( U.S. NIH Grant/Contract )
Has Data Monitoring Committee Not Provided
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement Not Provided
Responsible Party Not Provided
Study Sponsor National Heart, Lung, and Blood Institute (NHLBI)
Collaborators Not Provided
Investigator: Michael Marmot University of London
PRS Account National Heart, Lung, and Blood Institute (NHLBI)
Verification Date January 2008