Organizational justice and long-term metabolic trajectories: a 25-year follow-up of the Whitehall II cohort.

CONTEXT Organizational justice has been linked to lower risk of several chronic conditions among employees, but less is known about the long-term mechanisms underlying this risk reduction. OBJECTIVE To assess whether self-reported organizational justice is associated with individual and composite metabolic trajectories. DESIGN 25 years follow-up of the Whitehall II prospective cohort study. SETTING Middle-aged public servants from the United Kingdom. PARTICIPANTS Data on 8,182 participants were used. MAIN OUTCOME MEASURES Levels of eleven anthropometric, glycaemic, lipid and blood pressure biomarkers were measured at five timepoints (1991-2013). We used generalized estimating equations and group-based trajectory modelling to investigate the relationship between organizational justice and biomarker trajectories. RESULTS High vs. low organizational justice were associated with lower waist (-1.7 cm) and hip (-1 cm) circumference, BMI (-0.6 kg/m 2), triglycerides (-1.07 mmol/L) and fasting insulin (-1.08 µIU/mL) trajectories. Two latent metabolic trajectory clusters were identified: a high-risk and a low-risk cluster. High organizational justice (vs. low) were associated with belonging to the low-risk cluster (ORpooled=1.47). The low-risk cluster demonstrated lower baseline levels of most biomarkers and better glycaemic control, whereas the high-risk cluster showed higher baseline levels of most biomarkers, glycaemic deterioration, but also greater improvements in lipid levels over time. CONCLUSIONS People with high organizational justice had more favourable long-term cardiometabolic biomarkers patterns than those with low organizational justice, a potential mechanism contributing to the lower risk of chronic diseases in the first group. Further intervention studies are warranted to determine whether improvement of organizational justice might improve long-term health.