What was a central finding of the Whitehall study (Marmot et al., 1984) with the British civil servants?

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Question: What was a central finding of the Whitehall study (Marmot et al., 1984) with the British civil servants?

Option a: Demonstrated the "executive stress" hypothesis - higher status individuals had worse health due to job pressure. This option misstates the classic finding. The Whitehall study did not primarily attribute better or worse health to executive stress among high-status individuals; rather, it showed a gradient in health across grades, with lower grades experiencing poorer health outcomes. The term executive stress is more associated with later discussions about job strain, but the central Whitehall finding was not that high-status individuals had worse health due to pressure.

Option b: Mortality rates were similar across all employment grades, showing no link between job status and health. This is incorrect. The study found a clear association between grade and health/mortality, revealing a socioeconomic gradient in health, not uniform mortality across grades.

Option c: Higher grade jobs had better health outcomes compared to those in lower grade jobs, even after controlling for health behaviors and access to health care. This accurately captures the key finding of the Whitehall (Civil Service) studies: a systematic health advantage among higher-grade (higher-status) civil servants, persisting even when accounting for certain health behaviors and healthcare access.

Option d: Health disparities existed only at the two extremes (poorest and richest) and lifestyle factors fully accounted for differences in mortality. This claim is not correct. The Whitehall findings demonstrated a gradient across many levels of employment, not just at extremes, and while lifestyle factors explained part of the differences, they did not fully account for the observed gradient in mortality and health.

In summary, option c correctly reflects the core result of the Whitehall study: a graded association where higher grade jobs correlated with better health outcomes, independent of some health behaviors and access to care. The other options either overstate or misstate the relationship between job status and health, or imply a uniform effect across grades that the study did not support.

What was a central finding of the Whitehall study (Marmot et al., 1984) with the British civil servants?

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