Quality of leadership and self-rated health: the moderating role of ‘Effort–Reward Imbalance’: a longitudinal perspective

OBJECTIVE: Longitudinal studies on the influence of leadership behavior on employees’ self-rated health are scarce. As a result, potential mechanisms describing the impact of leadership behavior on health have not been adequately investigated so far. The present study accounts for the influence of leadership behavior on self-rated health within the framework of the Effort–Reward Imbalance model. METHODS: The study was conducted on the basis of a cohort which comprised a random sample of healthcare workers from ten different hospitals and one elderly nursing home in Germany. A 2-level repeated measurement model with random intercept and slopes was modeled, since it was aimed to account for individual as well as intra-individual variation of subjective health across three time points over 36 months. Beside ‘Effort–Reward Imbalance’ and ‘Quality of Leadership’ from the Copenhagen Psychosocial Questionnaire, physical and mental health was assessed by German version of the SF12 multipurpose short-form measure of health status. RESULTS: ‘Effort–Reward Imbalance’ and a lack in ‘Quality of Leadership’ negatively affect self-rated physical health. No effect was found for self-rated mental health. Effort–Reward Imbalance significantly moderates the effect of ‘Quality of Leadership’ on self-rated physical health. CONCLUSION: The findings, and the interaction effects in particular, suggest that leadership behavior moderated by factors such as appreciation and support, influences self-rated physical health. The study therefore provides an interpretation for leadership behavior and its influence on employees’ self-rated health within the ‘Effort–Reward Imbalance’ model. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00420-022-01941-w.