Stressful Work Conditions Linked to More Doctor Visits in French Study

Workers in France who reported poor psychosocial conditions at their jobs went on to consult their general practitioners more often over the following two years, according to a prospective study published in BMC Public Health. The research, led by Isabelle Niedhammer and Maël Quatrevaux, linked national survey data to records from the French national health insurance system, allowing the number of GP consultations to be measured objectively rather than self-reported.

The study drew on three waves of the national French ESPS survey conducted in 2010, 2012 and 2014. Each participant’s survey responses were matched to their health insurance records, and the researchers counted how many times each worker saw a general practitioner in the two years following each survey wave. The sample comprised 8,771 workers aged 18 to 65.

Psychosocial work exposures were assessed using ten items that served as proxies for established occupational health models, including job strain and effort-reward imbalance. These covered quantitative demands, freedom at work, possibilities for learning new things, colleague support, recognition at work, salary satisfaction, job insecurity, tension with the public, temporary contracts and the presence of a redundancy plan.

Five of the ten exposures showed prospective associations with GP consultations: low possibilities for learning new things, low colleague support, low recognition at work, low salary satisfaction and job insecurity. In other words, workers who reported these adverse conditions at one survey wave subsequently made more primary care visits over the following two years than workers who did not.

The associations were estimated using mixed effect negative binomial models, a statistical approach suited to count outcomes such as the number of consultations. When the researchers adjusted for covariates and for the number of GP consultations in the six months preceding each survey wave, the associations were slightly weakened but remained present, suggesting that pre-existing consultation patterns did not fully explain the findings.

A dose-response pattern also emerged. The more psychosocial work exposures a worker reported, the more GP consultations they accumulated over follow-up. This graded relationship is consistent with an accumulating burden of adverse work conditions being reflected in primary care use, although the prospective observational design cannot establish causation.

Almost all of the observed associations were similar for men and women, indicating that the link between adverse psychosocial work exposures and primary care use was largely consistent across sex in this French working population.

A key strength of the study is its use of an objective data source for the outcome. Because GP consultations were derived from health insurance records rather than participant recall, the findings avoid the reporting bias that can affect surveys asking people to remember their own healthcare use. The authors note that the literature has lacked studies linking psychosocial work exposures to health outcomes measured through such objective sources, particularly for primary care use.

The authors conclude that five of the ten studied psychosocial work exposures were prospectively associated with the number of GP consultations, and they call for more research using prospective designs and objective outcome data to confirm the results. As an observational study in a single national context, the findings identify an association between workplace psychosocial conditions and subsequent primary care use rather than a demonstrated causal effect.

Subject of Research: Prospective associations between psychosocial work exposures and general practitioner consultations in France

Article Title: Prospective associations between psychosocial work exposures and general practitioner consultations in France

Article References: Niedhammer, I., & Quatrevaux, M. (2026). Prospective associations between psychosocial work exposures and general practitioner consultations in France. BMC Public Health. https://doi.org/10.1186/s12889-026-30113-5

Image Credits: AI Generated

DOI: 10.1186/s12889-026-30113-5

Keywords: psychosocial work exposures, general practitioner consultations, occupational health, job strain, effort-reward imbalance, job insecurity, primary care use, prospective cohort, France, health insurance records, BMC Public Health, Prospective