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Leadership, Job Well-Being, and Health Effects—A Systematic Review and a Meta-Analysis

Kuoppala, Jaana MD, PhD; Lamminpää, Anne MD, PhD; Liira, Juha MD, PhD; Vainio, Harri MD, PhD

Journal of Occupational and Environmental Medicine: August 2008 - Volume 50 - Issue 8 - p 904-915
doi: 10.1097/JOM.0b013e31817e918d
Original Articles

Objective: The aim of this systematic literature analysis was to study the association between leadership and well-being at work and work-related health. These intermediate outcomes are supposed to predict work-related loss of productivity and disability at work.

Methods: Original articles published in 1970 to 2005 were searched in MEDLINE and PsycINFO databases in a systematic manner. The main search terms were leadership, job satisfaction, well-being, sick leave, and disability pension. Out of 303 references, 93 publications were retrieved. In addition, other sources produced 69 articles. The strength of evidence was evaluated comprehensively. Altogether, 109 articles were thoroughly analyzed; our conclusions are based on 27 articles providing the best evidence.

Results: There was moderate evidence that leadership is associated with job well-being (risk ratio [RR] 1.40, range 1.36 to 1.57), sick leave (RR 0.73, range 0.70 to 0.89), and disability pension (RR 0.46, range 0.42 to 0.59). The evidence was weak on that leadership is associated with job satisfaction (median RR 2.23, range 1.30 to 3.51) but not with job performance (RR 1.13, range 0.55 to 1.20).

Conclusions: There is a relative lack of well-founded prospective studies targeting the association between leadership and employee health, but the few available good studies suggest an important role of leadership on employee job satisfaction, job well-being, sickness absences, and disability pensions. The relationship between leadership and job performance remains unclear.

From the Siinto, Myllyojantie 22, 85470 Kiiskilampi, Finland (Dr Kuoppala); State Treasury, Division of Insurance (Dr Lamminpää), Helsinki, Finland; City of Helsinki, Center for Occupational Medicine (Dr Liira), Helsinki, Finland; and Finnish Institute of Occupational Health (Dr Vainio), Helsinki, Finland.

CME Available for this Article at

Jaana Kuoppala, Anne Lamminpää, Juha Liira and Harri Vainio have no commercial interest related to this research.

Address correspondence to: Anne Lamminpää, MD, PhD, State Treasury, Division of Insurance, P.O. Box 10, 00054 State Treasury, Helsinki, Finland; E-mail:

Copyright © 2008 by the American College of Occupational and Environmental Medicine