Rethinking Work Control and Its Relationship to Health

Work control is widely recognized as a core dimension of job quality and a key determinant of worker health, especially in increasingly precarious labor markets. Yet the concept is inconsistently conceptualized and poorly measured. The author reconceptualizes and analyzes work control as a multidimensional, context-sensitive balance between autonomy-enhancing enablers and constraint-imposing barriers, using cross-national survey data from the 2015 International Social Survey Programme Work Orientations IV Module. The author examines how the reconceptualized work control measure relates to self-rated health across 15 countries with varying economic and welfare contexts. Results from survey-weighted and mixed-effects ordered logistic models show that workers with high work control, defined as having more enablers than constraints across control over work hours, time off, and work-family boundaries, report significantly better self-rated health, even after adjusting for job characteristics, household structure, and macro-level conditions. This relationship remains robust across multiple sensitivity tests. Descriptive and validation analyses further indicate that reducing constraints, particularly those from work-family interference, plays a more decisive role for well-being than autonomy alone. By distinguishing meaningful work control from nominal flexibility or perceived autonomy, this study clarifies how effective control is associated with health in the post-2008 labor market and underscores the importance of policies that make control both possible and meaningful in everyday work.