Conference reading materials

PRESENTATION: KEYNOTE ADDRESS, April 28: Professor Robert Karasek

Instruction for Reading Conference Resource Materials

This short note is only a “beginning,” covering only the background sources for the integrating Keynote Lecture.

Resource materials to adequately address the broad range of Conference Themes will require a wide diversity of resources. These will be developed as the Conference evolves, via participant suggestions (check the Conference website for updates).


  • STEP I. All Conference Participants:KEYNOTE BACKGROUND

Read the Conference Keynote overview paper “From the Demand/Control Model to A Feasible Economy of Innovative and Healthy Work” (RK, December 2, 2014).  This short paper integrates the Four Themes of the Conference in a short file (11 p).



  • STEP II-A and II-B. The Next Steps for Economists and Productivity persons;

The above overview article provides a “starting point” for economists and others wanting to understand the Conducive Economy concepts in broad context. Then go to Section IIA and IIB.


  • STEP II-C. The Next Step for Social Policy persons:might want to go further first with:  II-C below. Then follow path II or path III.


  • STEP III. The Next Step for Health-focus persons: (persons presumably already somewhat familiar with the Job Strain/disease literature of the last decades [not here included]). They might want to explore the newer, if more speculative, implications of the major new theory: Stress-Disequilibrium Theory for disease development processes in Section III.



Section IIA: HOW TO READ: The Conducive Production/Conducive Economy papers[1]

There are two “main papers” both easy to read – but now also somewhat “Wrong” in that they were written before the critical limitations introduced in 2007/2008 with Stress-Disequilibrum Theory (SDT) – see Section II-A4.



II-A-1a. New Work Organization and Conducive Value,” 1999.  This “Gids” version is a good beginning to “get the vision.” This is a short easy-to-read paper describing the Conducive Economy/Production ideas that was edited by Ton Korver (actually the “theme article” for a full journal issue in the Dutch Sociol. Gids about Conducive Production topics). The useful description/definition of the "skill-based economy" begins on p. 315 (it is “social policy” before that).


II-A-1b. “Alternative Economic Vision,” BSTS, 2004b.  This is a more complete text than “Gids.” Start at p. 400 to p. 415  (it is social policy before that).  It adds many related topics, including a “social capital” linkage. There is a “Combined Commodity and Conducive Economy” text at pps. 418-20 (now also in the Keynote above), and the last pages are current historical context: pps. 425-27. 

The problem is – just as with the Gids version above – that this version is also “Wrong” (pre-2007/2008), because it has NONE of the Health/Stress "limits" (from SDT).  Thus, both these versions of Conducive Economy may seem unrealistically optimistic, too Utopian or somehow “ungrounded” (most of the “second half” of the Alternative Economy article, particularly after pp. 420, is thus limited, and is not logically as tight as is needed). 

It is only the newer formulations that resolve this problem: the Keynote above, and the Draft paper, (II-B-2) on the new “Associationalist Demand/Control Model.” They both integrate the Health/Stress discussion of the "limits/ and constraints" together with Conducive Innovation to further expand on the combination of growth possibilities and need for healthy stability platforms. 

The Keynote and Conducivity Model papers present a rough outline at an introductory level. However, the more sophisticated analytic explanations needed for today’s reality are further discussed in the further papers below.




For a deeper level of sophistication, there are the following four additional papers and Notes.


NOTES: Comparison between Conducive Production and Value Neo-Classical Economy

1. History: Locke’s Labor Value, Property Value and Democracy Concepts

2. Definition: Market Value (Commodity Value) and Limitations

3. History: A Second Labor Value Pathway: Skills and Conducive Value

4. Definition: Conducive Value, Implication and current relevance

5. Social Production Value Transitions and Value Conflicts

6. Appendix:  Locke’s Two Treatises; and Job Socialization figure (BSTS, 20041-a)



IIB-2. DEMAND/CONTROL MODEL & CONDUCIVE PRODUCTION:  The Revised Demand/Control Model (“A-D/C Model”),* and Systems Dynamics of Ordering Capacity (THEME #3)

            *Associationalist Demand/Control Model (A-D/C Model):

This draft “paper excerpt” has a dual purpose for the Conducive Economy discussion:

            Purpose A. This paper excerpt provides more insight into Conducive Production’s Innovation processes” (which at base are Growth processes) - from the perspective of Stress-Disequilibrium Theory” (SDT) (Karasek, 2008 paper) which has a natural science base conceptualization.

            Purpose B. This paper excerpt also provides the social science audience[2] a sort of “concept translation guide,” explaining how the classic D/C Model Terminology: Demand/ Control/ Support (now Stability), Strain, Active, etc. can be re-conceptualized in the context of the now vastly generalized- SDT systems-dynamics processes (p. 11).

This paper includes the following selected summary draft texts:

A. Creation of High-level Ordering Capacity – p. 5

This is A START for understanding of all SDT Themes: there is a “summary” short, simple Stress-Disequilbrium Theory version in the core of this paper

B. Model of the Growth Process: A Basis for Conducive Development –p. 8

C. Platforms of Stability (Equilbrium of flows) – p. 13

D. Classic D/C and new Assoc.-D/C – Diagramatic transistions – p. 15    

E. Appendix: Dollard and Karasek, 2010 paper (some pages as PPT).  Maureen Dollard – in a stroke of genius – found a way to apply the SD Theory at the organizational level in the context of describing the creation of a “Psychosocial Safety Climate “ to protect job-level stress prevention efforts.



“Social Behaviors in Conducive Production...”, BSTS 2004c.  This is Karasek’s closest approach to describing the “new social relations” that would occurin Conducive Production. How would people creatively relate to each other  (fx: in improvisational jazz)?  How does that differ from the current Free-Market behavioral model?  This is a very “new article”, and describes a type of “relational coordination” - but is definitely not the same as Jody Gittell’s (2010) organization-level version, for example. 




“ Low Social Control and...” (Karasek, SJWEJH, 2008):

This paper integrates Conducive Production (System Growth) and Self-Regulatory Health (avoiding System Decline), via Stress-Disequilibrium Theory (SDT), explaining the Origins of High-level-Ordering Capacity Creation and Use.

 THIS IS BY FAR THE MOST IMPORTANT PAPER (of all of these): “Low Social Control and...” SJWEH, 2008.  While this is Karasek’s most important paper (in his view), it is inaccessible[3], and is not easy to read.

  The paper describes rigorously the basis and principles (Eight Principles) of the Stress-Disequilbrium Theory of Disease Process – of decay of any complex organization. Then, at the very end (Principle #8, p. 130-132) it goes on to use these principles as a basis for suggesting how Growth Process in complex organisms/organizations, i.e., those in Conducive Production,” could occur.  Thus, these could easily be included with reconfiguration into a new “combined theory” (and is thus the logical basis of the Associationalist Demand/Control Model, called: ” he A. D./C. Model).”

 This is also the underlying theme of the Conference Keynote Summary – combining both Health and work organization-based Innovation/creativity.

THIS IS A COMPLEX PAPER: HOW TO READ IT (!): Start by reading the first 2/3 pages of the paper’s introduction.  Then switch to the END of the paper (!), and read “backwards,” section-by-section, through to the beginning of Part II of the paper.  After this: THEN go to the core SDT Principles, at the end of Section I: this is very rigorously, tightly formulated text.  This explanation is presented in physiological and physics terminology, but is claimed to have relevance at multiple levels: this also potentially including the workplace organizational level. That point is demonstrated in the Appendix to the “A-D/C Model" Draft Paper above explanation and (Dollard and Karasek, 2010).



The Conducivity Game: A Micro Experiment in Conducive Work Organization: “Tools...” (BSTS, 2004d)

This project describes a workplace field project in Swedish companies based on the Conducivity Game, which teaches participative and adaptable processes for job redesign. The game demonstrates how the links to adaptive customer demands can lead directly to changes in worker’s skill development, their internal work activity coordination, and visa versa.

The game introduces visual tools to provide game participants with easy-to-use “language development” process and allow workers themselves to redesign their job situations - facilitating participative both work redesign and innovation production.

This paper provides some of the “Conducive Communication” process description and visual images, albeit in Black/White only (very colorful in reality).




IIC-1: “A Vacuum...” BSTS, 2004a.   This paper describes the situation in 2004 for policy standoff between -market capitalism (MOP) and. the welfare state model (WSP). It claims that as a result of these two dominant but incomplete models (both materialistic), we have been left with an effective “vacuum” in relevant social policy discussions and actions in the West - for a significant number of decades, with destructive results.

The new social policy direction, related to work organization and new forms of value, is called Work Quality Policy (WQP).  That is what we would now want to “create” – with broad, new multidisciplinary discussions. This 2004 article still seems to be a relevant description of the “current state of the economic/political dialogue” - even if the overall economic /political situation is “tighter” now.


Ton Korver presents a short Dutch perspective (2004) on the possibilities of Conducive Economy in “Working Economics and Labor Policy..,” and also reviews historical precedent for WQP.




There are many programmes Social Innovation. This one is about research:
The Finnish policy is an interesting example as well:
The latest high tech research programme of Germay includes ‚good work‘ (gute Arbeit):

Workplace innovation: European policy and theoretical foundation:


Steven Dhondt Frank Delano Pot Karolus O. Kraan, (2014),"The importance of organizational level decision latitude for well-being and organizational commitment", Team Performance Management, Vol. 20 Iss 7/8 pp. 307 - 327:








Moving Beyond Job Strain, toward new descriptions of disease process and social implications

 NOTE: The audience here is presumably familiar with the Job Strain/Disease research, which is basically a hypothesis confirming literature, but will not be further presented here (else see: Karasek and Theorell, 1990/2, Healthy Work,  


HOW TO READ the Stress-Disequilbrium Theory/Associationalist D/C Model papers:

III-1. START with a “summary” version: either above Paper IIB-2, or III-2 Section 3

Paper III-2, Section 3 (IJOMEH 2010) below, includes a short, simple Stress-Disequilbrium Theory, set in the context of stress theory’s evolution, in Section 3 of the paper (4 pages).

III-2.  IJOEM 2010: “Large Scale Study Design...for Job Stress Research..”

The remainder of this paper is exactly as the title implies: Karasek’s outline of how the Job Stress / Job Strain and heart disease research field should go forward from where it is now. It contains a structured review of multi-level evidence paragraphs toward the beginning.

 Then the body of the paper outlines the hypotheses, the main “tests” in the SDT context:  (Controller/ Controlled physiological measurement tests), and then describes the methodological issues involves, and has a summary of the current epidemiological challenges.

 NOTE: Such a specific, “positive next research step” suggestion is needed after the recent, controversial “mess” in a set of European studies collectively known as the IPD studies (these studies are another, albeit meta-analytic – but flawed - summary of the main epidemiological studies from the previous two decades of research, now published several very high visibility medical journals). The studies usually show indisputable Job Strain/ CHD hypothesis confirmation, but this is combined with a terribly misleading, conservatively interpreted estimations of explanatory power.  Karasek recommends instead Belkic, et al, 2004’s review of these same and many more studies as much more useful. 

III-3 (One Job Strain research paper): “Job Stress & Disability.., “(Canivet, Choi, Karasek, et al, 2012, IAOEH  ..”

The Swedish data on Job Strain and chronic disease disability from social registers shows clearly that extensive job stress costs are borne, not only by individuals, but by society as a whole.



III-4. Health and Stress-Disequilibrium Theory: A Speculative Essay: (unpublished, 2005) (Word file)

This is the most comprehensive essay on the very general “form” of the disease processes under SD Theory, and a statement of the health implications of the SD Theory. It includes a selection of evidence using diverse examples from the literature, and includes several current “extrapolations” – revealing both the power and limitations of the theory (as constituted at the time in early development – 2005).

An “ecological fallacy” example relating to application of SDT principles at the level of human social organization is discussed: the case of the automobile: its production and evolutionary growth.  



III-5. Stress-Disequilibrum Theory and  Prevention-Only Treatable Disease (P-O.T.D.

A major implication of Stress-Disequilibrium Theory is that there is a “High-Level Theory of Disease Causation.”  The means that for a widespread set of chronic disease conditions (sudden death heart attacks, etc.) the causes are high-level threats (stressors) to the organism - when, in spite of the onset of disease, the lower biological functional levels are all still healthy.  The implication is that the ONLY “pathway to health” is by high-level reduction in risk - i.e. social level “prevention,” for example at work. This is because there are no “low-level,” biologically based deficits to be corrected (a) with drugs, (b) no damaged tissues to be repaired with surgery. (c) Not even generic life-style interventions could be effective.

We have used the preliminary label: Prevention-Only Treatable Disease: P-O. T. D., to emphasize the societal-level solution priority. Of course, if found to be true, such an explanation would have a major effects on medical spending priorities in advanced economies - reallocating resources toward prevention. 

The above explanation is primarily speculative at this point, although we do have workplace field study heart/health empirical confirmation (Collins et al, 2005). However, given the generality of the SDT hypotheses, we can also present some “suggestive” evidence from an organization-level analogy of the same mechanisms - which can easily be accepted as valid (see enclosed draft: A-D/C Model paper).

III-5a. PPT: “Prevention-Only Treatable Disease (P-O.T.D.),” (2012)

Perhaps the best “written narrative” is in these PowerPoint Slides, outlining the logic of the P-O.T.D. approach.



III-5b. “Guidelines for Student Research Projects”, 2012 (Word file): 

While still a speculative theory of disease development, it is still demonstrably useful: we can effectively teach students at a graduate university program to do research based on the SD Theory’s most “unique,” powerful, and socially relevant set of SDT predictions:  the “Prevention-Only Treatable Disease Hypothesis.” 

However different from “conventional medicine,” given the clear guidelines, this approach can rather non-problematically be followed by students to pieced together useful insight from the enormous literatures that do exist.  This graduate student “research guideline” has been working very well in advanced courses to guide students (and teachers), step-by-step, though the background understandings that would be needed to “do/write/practice” good medical research and preventive medicine following the SD Theory.



Main Theoretical Source List - Keynote Narrative Summary

(1. Karasek and Theorell, 1990;  especially Ch. 3 pps. 86-103, and Ch. 5; p. 187- 97.)

2. R. Karasek, Low social control and physiological deregulation: The stress-disequilibrium Theory, towards a new demand-control model, Scandinavian Journal of Work, Environment & Health. 2008 ; vol. 6, nr. suppl., s. 117-135. - PDF


3. Karasek R, Collins S, Clays E, Bortkiewicz A, Ferrario M: Description of a large-scale study design to assess work-stress-disease associations for cardiovascular disease. Int J Occup Med Environ Health; 2010;23(3):293-312
PMID: 21306975

4.  R. Karasek: P-OTD Research Project Guide, 2013  -Word doc

5. R. Karasek: New Work Organization and Conducive Value, (/Ed. T. Korver),  Soc. Guids, 1999 

6. R. Karasek, A Vacuum in Political and Economic Labor Policy? Bulletin of Science Technology and Society, (BSTS), 2004 24: 353-365. - PDF

7. R. Karasek, An Alternative Economic Vision for Healthy Work: Conducive Economy, BSTS 2004 24: 397-429. - PDF

8. R. Karasek, The Social Behaviors in Conducive Production and Exchange, BSTS 2004 24: 457-468. – PDF

9. R. Karasek, A Tool for Creating Healthier Workplaces: The Conducivity Process,

BSTS 2004 24: 471-479. - PDF.

10. M. Dollard and R. Karasek, “Building Psychosocial Safety Climate: Evaluation of a Socially Coordinated PAR Risk Management Stress Prevention Study,” in 2010 Houdmont, J. & Leka, S. (Eds.) (2010). Contemporary occupational health
psychology: Global perspectives on research and practice
, Chichester,
UK: Wiley-Blackwell.

11. R. Karasek, Health and Stress-Disequilibrium Theory: A Speculative Essay  (unpublished, 2005) (“S-D Process Conclusions”)

[1]  Here also included is the Combined Outline of two Dedicated Journal Issues to Conducive Production: Bulletin of Science, Technology and Society (BSTS) Contents: August, October 2004, Volume 24, No. 4,5  - all about Conducive Economy, (and Demand Control, Active Work).


[2] All texts are excerpts from the draft “JCQ2 Theory Paper 1B” (from the Job Content Questionnaire (JCQ) 2.0 Paper Group (to be submitted for publication, approx. May 2016), Nov 10, 2015, Robert Karasek.

            This particular paper text is from a social science-focused work organization measurement instrument (JCQ2 theory background paper (now being written).

            This paper addresses a different audience that the first version of this theoretical framework: the Stress-Disequilibrium Theory paper (Karasek, SJWEH, 2008), which focused on the physiological processes involved in social causation of physiological disease, written for a medical/social epidemiological research audience.

            The Demand/Control model has always spanned an important “duality:” health and behavioral outcomes were both predicted (Questions below: 1,2 and then 3 demonstrate this duality).  While health outcomes (for example: job stress and disease risk) were often very person-focused, or even physiological in the recent decades of job strain medical research, the active behavior consequences involved social behavior at the individual level and above.

            This article’s first author first evolved this new theory approach herein in an attempt to find the answer to Question #3: How does low control cause disease? Thus, some of the narrative below has evolved from the expanded systems theory perspective first developed in physiological terms (Karasek, 2008, SJWEH, (Karasek, et al, 2010). The original D/C model was introduced (Karasek, 1976) by tests, at with sociological-level data, of the Active Work hypothesis.


[3] Not available on Medline, although a much shorter, Medicin de Lavoro, 2006, version, is available but with no “growth, no “A D/C,” no social implications, etc.



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