The mismatch between high effort and low reward in household and family work predicts impaired health among mothers.

Background: So far, Siegrist's model of effort-reward imbalance (ERI) has been tested almost exclusively for paid employment. This article reports results on a newly developed questionnaire measuring ERI in unpaid household and family work.

Methods: Using data of a population-based sample of 3129 German mothers, logistic regression analyses were performed to test the following three main assumptions: (i) high effort combined with low reward in household and family work increases the risk of poor health; (ii) a high level of overcommitment may enhance the risk of poor health; and (iii) mothers reporting an extrinsic high ERI and a high level of overcommitment have an even higher risk of poor health.

Results: ERI was significantly related to self-rated health, somatic complaints and mental health. A high level of overcommitment increased the risk of poor health, whereas ERI and overcommitment combined was associated with the highest risk of poor health. Statistically significant synergy effects of combined exposure of ERI and overcommitment were found for 'anxiety'.

Conclusions: With some limitations, all three assumptions underlying the ERI model were confirmed. Thus, we conclude that ERI is applicable to domestic work and may provide an explanatory framework to assess stress experiences in mothers.