Hierarchies of health: health and work-related stress of managers in municipalities and county councils in Sweden.

Objective: The aim of this study was to investigate the risk of poor health and stress among male and female managers working at different levels in the public sector.

Methods: A cross-sectional study using register data. A modified Poisson regression approach was used to examine the risk of stress and illness in relation to management level and sex; 1088 managers participated and were categorized into different management levels and sexes.

Results: The results showed a clear hierarchy of health in relation to managerial level and sex with several significant statistical differences. Women with lower-level management positions suffered to a greater extent from poor health and stress.

Conclusions: Organizations should focus not only on developing individuals in their managerial roles but also on improving the conditions that allow managers to remain healthy and less stressed.