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Objectives. The authors' objective was to investigate whether increasing health heterogeneity during the middle years is attributed, at least in part, to the influence of varying levels of, and changes in, work control of the current midlife cohort. The specific study objective was to examine how individual trajectories of work control influence mental and physical health outcomes of middle-aged men and women both directly and indirectly through occurrences of stressful life events. Methods. The study used four waves of data collected from 372 employed rural women and 320 employed men of the midlife cohort during a ten-year period. Variables included self-reported work control, stressful non-work life events and mental and physical health. The analyses used latent growth curve modeling. Results. The results partially supported the hypothesized pathways wherein initial level and change in work control contributed to increased depressive symptoms and poor physical health of men and women. For middle-aged men, work control directly influences health outcomes whereas for middle-aged women, work control indirectly influences health outcomes through the occurrence of stressful life events. Discussion. Through understanding these processes, work can be better designed to promote positive health outcomes, minimize negative health outcomes, and allow for better formulation and more effective implementation of health promotional programs. [ABSTRACT FROM AUTHOR]