Health Shifting The Health of the Worker, As a Worker

Construction workers walking

“Health Shapes Work and Work Shapes Health”

The Robert Wood Johnson Foundation, as well as the Harvard T.H. Chan School of Public Health and National Public Radio, may have given a boost last week to advocates of employee wellbeing. Here, I refer to what I consider authentic wellbeing — based on workers’ exposure to harmful job conditions and environments — not the store-bought imitation based on wellness websites, apps, incentives, and medicalized interventions. To promote the findings of their Workplace Health poll of 1,601 workers, these sponsoring organizations waged a publicity blitz that brought the “healthy work” perspective to a broad new audience. A Health in the American Workplace panel, streamed live on the web, served as a centerpiece of the...

Be Fair

Workplace Health, Injustice, and Your Mother

Your mother always told you life wasn’t fair. In few places did her words ring truer than workplaces where favoritism, bullying, discrimination, or broken promises rule the day. But if life’s not fair, it may be no small consolation that, when facing an unjust and uncivil work environment day in and day out, life may not be very long either. One study has shown that workers who felt they were treated unfairly at work — compared to well-treated workers — had a 55% greater risk of heart disease, even after controlling for other risk factors. Organizational Injustice Organizational unfairness, or injustice, refers to a pattern of exposure to...

Awake

Waking Up To How Sleep and Work REALLY Interact

  By this time, most of us are well-versed in how sleep — more accurately, the lack of it — affects work. Injuries, errors, accidents, and health care costs have all been linked to sleep loss and shown to affect business results. What’s more, as reported by McKinsey in the article “The Organizational Cost of Insufficient Sleep,” there’s a host of psychosocial and cognitive problems that have been linked to sleep loss, including impaired attention, concentration, creativity, learning and memory, decision making, and relationship formation. Some studies have even shown that lack of sleep is associated with unethical behavior and have proposed specific pathways in...

Arrows -- unemployment harms health, recession improves it

Unemployment Makes Health Worse. Recession Makes It Better?

Getting laid off, job insecurity, and long-term unemployment are hazardous to your health. So why do health measures for statewide populations tend to improve during economic downturns? Job loss is associated with a 73 percent increase in mortality risk — the equivalent of adding 10 years to a person’s age, according to a 2014 study from Drexel University. Yet the same study found that  each percentage-point increase in state unemployment rate reduced the mortality risk of a resident of that state by 9 percent, about the equivalent of being one year younger. In other words… Joblessness strongly increases the health risk for people who are jobless. But… Periods...

getting_axed

Getting Axed Is Hazardous To Your Health

You look to your job not only for income and benefits, but also for purpose, social interaction, and daily routine. These influence your health, and the loss of them — or the threat of losing them — can suck the life right out of you. Every day, millions of Americans either look for work or go to work. Their success at finding and/or maintaining a decent job with good benefits will, to a large degree, determine their current and future health. — Robert Wood Johnson Foundation Job loss, long periods of unemployment, and job insecurity have all been linked to...

Occupational stress affects signals from the amygdala to the prefrontal cortex

Job Stress Is In Your Head. Literally.

Or… Half of What I Know About Employee Health I Learned from Concussion Concussion is a movie about employee health as much as it’s about anything. In the movie, the National Football League goes to great lengths to cover up the harm it allows to be inflicted on its players. The league is motivated by fear of liability and its unquenchable thirst for ever-increasing revenue. Medical examiner Bennett Omalu, MD, a trained neuropathologist played in the movie by Will Smith, determines that several ex-players who died of unnatural causes suffered from chronic traumatic encephalopathy — CTE. The disease is characterized by long-term damage to specific sections of the brain, where tau proteins surround and...

Good Work image

NICE! Good Work Is the Key to Good Employee Health

On June 19, 2015, while the U.S. federal government was determining how much employers should be allowed to fine workers for high blood pressure and cholesterol, the United Kingdom’s quasi-governmental National Institute for Health and Care Excellence (NICE) was doing something beneficial for employee wellness. NICE issued evidence-based guidelines for management practices and policies that support employee health. In the U.S., where we lean on behavioral programs and medicalized approaches to try to manipulate worker health, NICE’s focus on workforce management and policy may seem…um…foreign. But as often mentioned in this blog, much of the rest of the economically advanced world long ago realized that management...

Exhausted worker

Long Hours Grind Away at Employee Wellbeing

Of all the job conditions known to undermine the wellbeing of employees, few have been as well studied as long work hours and overtime. While we still need convincing evidence that reducing work hours may improve health, the body of knowledge about how work hours erode worker health should persuade employers that this is an area with considerably more potential for health improvement compared to conventional approaches like screenings and lifestyle interventions. A review of data from the Whitehall II study (which I described in my previous post about effort and reward balance) found that risk of heart disease, including fatal heart attacks, increased as the...

Balance Scale

At Work, But Out of Whack

Effort-Reward Imbalance Underpins Worker Stress It may be hard to get your brain around abstract models of stress, especially when they don’t line up with the usual fright-or-flight illustrations or seem remediable by the relaxation tips commonly sold as solutions. But if we care about workers, and how employers may be able to help them, we can’t ignore the harmful effects of effort-reward imbalance. Think back to Psych 101 and you’ll remember that most human transactions are based on our expectation of an even exchange, or social reciprocity. It’s like an unwritten contract. We’re hard-wired for evenhandedness, and when we get — or believe we’ve...

Man working overtime possibly linked to illness and cost

Mapping Workplace Gremlins to Health, Costs, and Mortality

The workplace gremlins that threaten employee health include long work hours, job insecurity, low job control, high job demands, unemployment, shift work, work-family conflict, inadequate workplace social support, and unfair treatment. These can be bucketed in various ways, but whatever you call them, they are the work conditions — controllable by employers — that research has consistently shown to influence employee health and well-being. Now, along comes a study out of Stanford University that not only endeavors to quantify the burden — in terms of health outcomes, cost, and mortality — of these gremlins (what the researchers called “stressors” and I sometimes refer to as the determinants of workplace health), but also puts it into...

Commute time and quality are linked to health. Employers can have a meaningful influence on employees' commutes and, consequently, well-being.

Trains, Pains, and Automobiles: Your Commute Influences Your Health

I’ve been commuting since I was in high school, when I had to take the F train to Coney Island  to switch for the B train to Bay 50th. After college, it was a long schlep from Brooklyn to Manhattan, standing shoulder-to-shoulder with other passengers in a stiflingly hot subway car. Fast forward to my California days, forfeiting 90 minutes in each direction sitting in traffic on the 101, arriving at work drained and, later, missing dinner with the family. Then a new job I could ride my bike to, over a hill in Sonoma County, burning 500 calories each way! I can testify firsthand to...

The Health Impact Assessment process, a potential tool to help advance the objectives of employee health and welling

Health Impact Assessment: The Shift Gets Real

“The problem with taking an evidence-based approach to employee health,” a colleague once told me, “is that there isn’t any evidence.” Fair enough. This is where health shifting comes in. But to fully appreciate health shifting, we first have to understand the potential role of health impact assessment. There isn’t a lot of evidence showing us how to improve employee health, but there’s plenty showing us how to diminish it: Require too much overtime, design jobs with high demands but limited employee control, have inflexible time-off policies, and fail to balance rewards with efforts, to name a few. (Check out this site’s Evidence page for a sampling of relevant studies.) The...

Napo spotlights the causes of stress at work

Napo Lovably Spotlights the Causes of Worker Stress

The psychosocial and environmental interplay of stress at work are foregone conclusions among regulators, thought leaders, and many employers across the globe, especially in Europe. In the United States, with the exception of NIOSH’s Total Worker Health strategies, the drivers of stress at work remain largely ignored. In the US, we take the reactive viewpoint that an individual’s response to stress is more important than the causes of stress. In doing so, employers grant themselves license to put the onus for solutions on employees, too. Whereas the rest of the industrialized world endeavors to address stress by balancing employees’ job control and demands, offering scheduling flexibility, limiting overtime,...

Blind Spot

Hostile Workplaces and Overtime Linked to Obesity

The Wall Street Journal recently reported on employers’ increasingly aggressive efforts to get workers to lose weight, igniting the inevitable social media hullabaloo from pro- and anti-wellness pundits. The article featured a table, Obesity by Occupation, which reported the prevalence of obesity in 10 categories of occupations (ranging from 40.7% for police, firefighters, and security guards, to 14.2% for  economists, scientists, and psychologists). But the newspaper and the pundits missed the scoop. When the reporters discovered the obesity-per-occupation stats in a study published earlier in the year, they glossed over the most important findings. The study, Prevalence of Obesity Among U.S. Workers and Associations with Occupational Factors — published in the...

Cartoon showing Triangle Shirtwaist Factory Workers Locked In to the Inferno

Of Workers, Shirtwaists, and Wellbeing: Unlocking the “Human Factor” in Employee Health

Years ago, in lower Manhattan, flames burst through the windows of a skyscraper. Cornered by a fast-moving fire, employees clung to the window frames until the heat, the flames, and the terror became too much to bear. They leapt from the windows to their certain death, their burning hair and clothes leaving a smoky trail, and crashed smoldering to the ground with an unearthly thud. This is not an account of a terrorist attack. This is the scene of what, for 90 years prior to 2001, had stood as the worst workplace disaster in New York City history.  Like 9/11, this tragedy changed the world — especially the world...

Levers for shfting

What Is Health Shifting?

Driven by escalating health care costs, employers often resort to cost shifting — structuring their health insurance coverage so that employees pay an increasingly greater share. The “levers” they pull to shift costs include insurance deductibles, co-pays, co-insurance, and tactics presented euphemistically as “wellness penalties” and “consumerism.” There is another, more important, kind of shift, however, which American employers — unlike their counterparts in other industrialized nations — have been slow to catch on to: Shifting more accountability for employee health to the employer. The levers for health shifting include… work schedules (including limits on overtime) job security fairness commute times paid leave...

Job strain

Job Strain May Be Making You Ill

Job strain is a particularly insidious form of stress that goes far beyond overflowing inboxes or tight deadlines. It is characterized primarily by organizational environments and job structure in which employees have high levels of demands placed on them and limited control over those demands (that is, low “decisional latitude”). This is the demand-control model that was originally described and measured by Robert Karasek. Other organizational and job-related factors that contribute to unhealthy job-related stress are effort-rewards imbalances, long work hours (sometimes including long commutes), job insecurity, and lack of social support on the job. Some researchers have categorized all...