Recently, over lunch my dad told me about a period toward the end of his career in which the stress of his workload started to have a significant effect on his health. Now retired, my dad was an aerospace engineer for Northrop (and formally TRW). After being in management for many years, he went back to the technical side toward the end of his career and worked as a technical liaison between Northrop and numerous subcontractors from whom they purchased satellite equipment and other “space stuff.” During one period his company had numerous government contracts and the workload became “crushing.” My dad was in charge of 250 million worth of technical equipment. In his early 70s he was working 60-70 hours a week and sleeping 5-6 hours a night. It got to the point where he would be out of breath after walking 10-20 feet. He would drive to meetings in other buildings on campus because it would take him too long to walk there. If he did walk to a meeting, he had to plan enough time to stop and take breaks on the way to catch his breath. Obviously this had a huge impact on his productivity and overall well being. Thankfully, my dad's workload gradually decreased and his health improved over a period of months.
Job Stress and Health Care Costs on the Rise
Unfortunately, my dad’s story is not an isolated incident. Workplace stress and stories like this are all too common. All of my senior level clients, and many of my younger clients have stories like this. According to The American Institute of Stress, job stress is by far the leading source of stress for US adults and it’s increased steadily over the past few decades . As workplace stress increases, it’s not surprising that US health care costs are rising as well. The US spends a higher proportion of its gross domestic product on health care than other advanced industrialized nations, and our rate of growth in health care spending is steeper than other countries . But here’s the real kicker: despite higher spending on health care in the US, life expectancy is lower and infant mortality is higher than in countries that spend a lot less on health care (e.g., Japan, Sweden, & Switzerland) .
This parallels a recent report on the well being of US children by the Commission on Children at Risk. Despite increasing material well being, we are seeing higher rates of mental illness among our children. The Commission concluded that the major cause seems to be decreasing social connection . This general trend toward social disconnection has also been confirmed by Robert Putnam's study reported in his landmark book Bowling Alone . Perhaps social disconnection in our organizations is at the root of increasing job stress and related health problems.
The Impact of Workplace Stress on Health
As in my dad’s case, workplace stress has a huge negative effect on employees’ physical and mental health. In fact, according to recent research, the effect is as large as that of second hand tobacco smoke. Work stressors increase the odds of mental and physical illness by 35% to 50% . This lowers productivity, performance, and innovation and costs US industry an estimated $300 billion annually  (the business case for addressing workplace stress) and lowers the well being of employees (the human case for addressing workplace stress).
A recent meta-analysis conducted by Joel Goh, Jeffrey Pfeffer, and Stefanos Zenios from Harvard and Stanford Business Schools found evidence of a strong relationship between workplace stressors and health outcomes . This is the first study to use common meta-analytic procedures (which aggregate results across numerous studies that used similar variables) to examine the health effects of a comprehensive set of workplace conditions. The goal of the study was to analyze work conditions (positive conditions and stressors) that affect people’s psychological and physical health and can be addressed by public policy or managerial interventions.
They analyzed the effects of 10 workplace conditions on four health outcomes from 228 studies.
10 Workplace Conditions
- Long working hours
- Shift work
- Work-family conflict
- Job control
- Job demands
- Social support
- Social networking opportunities
- Organizational justice (perceived level of fairness in the workplace)
- Availability of health insurance
- Whether a person is employed
4 Health Outcomes
- Presence of a diagnosed medical condition
- Perception of poor physical health
- Perception of poor mental health
Here’s a summary of what they found:
- Low job control significantly increases the odds of all four negative health outcomes.
- Four of five workplace stressors (excepting work-family conflict) increase the likelihood of developing a diagnosable medication condition.
- Psychological and social aspects of the organizational culture (e.g., perceived fairness in the organization, low social support, work-family conflict, and low job control) are related to health outcomes as strongly as more concrete conditions such as long work hours and overtime.
- In general, the association between workplace stressors and health is strong (e.g., high job demands increase the odds of a physician-diagnosed illness by 35%; work-family conflict increases the odds of perceived poor physical health by 90%; and low organizational justice raises the odds of a physician diagnosed medical condition by about 50%).
The Missing Link in Workplace Stress and Health
It’s possible to create a work culture in which people feel connected and cared for, and to minimize the impact of work stress on health. But we’ve got to address work conditions and ultimately organizational culture and not just individual behavior in wellness programs.
Employee wellness programs help in some ways, but the overall evidence for their effectiveness is mixed . Joel Goh and his colleagues suggest that part of the reason for this is that we’re focusing too much on individual behavior, and not enough on the overall work environment, including things such as layoffs, work hours, flexibility, and medical insurance/benefits.
I would suggest we need to broaden our perspective even more, and look at the social environment and culture of our organizations. These practical factors listed above are means by which employees feel cared for by the organization. I think the root cause is the social connection in an organization and this sense of connection and being cared for (or the lack thereof) is partly communicated by the conditions and policies and organization sets. In other words, the social culture of the organization provides the context for how employees experience specific work conditions.
For example, if you work long hours for a season on a project and 1) your boss has helped you see the importance of the project, 2) you feel appreciated for going above and beyond, and 3) your boss provides increased support in other ways (e.g., more flexible work hours), that feels very different from a boss who expects you to work long hours while showing no appreciation for your work and your sacrifices. Research indicates that perceived social support is more predictive of health outcomes than “objective" indicators of social support. If you feel supported, that is the most important thing in a very real sense.
Workplace conditions and policies don’t impact engagement and health by themselves. When people feel connected to their colleagues and to the mission of the organization, it decreases work-related stress, and mitigates the negative impact of stress on health. A connection culture is the missing link in managing workplace stress and promoting employee health.
Here are 6 practices to help your organization minimize the negative impact of workplace stress.
1. Create a culture in which people feel cared for and connected. Our consulting firm recently interviewed Zach Toback of ABC News about their efforts to promote employee engagement and well being. They formed a committee to promote employee well being in this very demanding industry. They’ve launched a number of initiatives to help employees connect with each other, promote work-life balance, and address barriers to their productivity. Zoback commented that employees felt cared for by many of these efforts. The specific efforts aren't as important doing something intentional to show that you care about your employees’ well being and work-life balance. So get in put from employees, be creative, and try some new things to promote your employees' well being.
2. Listen to employees' experience of the workplace environment, policies, and programs.
As I mentioned above, how people perceive and experience the work environment is as important as the concrete policies and conditions. So be intentional about getting feedback and really listening to how employees experience the workplace.
3. Regularly collect data on workplace stress and employee health.
One way you can listen to your employees is to conduct regular employee surveys. Make sure you share the results and take action on them. Joel Goh and colleagues suggest that organizations should collect data regularly to analyze the relationship between your organizational culture(s), workplace conditions, and health/performance outcomes. You need to understand the links between these variables in your local culture to figure out how to best target your interventions.
4. Give employees as much control as possible over their job.
One of the factors that comes up over and over in the workplace stress literature is perceived control over one’s job. In the meta-analysis, low perceived job control increased the odds of all four negative health outcomes, in some cases by up to 45% (e.g., self-reported poor physical health). It’s important to understand that it’s the perception of job control that matters, not some “objective” rating based on type of job. The only way you can know how your people perceive how much job control they have is to ask and listen. Once you know where the low sense of job control is, brainstorm with your employees about how you can give them a greater sense of control. The original rationale for some procedures that create a low sense of control may no longer exist, and these procedures continue “because we’ve always done it this way.” If changing these procedures will increase your employees sense of job control and ultimately health, it’s worth fighting inertia to do so.
5. Have realistic discussions about expectations, workload, and sustainable productivity.
As in my dad’s case, a lot of workplace stress is cause by crazy demands and crushing workloads. This can be done for a short while, but at a long term cost. Unrealistic goals have a negative effect on employees’ engagement and the overall culture of the organization. They do this through the feelings they create. Feelings are a form of implicit knowledge; they carry information within them.
Consider this statement from the American poet Maya Angelou:
I’ve learned that people will forget what you said, people will forget what you did but people will never forget how you made them feel.
You can read my previous post about the power of expectations and 3 practices to set the right goals for your team here. The bottom line is if you want to take you’re people’s health seriously, and increase your overall productivity and performance, then you’ve got to be realistic about workloads and expectations. In the long run, it will pay off. This requires delaying gratification. Don’t force things. Slow and steady wins the game.
6. Promote good job-fit for employees.
A major factor in employees’ stress is how well they fit with their job in terms of their talents, strengths and motivations. Often times we overlook this and, to use Jim Collins’ language, neglect getting people in the right seat on the bus. You can be intentional about this and help employees maximize their job-fit. The old-school mentality that still lingers all too-often is that employees should just “suck it up” and get the job done. But being in a job that’s not a good fit is stressful and this, as we’ve seen, has very real negative effects on health. The cumulative effect of poor job-fit across your entire team lowers morale and is very costly. Do your people and team a favor, and take the time to understand people’s talents and motivations and do everything you can to get them in the right seat on the bus. You can read more here about how to develop your strengths and core motivations to maximize your job-fit.
I hope these practices help you and your organization minimize stress and promote the health and well being of your employees.
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2. Goh, J., Pfefer, J., & Zenios, S.A. (2015). Workplace stressors & health outcomes: Health policy for the workplace. Behavioral Science & Policy, 1(1), pp. 43-52.
3. Hard Wired to Connect: The new scientific case for authoritative communities. Commission on Children at Risk. (Institute for American Values, 2003).
4. Putnam, R.D. (2000). Bowling Alone: The collapse and revival of american community. New York: Simon & Schuster.