Workplace health should be a fundamental human right

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Workplace health is one important indicator of organizational performance — as a society’s success cannot be separated from the quality of its members’ lives. In his brand new book Dying For A Paycheck, Jeffrey Pfeffer exposes exactly why our workplaces are so toxic and what humans need instead.

“You are the cause of the healthcare crisis because 74% of all illnesses are chronic. The biggest cause of chronic illness is stress, and the biggest cause of stress is work.”
— Global manufacturer Barry-Wehmiller CEO Bob Chapman to a room of CEOs

Companies obsess over their carbon footprint. But what’s their human footprint?

We have environmental regulations to limit environmental risks — but what about employee well-being? We monitor workplace accidents and deaths, but we don’t mention the human impact of abuse, wages, health insurance, or work-family policies. Without measurement, reporting, and requirements for social pollution, organizations ignore what they do to their employees. Leaving decisions about practices that affect employee health to the discretion of CEOs puts employees’ well-being at risk. We don’t leave environmental pollution to the discretion of CEOs. So why do we leave employee health up to CEOs — when CEOs too often lead in ways that serve neither the employees nor themselves?

Sickness caused by employers impacts public costs and themselves, who are mostly free to:

  • Abuse employees through verbal abuse, sabotage, and threatening and intimidating behavior.
  • Impose layoffs, which kill people but provide no discernible benefits to employers
  • Require flexible hours and shift work, depriving employees of sleep and weakening their immune systems.
  • Not provide vacation or adequate sick time.
  • Not provide health insurance. Most of the increase in healthcare costs arises from chronic (and often preventable) diseases such as cardiovascular disease and diabetes. The productivity losses from employees with chronic disease were 4x the costs of treating those diseases.

What we’re doing isn’t working

Employers assume that such interventions as exercise classes will be sufficient for behavioral change, but they rarely consider what happens in the workplace as affecting behavior. Research shows that job-related conditions profoundly affect such individual decisions as drinking, smoking, drug abuse, and overeating. Simply put: people who do not like their lives are less likely to take good care of themselves.

Job-related stress also affects business performance. Employers can implement practices that improve more than healthcare costs. By focusing on well-being, they can reduce their costs from:

  • Turnover
  • Medical expenses
  • Absenteeism
  • Workers’ compensation insurance costs
  • Productivity loss (employees who are physically at work but not “really there” or presenteeism). The productivity costs of employee ill-health are higher than the direct medical claims costs incurred by sick workers.

Few employers report doing anything to address these health- and performance-related issues. Looking at what employers do daily to create healthy workplaces is a crucial missing piece to human well-being.

The huge toll of toxic workplaces

US workplaces may be responsible for 120,000 excess deaths per year, which would make workplaces the fifth leading cause of death, and account for about $180 billion in additional healthcare costs. About half of the deaths and 1/3 of the excess costs might be preventable, meaning they resulted from not tending to well-being. That’s more deaths than the number of deaths resulting from diabetes, Alzheimer’s, influenza, and kidney disease. Most of the workplace exposures have health effects comparable to or even greater than exposure to secondhand smoke. Prevention is both less expensive and more effective than remediation. (Indirect costs from disengagement, being physically present but not feeling well enough to do one’s best, and being distracted by stress are typically estimated to be about 5x as large as the direct medical costs.)

Critical elements of a healthy workplace

Companies that attract, retain, and motivate workers do so not by offering amenities like naps and free food. What matters is the work environment itself — from not having an abusive boss to having a workplace with comfortable temperature and good lighting to job control/autonomy and social support:

  • Job control — the amount of discretion you have to determine what you do and how you do it — is a key predictor of job satisfaction and motivation, ranking higher than pay and the most important predictor of heart disease. More control means higher well-being, fewer illness symptoms and absences, less anxiety and depression, and a lower mortality rate. The higher one’s hierarchical rank and wages, the better his or her health, life expectancy, job performance, job satisfaction, and motivation.
  • Social support — social help and feeling part of a community — contributes to health by buffering stress and affecting mortality rates associated with cardiovascular disease, cancer, and infectious disease.

What should be different

Companies make their employees sick, governments don’t much about it, and everyone pays the price. But it doesn’t have to be that way. We can save thousands of lives and billions of dollars while making organizations more productive. Leaders decide whether or not to tolerate toxic work environments. Yet when a survey asked respondents what their employers did to alleviate workplace stress, 66% replied nothing.

As a civilized society, there ought to be limits on what companies can to do their people. Afterall, people aren’t advocating for slavery or child labor just because they might increase profits. We should prohibit companies from creating social pollution and create policies for them to measure employee well-being through such factors as paid claims, turnover, and work hours.

Capturing public costs

We need policies to capture the magnitude of externalized costs — real costs passed off, in this case to taxpayers. Companies currently have few or no incentives to internalize healthcare costs:

  • Companies that don’t provide health insurance to their often low-paid employees leave them to fend for themselves, and they’re frequently uninsured. When they get sick, they turn to ERs for care, where delivering primary care is cost-inefficient. By the time they get there, their health has already deteriorated to a point where treatment requirements and expenses are far greater than earlier diagnosis and intervention would have been.
  • Laid off and underpaid workers are the responsibility of the public, yet employers benefit from paying less and reducing their costs. Studies suggest the cost is significant. One study in California estimated $10 billion in costs from two million working families, nearly half of whom were on MediCal. Many weren’t even employed by small businesses. Such systems as insurance for unemployment and workers’ compensation serve as a model to encourage employers to be more responsible.

There’s no trade-off between health and profits

Governments should consider the harmful effect of employer practices on workers’ well-being. Forms of workplace abuse — long work hours, absence of job control, work-family conflict, an absence of social support, instability created by layoffs, and absence of health insurance — are a threat to employees’ lives.

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