Stephen Bevan and Michelle Mahdon of the The Work Foundation argue that employers need to go beyond thinking about work and health in the context of either sickness absence or health promotion in the workplace.ÂÂ
At an economy-wide level most commentators agree that it is critical to our future economic success that the UK raises its productivity growth rate in order to sustain its position as one of the world’s leading economies.
A significant barrier to achieving this growth is that much of the British workforce is not healthy enough to drive the improvements in productivity that the UK needs. Good performance requires wellness. Conventional economic solutions such as investment in R&D, do not provide an answer to this particular issue. Workplace health is now becoming a hard, economic ‘factor of production’ and it is time to take wellness as seriously as we take R&D, investment in technology and customer relationship management.
Wellness is not simply about physical health but also includes psychological and overall well-being. Michael Marmot (2004) and his colleagues have shown that the intrinsic quality of the jobs we ask people to perform, their place in the hierarchy and the amount of control they have in their jobs can have more impact on their long-term health outcomes than smoking or diet. His data demonstrates that bad quality jobs make people ill and that, above all else, the UK needs more good jobs if we are to become both individually and economically healthier.
Research (see Coats, 2005 for a more detailed discussion) suggests that a “bad job” is: insecure; boring; characterised by a “command and control” or “do as I say” managerial style; either low paid or inadequately rewarded; where employers fail to treat workers with respect; and where unfair treatment is the norm rather than the exception. “Control” in the working environment is especially significant.
Of course, part of the solution here rests with Government. It must take the lead in the Public Health arena, encouraging and educating citizens to make healthier choices in their lives. However, employers and employees have a role to play too. For organisations, this means going beyond the bare bones of the legal ‘duty of care’ for which they are already accountable under Health and Safety legislation and tackling the underlying causes. For individuals, it means taking more proactive personal responsibility for their lifestyle choices, health and well-being.
Taking these findings seriously demands a real effort to improve the quality of employment, particularly for those at the bottom of status hierarchies, not all of whom will be low paid and exploited. Tackling these underlying causes of ill-health is essential if we are to have more “good jobs” and healthier workplaces in the UK. In most organisations the extent of illness amongst the workforce is, fundamentally, a management problem rather than a medical problem.
Employers need to go beyond thinking about work and health in the context of either sickness absence or health promotion in the workplace. Despite the growing focus on health promotion, it can still be said with confidence that employers are devoting less attention to the causes of workplace related ill-health than they should. The tendency is to see sickness as a phenomenon affecting individual employees even though the biggest and most positive effects may flow from an effort to reduce the risks of poor health amongst lower status employees as a group. However, it would be wrong to conclude that employers are in some way to blame for their apparent failure to grasp the nettle; the issues here are difficult and often poorly understood.
To help understand the complex relationship between the factors that influence wellness The Work Foundation, together with Welkom, have developed the Wellness Index, a comprehensive, online ‘Wellness’ profiling tool. The tool allows employers an opportunity to assess the factors in their organisation contributing to employee wellness and benchmark those factors against other organisations. In addition, the tool provides a valuable opportunity for individual employees to assess their own well-being. Using aggregate data from this tool The Work Foundation is able to explore the factors which impact on people’s well-being. This research will provide employers and employees with a more in depth understanding of the complex nature of wellness and how the activities of each party can complement each other.
To date, research conducted by The Work Foundation (Bevan and Mahdon, 2007) based on the data from the Wellness Index is reinforcing the view that it is only through a sense of personal empowerment that individuals can begin to make sustainable changes to their well-being. Psychologists (e.g. Rotter, 1966) have, for some time, referred to a phenomenon known as ‘locus of control’. Those with an ‘external locus of control’ have a belief that their lives are controlled by outside forces rather than themselves. By contrast, those people with an ‘internal locus of control’ feel that they are in control of their own destinies. Research suggests that the number of students with an external locus of control is increasing, which may result in more people with an external locus of control in the workplace. In a study ranging across six Local Authorities, Bevan and Mahdon found that employees with 100 per cent attendance records were more likely to be satisfied with their professional life and financial well-being than those with any self-reported absence. Moreover, employees with an internal locus of control and with a positive attitude to health, exercise and diet were significantly less likely to report any sickness absence from work. The next phase of work will look more closely at the relationship between personal control and autonomy at work and absence.
The findings from The Work Foundation research highlight the complex nature of factors that impact on well-being. Well-being is not principally about diet, lifestyle choices, travel to work time or family circumstances, although all can be contributory factors. The important element here is stress, not in its commonsense conception, but as a term which embraces the relationship between the working environment, changes in body chemistry and the physiological consequences. Understanding the relationship between the factors that impact on wellness is the first and crucial step to managing wellness and improving the health and productivity of the British workforce.
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