The Leader Magazine

JUN 2018

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T hese are strong incentives for not caring about employee health and well-being. More troubling, the human cost of poor working conditions and the lack of access to health insurance are invisible. As a country, we do not have a sense of the size of that cost and its implications – until now. Stanford Professor Jeffrey Pfeffer and his colleagues Stefanos Zenios and Joel Goh have done the calculations. 1 In his newly released book, Dying for a Paycheck, Pfeffer reports their findings on the health effects of workplace stressors. He reports that working conditions such as long working hours, low job control, high job demands, low social support, lack of fairness in the workplace, and poor access to health insurance result in 120,000 excess deaths per year and account for 5 to 8 percent of annual healthcare costs – or $190 billion. These researchers believe that their calculations underestimate the true costs because they only account for a subset of factors that cause stress and toxic situations employees encounter in the workplace. They do not account for costs associated with increased health needs or the cost to families of the loss of employment. The implication of these calculations is that common working conditions make employees sick and, for some, lead to unnecessary death. Although it is difficult to tie a direct line between employers' decisions and employee illness and death, clearly, the association has been established. How can employers better understand the human cost of poor working conditions they might be tolerating, or even stoking, to get the most out of their employees and maximize profitability? If the numbers reported by Pfeffer and colleagues are not persuasive – that the conditions employers create in the pursuit of profit actually harm people and some very seriously – then we need to change the narrative. Instead of focusing on how investment in employee health and well-being lowers costs, we can refocus the discussion on how the investment builds value for employers. Connecting health and productivity Although many experts have made the argument that healthy employees are productive employees, there is often a failure to make obvious why this connection exists. I will make the connection here. The value proposition results from one simple fact: employees care whether their employer takes steps to preserve and promote their health and well-being. Both employees and employers have for decades recognized the impact physical and psychosocial factors in the work environment have had on employee health and well-being. 2 Today there is considerable attention paid to how these factors cause job stress, which is responsible in large part for negative organizational outcomes such as absenteeism, presenteeism, lower productivity, and turnover. 3,4 When employees have work environments where their health and well-being are supported, their productivity increases because they are engaged, motivated and able to do their work. 5 In such workplaces, employees are not hampered by chronic illness, musculoskeletal pain, poor mood, feelings of social isolation and unfairness, and physical fatigue, among other maladies. A principal connection between health and productivity lies in the "performance equation," which says that employee performance is a function of ability times motivation, or, in equation form, performance = f (ability X motivation). In other words, for an employee to exhibit high performance (productivity) on the job, he or she must have both high ability to do the job as well as high motivation to exert the effort to perform at a high level. Anything that detracts from ability or motivation will result in lower performance. Aspects of the work environment that compromise employee health and well-being also compromise employee ability and motivation. This is because when employees work under conditions that affect their health and well-being, they cannot apply their abilities fully and their desire to exert effort is diminished as a function of their negative emotional response to the work environment. Translating this into the workplace design, physical or psychosocial factors that affect employee health and well-being and thereby interfere with an employee's ability or motivation to perform at a high level will result in underperformance or productivity loss. i dentifying negative, positive factors It is easy to imagine how the physical environment might affect negatively both the ability and motivation components of the performance equation. Ability can be negatively affected, for example, by aspects of the physical environment that make completion of tasks difficult, interrupt concentration, create barriers to desired collaboration, are physically uncomfortable to the point of distraction, raise concerns about visual or personal privacy, create fatigue, or put safety or security at risk. Motivation can be affected negatively, for example, by aspects of the environment that create job dissatisfaction, disengagement, feelings of unfairness, a sense of things being out of one's personal control, burnout, and frustration. Aspects of the psychological environment can also contribute to deficits in ability and motivation, but we will focus only on the physical environment here. We can also imagine how the physical environment might positively affect both ability and motivation. Ability can be supported in the physical environment, for example, by building in aspects that promote employees' focus, accomplishment, mastery, ease of task completion, elimination of distractions, refreshment, social support, enhance their immunity to illness, and create a harassment-free and safe workplace. Similarly, motivation can be supported in the physical environment, for example, by stimulating employees energetically, raising their mood states, increasing the satisfaction with important elements within the workplace, build in personal controls over the physical environment, creating spaces for refreshment, and making tools, equipment, and resources easy to access and use. We at the Interdisciplinary Center for Healthy Workplaces have studied connections between health, well-being, and productivity, and we have concluded that at the core of these connections is the role of basic human needs in determining whether employees have a work environment that results in need satisfaction. The needs we have identified will be familiar to you: positive emotions such as pride, hope, inspiration, joy and awe; autonomy; belongingness; competence; psychological safety; meaning and/or sense of purpose; accomplishment; and personal growth. When these basic needs are satisfied, employees experience positive physical and psychological states, which underlie health and well-being. When this is experienced, employees are able and motivated to do their best work. the leader June 2018 23

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