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Our workplaces are killing us in several ways.
Number one, they are working us to death.
Too many hours.
Hours have been shown to be related, for instance,
to blood pressure in an almost monotonic relationship.
Workplaces are killing us because they stress us and absence of job control,
work-family conflict economic insecurity is obviously stressful.
So the combination of working us to death and
stressing us to death is what's killing us.
We understand that people's minds effects their bodies and
stress is, of course, a mental state and a mental attitude.
So in some sense, it's not that surprising that things that make you stressed,
nervous, anxious feel out of control would have enormous physiological impact.
And that's what the epidemiological literature has shown really for
a long time.
So our contribution and the research that we did
was to take a bunch of stuff that was kind of sitting there and put it together.
So there were studies of health effects of various workplace stressors, and
there were estimates of the pre, prevalence of various workplace stressors.
What we did is put this all together in a big model to estimate the total
effects on population health and healthcare costs.
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What we found when we put all these data together is that our best estimate is
that there are about 120,000 excess deaths annually just in the United States and
close to $200 billion in excess healthcare costs as a consequence
of what we call exposures to harmful workplace conditions.
And those would be things such as economic insecurity absence of health insurance,
shift work, work-family conflict, things that either effect directly access
to healthcare like health insurance, or put stress and strain on people.
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So when you say, what is the worst, it depends on the outcome.
It turns out death is cheap.
Once you die, your healthcare costs stop, so the biggest contributors to
healthcare costs are what I would call chronic stressors,
things like work-family conflict and economic insecurity.
The single biggest factor affecting mortality is
the absence of access to healthcare which comes from not having health insurance.
So the causes of costs are a little bit different than the costs of mortality.
Because mortality and costs are not perfectly correlated.
Things like economic insecurity and work-family conflict
had pretty large effects, not as big as the absence of health insurance or
work hours, but almost as big.
So psychology matters as well.
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Well, I think for people employees, they need to understand that going
to places where they experience work-family conflicts, shift work,
long work hours, economic insecurity, don't get access to health insurance,
that this is more than just, you know, something that's inconvenient.
This is something that actually affects their well-being in a deep and profound
way, and they ought to take these factors into account as they select their jobs.
For employers who are concerned about healthcare costs,
they should worry a lot about the work environment.
At the moment, employers worry mostly about individual decisions, eating,
exercise, smoking, drinking, things like that, or they worry about broad,
social policy issues, like how we pay for healthcare in the United States.
A lot of their excess healthcare costs come from what happens to people
every day in the work environment, and almost everything that, is around
the work environment are things that employers could fix if they wanted to.
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Just as we have regulated secondhand smoke exposure,
presumably public policy could do something to,
intervene and not so much to regulate the workplace.
But if you think about it,
what we're talking about is a form of social pollution.
So, 50, 60 ,70 years ago, if I foul the water or
foul the air, I did not have to pay for the cost of that.
And so, if you had companies incur the cost
of laying people off and making people feel economically insecure,
if you had companies facing the costs of not providing people health
insurance not providing people flexibility to take care of their family obligations,
not providing justice and fairness, which is another one of the workplace exposures,
then those costs would become internalized to the employer, and
they would make better and more economically rational decisions.
But at the moment, they just pass the cost off to the larger society, so
therefore, they are not very concerned about this.
Because at the end of the day if you think about it
if an employee gets really sick or really dies the, they drop out of the workforce,
and then they're no longer the employer's responsibility at all.
So what we need to do with respect to social pollution or human pollution,
it's what we have done in the past with environmental pollution,
which is to have the employers see the cost of their actions, so
they can make more intelligent and sounder decisions.
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