Impact of Health on Work – Impact of Work on Health

This week I would like to point out a key difference between the U.S. and Europe with regard to how workplace health promotion is interpreted and implemented. While the U.S. heavily focuses on health behaviors and health risks of the individual (and how these impact health care costs) numerous employers in Europe are now taking a close look at how the psychosocial work environment is impacting worker health. While physical hazards are largely under control, at least in the Northern European states, psychosocial hazards are most often not assessed while at the same time work-related stress and mental disease are on the rise. This is taking a significant toll on employee morale and engagement. Unfortunately, stress management, resiliency and energy management programs will only be able to make a marginal difference, if the underlying stressors are not addressed employees will keep falling sick, and productivity will suffer. In the worst case, your innovators and creative people are affected resulting in reduced output.

Work-related psychosocial hazards include (but are not limited to):

  • A lack of variety, underuse of skills, high uncertainty
  • A work overload or underload, high levels of time pressure
  • Shift working, inflexible work schedules
  • Low participation in decision-making, lack of control over workload
  • Poor environmental conditions such as lack of space
  • Poor communication, low levels of support for problem-solving
  • Social or physical isolation, interpersonal conflict
  • Bullying or harassment at work
  • Role ambiguity, role conflict
  • Career stagnation and uncertainty, poor pay, job insecurity
  • Conflicting demands of work and home

European Union employers actually have the obligation to assess and manage psychosocial risks and prevent work-related stress through the Framework Directive 89/391/EEC, which deals with health and safety in the EU. Similar legislation exists in other countries outside the EU, like Australia and Canada.

The World Health Organization (WHO) has addressed the psychosocial challenge with the Healthy Workplace Framework ( in which the psychosocial working environment is a key avenue of influence for a health workplace. A number of additional useful resources exist to assist managers and practitioners:

  • Health Impact of Psychosocial Hazards at Work: an Overview. This WHO report provides comprehensive evidence on the impact of psychosocial hazards on a number of health outcomes.
  • PRIMA-EF: Guidance on the European Framework for Psychosocial Risk Management: A Resource for Employers and Worker Representatives The booklet provides guidance in relation to key psychosocial issues including risk assessment, social dialogue and employee participation, key indicators, best practice interventions and corporate social responsibility.

As US-based employers are slow to pick up on this significant issue I will continue to emphasize the necessity and value of assessing and reducing psychosocial risks (eliminating where possible) in my work, publications and presentations (next up is the Annual AAOHN Conference in Nashville on Friday).