Brave, new world of work – more flexible, older and increasingly diverse but also healthier?
Article Outline
- Introduction
- Health – a private matter only?
- How work impacts on health
- Working life under change – opportunity or risk for health?
- References
- Copyright
Introduction
The European Network for Workplace Health Promotion (ENWHP) contributes towards the healthy development of the world of work. Similar company networks and forums to the ENWHP exist in many other countries. Together they aim to develop and promote a variety of strategies that can be used at company level to make company practice become more health enhancing.
Male and female workers differ in terms of health and ill-health, the working and living conditions that influence their health and well-being, their coping behaviour in relation to stress and their utilisation of general prevention services. The main reason for these gender differences is the high segregation still existing in European labour markets.
This article will consider how the foreseeable changes in the world of work might impact on the health of employees and what role health might play for the future world of work. Is economic success in global conditions reconcilable with the sustainable care of natural and human resources?
Health – a private matter only?
In political statements health is always regarded as the ‘most important personal commodity’, the protection of which enjoys high priority. For many years, national economies have seen an increasing part of their gross national product being used to finance health care. Yet in many situations, the quality of health care has not substantially risen as a consequence. For some time many countries have been confronted with tremendous financial problems in the provision of health care; with service rationing and an increase in individual financial contributions often being the result. This trend has been sustained by the expensive harvest of technological innovations, the ageing of societies and the change in the disease panorama caused by the continuous increase in chronic, degenerative illnesses.
Health prevention still tends to be a marginal area in health care even though it is valued and rated very highly in political manifestos. However, a sort of ‘repair culture’ prevails that is deeply rooted in all areas of life in our societies and also governs individual behaviour and thinking to a large extent. Individual and collective experience of failure in relation to changing lifestyles that are detrimental to health, such as the example of smoking or a poor diet, also confirms the broad scepticism towards the prospects for success of behaviour-related solutions compatible with health.
Health still ranks in many companies as a ‘private matter’ for their employees, except for work accidents and occupational diseases for which company and supra-company authorities and responsibilities are clearly defined. While the harmful effect of physical workloads and chemical/toxic environmental influences is recognised, the connection between psychosocial working conditions and illness is largely unknown or is regarded as something that is irrelevant or unchangeable.
Even when working in the same business sector and performing the same tasks, men and women are exposed to different working environments, demands, stresses and strains. Women are employed more often in part-time jobs and in low-income and insecure employment conditions. Men suffer more from work-related injuries and musculo-skeletal disorders [1]. These facts reflect the employment structures for men, who still predominate in industrial production and other physically demanding jobs. Men also have more days off sick because of cardiovascular diseases. This is certainly related to their different work patterns and circumstances, their consumption habits and other risky behaviours. (Men smoke more and consume more alcohol and illegal drugs. Women are more addicted to medication [2]).
How work impacts on health
Work-related health risks are largely linked to three main areas of influence: chemical, biological and physical environmental influences, excessive physical workloads and excessive psychosocial workloads (including workloads relating to working time). At the same time, well-founded knowledge is readily available about the health effects of all three [3].
When examining the sickness and health situation in the world of work, two issues have become noticeable: firstly, industrial accident figures are falling, resulting from the success of company occupational health and safety schemes and as a result of the fact that the prevention of work accidents and occupational diseases has been integrated into the management routines in many, in particular larger, enterprises. However, data analysis shows that in certain sectors in the world of work, above all in small and medium-sized supplier sectors, there has been a shift towards the classic occupational health and safety risks.
Secondly, excessive physical workloads are still to be found in many areas in the world of work and these contribute towards cardiovascular diseases, musculoskeletal illnesses and fatigue and exhaustion phenomena. Moreover, adverse psychosocial workloads are rising significantly, and these also have a strong link to the above-mentioned health problems. In addition, they impact on the occurrence and course of mental illnesses [4].
High psychosocial pressure in the world of work arises from the work organisation, the work activity itself and the social relationships [5]. The present state of research indicates that restricted latitude for action and limited possibilities for control are the key, critical factors. When workers see their possibilities of influence, decision-making and control being restricted or threatened, this leads to intense stress reactions [6].
Working life under change – opportunity or risk for health?
The key new work requirements include the intensification of the work processes as a whole – linked with mental demands which are, on average, increasing – as well as the tendency towards greater importance being attached to more complex and higher-quality activities. In contrast, new jobs will also be created for less qualified workers in certain service sectors. Furthermore, there will be an individualisation of the work processes as a result of a strong orientation towards the specific demands of customers and the expansion of the service sector [7].
The continuous adaptation that has become technologically possible between market demand and the manufacture and organisation of products and services is now being followed by the adaptation of the labour force resources through various forms of ‘flexibilisation,’ ranging from working time, the location of work, new forms of employment (temporary agency work, part-time work, time-limited employment) and income regulations (short-time employment), to new procedures for designing work and tasks which require a different use and deployment of qualifications.
Regarding the forms of employment, we are now seeing a gradual decline in the so-called ‘normal’ employment conditions (characterised by indefinite, full-time employment, frequently a family's sole source of income) and the new forms of employment which are evolving in very different ways and are quickly becoming more widespread. The increasing breakdown of rigid company structures towards that of the virtual company – a temporary network of independent companies which process a task together – will dominate future developments. In addition to the solutions designed for use in companies, the extent to which a flexible world of work offers more opportunities than risks primarily depends on the similarly ever-changing circumstances in social security systems.
Finally, demographic changes in the population overall, and the working population in particular, together with the rise in the proportion of older people and workers will permanently change the labour market structure and the composition of the workforces. It can already be seen that opportunities in the labour market largely depend on the level of training reached. The increased participation in employment and education will soon lead, in many countries, to young women overtaking their male peers in terms of the qualification level attained. The consequences for workers include the fact that leaving a company, either to change a job or because of dismissal, is becoming an increasingly ‘normal’ experience. Job positions and status benefits, qualifications and tasks are becoming relative factors that can change constantly over the course of an individual's working life. This is reflected in the development towards the so-called ‘patchwork biographies’. The new technologies also entail the detachment of the work from time and place. As a result, a considerable proportion of the work becomes free of boundaries, and work and leisure increasingly intermesh [8], [9].
Whether more opportunities for a high quality of work – and that includes health – will open up with these changes cannot be foreseen at present; and positive evidence is sometimes seen hand in glove with negative developments.
How can people in this new world (of work) cope with these changes and how can the dangerous consequences of high economic and social inequality in the form of wars, violence, starvation and poverty be effectively fought worldwide?
Looking from a perspective of health promotion and prevention may help to provide answers to these questions and create a starting point for design solutions in company practice [10]. The most important resources for mastering the future include education, the quality of professional development opportunities and well-functioning and healthy ‘networks’ (families, circles of friends and colleagues as well as communities). Here, companies can make a very important contribution by making the design of healthy corporate cultures a normal management task. In view of the work-related sickness rates, workplace health promotion concepts and measures should take gender-related differences more into account than they have done previously.
References
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PII: S1875-6867(08)00054-7
doi:10.1016/j.jomh.2008.02.005
© 2008 WPMH GmbH. Published by Elsevier Inc. All rights reserved.
