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leecture notes challenges in work, health and wellbeing
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sv lectures challenges in work, health and wellbeingLecture 1 - Introduction to the course
- Work is an important part of people's wellbeing, including socio-economic position,
prestige and identity but work is also a major cause of illness and injury, weighing
heavily on the health care system (and budgets). Therefore, health effects of work
are an area of growing policy attention in an aging society
- What is work? → there is paid or unpaid work/work. Whether work is paid or unpaid
may differ across time and place (e.g. childcare or cleaning). unpaid work is mostly
performed in domestic sphere by women
- Ahon et al. (2018) definition of jobs: situated descriptions of employment, that take
into account where and how work is actually performed → depends on:
- employment relationship (self-employment or contract)
- occupation (kind of job: like teacher or doctor)
- working conditions (location, work hours, wages etc.)
- job characteristics (physical/mental demands)
- Health and well-being are similar concepts, formally they’re two different things but
most of the time they overlap
- Well-being = the combination of feeling good and functioning well. The experience of
positive emotions such as happiness and contentment as well as the development of
one’s potential, having some control over one’s life, having a sense of purpose and
experience positive relationships
- Health = not merely the absence of disease or infirmity (classical definition) but a
state of complete physical, mental and social well-being (WHO)
- Work affects health and well-being in complex, reciprocal, heterogeneous ways:
Complex: work and wellbeing affect each other differently in different situations (so
it’s complex from a measurement but also policy perspective)
Reciprocal: causal relations run in both directions, work can be both health-
enhancing and health damaging at the same time
Heterogeneous: work affects the health/wellbeing of different groups of workers
differently (because of differences in job characteristics)
- Job rewards/resources = the positive impact of work on wellbeing and health
- Job rewards include income, social status, social networks and identity but also
health insurance & benefits
- Job demands/risks/stressors = the negative impact of work on wellbeing and health
- Job risks such as physical or mental demands are distributed in unequal ways, what
you’re exposed to really depends on what kind of job you have.
- Examples of physical demands: exposure to hazards (sharp objects, toxic
substances, heavy machines), working conditions (long hours, late work) or repetitive
overuse wears out the body (lifting heavy objects, mouse arm etc.)
- Examples of mental demands: stressful forms of work organization (insecurity,
scheduling, temporary contract etc.), stressful interpersonal encounters (toxic work
culture, client/patient aggression), work pressure (time pressure, overload of work)
- Overall, men are more often exposed to physical health risks, and women to mental
health risks
- As said, work demands and resources are not equally or randomly distributed, a
social gradient exists. This social gradient implies health inequalities mirror wider
, social inequalities (if you’re worse off in 1 part of society, you’re likely to carry that
over to other parts). In this case health inequalities mirror labor market inequalities)
- Labor markets are unequal institutions that can be divided in different ways:
- by class or occupation (social/occupational class theory)
- by segments → who are in secure/good jobs, and who have insecure/bad jobs?
(labor market segmentation/insider-outsider theory)
- Paid work(ers) is often subdivided into segments:
Blue vs white collar (manual vs non-manual)
Self-deployment vs dependent deployment (employee)
- In which class/category you fall determines a lot (like amount of salary, security,
autonomy etc., but also risks of getting fired, hazards of performing your job etc.)
- Generally blue collar jobs experience more physical demands and less mental
demands, whereas with white collar jobs it’s the exact opposite
- The health disparities related to work result from the exposure to health demands
and resources associated with different jobs (jobs = the package of occupations,
working conditions and job characteristics) → different jobs expose workers to
different risks, some jobs expose workers to more risks than others resulting in
unequal exposure to health risks across jobs
- Labour market inequality might be mirrored in health because of the inequality in
distribution of health demands and resources
People from lower socio-economic backgrounds, lower education, ethnic minorities,
migrants and women are less likely to acquire and hold on to good jobs in most
countries (vulnerable groups) → access to good jobs (with lots of job resources) is
unequal too, you can’t just pick a job, there’s a need for specific education
- Vulnerable groups=societal groups that spend extended periods of time in unstable
/precarious employment, are at risk of exclusion from the labor market (and thus at
risk of poverty) and lack resources to address negative life events or manage risks
- There are theories about the causality between factors like education, ethnicity
migration, status, disability and gender → all agree that they’re intertwined:
1. Social selection hypothesis: people in poor health at the beginning will be
ad disadvantage in the labor market later on since it’s harder for someone with bad
health to perform as good as someone with good health
2. Social causation hypothesis: people in bad jobs are exposed to more
physical/mental health hazards and equipped with fewer resources (less pay) to
address sickness/pursue healthy lifestyles
- Challenge based learning approach = experiential learning through solving real-world
challenges (integrating theory and practice), it’s impact-driven → 3 phases: engage,
investigate and act
- Fourth generation university = conceptual idea on how role of universities might
develop (societal impact is key)
Lecture 2 - How does work make you sick?
- Disease = medical diagnoses of a disorder
- Illness = personal experience, how do you feel
- Sickness = social consequences of disease (like calling in sick, not being able to
work, labeling of dropout, income changes due to long term disease etc.)
- Sickness can be caused both at work as outside of work, but in both cases it still
needs to be managed at work to avoid sickness
, - Sickness (physical as well as psycho-social) doesn’t only affects the person who’s
sick, but also their family, friends employer and society as a whole:
Individual: lost earnings, health care costs, decrease in wellbeing/life quality
Employer: sick pay, costs to replace sick employees, reintegration costs
Society/welfare state: lower general health and wellbeing, health care costs,
decreased tax base
- The bio-psycho-social model is a model used to think about people’s health and
wellbeing in a holistic way.The three components interact: when one element is
called upon, the other two provide support (so work
resources in one dimension can balance out demands in
other dimensions. Multiple work demands in one dimension
(or multiple) can reinforce each other
Bio: physical health, genetic vulnerabilities, drug effects
Social: peers, family circumstances and relationships
Psychosocial: physical health, coping skills, social skills,
self-esteem, mental health
- How can work be taxing?:
- Physical: manual work is heavy on the body since expected behavior involves
heavy lifting, uncomfortable positions, working with chemicals, this results in a risk of
workplace injuries
→ accidents, injuries, and exposure, repetitive overuse, working conditions
- Mental: work can expose workers to mental health stressors like:
→ stress, work load (time pressure/responsibility), organizational culture
(feeling underappreciated, discrimination, bullying), job insecurity, emotional labor
- Emotional: forms of emotional labor demands a lot emotionally
→ suppressing emotions, dealing with other people’s emotions, adapting to
work cultures
- Emotional mainly falls into the social dimension, mental on psychological and
physical on biology
- *Emotional labor = work in which employees are expected to manage their feelings in
accordance with organizationally defined rules and guidelines, part of the employee’s
job is to manage the emotions of clients or patients at the expense of their own (e.g.
waitresses are ask to be friendly at all times), the expected behavior includes
keeping your emotions in check, this requires a lot of self-control
- Most common health issues are musculoskeletal diseases, heart and circulatory
diseases, respiratory conditions and mild/moderate mental health disorders
- Job demands = factors that cost energy to deal with → e.g.: workload, task
ambiguity, role conflict etc. this has negative effects on mental health & wellbeing
- Job resources = factors that give energy → e.g.: supervisory support, appreciation,
job autonomy etc. this has positive effects on mental health & wellbeing
- Job-demands-resources framework: working environments can be modeled using job
demands and job resources. When job demands outweigh job resources an
unhealthy disbalance exists, which negatively affects mental health. However, job
resources can buffer the negative impact of job demands (e.g. when the workload is
very high (job demand) but you really like your job (job resource), it evens out)
- Job resources and job demands are moderated by personality type (personal
resources and demands) and home demands and resources (do you have children at
home that have to be taken care of (unpaid labor)
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