Work, Stress and Illness Flashcards
What does the concept of ‘work stress’ describe?
Employment-related factors, both objective and subjective, that generate negative reactions leading to heightened levels of stress
How does the HSE (UK Health & Safety Executive) define work stress?
The adverse reaction people have to excessive pressures or other types of demand placed on them’
What are high levels of work stress strongly associated with?
Sickness absence, with cardiovascular health, as well as common mental health problems such as depression and anxiety
In addition, workplace stress is linked to increases in the rate of accident and injury, as well as human error
What are the latest estimates from the UK Labour force Surface for the total number of cases of work-related stress, depression or anxiety?
- 828,000 - A prevalence rate of 2440 per 100,000 workers.
- In 2019/20, stress depression or anxiety accounted for 51% of all work-related ill health cases, and 55% of all working days lost due to work-related ill health
- Over the last decade or so, an established long-term trend shows an increasing proportion of people reporting job strain, for both men and women, as reported in a number of large scale social surveys.
- Professional occupation that are common across public service industries (such as healthcare workers, teaching professionals, public service professionals) show higher levels of stress as compared to all jobs
When was work-related stress and health being linked acknowledged by the government?
1998
What was stated in the acknowledgement of work stress as an important contributing factor to health outcomes, was later incorporated into the recommendations the last Labour government’s public health policy White Paper, Choosing Health : making healthy choices easier (2004)?
‘ …A focus on individual health can be counterproductive, leading to a failure to tackle the underlying causes of problems in the workplace. Evidence has shown that poor working arrangements, such as lack of job control or discretion, consistently high work demands and low social support, can lead to musculoskeletal disorders, mental illness and sickness absence… (DoH:2004:161).
In 2019, Public Health England produced a policy guidance paper entitled ‘Health matters: health and work, aimed at local authorities and local employers. What did they note?
That mental health and MSK conditions were 2 of the leading causes of sickness absence. The guidelines recommend that:
- It’s important to ensure health + wellbeing of healthy employees who do not have existing health conditions is maintained, as work and the workplace also play a pivotal role in this
- Jobs need to be sustainable and offer a minimum level of quality, which should include:
- Decent living wage
- Opportunities for in-work development
- Flexibility so people can balance work & family life
- Protection from adverse working conditions that can damage health
Describe the Job strain/ work stress model, including the DCS model and examples
- Since early 1960s, social psychological research has attempted to gain more insight into factors in play in relationship pertaining b/w work-related psychosocial risks and employee health by means of theoretical models
- 1 of these models is the Demand-Control-Support (DCS) model, first developed by Karasak and Theorell in 1990.
- DCS model proposes the job strain is likely to occur when a person faces the following:
- High job demands in combination with low job control and low social support from colleagues/ managers
- The job control variable itself consists of 2 components
- Decision authority (being able to choose when and how tasks are completed)
- Skill discretion (whether a job is boring or repetitive, and the extend to which skills can be used and developed).
- The job strain model seeks to provide quantitative data that can be correlated with indicators of psychological well-being and physical health
- A key assumption of the model is that job stress variables are inherently pathogenic and that they can be separated from the personal attributes and characteristics of the individual worker
- A substantial body of empirical evidence now supports the DCS model variables as predictors of the relationship between work stress and health outcomes. Example include:
- Bosma et al’s (1997) analysis of the Whitehall II data concluded that the effect of low job control in the work environment was associated with raised levels of stress, a known risk factor in heart disease.
- A further cohort study by Bosma, Mackenbach, et al (1999), measured perceived control through the use of the locus of control scale, and concluded that low socioeconomic status was related to mortality at least partly because this group more often had a low level of perceived control.
- Cheng et al (2000) in their study of the association between psychosocial work characteristics and health of 20,000 American nurses found that:‘The decline in health functioning associated with job strain were as large as those associated with smoking and sedentary lifestyles’ .
Describe a schematic of DCS
- If job demands are low and job decision lattitude is low, the job is passive
- If job demands are low and job decision lattitude is high, the job is low strain
- If job demands are high, and job decision lattitude is low, the job is high strain
- If job demands are high, and job decision lattitude is high, the job is active
Critique DCS
- DCS is an archetypal epidemiological approach in ‘stress-related personal injury’ - treated as an unmediated effect of objective work conditions
- Assumption is that high job demands, low job control and low social support are inherently pathogenic, in the same way that asbestos is carcinogenic, or that physical injury is caused by exposure to toxic substances or faulty machinery
- Social factors are treated as objective pathogens which exercise their effect on the human organism regardless of the perceptions and beliefs of the worker
- The problem with the epidemiological model of work stress is not that the relationship between work characteristics and morbidity is spurious, but that it fails to grasp the role of consciousness in mediating that relationship’ (Wainwright & Calnan:2002).
- The job strain variables in the DCS model are primarily concerned with psychological stress, anxiety and depression, and that these experiences may be embodied (presenting themselves as physical symptoms) and therefore measurable as physiological changes.
- However, crucially they also involve perception, cognition and reflection / assessment on the part of the subject (which is not so straightforward to objectively measure).
