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In a paper last year on the disappearance of many prime-age men from the US workforce, Princeton economist Alan Krueger presented the unsettling finding that 44 percent of working-age men who were not in the labor force reported taking pain medication on a regular basis, and two-thirds of these men were taking prescription pain medication. While improvements in video game technology may be contributing to these men’s lower workforce participation by making long-term unemployment more bearable, Krueger wrote, their high rates of poor health and use of narcotic painkillers are much more disconcerting.
In the Fall 2017 edition of the Brookings Papers on Economic Activity, Krueger publishes an update of that research with new data, homing in on the impact of opioid epidemic on the labor market. That impact, he finds, is even more significant than previously thought, accounting for some 20 percent of the decrease in men’s labor force participation between 1999 and 2015, and 25 percent of the decrease among women, Brookings editor Fred Dews explains:
Krueger’s paper suggests that, though much of the decline can be attributed to an aging population and other trends that pre-date the Great Recession (for example, increased school enrollment of younger workers), an increase in opioid prescription rates might also play an important role in the decline, and undoubtedly compounds the problem as many people who are out of the labor force find it difficult to return to work because of reliance on pain medication.
A new report from the RAND Corporation details the findings of the American Working Conditions Survey (AWCS), a wide-ranging survey fielded in 2015 by RAND in conjunction with scholars from Harvard Medical School and UCLA that paints a troubling picture of the state of the American workplace as “very physically and emotionally taxing, both for workers themselves and their families.” Some of the key findings include:
- The clear majority of Americans (eight out of ten) have steady and predictable work throughout the year, but many fewer work the same number of hours on a day-to-day basis (54 percent).
- Nearly three-fourths of Americans report either intense or repetitive physical exertion on the job at least one-quarter of the time.
- More than one-half of Americans report exposure to unpleasant and potentially hazardous working conditions.
- Nearly one in five American workers are exposed to a hostile or threatening social environment at work.
- Most Americans (two-thirds) frequently work at high speeds or under tight deadlines, and one in four perceives that they have too little time to do their job.
Furthermore, only 38 percent said their job offered good prospects for advancement. On the bright side, however, 58 percent of respondents described their boss as supportive, 56 percent said they had very good friends at work, and four out of five said their job met at least one definition of “meaningful” most of the time. Large majorities said their jobs involved solving unforeseen problems, applying their own ideas, engaging in complex tasks, and learning new things.
In a press release, RAND goes into more detail about what these findings mean for the US workforce:
At Personnel Today, occupational physician Dr. Paul J. Nicholson offers a detailed criticism of research purporting to show a return on investment from workplace wellness programs. These studies, Nicholson argues, are seldom rigorous and often appear designed to “show what people wish to demonstrate”—i.e., a direct financial benefit from wellness or wellbeing programs, when the real benefits may be less tangible:
A systematic review of the methodological quality of 34 economic evaluations of occupational health interventions reported that less than half of the studies satisfied more than 50% of methodological quality criteria, and only three studies met more than 75% of the criteria. After all, workplace wellbeing programmes are conducted at work sites and not in controlled environments, hence several intervening factors might explain, to some extent, the results of an evaluation. …
Taking note of the small, diverse body of evidence with many methodological limitations and risk of publication bias, the most that we may be able to say currently is that studies graded as having low strength of evidence support the effectiveness of wellbeing interventions for improving some health behaviours (reduced tobacco use, improved diet and reduced sedentary work behaviour); evidence is insufficient or lacking for other outcomes of interest.
The methodological problems with these studies range from selection and attrition biases, to the absence of a control group, to limited timeframes and subjective metrics. Nicholson points out these flaws not to disparage employee wellbeing as a goal of management, but rather to stress that “cost-effectiveness is not the only driving force for providing access to occupational health and wellbeing services”:
An experiment in Gothenburg, Sweden, that reduced the schedules of nurses at an old-age home to six hours a day while maintaining their pay, concluded in January with mixed results, finding that while shorter hours made the nurses happier and healthier while improving the quality of the care they provided, the high cost of hiring new staff to fill in the hours the nurses were no longer working made the six-hour days too expensive to continue indefinitely.
Yet Bengt Lorentzon, one of the researchers involved in the experiment, believes that this conclusion may be shortsighted, and that the long-term positive impact of shorter days on the nurses’ health and productivity might have reduced costs in the long term. Bloomberg’s Rebecca Greenfield takes a look at Lorentzon’s argument:
Specifically, the nurses took fewer sick days than they did when working longer, eight hour days. They also took fewer sick days than nurses in the control group. In fact, they took fewer sick days than nurses across the entire city of Gothenburg. Overall, they took 4.7 percent fewer sick days over the period of the experiment, while nurses in the control group took 62.5 percent more sick days over the same time frame. Nurses who worked fewer hours took less unexpected time off, too. …
In general, the working population of nurses in Sweden are in worse health than the average Swede. The women in the facility have higher body mass indices than the average worker, for example. While the study didn’t run long enough to fully measure health effects of shorter days, the research indicates nurses working only six hours will experience permanent health benefits, resulting in savings.
These findings are interesting, but still don’t address how employers can make up for the performance loss that comes along with reducing hours.
A two-year experiment at an old-age home in Gothenburg, Sweden, which maintained nurses’ pay while reducing their schedules to six hours a day, has concluded with mixed results, and will not be permanently adopted. The Guardian reports that, though the shorter workdays made the nurses feel happier and healthier, reduced their use of sick leave, and improved the quality of the care they gave, the benefits also came at a significantly higher cost. Bloomberg notes that 17 new employees had to be hired on account of the experiment, at a cost of roughly $1.3 million. A proponent of the plan, local politician Daniel Bernmar, acknowledged that it was too expensive to continue, but added that the cost also ended up being only half of what they had expected, and said he is eager to see more research done into the long-term benefits of abbreviated working days.
Even to the extent that a six-hour workday was feasible in Sweden, skeptics had cast doubt on whether it could be replicated in a country like the US, where employees are accustomed to working longer hours, often in exchange for greater rewards. Yet one California business owner made headlines last year with his revelation that he was successfully running his organization on a five-hour workday. In any case, the traditional eight-hour day is being rethought in various ways as the nature of work and employment changes and people’s attitudes toward work-life balance evolve.
Staples published its seventh annual cold and flu season survey last week, showing that while most employees and managers are well aware of the dangers of presenteeism and the importance of prevention, many workplaces still don’t take precautions to prevent the spread of seasonal illness, and many employees refuse or feel unable to take time off from work when they get sick, even though 73 percent of employees say they have caught a cold or the flu at work, and nearly one third say they caught a bug from a coworker last year.
The survey highlights several steps employers can take to reduce the spread of germs in their offices:
- Less than half (only 48 percent) of employees say their office provides disinfecting wipes to clean their work surfaces. To combat this, if employers aren’t providing these or other disinfectant products, 77 percent bring them to the workplace on their own.
- Nearly two-thirds (61 percent) of workers think employers should offer office-wide flu shots.
- Although most employers provide sick days, too many employees hesitate to use them when they should. Seventy-four percent think employers should encourage workers to rest and get better when they get sick.
Presenteeism can be a big problem in the workplace, and respondents to Staples’ survey know it: 67 percent said an employee going into work sick and not fully productive was worse for their organization than them staying home, compared to just 31 percent who said so in a 2014 survey. Nonetheless, Staples found, “workers don’t practice what they preach with regard to keeping illness at home”:
The primary goal of most workplace wellness programs is to lower health care costs, with the secondary objectives of reducing absenteeism and improving productivity. In judging the success of a wellness program, therefore, the first thing leaders tend to look at is how many dollars of health care spending were saved per dollar invested in the program.
But health care savings are not the only return an organization can expect from an investment in wellness, Carol Patton observes at HRE, pointing to one study that took a broader view of the impact a wellness program can generate:
In 2014, [Tzeyu] Michaud and several University of Minnesota faculty members analyzed the health data of the [school weight-management program’s] 1,500 participants between 2010 and 2012. They not only focused on cost, but also participants’ quality of life. While the program’s direct costs amounted to $164,000 each year, the results showed lower healthcare expenditures for participants when compared to non-participants. Specifically, the program saved approximately $3.7 million — or $4.65 million when including “quality-adjusted life-years” — over the three-year period. Annual savings totaled $876 per participant but dropped to $828 when employee spouses and dependents were included.
“From our experience, weight-management programs improve health and save money, but it might take a while to have this impact,” says Michaud, now a post-doctorate research associate at the Center for Reducing Health Disparities at the University of Nebraska Medical Center in Omaha. “[They] go well beyond saving money. We found that the quality of life improved for all participants — not just those who lost weight.” …