In the 1980s, a curious wave spread across Japan. Several senior executives, with no history of prior illness, started dying young. It was soon found that these untimely deaths were happening due to overwork, a legacy of Japanese production practices which enhanced productivity at the cost of employee well-being. This phenomenon became so rampant that it was given a name: karoshi or death by overwork. Most karoshi deaths were, very predictably, happening due to stress-induced problems like heart attacks and strokes.
While Japan has probably seen the worst case of workplace stress, employees in other countries are also feeling the heat. Jeffrey Pfeffer, a thought leader at Stanford University’s Graduate School of Business, has been thinking about the negative impact of organizations on human health for a while now. Pfeffer, the author of popular books like The Knowing-Doing Gap (co-authored with Stanford colleague Robert Sutton), Hard Facts (co-authored with Sutton), What Were They Thinking?, believes that health, both physical and mental, is an important indicator of an organization’s functioning.
“It is said that when people are dying prematurely, it reflects something about the well-being of society,” says Pfeffer. “I think that’s true about organizations as well: you would need to look at the health and well-being, physical as well as mental, of employees in an organization. I would use that as a measure of whether or not an organization is being well-run and well-managed.” In an Academy of Management Perspectives article titled ‘Building Sustainable Organizations: the Human Factor’, Pfeffer draws attention to the neglected effects of “organizations and their decisions about people on human health and mortality”.
Can Companies Be Held Accountable for the Health of Their Employees?
He goes a step further and recommends that just as companies have to report their carbon emissions, they should also report on and be held accountable for the health – both physical and mental – of their workforce. At the heart of Pfeffer’s argument is the fact that organizations take a very narrow view of sustainability: they give human and social sustainability little importance in contrast to environmental sustainability. “Just like we worry about environmental sustainability, we need to worry about social sustainability,” says Pfeffer “Do you have people who can work for a given number of years under the conditions in which they are working, or are they going to burn themselves out or be stressed out over economic insecurity issues?”
Pfeffer, who is known not to mince words, has every reason to hold organizations responsible. “There is actually a lot of evidence which talks about the effect of long working hours on high blood pressure, the effect of job loss on mortality and morbidity and the effect of the absence of job control on cardiovascular diseases and things like that. The more I looked at this, the more I found and the more important I began to think that this issue really was,” says Pfeffer.
The evidence is already out there. Research from across the world shows that layoffs are very stressful and raise, particularly for men, the risk of death from cardiovascular disease. Also, those laid off are about nine times as likely to come back to the workplace and commit a violent act as those not laid off. Long work hours lead to high blood pressure and have negative implications for work-life balance. An interesting angle here is that of the amount of control you have over your job. A study done by Sir Michael Marmot of University College London found that the higher your civil service rank, the lower your risk of dying. And that’s because the higher your rank, the more control you have over your job, and low job control increases the likelihood of illness, premature death and economic insecurity. If all that evidence is not enough, studies show that if you give women maternity leave, they are much less likely to undergo caesarean sections.
According to Pfeffer, several airlines, some Silicon Valley companies and management consulting firms, particularly investment banks, deserve a severe rap on the knuckles. While the airlines do not take employee needs into account while scheduling work, Silicon Valley companies and investment banks ignore the crucial issue of work-life balance. “I recall a woman from one of the large investment firms telling me that she had asked another woman to work on a weekend and she had said no. So she looked at me and said, ‘That’s like insubordination – we would have never done that!’ And so I think people are pushing back, but companies haven’t really done very much to accommodate the fact that people want to have a life,” says Pfeffer. The situation in the US might be worse than it may seem. “We are the only industrialized country that doesn’t have required vacation or required paid time off. We have now the longest or second-longest work hours in the world and I think all of this has contributed to the high cost of healthcare in this country,” says Pfeffer.
But apparently a lot of companies are doing things to improve employee health. So are they still to be blamed? Yes, according to Pfeffer, not all their efforts are well-directed. “What has struck me is that you see all these workplace health initiatives where there is all this effort on smoking cessation, exercise and healthier choices in the cafeteria, all of which are of course good things. But these are not the root cause of ill health. The much more important cause of ill health is the issue of economic insecurity – the long work hours, work-family conflict, the job stress and strain,” he says.
We live in an age with flatter hierarchies and apparently more flexibility – ideas like flexi-timing and work-from-home have gained widespread acceptance. Logically, that should have led to greater employee welfare. Has that happened at all? “Flexibility is actually interesting. It comes not just from the policies that companies have, but also from whether or not the company has a culture that permits people to take advantage of the apparent flexibility that they offer,” he says. He cites the example of simple things like the facility to work from home or maternity leave. “You’ll see people, typically women employees, not really availing themselves of these practices and policies. If you ask them why, they say that the company has actually has made it ‘formally’ available but it’s not considered good – it’s not considered to be career enhancing to actually take advantage of these formal policies which are supposedly made available. So it’s a tricky issue,” says Pfeffer.
Undoing the Damage
Companies need to rethink job design and give people more autonomy, something that has been advocated by many organizational behavior experts for a long time. This could mean autonomy to decide when to work so that you have some control over your life. “It’s like saying, ‘Here’s the set of things you need to accomplish. You have to take responsibility to figure out how to accomplish them’,” says Pfeffer. “I am not going to tell you every minute, what to do and how to do it.” He adds that autonomy and freedom are both important – the freedom to say I have other responsibilities so I need to take time off to go and watch my kid’s soccer game.
But does such a job exist? “Yes. If you look at SAS Institute, the largest privately owned software company in the world and a company that it is typically ranked very high on the Fortune Best Places to Work list, this is exactly how they operate,” says Pfeffer. So what makes SAS different? “SAS has reasonable working hours (and) tells its employees to go home by 6; many exercise and eating facilities that provide opportunities to exercise and relax at work; generous benefits including medical and also support for adoptions and eldercare that reduce stress; onsite daycare which reduces work-family conflict and the associated stress; private offices for everyone; and most importantly, work that is engaging and that provides a lot of control to the individuals doing the work,” says Pfeffer.
Eventually, all this boils down to the organization’s culture and values and whether or not it is really serious to permit people to have both a job and a life. A lot of times this is just something they talk about and don’t really emphasize. “It is about the culture of the organization and whether or not you believe that Number 1, your people are important; and Number 2, if your people are important, then you really need to take care of them,” says Pfeffer.