Quoted by Peter Crush from the Guardian, "Are you well?" So familiar is this polite conversation opener, it almost goes unnoticed. But for such a simple question, wellness still leaves the worlds of academia and psychology pretty much stumped. Is wellness a measure of our "happiness" (which the government is now attempting to survey) or is it a physical rather than a mental state – or both?
What is increasingly accepted is the role long hours in the workplace can play in illness. "The workplace is a scary place," says Cary Cooper, professor of organisational psychology and health, Lancaster University Management School, and co-author of Well-being, published in April. "The growing long-hours culture is symptomatic of unmanageable workloads, and the stresses and strains of this are directly linked to medical problems that need not have, but will now create, long-term absence."
Anything that adds to long-term sickness absence is bad news for the UK economy. Although responsible for just 5% of all absences, long-term absence disproportionately accounts for 33% of all working days lost, with mental health problems the largest contributor to long-term sickness. Real-life studies confirm Cooper’s view that poor workplace practices could increase this.
In April, the latest results from Whitehall II, a study (ongoing since 1985) into the health and wellbeing of more than 10,000 civil servants, were published. It found working more than 11 hours a day increased the risk of heart disease by 67%, compared with those working a standard seven- or eight-hour day. Coronary heart disease is responsible for 12% of all working days lost as a result of sickness.
"Ill health at work is set to be something more companies have to plan for," says Paul Litchfield, BT’s chief medical officer and head of health. "Sickness is now 60% lifestyle- rather than contagion-caused, and the removal of the default retirement age will mean more people will get ill while of working age. I’m already seeing a gradual increase in chronic illness as more staff decide they don’t want to retire at 65."
Even without work-related illnesses of a long-term nature, the rather frightening reality is that other illnesses, such as cancers, are also becoming more common. According to Cancer Research UK, the incidence of cancer in Britain from the late 1970s to the late 2000s increased in males by 16% and in females by 34%.
What’s more, illnesses are no longer affecting only older employees. Nationally, 10% of all cancers affect people aged 25-39 while one in seven people with Parkinson’s disease are under 40.
So isn’t it about time workplaces organised their benefits to reflect this fact? "Staff are three times more likely to suffer a long-term illness than die during their working lives," says Jack McGarry, CEO of income protection provider Unum. "Yet, staff are more likely to be offered life insurance rather than income protection as part of their benefits package."
McGarry argues work is an important path back to wellness by giving people a routine, a sense of purpose and financial security after a period of long-term absence. He adds that the one positive about getting ill today is that better medical science means sufferers need not be condemned to a life of never working again (see case study, below).
"Cancer is the leading cause of disability, but it boasts ever-increasing survival rates," McGarry says. "The last thing convalescing people need are worries about whether they can make ends meet."
The benefit that reducing financial worry brings chimes with research currently being carried out by the Institute for Employment Studies (IES) for the Department for Work and Pensions. "Whether it’s work-caused or not, people get sick," states IES research fellow Sally Wilson. "But it’s how this is managed that is becoming the focus of attention. Things that are increasingly affecting health include financial worries, and research is trying to identify the things that turn short-term absence into long-term absence.
"Ill people with financial worries only create presenteeism, which is not good. This is very likely to turn short-term ill health into something more serious and long term."
Instead of returning before they are ready, a structured return-to-work policy – including regular contact with agents who can professionally assess people’s wellbeing and work readiness – was an important recommendation made by Dame Carol Black in her Working for a Healthier Tomorrow report, which she presented to the government in 2008.
Now national director for health and work, Black says: "Worklessness on its own creates poor health. Re-employment leads to improved self-esteem, improved general and mental health, and reduced psychological distress.
"The personal cost of ill health and associated adverse health consequences from job loss and unemployment means there is a need for real strategies to guide the employment, healthcare and vocational rehabilitation of patients who become unwell or are disabled."
