In her incisive Redesigning Wellness interview with Julian Reif (principal investigator of the Illinois Workplace Wellness Study), Jen Arnold elicits answers to controversial questions like how the research team defined “comprehensive program” and why they believe their randomized study design “cancels out” most previous wellness program study findings.
Thanks Jen (and thank you for the shout-outs), and thank you, Julian Reif.
Essential listening for wellness leaders who care about results. Click below to go to the podcast episode page:
I don’t agree with everything in The Hard Problems of Corporate Wellness, including the premise that wellness hasn’t worked. But I’m grateful as all get-out that my friend and colleague Scott Dinwiddie is saying it. We don’t all need to agree, but we progress only by questioning the status quo, engaging in civil dialog, and seeking better solutions.
If we’re inclined to look, in this article we find wellbeing as a microcosm for the human condition. In fact, Scott’s exploration of personal accountability in the context of systemic disorder may shine a light on social issues that appropriately preoccupy us today.
In the aura of this microcosm, we in the wellness profession are called upon to renew our own personal sense of purpose.
I don’t know what’s going to happen to the economy or what course the coronavirus pandemic will take. But I’ve had time to reflect on what a new world order may mean for employee wellness and the future of work.
Here are 10 hopes, fears, and questions (not predictions):
1) We’ll re-frame “meaningful work” — I recently heard, in an interview, a worker who delivers tortillas to grocery stores poignantly articulate what will prevail as a fresh take on meaning and work: Continue reading »
Jozito’s Bob Merberg Served As Key Consultant For Innovative Emotional Well-Being Program
Mindfulness, Gratitude, Optimism, Connection, and more.
The Art of Living an Emotionally Healthy Life
I’m delighted to tell you about a solution to an employee well-being gap I’ve written about often — a solution just announced by my client, Health Enhancement Systems (HES)…
Work of Art is a program about the art of living an emotionally healthy life, featuring the personalization, quality, and spirit that only HES can deliver. As a consultant on the product, playing a major role with background research, content development, testing, and some feature design, the release of Work of Art — a program I’m certain will make a difference in the lives of workers and the organizations that employ them — is one of the proudest milestones of my career.
I urge you to learn more about Work of Art, and to pass this message along to your colleagues, because it may just be the most important employee wellbeing product of its time.
A new study repudiates gratitude interventions as a treatment for depression.
The original intention of positive psychology was to expand mental health, not to cure mental illness. But wannabes self-help gurus, and some mental health professionals, hawk positive psychology interventions as a panacea for clinical disorders.
As the study authors note, gratitude interventions have value (for example, improving relationships) — but not much for the treatment of depression or anxiety.
Consistent with past reviews, we found gratitude interventions had a medium effect when compared with waitlist-only conditions, but only a trivial effect when compared with putatively inert control conditions involving any kind of activity.
In other words, gratitude interventions didn’t fair better than other behavioral activities used as controls.
A remaining controversy is how the limited efficacy of gratitude interventions compares to popular antidepressant medications.
In 2019, employees filed a class action lawsuit against a prominent employer for allegedly selling out its workers’ 401(k), costing the plan tens of millions of dollars in excess fees and underperformance, in exchange for mega-donations and lavish personal gifts. These shady dealings with employees’ savings were being finagled at the same time financial wellness program promotions admonished employees to “understand their values and get their finances in order.” (Learn more in myFinancialWhatness?article.)
On the other hand, Dan Price of Gravity Payments, who, in 2015 raised his company’s minimum wage to $70,000 per year while slashing his own salary, launched aplanin 2019 to establish the same healthy wage for employees of a new acquisition in Boise, Idaho. Mr. Price has his naysayers, but you’ll be convinced he understandshisvalues when it comes to employee wellbeing — financial and otherwise — after you listen to this interview:
In the early going, a typical employee wellness program doesn’t have much impact on healthcare costs, health, quality of life, or job performance. This, based on data from a cluster-randomized study of employee wellness at BJ’s Wholesale stores. (Clusterrandomization means the worksites, not the individual participants, were randomized.) Get the lowdown in my article,The 4 Factiest Facts Overlooked in the Latest Wellness Study Kerfuffle.
But rumors of wellbeing’s demise have been greatly exaggerated. A cluster-randomizedstudyof Gap stores showed thatstabilizing worker schedules led to increased sales and — while it’s no panacea — enhanced employee wellbeing, especially sleep. (Aseparate major studyconfirmed that unstable schedules are strongly linked — more strongly even than low wages — to workers’ psychological distress, sleep disruption, and unhappiness.) The contrasting results from these studies, building on previous research, surely will persuade business leaders to prioritize organizational strategies over health behavior modification products.
The National Institute of Mental Health reports that 20% of people live with a mental illness.
Mental and behavioral disorders are the 3rd-leading cause of disability in the U.S. That’s a lot and warrants special attention.
Not everyone recovers from mental illness. Many (here, I don’t have stats, but the 20% figure — and my own observations — suggests this is true), suffer their entire lives with mental illness, and an increasing number of people end their lives as a result. Suicide is the 10th leading cause of death in the U.S. We need to help these people.
Mental health and emotional wellbeing, unquestionably, are important for everyone. But in the wellness industry’s well-meaning enthusiasm for covering everyone under the mental health umbrella, we must be sure not to marginalize the large portion of people experiencing mental illness.
If we do communicate that there’s no difference between someone with a common disabling mental illness — like PTSD, bipolar disorder, and anorexia nervosa, as well as severe depression and anxiety — compared to anyone else who may be going through a tough stretch in an otherwise smooth-sailing life, we risk perpetuating mental health stigma rather than alleviating it.
Wellness thought leaders, under the guise of “wellness isn’t just about physical health,” brush physical health aside as if it’s no longer our concern. We’re all about connection, humanization, and collaboration.
You know those organizational inventories we recommend for other dimensions of wellbeing? Before launching a physical wellness program, for example, we conduct audits of workplace factors that influence physical health, like pretty stairwells, healthy food in vending machines, and so forth. Before launching a culture-of-health strategy, we assess the current state of the organization’s culture, using criteria like “Is wellness mentioned in the company’s mission statement?” and “Does the CEO visibly model wellness behaviors?”
We should do the same with our ever-popular financial wellbeing strategies. Before launching strategies to promote savings, budgeting, debt management, and retirement planning, let’s assess Continue reading »
This week, CBS News, CNN, and other major outlets blared headlines and articles — most accompanied by photos of office workers collapsed face-down on their desks — claiming that burnout had officially been recognized as a disease. The news spread like wildfire but was almost completely unfounded. Continue reading »
Health Circles is a structured process in which employees hold facilitated meetings over a course of time to identify what’s holding their health back and what can be done to improve it – with an emphasis on job design and the psychosocial health risks at the workplace.
This excerpt from a webinar (hosted by Lumity) describes a multi-year, controlled study of hospital nurses and aides at a hospital Continue reading »
What wellness vendors sell, and what employers buy, often contrasts with what employees want. Over the course of my career, I’ve heard directly from more than 100,000 employees via surveys and face-to-face interactions, and this is one of the most valuable lessons I’ve learned.
Using an unscientific approach, I’ve summarized some of the differences below. Continue reading »
California mandates that publicly traded companies based in the state have a minimum of one woman on their boards of directors by the end of 2019. If the new regulation survives anticipated legal challenges, representation will increase: By the end of July 2021, companies have to have at least 2 women on boards of 5 members; at least 3 women on larger boards.
If states can require corporations to place women on their boards, how far are we from Continue reading »
Big thanks to the folks at Lumity, Inc. for inviting me to present the webinar “Wellness, Wellbeing, and Workforce Sustainability: 3 Routes to Employee Wellness and Optimal Performance.” If you missed it, check out the recording.
In this orderly mash-up, I present about 40 years of work in 33 minutes (plus Q&A). It has something for everyone — from the HR generalist who’s been assigned to wellness but may not know much about it, to veteran managers of comprehensive programs trying to figure out what does and doesn’t work. I cover
the premise of health risk costs and risk reduction;
the distinctions between wellness and wellbeing;
ROI vs. VOI;
typical wellness program components;
work, stress, and health;
Without being overly prescriptive, I offer my own interpretations of evidence and practices, some of which you’ll find immediately applicable and some of which will irk you to no end. This link, exclusively for my blog readers, takes you directly to the recording.
In previous posts about the transition from wellness to wellbeing, I neglected to address the studies of wellbeing — including many attempts to define it — that were done before corporate America appropriated the term.
As legendary occupational psychologist Sir Cary Cooper says, “Define wellbeing? We can’t even agree on how to spell it Hyphen or no hyphen?” (I’ve paraphrased Sir Cary.)
“Wellness programs focus on physical health while well-being addresses ‘all things that are stressors in an employee’s life.’”
So far, so good.
Then they wrote:
“ Improving employee health was the most frequently mentioned (82%) reason for offering well-being programs, followed by: decrease medical premiums and claim costs…”
If those two quotes don’t have you scratching your head, you’re reading too fast. Please back up and keep rereading until you’re appropriately distressed.)
Gallup’s Essential Elements of Wellbeing
In recent years, Gallup describes wellbeing, based on their massive surveys, as consisting of (these are verbatim):
Purpose*: liking what you do each day and being motivated to achieve your goals
Social: having supportive relationships and love in your life
Financial: managing your economic life to reduce stress and increase security
Community: liking where you live, feeling safe, and having pride in your community
Physical: having good health and enough energy to get things done daily
In 2010, Gallup’s Tom Rath and James Harter published “Wellbeing: The Five Essential Elements.” The book served up the same five elements that Gallup advocates today, except the book used the label “Career,” whereas Gallup now calls the same element “Purpose.” Hmmm.
Gallup, with their partner Healthways (which eventually was acquired by Sharecare — creating the Gallup-Sharecare pair) argues that employers should address all five elements of wellbeing. For a price, they offer consulting services to help.
Employers faithfully adopted the five elements, depicting their wellbeing program goals with circles perfectly divided into equal parts — each representing one of the five elements — sometimes shoehorning in another element or two, like “emotional,” “environmental,” or “spiritual.”
But employers have not been well-served by their simplistic pie diagrams, which are used as virtual checklists to perfunctorily confirm that each element is addressed…
A fragmented effort to address what is in wellbeing, rather than a cohesive strategy to support what wellbeing is, may be one reason why, in practice, nothing but the name has changed.
Since his groundbreaking review, “Subjective Wellbeing,” first appeared in 1984, psychologist Ed Diener has probably published more wellbeing research than anyone. Though Diener evaluated the elements of what he calls “subjective wellbeing,” he defined it not by its elements but by the experience. To Diener, wellbeing is…
“…how people evaluate their lives — both at the moment and for longer periods… These evaluations include people’s emotional reactions to events, their moods, and judgments they form about their life satisfaction, fulfillment, and satisfaction with domains such as marriage and work. Thus, subjective wellbeing concerns the study of what lay people might call happiness or satisfaction.”
“Happiness or satisfaction.” Isn’t that what we always knew wellbeing to be, before we picked it apart?
I Feel Good!
With the various definitions of wellbeing circulating helter skelter, Uncle Sam (in the form of the CDC) played peacekeeper:
“There is no consensus around a single definition of well-being, but there is general agreement that at minimum, well-being includes the presence of positive emotions and moods (e.g., contentment, happiness), the absence of negative emotions (e.g., depression, anxiety), satisfaction with life, fulfillment and positive functioning. In simple terms, well-being can be described as judging life positively and feeling good.”
Rath and Harter’s description of wellbeing and other definitions of wellbeing emphasizes how you get there — the road to wellbeing. Diener and other psychologists emphasize how you are when you arrive.
Wellbeing and Burnout
Diener mentioned marriage and work, referring to domain-specific wellbeing. Here’s where that comes into play…
In job crafting research — as with a lot of organizational development research — “wellbeing” often is measured in the work domain only. Work wellbeing doesn’t just mean job satisfaction; it goes deeper to how employees are.
How do you measure how employees are at work?
For perspective, consider the symptoms of burnout:
A feeling of not making a difference
It’s not unreasonable to say that the opposite of burnout is work wellbeing — having energy, purpose, and optimism at work. This is why burnout metrics have, sometimes, been used to measure work wellbeing.
Focusing on work wellbeing — which, on the surface, seems to be just one domain — may be heresy to employee wellness leaders looking to check off their list each element of wellbeing.
But employee wellbeing programs risk getting in their own way if they try to do too much. Would it make sense to help employees thrive at work — the domain over which employers have most control — before trying to get them to thrive in, say, relationships, community, or even physical health?
On one hand, focusing on work wellbeing seems to contradict arguments against checking the elements off one-by-one. On the other hand, if the elements are interdependent, bolstering work wellbeing helps support the other elements. And if the others are supported at the appropriate time and place, work wellbeing will benefit.
Last year, online media had a field day when a survey showed that one third of respondents who owned a “wearable” activity tracker stopped using their device within six months. The firm that conducted the survey referred to this as “the dirty secret of wearables.” But it’s premature to judge this disengagement rate, and there’s no secret to keep. Sixty-six percent adherence for wearables after six months may, in fact, be something to celebrate.
Is It Time to Disengage from Disengagement Rates?
We haven’t identified universally accepted goals for activity trackers (by “trackers,” we’re talking here about devices like Fitbits, Jawbone Ups, and the like). Is the purpose to increase activity? To lose weight? To (perish the thought) have fun? Without goals, there’s little we can say about effectiveness or the significance of disengagement rates.
The assumption behind the negative publicity for disengagement rates implies that users should wear their trackers indefinitely. But…Says who? Many consumers wearing a tracker for the first time will see, within a few days, that they aren’t as active as they thought. This may be a first step to modifying behavior, even if they ultimately rely on non-tracker strategies to make changes, and even if those strategies take place at a later date.
Business Insider writer Erin Brodwin recently published an article called, I Tried Fitbit for a Month, and Taking It Off Was the Best Decision I’ve Made. Judging from the title, we might think that Brodwin’s story is a testimonial to the transience of tracker engagement (or that she needs to make better decisions in her life). And it may be. But this observation she makes near the end of the piece may exemplify unexamined potential of wearables:
I still do some of the healthier things I learned to do with my Fitbit, like taking the stairs at work and going for a walk when I take a phone call.
In Brodwin’s case, sustainability of her Fitbit use would have been the wrong metric if her goal was to increase physical activity.
Do One Third of Users Disengage with Wearables after Six Months? Or Do Two Thirds Continue?
What benchmark are we using to judge sustainability of engagement with wearables? Do we compare it to the 20% of patients that drop out of psychotherapy early? Or to the attrition rate for Crossfit, physical therapy, yoga, walking groups, Weight Watchers, or gym attendance? What about mindfulness, our panacea du jour? What percentage of mindfulness practitioners sustain their efforts for more than six months?
I don’t have credible citations for disengagement rates on any of these potential benchmarks, because hardly anyone’s even asking the question. But, by most accounts, a 66% adherence rate after six months compares favorably to…well, just about anything that requires effort.
Previous research on pedometers and early-day accelerometer devices has shown they can be useful tools for increasing physical activity…when they’re integrated with a sound behavioral program. And this was the optimistic conclusion of the “dirty secret” survey — that use of wearables can be sustainable when integrated with behavioral approaches.
Through my job, I’ve overseen the distribution of thousands of pedometers and hundreds of modern tracking devices to people engaged in top-tier behavioral programs lasting several weeks, often offered periodically throughout the year. The pedometer users, I did indeed find, are usually eager to abandon their device in the junk drawer after a program ended. But those who stop wearing their pedometer after eight weeks tend to be perfectly happy to resume wearing it when the next program rolls around. And I’ve seen unpublished data showing that the effects of this intermittent participation on activity levels is sustainable for more than a year. Using it or not using it for the first six months of ownership doesn’t seem essential.
Our wearable technology is ahead of our research. Do we know what consumers expect from trackers? Not everyone wearing a tracker wants to change. Some may be quantified-self devotees. Some enjoy a tracker as an expensive toy.
As for me: I need to have an activity tracking device because I’m in the business, and I’m extra motivated to continue so that I can contribute my data as a subject in the Heart Study (which, I hope, may ultimately resolve some of our questions about wearables). If my job was unrelated, I doubt I’d pony up the bucks for a glorified pedometer.
Calorie-counting apps have come under similar criticism, but there’s no arguing that expectations of these apps are more clearly defined. Consumers come to these apps to lose weight, though research shows that attrition is high and that the apps, perhaps like wearables, are useful as a measurement tool and not a standalone strategy.
I use MyFitnessPal to track calories for 3 to 4 weeks each year. In the first three weeks I used it, I suffered the revelation that I consumed more daily calories in snacks than I did in meals. While I caution that n=1 — my experience may be irrelevant to anyone else’s — approximately three weeks was all it took to trigger a lasting change in my eating patterns. I consider that a win and, as of this moment, it’s no secret.
[This post was originally published on Medium.com on May 18, 2015]
I’ve compared, in a separate post, the terms health, wellness, and wellbeing.
But even “wellbeing” doesn’t go far enough. The term, as it’s typically used in employer circles, overlooks the interaction between an employee’s wellbeing and their work — the job conditions, the people they work with, the support they receive… indeed, all the way to the very way work is done. The consequences of a sustainable workforce are the very ones employers seek: work engagement, productivity, consistent attendance, and retention.
One of the best descriptions of workforce sustainability is offered by researchers Ellen Kossek, Monique Valcour, and Pamela Lirio in their chapter, The Sustainable Workforce: Organizational Strategies for Promoting Work–Life Balance and Wellbeing, published in the book Work and Wellbeing: A Complete Reference Guide:
“A sustainable workforce is one where the work environment is caring and supports employee wellbeing. Employees are not seen as primarily resources that can be deployed (and depleted) to serve employers’ economic ends. Their skills, talent, and energies are not overused or overly depleted. They are not faced with excessive workload nor with a relentless pace of work for weeks or years on end. During times of crisis (e.g., natural disasters, sickness), employees are given time to recover or seek the extra resources they need to be able to perform in the future. Burnout is avoided and workers are given time for renewal.
“When human resources are used in a sustainable way, employees are not only able to perform in-role or requisite job demands, but also to flourish, be creative, and innovate. Sustainable human resource management practices develop positive social relationships at work, which enhances business performance, including greater cohesion among organizational members, commitment to common purpose, hope for success, resilience, knowledge sharing, and collaborative capacity.”
There’s no secret sauce to achieving a sustainable workforce. But it’s important to understand the essential elements of workforce sustainability when implementing a wellness program, so that program offerings are crafted through a sustainability lens.
I recently read an article about business’s revolutionary transition from employee wellness to wellbeing. “Historically speaking,” the author wrote, “wellness has been thought of as strictly pertaining to physical health, usually measured by biometrics.”
But, accurately speaking, this is not so.
Of course, there’s no single arbiter who can proclaim what exactly health, wellness, or wellbeing mean, but it’s worth understanding some of the ways these words have been interpreted in order to fully appreciate the implications, or lack thereof, of the “transition” from wellness to wellbeing
“Health” was defined by the World Health Organization (WHO) in 1946 as
a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
WHO’s definition, incorporated into its constitution, remains unchanged to this day. But in 1986 the organization held an International Conference on Health Promotion in Ottawa, which resulted in the famous Ottawa Charter for Health Promotion that elaborated on the definition, stating,
An individual or group must be able to identify and realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.
The Charter went on to list the conditions for health: peace, shelter, education, food, income, a stable eco-system, sustainable resources, and social justice. A far cry from biometrics.
In the late 1950s, the chief of the US Office of Vital Statistics — Halbert Dunn, MD — described a dynamic state-of-being he called “high-level wellness.” This is generally considered the founding of wellness, and Dr. Dunn’s sermon-like lectures reveal his concept to be anything but a simple embodiment of physical health. Dr. Dunn said…
The state of being well is…a fascinating and ever-changing panorama of life itself, inviting exploration of its every dimension.
I believe Dr. Dunn was amplifying — not refuting — WHO’s original definition, and the Ottawa Charter later adopted much of his take on wellness as a never-ending interaction with the environment.
But Dr. Dunn’s framework may have proven too cosmic for the mainstream. And many thought leaders have since distilled wellness into the sum of its various dimensions.
The National Wellness Institute adopted a model that incorporates six dimensions of wellness — occupational, physical, emotional, spiritual, intellectual, and social. Others have divvied wellness up into five, six, seven, or eight dimensions, sometimes tossing in a “relationship” dimension, sometimes “environmental,” “financial,” or “community.” A quick image search reveals a galaxy of multidimensional wellness models in the shape of pies, hexagons, prisms, Venn diagrams, concentric circles, and geodesic domes.
I don’t know exactly how “wellbeing,” in the last few years, worked its way into the hearts of employers and the wellness industry. But one catalyst probably was the bestselling book, The Five Elements of Wellbeing, by Tom Rath and Jim Harter. Both authors are workplace consultants with Gallup (a partner of wellness vendor Healthways) and entrepreneurial marketers with a track record of successfully persuading employers to their way of thinking.
Rath and Harter argue, based on Gallup findings, that wellbeing is more profound than health and wellness, incorporating career, social, financial, physical, and community wellbeing. Sound familiar?
In practice, employers are rallying around mindfulness programs and financial planning, and repackaging stress management as resilience, and using these incremental expansions of the status quo as markers to distinguish wellbeing from wellness. Ultimately, the transition amounts to little more than a name change.
I’m more than happy to dispose of the word “wellness.” I never cared for it — not because of its definition, but because it has failed to resonate with employees or the public at large. And I see no harm in calling it wellbeing instead of wellness. Certainly, while the employee wellness industry has been celebrating this “transition,” I doubt many employees have noticed a difference.
Besides, I’m open to the evolution of language, as long as it isn’t contrived to cover up a deception (like calling participation “engagement,” which I’m sure no self-respecting wellness professional would ever do).
Here’s my bottom line based on this incomplete and superficial exploration of the terms health, wellness, and wellbeing: Some people are inclined to see connections, whereas others are more drawn to compartmentalize. Maybe surgeons and benefits directors are more likely to see what’s tangible and quantifiable, while artists and farmers see the whole and the dynamics it contains. Both points of view probably deliver value.
Either way, I’m guessing that anyone who views health and wellness as only physical phenomena is likely to see wellbeing the same way. Others who view these concepts holistically are likely to do so regardless of the labels we attach to them.
Health, wellness, wellbeing: In the end, what we call it won’t matter as much as how we think of it…and how we act on it.
Summer’s here, and it’s time to unstrap the Fitbit and track some physical inactivity — the kind, for example, that takes place while reading. Pictured here is a pile of books that I’d recommend, or almost recommend, to wonky wellness professionals who have been at it for a while and are still searching.
You may think it weird that some of these books are old or even out-of-print. What good does an out-of-print book recommendation do you? Well, sometimes the story of a book is worth telling just as much as the story inside it.
Starting at the bottom of the pile…
Making Health Communication Programs Work.
Can you imagine there was a time — from 1989-2004, to be exact — when the US government gave this health communication book away for free? All you had to do was call and ask. This was the authoritative source on health communication — with more of a public health bent rather than employee wellness — affectionately known to health communicators as “The Pink Book.”
The good news is that you can get the final version of the book as a pdf. Who cares if it doesn’t include the last 13 years of developments? Who cares if the last entry in the glossary is a definition of “World Wide Web”? The book still covers an evidence-based approach to health communication theory and practice, with some behavioral change theory thrown in to boot. Get on it.
I’ve been studying the Hawthorne experiments for the last couple of years, and have assembled quite the collection of yellowed, musty, out-of-print books, this being one of the most important and, published in 1993, the most recent. At the heart of the matter is the field study of workers, supplemented with detailed interviews of 23,000 workers, under different conditions at Western Electric’s Hawthorne plant outside Chicago, in the 1920s and early 1930s. It stands as one of the most important studies of workers, management, and productivity ever.
While the Hawthorne researchers weren’t committed to worker wellbeing as we think of it, they did recognize wellbeing as relevant to productivity. And much of what we believe today about management styles, leadership, employee engagement, and teamwork was rooted in the Hawthorne research. Forget the fact that it started as a study of lighting, or that it had an entire category of bias named after it. Most experts today believe that if there is such a thing as the Hawthorne effect — in which research subjects change their behavior simply as a response to being observed — it didn’t occur at Hawthorne.
Let’s get real… You’re not going to read an old book about a 90-year-old study. So take 9 minutes to listen to this peppy BBC podcast on the topic. Regardless of the Freakonomics interviewee drawing an unfounded explanation of the Hawthorne findings, the podcast may start to give you a sense of how important the Hawthorne experiments are to our understanding of work, motivation, and even research design.
Yup, out-of-print — I don’t know why, as this is a seminal classic about the relationship between work and health, in which Robert Karasek, one of the most important worker health researchers of our time, lays out the case for the demand/control model of job strain.
Healthy Work may be too technical for a lot of people, but if you can get your hands on a copy, it’s great to keep around and skim through whenever you have a chance. Healthy Work changed how managers, health agencies, and labor organizations around the globe think about worker health.
Health Behavior and Health Education.
Get the 2015 version (5th edition), which is called Health Behavior: Theory, Research, and Practice. Health behaviors aren’t the foundation of employee wellbeing. (Exposures are.) But whether you agree with me or are convinced that, like people always say, “it all comes down to behavior,” isn’t it important to understand what makes health behavior tick?
This book was published in 2000 predominantly for clinicians and other wonks. It gets highly technical — so it’s not something you’ll want to read at the beach. But I keep it handy on my desk. It’s a collection of evidence documenting the relationship between work, psychosocial job stressors, and health, and suggesting a causal relationship — that is, bad jobs lead to poor health. The rigor of the studies contrasts with the vendor- and employer-fueled quasi-science to which wellness professionals are customarily subjected.
Amazon usually sells The Workplace and Cardiovascular Disease, used, for less than 10 bucks. If you want something cheaper and more current, you can try to access the article, “Globalization, Work, and Cardiovascular Disease,” published in 2016 in the International Journal of Health Services. Two of the article’s authors, distinguished researchers Peter Schnall and Paul Landsbergis, were among the editors of the book.
The only thing I find more painful than hearing our industry called the “ignorati” is noticing that we often do ignore criticism. Sure, we’ve all been paying the price for Al Lewis’s book ever since it was published, but we can be thankful that someone cast skepticism on the claims of the wellness industry. I don’t know if this is Al’s goal, but it is mine: To get better at supporting the wellbeing of the American workforce. In order to achieve this, we need to be able to assess our practices critically, and this book rallies us to do just that.
Former Washington Post reporter turned work-life balance hunter, Brigid Schulte, endeavors to wake up America to the mess we’ve gotten ourselves into by putting obsessive “busyness” and profits ahead of our kids, our spouses, and ourselves. Schulte deconstructs an American culture driven by a destructive sense of individualism and machismo that puts us on a never-ending treadmill — the unhealthy kind — as well as the policies and gender inequality that keep us there. She draws upon the experience of her own work and family life, and visits Denmark where the possibility of a better way reveals itself to her.
Health is influenced by social status — specifically, our position in the spectrum of autonomy and of full participation in society. The workplace is a microcosm for this “social gradient.” Epidemiologist and author Sir Michael Marmot, who has devoted his career to spotlighting the social determinants of health, led the Whitehall studies — investigations into the work lives and the health of thousands of British civil service workers. Whitehall II is among the most important studies of worker health, but — as with much of the excellent research from Europe and other countries around the globe — is noncommercial and, consequently, infrequently discussed at American wellness conferences. Sir Michael once wrote in Lancet,
Healthy behaviors should be encouraged across the whole of society. More attention should be paid to the social environments, job design, and the consequences of income inequality.
Of all the books in my pile, this is the one I most enjoyed reading. If it’s nothing else to you, it’s a heart-wrenching story well told. Triangle also is filled with historical detail about working life that, for many, will continue to resonate today. The importance of the Triangle Factory fire — along with the events that preceded it and those that ensued — remind us of the context for worker wellbeing, and how it represents something more profound than lower health care costs or even improved morale.
Worthwhile reading, but not in my pile:
Workplace Wellness That Works, by Laura Putnam. At this point in my career, I learn most by delving into topics that are unrelated or only somewhat related to wellness. I don’t own Laura’s book, but I flipped through a co-worker’s copy and found it to be thorough and well-researched. This is the book I’d recommend to someone who’s looking for wellness ideas or trying to assess the evidence basis for employee wellness.
Quiet: The Power of Introverts in a World That Can’t Stop Talking, by Susan Cain. Quiet raises consciousness about what life is like for the large segment — perhaps the majority — of employees who consider themselves introverts. This is relevant as we plan our wellness programs and events and target our communications. Quiet isn’t on my pile because I lent it to someone and never got it back. I’d like to think that’s some sort of endorsement.
Any text on occupational health psychology. I like The Handbook of Work and Health Psychology, but others will do. Just as we should understand health behavior if we want to influence employees’ exercise and eating habits, we need to learn the science behind stress, burnout, adjustment to change, resilience, depression, motivation, and engagement.
Even if we don’t always understand the science of worker health, we benefit from recognizing that there is science to worker health.
For those interested in evidence-based approaches to wellness, reading these or similar books will be a breeze this summer.
Recently, I chatted with the Human Resources director from an employer known for encouraging “fun at work.” The company had the usual symbols of a fun workplace: foosball tables, slides, Xbox, pie-eating contests, and parties for every occasion. The HR director boasted about parades, in which employees construct floats, dress up in costumes, and march around the office to mark company milestones. I asked, “What if you don’t want to join the parade?” No problem. If you’re not the parading type, you can work on building a float. “Everyone is expected to participate in some way,” she told me. “Our employees know what kind of place this is when they accept a job.”
Fair enough. But count me out. When the data reconciles, when I have that eureka moment of identifying a creative solution to a work-related problem, when a team member rises to a new challenge or lights up when recognized for a job well done… That’s what I call fun. Some employees enjoy the fun of work, and don’t depend on adding fun to work.
Much of what passes for “fun at work” — parties, games, playground apparatus, contests, dress-up, etc. — represents little more than workplace tyranny of extroverts over introverts. And studies show, according to author Susan Cain, that one third to 50% of employees are introverts. So consider that half of your workforce may experience fun by setting their minds to their work, and they may be put off by someone else’s brightly colored and boisterous version of fun.
Lately, the social web has shone a light on “surface acting” in the workplace and the body of research, albeit thin, which suggests that being compelled to demonstrate positive emotions — like when service workers are required to smile and chirp to customers, regardless of what they are actually feeling — leads to emotional exhaustion, stress, and reduced productivity.
While most research demonstrating the negative effects of surface acting is based on studies of frontline workers such as customer support reps, food servers, hair stylists, clinicians, and first responders, blogger Mike Pearce — in a post called Surface Acting: Bad for Business and Your Health — points to a study suggesting that expressing inauthentic emotion in meetings is linked to employee burnout and turnover. Indeed, it’s not unheard of for supervisors to warn office workers — even those who have no exposure to customers — to smile more, a directive that serves no purpose other than allowing the supervisor to perpetuate their own delusion of leading an energized team.
In a LinkedIn post called The High Cost of Acting Happy, Time magazine contributing writer Annie Murphy Paul proposed well-founded alternatives to forced happiness:
Train workers well, so that they satisfy their customers with good service. Offer them congenial working conditions, so that they’re glad to be at work. Allow them more personal control over how they do their jobs (research shows this can buffer the stress imposed by surface acting). And provide them with opportunities to develop genuinely warm relationships with managers, coworkers, and customers—so that employees have something real to smile about, and so that when they tell someone to “be well,” they mean it.
Paul’s advice is rooted in evidence that maps how employee well-being is a product of healthy organizations and job design rather than employee behavioral change.
Do employers’ attempts to foster fun at work actually promote surface acting and its unwelcome outcomes? Do employees really want fun at work? Does contrived fun serve any purpose whatsoever? We’ll need more evidence to know for sure. In the interim, here are six tips for keeping the fun fun, and for keeping the surface acting at bay:
Genuine fun arises effortlessly. It may come organically to some workplaces whose culture is well suited for it. If you try to have fun, you’re not likely to.
Allowing people to bring their individual authentic personalities to the workplace, to express them freely, and to socialize according to their own desires, may be more fun than so-called fun-at-work events, campaigns, or games.
Not all employees seek fun in the workplace, and not every organization needs it. Tune in to employee demographics and organizational culture.
Fun in the workplace efforts may not be the only employer contrivances that promote a culture of surface acting. Be on the lookout for unintended consequences of the increasingly popular resilience and positive psychology initiatives so that stress, sadness, depression and even everyday introversion are not stigmatized.
What employees and employers sometimes perceive as a need for more fun may actually be a need for something else — gratification, camaraderie, satisfaction, purpose, hope, inspiration, or self-expression.
Based on studies of surface acting, expecting employees to act like they are having fun may lead to burnout, job dissatisfaction, turnover, and absenteeism. And that’s no fun for anyone.