Lecture notes Challenges in Work, Health and Wellbeing ()

LECTURE 1: CHALLENGES IN WORK, HEALTH AND
WELLBEING
PART 1: INTRODUCTION TO THE COURSE
ORGANIZATION
We need to talk about work, health and wellbeing
- Work is an important part of people’s wellbeing, including
socioeconomic position, prestige and identity
- Work is a major cause of illness and injury, weighing heavily on the
health care budgets of welfare states, the successfulness of
businesses, and people’s quality of life
- Health effects of work are an area of growing policy attention in an
ageing society

PART 2: WHAT DO WE MEAN BY WORK, HEALTH AND
WELL-BEING, AND HOW ARE THEY RELATED?
What is work?
- Paid and unpaid work/labor
o Productive versus reproductive/subsistence labor (c.f. Marx)
- In this course we mainly focus on paid work within organizations
- Whether work is paid or unpaid may differ across time and place
(e.g. childcare, elderly care)

Jobs
- When we talk about people’s ‘work’, we tend to talk about their jobs:
o Job = situated descriptions of employment, that take into
account where and how work is actually performed
- This is dependent on, for example:
o Employment relationship (e.g., self-employment, contract)
o Occupation (e.g., teachers, welders, nurses)
o Working conditions (e.g., location and hours worked, wages)
o Job characteristics (e.g., ergonomic demands)

Health and well-being
- Health and well-being are adjacent concepts
o Don’t see them as two completely separate concepts
- Well-being is the combination of feeling good and functioning well;
the experience of positive emotions such as happiness and
contentment as well as the development of one’s potential, having
some control over one’s life, having a sense of purpose, and
experiencing positive relationships
- Health is not merely the absence of disease or infirmity but a state
of complete physical, mental and social well-being (World Health
Organization)

What are job rewards/resources
- Work can have a positive impact on wellbeing and health
- We refer to these positive impacts as job rewards, or job resources

, - Wellbeing rewards of employment include
o Income, social status
o Identity
o Social networks
- Health rewards of employment include
o Better self-reported physical and mental health
o Psycho-social resources
o Health insurances & benefits

Job demands or risks
- Work can have a negative impact on wellbeing and health
- We refer to these negative impacts as job demands, stressors or
risks
- Work related health problems are common

How does work affect health and wellbeing?
- Work affects health and wellbeing in complex, reciprocal,
heterogeneous ways
o Complex: work affects health/wellbeing differently in different
circumstances (and vice versa) – and work can even be both
health-enhancing and health-damaging at the same time
o Reciprocal: causal relations run in both directions
o Heterogeneous: work affects the health/wellbeing of different
groups of workers differently (lecture part 3)

PART 3: THE UNEQUAL DISTRIBUTION OF
HEALTH/WELLBEING RISKS AND REWARDS OF WORK
Unequal exposure to physical health risks
- Employment exposes workers to physical and mental health
demands or risks in heterogeneous or unequal ways
- Different jobs poses different physical demands/risks
o Exposure to hazards (e.g. production and use of harmful/toxic
substances, operation of heavy machinery and sharp objects)
o Repetitive overuse “wears out” body (e.g. lifting of heavy
objects, mouse arm, etc.)
o Working conditions (e.g. long hours, night work)

Common physical health risk at work
- Tiring or painful positions
o Plumber gets under the sink
- Activities involving strong visual concentration
o Staring at computer screens
- Handling or heavy loads
- Etc.

Differences in exposure to physical health risks

,Exposure to mental health risks
- Some work poses psycho-social demands (stressors), e.g.:
o Stress enhancing forms of work organization (insecurity,
scheduling)
 Psychosocial stressors
o Stressful/traumatic interpersonal encounters (e.g, toxic work
cultures, client/patient aggression)
o Work pressure

Most common mental health risk factors
- People reporting exposure to risk factors that can adversely affect
mental well-being:
o Time pressure or overload of work, dealing with difficult
customers/patients etc., job insecurity etc.

Differences in exposure to mental health risks




Occupational health disparities
- Unequal exposure to health risks across jobs
- Occupational health disparities (OHD) framework
o Health disparities related to work result from the exposure to
health demands and resources associated with different jobs
(i.e. the package of occupations, working conditions and job
characteristics)
- Jobs expose workers to different risks
- Some jobs expose workers to more risks than others

Unequal exposure to wellbeing benefits and risks
- Wellbeing inequalities mirror labor market inequalities

, - Labor markets are unequal institutions
o Social/occupational class theory
o Labor market segmentation; insider/outsider theories (c.f.
Kalleberg’s good jobs, bad jobs)
- Paid work or workers is often subdivided into segments:
o Blue vs white collar; manual vs non-manual
o Self-employment vs. dependent employment (employee)
o Occupation / occupational class

Inequalities in wellbeing & rewards
- Labor market inequalities are related to, for example:
o Earnings
o Contract status & job security
o Entitlement to paid leave
o Autonomy and authority
- But also:
o Exposure to health risks and benefits

Organizations as spaces that generate inequalities
- Relational inequality: how categorical distinctions, when wed to
organizational divisions of labor, become the interactional bases for
moral evaluation, inclusion and exclusion from opportunities, and
the exploitation of effort and value.
- The causally most powerful locations in social life are proximate
networks of social relationships.
- Relational inequality theory: organizations/workplaces create and re-
create categorical inequalities

RIT: generation of workplace inequalities
- Exploitation
o Organization provides services, makes product and makes
profit
o Some people get more than others
- Social closure, exclusion & opportunity hoarding
- Claims making
o Organizations are seen as inequality regimes
o We find those inequalities legitimate
o EX I claim that I am smarter so I have to earn more
 Those claims get accepted
 Often based on education level

Lecture 1, part 3 take-away messages
- The physical and psycho-social demands and resources of jobs are
unequally distributed
- Different jobs are associated with different exposure to physical and
psycho-social risks, demands and resources
- A range of factors like gender, age, education, disability, ethnicity
and socio-economic background affect the types of jobs people have
access to as well as their health status