Work
Quality | Unemployment | Security
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Why work matters for health
Employment, or the lack of it, can have a considerable influence on health and wellbeing. Poor health can limit people’s ability to find and sustain work. The nature of people’s work matters for health, but also impacts other factors that influence health, such as having sufficient income and forming social connections.
Explore the different ways in which work can affect health:
Unemployment is defined as a situation where people of working age are without a job, but would like to be in employment.
Unemployment has consistently been found to have a negative impact on health in a number of ways. Reviews have found links between unemployment and self-rated health, with worse outcomes for men and people who are unemployed due to health reasons. These outcomes improved, however, if people had strong social networks. There is a similar relationship between unemployment and mental health, including depression, anxiety and levels of self-esteem.
There is a range of different mechanisms through which unemployment could harm health.
- Unemployment is a source of stress, which can eventually have a physiological impact.
- Mental health impacts of unemployment can result in unhealthy coping behaviours, such as smoking and drinking.
- Unemployment can cause poverty, which itself damages health and can harm future employment, leaving people with a lower earning potential and, therefore, lower future resources.
Poor work and unemployment can affect health, and it can be argued that people with health problems might also be more likely to be unemployed or in poor work. The main reason that health might affect employment is that it can lead to either a reduced capacity to work or premature retirement. Meta reviews find that while there is evidence that health problems affect employment, unemployment has significant impacts on health, even taking account of someone's health status before a period of unemployment.
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Analysis shows that low-quality employment is as bad for health as unemployment. The nature of jobs can vary significantly in terms of pay, the potential hazards, level of security, control and autonomy over the job, and the support offered to workers.
Traditionally, much of the focus on the health impact of employment has been on hazards in agricultural and industrial workplaces. The risks of fatal and non-fatal injury today are far lower than they were 20 or 30 years ago, partly due to improved regulation and safety measures and partly due to changes in the composition of industrial sectors in the UK. There are still physical risks linked to work in the UK, but these fall into broader categories, including prolonged sitting and working with screens.
Work is both physically and psychologically demanding for employees. Whether these demands eventually manifest as stress that can harm health depends in part on the resources available to people and on how much control they have to meet these demands. This is one of the main insights from the Whitehall II Study, which found a social gradient in health among the study group of civil servants. The people at the highest grades had the best health outcomes.
Job strain is associated with a range of negative health effects, such as cardiovascular diseases and hypertension, with chronic stress undermining the immune function and increasing susceptibility to a range of conditions. The severity of these depends on other factors, such as social support networks.
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Job security, or confidence in the continued existence of a job or hours of work, can also have a significant impact on health. Causes of stress include being concerned about the loss of particular job functions and an individual’s capacity to resist change. The psychological challenges posed by uncertainty have been categorised as unpredictability (lack of clarity on how to respond) and uncontrollability (powerlessness towards the threat). The latter is considered a key part of how insecure work can affect physical and mental health.
Job insecurity has been linked to reduced wellbeing, job satisfaction and a range of physiological problems. It has also been linked with poorer self-rated health, psychiatric morbidity, hypertension and coronary heart disease. Insecurity can combine with other stressors, such as low control, limited participation in decision-making or concern over job prospects. Several studies have found job insecurity to be a cause of chronic stress, affecting both short-term and long-term health, and becoming more potent the longer insecurity lasts.
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