Challenges in work, health and well-being – Hoorcolleges
Hoorcollege 1 – Part 1: Introduction to the course organization
- Why do we need to talk about work, health and well-being? There are a couple of reasons:
o 1) Work is an important part of people’s wellbeing, including socio-economic
position, prestige and identity.
o 2) Work is a major cause of illness and injury, weighing heavily on the health care
budgets of welfare states.
o 3) Health effects of work are an area of growing policy attention in an ageing society.
- How are we going to study WHW in this course?
o 1) The first question we will look at is: How does work affect health and wellbeing?
o 2) Then we will talk about the regulation and management of the health and sickness
at wrok.
o 3) Finally, we look at the question: How do health and wellbeing affect work?
- Today’s lecture:
o Part 1 Introduction to the course organization.
o Part 2 What do we mean by work, health and wellbeing?
o Part 3 The unequal distribution of the health/wellbeing risks and rewards of work.
- Part 1: Introduction to the course organization
o Tuesday Lectures and film screenings
o Thursday Tutorials:
Smaller groups
Required attendance
Literature discussion
Moderation assignments
Developing research skills
o Course assessment:
You need an overall grade of 5.5 or higher to pass the course. Your grade
depends on two things:
1) Portfolio = 50% of grade The portfolio consist of:
o 1A) An individual written assignment December 20th
2021, 09:00
o 1B) A group written assignment January 17th, 09:00
o 1C) A group moderation assignment Each group different
week
Your portfolio grade will bet he mean score on the three
assignments.
2) Final exam = 50% of grade Some information:
o It takes place on January 25th, 13:30-16:30, Olympus Hall 3.
o It is made on UU-computers.
o It consists of essay questions covering all materials discussed
in the readings and the lectures.
Hoorcollege 1 – Part 2: What do we mean by work, health and wellbeing, and how are they related?
- In this course, we look at the interplay between work, health and wellbeing.
- What is work?:
o Let’s start with making a distinction between paid and unpaid work. This
distinction comes from the distinction productive (paid) versus
reproductive/subsistence (unpaid) labour. In this course we mainly focus on paid
, work. But keep in mind; whether work is paid or unpaid may differ across time and
place.
o Also, in this course we mainly focus on employment. Employment is defined as
‘paid work outside the household, including the informal sector’.
Ahonen et al. described employment as ‘a legal relationship that buyers of labor
have to sellers of labor. This relationship determines the obligations, responsibilities,
and expectations of employers and employees in that relationship.’
o When we talk about people’s ‘work’, we tend to talk about their jobs. Ahonen et al.
consider jobs to be situated descriptions of employment, that take into account where
and how work is actually performed. This is dependent on, for example:
1) Occupation
2) Working conditions
3) Job characteristics
- Health and wellbeing:
o Health Health is not merely the absence of disease or infirmity but a state of
complete physical, mental and social well-being.
o Wellbeing Well-being is the combination of feeling good andd 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.
- One of the key questions of this course is going to be: How does work affect health and
wellbeing? According to Landsbergis et al. & Ahonen et al. work affects health and
wellbeing in complex, reciprocal, heterogeneous ways. One by one:
o 1) The relationship is complex. Why? 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 2) The relationship is reciprocal. Why? Causal relations run in both directions.
So, work, health and wellbeing affect each other.
o 3) The relationship is heterogeneous. Why? Work affects the health/wellbeing
of different groups of workers differently.
- We will first focus on the ways in which work affects health and wellbeing:
o Positive impact Work can have a positive impact on wellbeing and health:
Positive impact on wellbeing Wellbeing rewards of employment include:
1) Income, social status
2) Identity
3) Social networks
Positive impact on health Health rewards of employment include:
1) Better self-reported physical and mental health
2) Psycho-social resources
3) Health insurances & benefits
o Negative impact We wonder: How does work cause physical health risks?
Employment exposes workers to phsyical and mental health demands or risks:
Some work poses physical demands/risks For example:
1) Exposure to hazards For example:
o 1A) Production and use of harmful/toxic substances
o 1B) Operation of heavy machinery and sharp objects
2) Repetitive overuse ‘wears out’ body For example:
o 2A) Lifting of heavy objects
o 2B) Mouse arm
3) Working conditions For example:
o 3A) Long hours
o 3B) Night work
Some work poses psycho-social demands (stressors) For example:
1) Stress enhancing forms of work organization For example:
, o 1A) Insecurity
o 1B) Scheduling
2) Stressful/traumatic interpersonal encounters
3) Work pressure
- Why should we care about adverse health impacts of work? When physical or psycho-
social risks lead to ill health, this affects both the individuals who get sick and their families,
the employers they work for, and society as a whole. Individuals, employers and welfare
states incur costs due incapacity to work or illness at work:
o 1) Individuals will face, for example:
1A) Lost earnings
1B) Healthcare costs
1C) Experience decreases in wellbeing/quality of life
o 2) Employers will face, for example:
2A) Sick pay
2B) Cost to replace employee
2C) Reintegration costs
o 3) Welfare states will face, for example:
3A) Lower general health and wellbeing
3B) Healthcare costs
3C) Decreased tax base
- Welfare states aim ensure the health and wellbeing of its population and attempt to mitigate
the negative effects of employment. In ageing societies with high retirement ages, ‘managing
health conditions at work’ becomes an increasingly large area of attention. (European) welfare
states aim to increase the share of workers capable of performing paid work. How?
o 1) Trying to lower the costs of sickness/disability/unemployment benefits and health
care.
o 2) Delaying retirement in the context of an ageing population.
o 3) Reinforce pro-work narratives of deservingness.
- Recap Part 2:
o 1) Work and health/wellbeing affect each other in both negative and positive ways.
o 2) Employment exposes workers to physical and psycho-social demands (risks) and
resources (rewards).
o 3) Employment and unemployment co-determine workers’ place in societal
hierarchies and networks, which affect wellbeing.
o 4) Managing health and illness at work over the life course is an important policy goal
for modern welfare states and work organizations.
Hoorcollege 1 – Part 3: The unequal distribution of the health/wellbeing risks and rewards of work
- Employment is associated with physical and psycho-social resources as well as demands.
These demands and resources are not distributed equally or randomly across the population.
There is a broad consensus on the existence of a ‘social gradient’ in health. The social
gradient implies that ‘health inequalities mirror wider social inequalities’.
In this case, health inequalities mirror labour market inequalities. Labour markets are
unequal institutions. This unequality is described in:
o 1) The social/occupational class theory
o 2) The labour market segmentation Insider/outsider theories: Insiders get the good
jobs, outsiders the bad jobs. Paid work or workers is often subdivided into
segments:
2A: Blue vs white collar & Manual vs non-manual
2B) Self-employment vs dependent employment
2C) Occupation / occupational class
- Labour market inequalities are related to, for example:
o 1) Earnings Think of the gender pay gap
, o 2) Contract status & job security
o 3) Entitlement to leave
o 4) Autonomy and authority
o 5) Exposure to health risks and benefits
Why are work-related inequalities mirrored in health? Inequalities in work might lead to
inequalities in health (and vice versa) in multiple steps:
o 1) First, the exposure to physical and psycho-social risks at work is unequal. The
occupational health disparities (OHD) framework: Health disparities related to work
result from the exposure to health demands and resources associated with different
jobs. For example:
1A) The package of occupations
1B) The working conditions
1C) The job characteristics
So; jobs expose workers to different risks & some jobs expose workers to more
risks than others.
o 2) Second, the access to jobs with greater physical and psycho-social health resources
is unequal. So, labour market inequalities might be mirrored in health due to
unequal selection into jobs. In general, people from lower socio-economic
backgrounds, lower educated, ethnic minority groups, migrants and women are less
likely to acquire and hold on to ‘good jobs’ in most countries.
In labour market research, we use the term ‘vulnerable groups’. There is not one
common definition, but the term generally refer to societal groups that:
2A) Spend extended periods of time in precarious employment.
2B) Are at risk of exclusion from the labour market, at risk of poverty.
2C) That lack the resources to address negative life events or manage risks.
Groups often considered vulnerable in the labour market include:
2A1) Workers in disability
2A2) NEETs
2A3) Low educated
2A4) Migrants
2A5) Ethnic minorities
2A6) Single parents
2A7) LGBTQIA+
These factors are intersecting with age and gender.
- So, factors like educational achievement, ethnicity, migration status, disabilities, and gender
are intertwined with both work and health. Theories differ with regard to the direction of
causality:
o 1) The social selection hypothesis (Mudd et al.) states: “People in poor health will be
at a disadvantage in the labour market.
o 2) The social causation hypothesis (Mudd et al.) states: “People in ‘bad’ jobs are
exposed to more physical and mental health hazards and equipped with fewer
resources to address sickness and to live healthy lifestyles.
- In summary:
o 1) The physical and psycho-social demands and resources of jobs are unequally
distributed.
o 2) Different jobs are associated with different exposure to physical and psycho-social
risks, demands and resources.
o 3) 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.
Hoorcollege 2 – Part 1: How does work make you sick? Physical, mental, emotional labour & health
- Disease, illness & sickness:
Hoorcollege 1 – Part 1: Introduction to the course organization
- Why do we need to talk about work, health and well-being? There are a couple of reasons:
o 1) Work is an important part of people’s wellbeing, including socio-economic
position, prestige and identity.
o 2) Work is a major cause of illness and injury, weighing heavily on the health care
budgets of welfare states.
o 3) Health effects of work are an area of growing policy attention in an ageing society.
- How are we going to study WHW in this course?
o 1) The first question we will look at is: How does work affect health and wellbeing?
o 2) Then we will talk about the regulation and management of the health and sickness
at wrok.
o 3) Finally, we look at the question: How do health and wellbeing affect work?
- Today’s lecture:
o Part 1 Introduction to the course organization.
o Part 2 What do we mean by work, health and wellbeing?
o Part 3 The unequal distribution of the health/wellbeing risks and rewards of work.
- Part 1: Introduction to the course organization
o Tuesday Lectures and film screenings
o Thursday Tutorials:
Smaller groups
Required attendance
Literature discussion
Moderation assignments
Developing research skills
o Course assessment:
You need an overall grade of 5.5 or higher to pass the course. Your grade
depends on two things:
1) Portfolio = 50% of grade The portfolio consist of:
o 1A) An individual written assignment December 20th
2021, 09:00
o 1B) A group written assignment January 17th, 09:00
o 1C) A group moderation assignment Each group different
week
Your portfolio grade will bet he mean score on the three
assignments.
2) Final exam = 50% of grade Some information:
o It takes place on January 25th, 13:30-16:30, Olympus Hall 3.
o It is made on UU-computers.
o It consists of essay questions covering all materials discussed
in the readings and the lectures.
Hoorcollege 1 – Part 2: What do we mean by work, health and wellbeing, and how are they related?
- In this course, we look at the interplay between work, health and wellbeing.
- What is work?:
o Let’s start with making a distinction between paid and unpaid work. This
distinction comes from the distinction productive (paid) versus
reproductive/subsistence (unpaid) labour. In this course we mainly focus on paid
, work. But keep in mind; whether work is paid or unpaid may differ across time and
place.
o Also, in this course we mainly focus on employment. Employment is defined as
‘paid work outside the household, including the informal sector’.
Ahonen et al. described employment as ‘a legal relationship that buyers of labor
have to sellers of labor. This relationship determines the obligations, responsibilities,
and expectations of employers and employees in that relationship.’
o When we talk about people’s ‘work’, we tend to talk about their jobs. Ahonen et al.
consider jobs to be situated descriptions of employment, that take into account where
and how work is actually performed. This is dependent on, for example:
1) Occupation
2) Working conditions
3) Job characteristics
- Health and wellbeing:
o Health Health is not merely the absence of disease or infirmity but a state of
complete physical, mental and social well-being.
o Wellbeing Well-being is the combination of feeling good andd 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.
- One of the key questions of this course is going to be: How does work affect health and
wellbeing? According to Landsbergis et al. & Ahonen et al. work affects health and
wellbeing in complex, reciprocal, heterogeneous ways. One by one:
o 1) The relationship is complex. Why? 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 2) The relationship is reciprocal. Why? Causal relations run in both directions.
So, work, health and wellbeing affect each other.
o 3) The relationship is heterogeneous. Why? Work affects the health/wellbeing
of different groups of workers differently.
- We will first focus on the ways in which work affects health and wellbeing:
o Positive impact Work can have a positive impact on wellbeing and health:
Positive impact on wellbeing Wellbeing rewards of employment include:
1) Income, social status
2) Identity
3) Social networks
Positive impact on health Health rewards of employment include:
1) Better self-reported physical and mental health
2) Psycho-social resources
3) Health insurances & benefits
o Negative impact We wonder: How does work cause physical health risks?
Employment exposes workers to phsyical and mental health demands or risks:
Some work poses physical demands/risks For example:
1) Exposure to hazards For example:
o 1A) Production and use of harmful/toxic substances
o 1B) Operation of heavy machinery and sharp objects
2) Repetitive overuse ‘wears out’ body For example:
o 2A) Lifting of heavy objects
o 2B) Mouse arm
3) Working conditions For example:
o 3A) Long hours
o 3B) Night work
Some work poses psycho-social demands (stressors) For example:
1) Stress enhancing forms of work organization For example:
, o 1A) Insecurity
o 1B) Scheduling
2) Stressful/traumatic interpersonal encounters
3) Work pressure
- Why should we care about adverse health impacts of work? When physical or psycho-
social risks lead to ill health, this affects both the individuals who get sick and their families,
the employers they work for, and society as a whole. Individuals, employers and welfare
states incur costs due incapacity to work or illness at work:
o 1) Individuals will face, for example:
1A) Lost earnings
1B) Healthcare costs
1C) Experience decreases in wellbeing/quality of life
o 2) Employers will face, for example:
2A) Sick pay
2B) Cost to replace employee
2C) Reintegration costs
o 3) Welfare states will face, for example:
3A) Lower general health and wellbeing
3B) Healthcare costs
3C) Decreased tax base
- Welfare states aim ensure the health and wellbeing of its population and attempt to mitigate
the negative effects of employment. In ageing societies with high retirement ages, ‘managing
health conditions at work’ becomes an increasingly large area of attention. (European) welfare
states aim to increase the share of workers capable of performing paid work. How?
o 1) Trying to lower the costs of sickness/disability/unemployment benefits and health
care.
o 2) Delaying retirement in the context of an ageing population.
o 3) Reinforce pro-work narratives of deservingness.
- Recap Part 2:
o 1) Work and health/wellbeing affect each other in both negative and positive ways.
o 2) Employment exposes workers to physical and psycho-social demands (risks) and
resources (rewards).
o 3) Employment and unemployment co-determine workers’ place in societal
hierarchies and networks, which affect wellbeing.
o 4) Managing health and illness at work over the life course is an important policy goal
for modern welfare states and work organizations.
Hoorcollege 1 – Part 3: The unequal distribution of the health/wellbeing risks and rewards of work
- Employment is associated with physical and psycho-social resources as well as demands.
These demands and resources are not distributed equally or randomly across the population.
There is a broad consensus on the existence of a ‘social gradient’ in health. The social
gradient implies that ‘health inequalities mirror wider social inequalities’.
In this case, health inequalities mirror labour market inequalities. Labour markets are
unequal institutions. This unequality is described in:
o 1) The social/occupational class theory
o 2) The labour market segmentation Insider/outsider theories: Insiders get the good
jobs, outsiders the bad jobs. Paid work or workers is often subdivided into
segments:
2A: Blue vs white collar & Manual vs non-manual
2B) Self-employment vs dependent employment
2C) Occupation / occupational class
- Labour market inequalities are related to, for example:
o 1) Earnings Think of the gender pay gap
, o 2) Contract status & job security
o 3) Entitlement to leave
o 4) Autonomy and authority
o 5) Exposure to health risks and benefits
Why are work-related inequalities mirrored in health? Inequalities in work might lead to
inequalities in health (and vice versa) in multiple steps:
o 1) First, the exposure to physical and psycho-social risks at work is unequal. The
occupational health disparities (OHD) framework: Health disparities related to work
result from the exposure to health demands and resources associated with different
jobs. For example:
1A) The package of occupations
1B) The working conditions
1C) The job characteristics
So; jobs expose workers to different risks & some jobs expose workers to more
risks than others.
o 2) Second, the access to jobs with greater physical and psycho-social health resources
is unequal. So, labour market inequalities might be mirrored in health due to
unequal selection into jobs. In general, people from lower socio-economic
backgrounds, lower educated, ethnic minority groups, migrants and women are less
likely to acquire and hold on to ‘good jobs’ in most countries.
In labour market research, we use the term ‘vulnerable groups’. There is not one
common definition, but the term generally refer to societal groups that:
2A) Spend extended periods of time in precarious employment.
2B) Are at risk of exclusion from the labour market, at risk of poverty.
2C) That lack the resources to address negative life events or manage risks.
Groups often considered vulnerable in the labour market include:
2A1) Workers in disability
2A2) NEETs
2A3) Low educated
2A4) Migrants
2A5) Ethnic minorities
2A6) Single parents
2A7) LGBTQIA+
These factors are intersecting with age and gender.
- So, factors like educational achievement, ethnicity, migration status, disabilities, and gender
are intertwined with both work and health. Theories differ with regard to the direction of
causality:
o 1) The social selection hypothesis (Mudd et al.) states: “People in poor health will be
at a disadvantage in the labour market.
o 2) The social causation hypothesis (Mudd et al.) states: “People in ‘bad’ jobs are
exposed to more physical and mental health hazards and equipped with fewer
resources to address sickness and to live healthy lifestyles.
- In summary:
o 1) The physical and psycho-social demands and resources of jobs are unequally
distributed.
o 2) Different jobs are associated with different exposure to physical and psycho-social
risks, demands and resources.
o 3) 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.
Hoorcollege 2 – Part 1: How does work make you sick? Physical, mental, emotional labour & health
- Disease, illness & sickness:
