Suggested actions to implement healthy work are shown in the Table below. Many more may be available to both employers and employees, depending on the work context.

A number of comments need to be made about several features in this table:

• The suggestions relate to averaged findings of results about groups of people. Some people can be expected to be happy working in some of the situations described as ‘unhealthy’.
• Work underload can be as ‘stressful’ as work overload, but in a different way.
• The initiative in creating healthy work seems to lie with employers, but it is a shared responsibility. Employers can implement the suggestions in Table 1.2 only with the co-operation of employees.
• By the nature of their operating environment, employers may have little latitude to address some of the features. For example, providing task variety may be difficult in some situations.
• All the items in Table 1.2, but especially 3, 7 and 8, rely in some measure on how people perceive them. There is a degree of choice in those perceptions, and therefore the opportunity to make the best of something.
• Implementing all the things in Table 1.2 will be difficult in some organisations owing to the nature of their business. In those cases, the presence of some good features in work can be expected to make up for the features that cannot be made good. DOL suggests that those factors be made good and that employers keep abreast of opportunities to do so.
• Nobody should fix on an isolated feature of this table as the source of all their problems. The awareness of not coping is a complex mixture of workplace, environmental and personal factors and to isolate one feature may be scapegoating.

Characteristics of healthy work – with suggested actions to promote it.

A Work Content

Healthy work[1]	Unhealthy work	Suggested focus for employers	Suggested focus for employees
A balance of effort and rest[2]	Extended, intense, physical and mental effort without breaks.  No ability to switch off from work out of hours.	Make sure there are sufficient breaks in periods of intense physical and mental effort and adequate recovery time outside work.	Know limitations; do not accept pressure or create it by ‘competing’; use recovery time wisely; have a life outside work.
A variety of tasks[3]	Boring, repetitive, unfulfilling tasks.	To the extent possible, provide a variety of tasks for each employee; match the right people to the right tasks.	Do not be afraid to try something new; where practicable, share less interesting tasks with other people
A sense of personal control[4]	Little control or independence in the workplace – there is no ability to decide how or when to carry out tasks.	Provide employees with the means to take some control over the way they do their work – perhaps the order in which they do tasks or the means used to accomplish them.	Take responsibility for personal tasks; use discretion provided wisely; respect the employer’s position when there is no latitude available.

 

B Workplace relationships

Healthy work	Unhealthy work	Suggested focus for employers	Suggested focus for employees
Poor relationships are resolved swiftly	Poor relationships in the workplace remain unsatisfactory.	Provide fair mechanisms to identify and reconcile workplace relationship difficulties and conflicts –opportunities to meet and exchange views; promote dialogue.	Work on maintaining healthy personal relationships; understand the difference between giving way and giving in; apologise if necessary
Good communication	Poor communication among people at work, particularly between extremes in the workplace hierarchy.	Have strategies for communicating about work; promote honest feedback in both directions; praise success at work; Have systems for employee participation	Contribute to a positive atmosphere in the workplace; avoid criticizing destructively or undermining colleagues; ask necessary questions.
Workplace hierarchies promote confidence[5].	No-one appears to be in charge; pecking orders rife. Artificial and/or marked separation between people.	Experienced people valued for their ability to inspire confidence and give direction. Hierarchies do not dominate; status (the ability to contribute) is valued at all levels.	Refuse to play status games; take responsibility for personal tasks; use discretion provided wisely. Acknowledge the usefulness of well designed hierarchies’.

 

C Employee involvement

Healthy work	Unhealthy work	Suggested focus for employers	Suggested focus for employees
Workplace collaboration	None exists	Involved employees in health and safety	Participate effectively and co-operatively with the employer and fellow employees
Healthy and safe workplace design and environment.	Poor workplace design, e.g: poor lighting and warmth, noise. Poor physical safety.	A well designed and participatory health and safety programme.  E.g. provide sufficient lighting and warmth; control noise; provide well-designed equipment using ergonomic principles.	Participate in the health and safety programme. Obey Health and safety instructions; Report hazards; take such responsibility as possible for personal comfort and safety; attend training
Good change management	It is assumed change will just happen.	Understand that change can be extremely tiring and threatening and threaten morale; good communication and consultation during change.	Accept that change may be inevitable and necessary; participate in communicating about and helping manage change.

 

D Employee support

Healthy work	Unhealthy work	Suggested focus for employers	Suggested focus for employees
Appropriate rewards[6]	Personal contributions ignored or demeaned. A mismatch between effort and reward.	Let employees know how they contribute to the organisation; acknowledge work well done and suggestions made	Maintain skills and knowledge; have a realistic sense of self worth; acknowledge others’ accomplishments.
A supportive workplace	No support or leeway when a person has a bad patch.	Have realistic expectations about outputs; offer support in difficulties; acknowledge skills/expertise; Stand between staff and external criticism.	Ask for help when you need it; accept support when you need it; give support when possible.
Personal progress.	No opportunities for personal growth.	Provide opportunities to work well and improve performance; match individuals to tasks; provide opportunities to progress.	Maintain skills and knowledge; learn from mistakes; contribute to the organisation’s goals; be willing to accept change and knocks.

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Footnotes

[1] For a general reference see - Karasek, R.A. & Theorell, T. Healthy work: stress, productivity and the reconstruction of working life. New York, Basic Books, 1990.

[2] The ergonomics literature has many studies which address this question on both the micro level (over one day) and macro level (over many months).

[3] Social Determinants of Health: The Solid Facts. World Health Organisation, Geneva 1998.

[4] Bosma, H. et. al. Low job control and risk of coronary heart disease in Whitehall II (prospective cohort) study. British Medical Journal, 314: 558–565 (1997)

[5] Why are some people healthy and others not? The determinants of health of populations. Eds. Evans R G, Barer M L, Marmor T R. Aldine de Gruyter, New York. 1994

[6] Siegrist J. Adverse health effects of high effort/low reward conditions. Journal of Occupational Health Psychology 1996; 1:27-41.

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From 'Healthy Work Managing Stress and Fatigue in the Workplace', Table 1.2 (pages 19 and 20)