Health and Safety Executive

Health and Work

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Outline of this presentation

• The health agenda

• Understanding sickness absence

• Identifying the underlying causes

Health: the role of the workplace

• 75% of working age people in Britain are in employment and spend a high proportion of their waking hours in the workplace

• The workplace offers great scope for targeting of messages and initiatives about healthy living – with potential impact on both employees and their families

• Need to go beyond essential compliance with health and safety legislation and promote health and well-being more generally

Work and health – what we know

• Work offers opportunities to promote individual health and well-being

• Work should be recognised by all as important and beneficial, and access to, and retention of work promotes and improves the overall health of the population

• Long-term sickness absence is a strong predictor of disability and mortality

• Work has a positive impact on health and well-being (‘good jobs’ in well managed organisations)

• Under some circumstances work can have adverse effects (‘bad jobs’)

• The key is prevention of underlying causes rather than relying just on management of outcomes (secondary & tertiary interventions)

Absence and Health

• Risk factors for sickness absence are not always the same as risk factors for disease

• An holistic approach needs to focus both on the risk factors that precede absence as well as implementation of policies & procedures for monitoring & management.

• Sickness absence data collection, analysis and interpretation methods need to reflect both aspects.

Estimated incidence rates of self-reported work-related illness, for people working in the last 12 months

0

500

1000

1500

2000

2500

All illnesses Musculoskeletal disorders Stress, depression or anxiety Other illnesses

Inc

ide

nc

e r

ate

(p

er

10

0 0

00

)

2001/02 2003/04 2004/05 2005/06 2006/07 2007/08 95% confidence interval

Health and safety statistics 2007/08

A national study of absence

Definitions:

• Disease: is defined in terms of objective biological abnormalities in the structure and/or functions of bodily organs and systems

• Illness : is the personal subjective perception of unwellness. Therefore, if a person feels ill, they are ill

• Sickness: is derived from the concept of the “sick role”, a role that carries certain privileges (to stay away from work), as well as obligations (to seek medical help and to ‘get well’).

Ill health: A Population Study

33

235

8

3

2

1

Illness %

Disease %

Absence % >14 days

None of these 25%

Wikman et al (2005)

Sickness Absence: NHS Trust

Typical - Stress Sickness Abscence Data(n=3600, mean 27 days)

0

10

20

30

40

50

60

70

80

01-10 11-20 21-30 31-40 41-50 51-60 61-70 71-80 81-90 91-100 101-110 111-120 121-130 131-140 141-150 151+

DURATION - DAYS

No.

INC

IDEN

TS

The Individual

The biopsychosocial model: (Waddell & Burton, 2004)

Biological:

• The physical or mental health function

Psychological:

• Recognises that personal and psychological factors also influence functioning and the individual must take some responsibility for their behaviour

Social:

• Recognises the importance of the social context, pressures and constraints, on behaviour and functioning

Drivers of sickness absence

• Individual factors – personality and motivation; past behaviour; sick role

• The ‘system’ – organizational culture and tolerability, what is legitimate; sickness certification

• Non-work factors – life events and family pressures

• Work factors – absence as ‘coping’, job satisfaction, chronic adverse features of work

• Commitment and involvement

Designing ‘good’ jobs

• Promote ‘healthy’ workplaces

• Prevention and management of common health problems

• Job content, job context and organizational arrangements critical

• Move from a less desirable (‘bad jobs) to a more desirable state (‘good jobs’)

• HSE Management Standards can help in prevention and management

Summary

• The workplace offers the opportunity to promote and improve the health of employees and their families

• The drivers for ill-health are not always the same as the drivers for absence

• We need a better understanding of the causes of sickness absence so these can be managed in a proactive manner

• Current attendance management practice and policy is based on convention rather than evidence (IES, 2007)