Working ourselves sick

The consequences of non-stop job stress include depression, weight gain and heart disease

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Dr. Diana Fernandez, an epidemiologist at the University of Rochester Medical Center, spent two years studying what she calls a “typical American workplace” and its health effects on employees. Her findings were stark: pressures at work are linked to cardiovascular disease, depression, anxiety, and self-reported poor health, she noted in a recent study of one U.S. company, and chronic job stress is strongly associated with being overweight or obese. What some would call the company’s most important assets—its workers—were in very poor shape.

These employees didn’t lack the resources to eat well and exercise, her findings suggest; most were middle-aged, married, and highly educated, making more than $60,000 a year. They’d worked at the company an average of almost 22 years. Still, about three-quarters of the 2,782 subjects were overweight or obese. Job strain had a lot to do with it. “People didn’t want to be perceived as working less than others,” so they’d spend long hours at their desks, she says, eating up time that could be spent relaxing at home, or getting some exercise at the gym. In especially stressful times, they told her, they also turned to junk food. Anecdotally, “when the next round of layoffs came, the first thing that disappeared from the vending machine were the brownies,” she says. When employees got home, more than 65 per cent of them watched two hours or more of television a day.

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Stressful working conditions aren’t just a problem for individual workers, says Dr. Elaine Chin, chief medical officer of Scienta Health, a private medical clinic based in Toronto; poor employee health creates a problem for the entire company, leading to time away from the office, higher utilization of benefits and drug plans, and “presenteeism,” she says, a word for employees showing up even when they’re not well.

Keeping employees and their managers in good shape is crucial for a company’s success. When an executive is incapacitated, the effect on the bottom line can be especially severe: losing such a person to illness can cost companies into the millions after lost revenue, disability expenses, and the costs of finding a replacement are taken into account, according to Chin. But most company health plans focus on treating disease instead of preventing it, which is backwards, Chin says. “Get employees healthy and keep them healthy, so they’re more productive. What people do with their body affects their brain.”

A growing number of companies are awakening to this reality, recognizing that the first step is identifying potential health issues, ideally before they become full-blown. Scienta’s corporate health program uses tools like the Q-GAP (a test currently available online at to identify the next step for medical screening and education in order to spend health care dollars in the workplace in a targeted way.

“Historically, [corporate health plans] have been one-size-fits-all,” Chin says, but just as symptoms vary among people, “we can’t assume that company A needs what company B or C does.” If it’s a young office, for example, “maybe instead of over-contributing to a life insurance policy,” you could invest elsewhere, Chin says. Workers offered a flex account may choose to spend some on massage, eyeglasses, or another health care service, according to their needs and their families’.

One of the first companies to adopt Scienta’s vision of targeted, personalized employee health spending was Cundari Group Ltd., a Toronto-based integrated advertising firm. Prior to this, says chairman and chief executive officer Aldo Cundari, the company offered a gym facility and benefit plan; still, he noticed how many workers in the industry were under severe stress, and thought he could do more. Last fall, he brought Scienta’s Q-GAP test into the office. “Our compliance rate was quite high,” he says. “We don’t like making it mandatory. In advertising, there are a lot of free-spirited individuals.”

The results were telling. Cundari’s staff is relatively young—almost half are aged 25 to 35—but few were symptom-free. Some of the most common complaints, Scienta found, included headaches, muscle pains, lack of sleep, bloating, and feelings of frustration. Women tended to report musculoskeletal and gastrointestinal issues, while men suffered more from emotional and psychosocial problems. Given these results, Scienta recommended modifying the plan to encourage better use of some health care professionals, like counsellors and dieticians, among other suggestions. Cundari’s now looking at ways to tweak the benefits package for optimal use; but even having test results in hand made a huge difference with individual employees, he says, as it spurred them to act. “Now that we have the information, it’s easier to see the areas [where] we can all improve,” he says.

Scienta is looking to personalize corporate health care even further—through “desk-side” biometric screening that could test for stress, pre-diabetes and cardiac risk through saliva and blood samples taken from a finger prick, for example. More traditional interventions can make a difference, too. In Fernandez’s study, she and her team focused on creating a work environment that promotes healthier living, including providing nutritional information in the cafeteria; changing snacks in the vending machine; and promoting use of the company gym facility. Above all, “the culture has to change, and that has to come from management,” Fernandez says. “Without management support, these interventions do not work.”