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 just on management of outcomes (secondary & tertiary interventions)

underlying causes

rather than relying

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.

Health and safety statistics 2007/08

2500

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

2000 1500 1000 500 0 All illnesses 2001/02 2003/04 2004/05 Musculoskeletal disorders 2005/06 2006/07 Stress, depression or anxiety 2007/08 Other illnesses 95% confidence interval

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

Illness % Disease % Absence % >14 days None of these 25%

33 23 3 8 2 1 5 Wikman et al (2005)

Sickness Absence: NHS Trust

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

80 70 60 50 40 30 20 10 0 01-10 11-20 21-30 31-40 41-50 51-60 61-70 71-80 81-90

DURATION - DAYS

91-100 101-110 111-120 121-130 131-140 141-150 151+

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)