Work is good for your bank balance but bad for your health, right?
Wrong. The characteristics of work - activity, social interaction, identity and status - are proven to be beneficial for our physical and mental health.
Recent research shows that people in work tend to enjoy happier and healthier lives than people who are out of work.
But much more than that: people with health conditions, such as back pain, stress and depression and high blood pressure find that getting back to work is often the best way to recover.
These are the conclusions of a 2006 review of more than 400 scientific studies on the relationship between work and health, entitled "Is work good for your health and wellbeing?"
Common health problems
The review focused on workers with common health problems (mild mental health conditions, muscle and joint pain, and heart and chest conditions) that account for two-thirds of sickness absence in the UK.
Below is a sample of some of the evidence that supports the review's assertion that work is generally good for your health.
- People with muscle and joint pain who are helped (by their health advisor and employer) to return to work tend to enjoy better health (level of pain, function and quality of life) than those who stay off work.
- When their health condition permits, people who are sick and disabled should remain in or return to work as soon as possible because it's therapeutic, helps to promote recovery and rehabilitation, and reduces the risk of long-term incapacity.
- The risk of a stress or depression-type condition getting worse at work are outweighed by the beneficial effects of employment on wellbeing, and the likely negative impact of long-term sick leave.
Likewise, the review found that being out of work for long periods was generally bad for your health, resulting in:
- more consultations, higher use of medication and higher hospital admission rates than for the average population
- a two-to-three times increased risk of poor general health
- a two-to-three times increased risk of mental health problems
- a 20% higher death rate
"Many people out of work lose contact with who they are and what they are," says Professor Kim Burton, co-author of Is work good for your health and wellbeing?
"When you meet someone in the pub, you may start by asking their name and then what they do. Work defines us. It gives people structure to their lives.
"Take that away and people lose their interaction with friends and colleagues, the mental stimulus, the daily activity.
"Worklessness is both a mental and physical decommissioning."
Confucius
The idea that work is good for our wellbeing is not new. The importance of work and the dangers of worklessness were understood long ago.
The Chinese philosopher Confucius (BC 551-BC 479) stressed the relationship between job satisfaction and wellbeing when he said: "Choose a job you love, and you will never have to work a day in your life."
The close link between work and our sense of purpose was underlined by the American humanitarian Eleanor Roosevelt (1884-1962), who said: "When you cease to make a contribution, you begin to die."
Singer John Lennon (1940-1980) mentioned the importance of work to our mental health: "Work is life, you know, and without it, there's nothing but fear and insecurity."
With the publication of research like Is work good for your health and wellbeing?, there is now strong evidence to back up these luminaries' words.
Health care professionals, including the British Medical Association and the General Medical Council, are signatories of the healthcare professionals' consensus statement on health and work. There's broad agreement among them that:
- Work is generally good for health and wellbeing.
- Unemployment is generally bad for health and wellbeing.
- Returning to work can lead to rapid improvements in health.
- You don't have to be 100% fit to work.
"You don't have to be 100% OK to return to work," says Professor Burton. "The earlier you can return to work the better.
"Work is often part of treatment, and getting back to work is part of the recovery process."
Professor Burton says that simple changes to your job may be the key to getting back quickly. Getting back to work will often involve you and your employer working together.
The proviso to all of this, states the review, is that work is good for your health and wellbeing "provided you have a good job".
It says a good job must be safe, fair, secure, fulfilling, supportive and accommodating.
Not all jobs are good and some work can cause risks to health. If you're worried about your work, speak to your employer and doctor. Use our services directory to find your local GP.
Likewise, not all unemployment is "bad": for a minority of people (about 5% to 10%) the review found that unemployment may be better for their health.
Fit note
Much of the old approach to treating people with common health problems reflected the assumption that common health problems are incompatible with being in work.
This resulted in many people seeking to be signed off work by their GP while awaiting or undergoing treatment, while prolonged and unnecessary sickness absence increased the risk of job loss.
But it's been proven that you don't have to be 100% "well" or "better" to do all or some of your job.
"The longer you're off work, the harder it is to get back," says Professor Burton. "Prolonged sickness absence can have devastating effects on the lives of patients and their families.
"With the right support, many people with common health problems can keep their jobs and progress in the workplace."
Professor Burton says there needs to be a change in the culture of work and health to reflect the new scientific evidence that work can help promote recovery.
"We need a fundamental shift in how we think about common health problems in the workplace, in health care and in society," he says.
Part of this cultural shift has involved the introduction of a fit note to replace the sick note, switching the focus to what people can do instead of what they can't.
The traditional sick note hadn't evolved much since its introduction in 1922 when workplaces were different and a lot less flexible than they are today.
The new fit note encourages GPs to explore with patients and employers the options for prompt return to work and any helpful workplace adjustments.
For employers, there's a strong business case for having a healthy workforce. Healthy staff are more productive and that's good for the bottom line, says independent government health advisor Dame Carol Black.
She says: "Employers should not underestimate the role that better management and engagement of employees can have on the wellbeing - and ultimately productivity - of their workforce."
Article provided by NHS Choices