What is a Work Design for Health Approach?

Many employers, increasingly concerned about rising health care costs, have implemented corporate wellness programs that use workplaces as venues for promoting individual health behaviors (such as healthy eating and increased exercise). However, recent research demonstrates that these programs are not very effective and have only limited positive influence on employee health outcomes, medical costs, and productivity.

In contrast to wellness programs, the approach we offer in this toolkit emphasizes the importance of targeting and changing work conditions—that is, how workplace practices and relationships are designed and organized. Ample research has demonstrated that these are often the real root causes of employee ill health and stress.

DISTINCTIVE FEATURES OF A WORK DESIGN FOR HEALTH APPROACH

• Changes That Benefit Both Employees and Employers. In this toolkit, we focus on how work can be changed in ways that benefit not only the health and functioning of workers but also the organizations that employ them. In other words, the emphasis is on both enhancing worker well-being and enabling employees to work more productively.

• A Focus on Root Causes of Worker Ill Health. We shift away from a conventional approach centered on helping workers better adapt to workplace stress by helping them cope with its symptoms (for instance, through mindfulness, exercise, or smoking cessation programs). Instead, our approach is systemic and focuses on identifying and changing underlying workplace conditions that are root causes of workplace stress and ill-being.

• Three Principles Grounded in Research. A strong base of research suggests that three work dynamics—job control, job demands, and social relationships at work— are root drivers of many forms of worker health. In particular, research has found that high work demands (that is, pressure to work long, fast or hard), low control over work conditions (in other words, little freedom and decision-making power at work), and/or a lack of supportive relationships at work are all associated with higher employee stress and poor health.³ The next three modules of this toolkit explain these important principles and offer a range of tested and effective practices for redesigning your workplace to improve worker health and well-being.

• A Focus on Positive Health. In addition to helping you reduce stress or ill health in the workplace, this toolkit will help you identify workplace conditions that enhance positive physical and mental health (e.g., employee engagement, personal growth, opportunities for learning, and having a sense of purpose and meaning). We highlight promising practices found to reduce ill-health and/or enhance positive health.

• Employee-Management Partnership. Successful organizational change requires the buy-in, commitment, and input of top leadership, middle management, and frontline workers in a collaborative process of change. In particular, our approach emphasizes the importance of including nonsupervisory employees as key stakeholders and participants in the process of problem identification and organizational change. 

Dimensions of Work Design This Toolkit Does Not Address

A Work Design for Health approach offers a broad-ranging set of tools employers can use to improve worker well-being. More specifically, our approach focuses on the psychological and social conditions of work; it does not address other key features of the work environment that also significantly affect worker well-being, such as physical hazards, wages and benefits, and hiring policies. We also focus on workplace change at the organization- or department-wide level rather than on the level of the individual worker (e.g., helping an employee to customize their job to suit their individual preferences) because this level has the greatest promise for wide-ranging impact.³ 

Finally, our approach is likely to be most relevant to employers who have a standard employment relationship with their workers, and less applicable to organizations that employ a largely contingent workforce. Independent contractors or “gig” workers are an important and growing part of the labor force, but less is known about what kinds of strategies will be most effective for reaching workers who do not have a fixed workplace and direct employer oversight of their work.

References

1. Kelly EL, Moen P. Overload: How Good Jobs Went Bad and What We Can Do About It. Princeton, NJ: Princeton University Press; 2020.
2. Ton Z. The Good Jobs Strategy: How the Smartest Companies Invest in Employees to Lower Costs and Boost Profits. Boston: New Harvest/Houghton Mifflin Harcourt; 2014.
3. Karasek R, Theorell T. Healthy Work: Stress, Productivity, and the Reconstruction of Working Life. New York: Basic Books; 1990.