As Published in Business 2 Business , October 2004

The Truth about Employee Stress

Bleeding at the bottom line
By Ira S. Wolfe

There have been so many reports of worldwide workplace stress recently that it would be perfectly reasonable to conclude that everyone everywhere is stressed out, burned out and depressed.

Every employee feels work-related stress. That's normal. Complaining about it is normal too. Many employers take it in stride that they complain about their jobs, their bosses, their co-workers. So is that occasional outburst that just releases enough pressure to allow you to calm down and get back to work.

What is not normal is sustained and prolonged stress. Kronos, Inc. a human resources consulting firm, recently conducted a Harris poll of American workers. Half of these American workers say work leaves them "overtired and overwhelmed." That alone is not alarming until you dig a little deeper and realize these workers develop chronic, often serious, stress-induced health problems.

Workplace stress has been on human resource professional's radar for years. But management considered the solution as soft stuff. A few execs threw HR a bone and agreed to offer “warm and fuzzy feel-good” training as long as it didn't interfere with business or cost too much. Others expected employees just to tough it out.

That is until recently. What always seems to get attention in the boardrooms however is money, especially the type that eats away at the bottom lines. With skyrocketing insurance and health care costs now getting the full attention of nearly every executive and small business owner, many solutions are focused on what many HR and organizational professionals knew for years - workplace stress is not only a major obstacle to continuous improvements in productivity, but the root cause of much of the increase in workplace health care costs.

To confirm the connection, all you have to do is watch and listen to workers and the link between the bottom line and chronic stress is obvious. Donna is a forty-something mother of two children. Described by everyone who knows her as loyal, hard-working, and generous, Donna doesn't believe it does any good to complain. “Everyone has their own problems”, she says. “I'm just grateful that mine aren't worse.”

But lately, Donna hasn't been feeling so good. She blames much of her aches, pains and “minor depression” on getting old. A former athlete, Donna now finds herself being a juggler of work and family commitments. She's beginning to feel like the better she gets at juggling, the more she is asked to juggle.

Donna just doesn't have much time for herself anymore, and that includes exercise. She joined the gym and tries to walk at lunch but there always seems to be one more obligation that interferes with what she considers her “free” time – another project meeting at work, getting the kids to doctor appointments, volunteering at the Chamber, working on her post-graduate degree, covering for co-workers on vacations – you get the picture.

Like millions of other people, Donna eats when she's stressed. Stress + Eating + No Exercise equals extra pounds. Donna by her own admission is at least 30 pounds overweight. The once trim and fit Donna has now officially joined the obese American's club. Being overweight and out of shape stresses her out even more - but she swears by the first of the year she'll change her ways. Of course, this is what she said last year and the year before that, too.

Donna has been staying later and arriving earlier in addition to taking work home on the weekends. Her company put a freeze on hiring last year and a few people who left weren't replaced. Just recently, they agreed to bring on a few temps-to-hire but their dependability was terrible and few of them had the skills or experience to help Donna. She decided it was easier to do the work herself.

And to add one more thing to her daily routine, Donna's mother-in-law moved in. An independent woman, her mother-in-law refused to go to a retirement home but was just too forgetful to live alone anymore. Donna adored this woman but now had one more person to take care for. What made this transition so difficult was that her husband's job now required him to travel overnight at least 3 or 4 days each week.

As a result of more work, more family responsibilities and less balance in her life, Donna's blood pressure went up, her cholesterol skyrocketed, her joints were hurting and she was just diagnosed with adult onset diabetes. Research now confirms that stress induces the onset of every one of these conditions – obesity, hypertension, arthritis, diabetes. Fortunately today's wonder drugs brought her blood pressure down, controlled her cholesterol, relieved the pain, and reduced her blood sugar count. On the surface this was great news. Donna never missed work and just like John Cameron Swayze used to say in the Timex watch commercials, she “took a licking, but just keeps on ticking.”

But the problem with chronic stress is its damage is insidious. You can cover up the symptoms, but the stress just keeps eating away at you. Chronic stress eventually dampens our ability to keep track of information resulting in mistakes and lost productivity. Our immune system is compromised, making us even more susceptible to infections, as simple as the common cold, and even more serious autoimmune diseases. People under chronic stress eventually pay the price with their bodies. Employers who tolerate and even encourage workplace stress are beginning to pay the price with their wallets.

What has finally grabbed senior management's attention is the effect workplace stress has on the bottom line. The American Institute on Stress reports chronic stress adds over $300 billion each year to cover associated health care costs and absentee rates, according to. That is like writing an extra paycheck exceeding over $600 to every "stressed" worker without getting anything in return. Even worse the cost for health insurance of a single employee jumped from $1.80 to $3.80 per hour over the last few years. How much of this was caused by workplace stress is anyone's guess but considering this research, its substantial.

Research, published in the February 2004 British Medical Journal, found that the risk for a worker having a heart attack and hospitalization doubled after downsizings, along with a number of other conditions. The risk occurred at a higher incidence following rapid expansion too. A Massachusetts-based study dating back to 1972 showed the surest predictor of heart disease was job dissatisfaction.. A recent study conducted by LLuminari® found that 54 percent of workers leave work fatigued. Ten percent of workers are too tired to enjoy their leisure time.

The result? Nearly one out of five workers is at risk for stress-related health problems. In addition to a threefold risk for heart and cardiovascular problems, stressed employees are two to three times more likely to suffer from anxiety, back pain, substance abuse, injuries, infections, cancers, and obesity. The cost of insuring and taking care of these stressed and frazzled workers is beginning to exceed the gains made from increased productivity per worker enjoyed over the last two years.

One solution being kicked around to control employer-paid health costs is cost sharing with employees. While I am the first to agree that employees must begin to share responsibility in taking care of themselves, my advice to all executives and human resources professionals is to be very, very careful in taking this strategy. It is not without its potentially catastrophic consequences.

First of all, cost sharing reduces the take-home pay, which for many employees, will just add more stress to their stretched checkbooks. While cost-sharing might be a financially sound strategy on the surface, its impact on morale might just result in higher turnover and lower productivity. With a critical shortage of skilled workers already handicapping many industries, senior management must look at all the effects cost-sharing carefully.

Second, employees with higher deductibles and co-pays postpone early intervention and wait until situations turn acute. This is like stealing from Peter to pay Paul. Office visits are replaced with emergency room visits and longer hospital stays. Short term treatment is replaced with long term therapy and costly prescription drugs.

Third, hard-working and trusted employees will push themselves to the edge for their boss. They never miss a day, even when sick. More often than not, they prolong their recovery and infect their co-workers as well. Ironically, many organizations reward (“what we need is more employees like you”) these employees for this selfless abuse to the point that a long term disability resulting from overwork is almost the ultimate display of loyalty. Unfortunately for the employer, disability comes with an unrecoverable price tag – the loss of a productive worker and higher health care utilization rates.

While reducing workplace stress is not the magic bullet for health care cost containment, all employers need to remember is this: Chronic disease is expensive to treat and workplace stress is now linked to chronic conditions.

Facts about Workplace Stress

Workplace stress costs the nation more than $300 billion each year in health care, missed work and stress reduction efforts.

(Source: American Institute of Stress)

Only 45 percent (Source: BLS) of private-sector employees are covered by or participate in employer-sponsored programs, employers who provide health insurance benefits experienced on average cost of $3,80 per hour for participating employees in 2003.  That cost has more than doubled in four years. (Source: Employment Policy Foundation, Employment Trends)

1 out of 5 workers are at risk for stress related health problems.

(Source: LLuminari® Landmark Study)

1 in 10 are so tired at the end of the work day that they do not enjoy their non-work time. (Source: LLuminari® Landmark Study)

1 in 5 stated that their work regularly interfered with their responsibilities at home and kept them from spending time with their family.

(Source: LLuminari® Landmark Study)

Workers who report they are stressed incur health care costs that are 46 percent higher, or $600 more per person, than other employees.

(Source: NIOSH)

The risk of a heart attack doubled among permanent after a major round of downsizing, with the risk growing to five times normal after four years. (British Medical Journal, Feb 2004)

The indirect costs of diabetes are e stimated to be $40 billion in 2002. In 2002, diabetes accounted for a loss of nearly 88 million disability days and 176,000 cases of permanent disability were caused by diabetes, at a cost of $7.5 billion.

The cost of lost productivity related to obesity (BMI > 30) among Americans ages 17–64 is $3.9 billion. This value considers the following annual numbers (for 1994):

• Workdays lost related to obesity: 39.3 million
• Physician office visits related to obesity: 62.7 million
• Restricted activity days related to obesity: 239.0 million
• Bed-days related to obesity: 89.5 million

Alcoholism causes 500 million lost work days annually. Absenteeism among alcoholics or problem drinkers is 3.8 to 8.3 times greater than normal (Bernstein & Mahoney, op. cit.) and up to 16 times greater among all employees with alcohol and other drug-related problems. (US Department of Labor)

Family members of alcoholics and substance users use ten times as much sick leave and have higher than average health care claims than family members of non alcoholic and substance using families. (HSS and NCADD Fact Sheet)

Up to 40 percent of industrial fatalities can be linked to alcohol use. Forty-seven percent of all industrial injuries are attributed to alcohol use. (NCADD Fact Sheet)

For more information, visit www.allaboutworkplacestress.com

Ira Wolfe founded Success Performance Solutions to help business owners hire and keep productive employees. He is a nationally recognized speaker and author for “Understanding Business Values and Motivators” and “The Perfect Labor Storm”. His full range of products and services includes High Motivation Employee Competency Identification and personality testing. Ira is scheduling 2005 speaking opportunities and is easy to reach at 717.656.4632.