Preparing for this tenth annual Labor Day essay for The Examiner, I asked the question, “What are the health benefits of working?”  Fourteen years ago, in a September 3, 1998 article for The Examiner, this author wrote:

“In The Brothers Kamarazov, Russian author Fyodor Dostoyevsky commented on the need of man for creative and satisfying work; he said: ‘To crush, to annihilate a man utterly, to inflict on him the most terrible of punishments so that the most ferocious murderer would shudder at it and dread it beforehand, one need only give him work of an absolutely, completely useless and irrational character.’  Here is the greatest curse. It is not the absence of leisure or pleasure; it is the absence of meaning in one's work.

“In The Fifth Discipline, Peter Senge said, ‘Early on...we recognized that there is a burning need for people to feel part of an ennobling mission.’  If you want to kill a man, take away his work. Who has not known a person who withers and dies soon after retirement from his life's work?  Senge adds the comment, ‘Having no work at all is a terrible problem...(Man's) deep spiritual need (is) for fruitful work, for the genuine employment of his talents and energies...Human beings are creative by nature, and are goal seekers and problem solvers. Every human being needs to be an originator of ideas and a creator of structures.’

“Born of an age which gave birth to the labor movement, President Theodore Roosevelt said, ‘Far and away the best prize that life offers is the chance to work hard at work worth doing.’ Without work ‘worth doing,’ man finds life hardly worth living. Are there exceptions to this principle?  Probably not!

“If you look for the population which has the least hope in the world it would probably be residents of death row. In The Fifth Discipline, Senge reports the ennobling effect of work on death row inmates. He said:  ‘The most surprising account...of the spiritual need for usefulness being met comes out of the Texas State Penitentiary at Huntsville, where the inmates on death row have been allowed to leave their cells and go to work making uniforms for the prison guards.  ‘Noting the positive benefit which work had on the conduct, cooperation and attitudes of death row inmates,’ Senge concluded, ‘The same force that can bring death-row prisoners positive morale can certainly build positive corporate spirit in our businesses.’

“The lottery can provide money, but it cannot provide meaning and purpose in life, only meaningful and creative labor can do that. As we celebrate Labor Day, let us celebrate our nature - given to us by God -- through which we can find ennobling and enriching activities for our lives. And, and let us celebrate the heritage, given to us by the labor movement, which has given the voiceless the right and capacity to speak!”

Focus on the health benefits of work

An internet search for  “What are the health benefits of work?”  produced extensive links to sites in Australia, New Zealand, England and Canada.  After reviewing over 100 links, only these were found from the Unites States:

• Harvard University addressing the health benefits of volunteering. Among other things this report states, “Volunteering provides many benefits to both mental and physical health.
• Volunteering increases self-confidence.
• Volunteering combats depression.
• Volunteering helps you stay physically healthy. Volunteering is good for your health at any age, but it’s especially beneficial in older adults. Studies have found that those who volunteer have a lower mortality rate than those who do not, even when considering factors like the health of the participants. Volunteering has also been shown to lessen symptoms of chronic pain or heart disease.
• The Center for Disease Control commenting on the benefits to employers for promoting health in their staff.
• A Fox News report of the health benefits of working from home.
• LiveStrong on the health benefits of biking or walking to work

After reviewing 70+ articles, a study from the United States on the health benefits of working is finally listed.  The study is entitled, The Mental Health Benefits of Work: Do They Apply to Welfare Mothers with a Drinking Problem?( J Behav Health Serv 36(1): 96-110.)  and states:   “A longstanding tradition of employment-related research has shown mental health advantages of employment. However, given welfare reform mandates for employment and a welfare population with disproportionately high rates of depression and co-occurring substance abuse problems, it is unclear if women on welfare reap this advantage. ..Studies of the U.S. labor force provide broad support for the beneficial mental health effects of employment on depression.”

Worklessness Equivalent to Smoking Ten Packs of Cigarettes a Day

In the Australian medical literature, it is stated, “For the working age population, not being at work is a progressively increasing health risk factor. Indeed, not working for six months or more has been found to be an equivalent health risk factor to smoking 10 packets of cigarettes each day. Accordingly, long-term worklessness is now considered to be one of the most significant public health risk factors. When a person is off work for 20 days, the prospects of them successfully returning to work are 70 percent; when they are off work for 45 days, the chances of getting back to work are 50 percent. However, when a person is off work for 70 days, the chances of successfully resuming work decline to 35 per cent. Thus, the overarching theme of the Position Statement is that, generally, work is good for health.”

Australian Consensus Statement on the Health Benefits of Work

“We acknowledge the following fundamental principles about the relationship between health and work.

• “Work is generally good for health and wellbeing.
• “Long term work absence, work disability and unemployment have a negative impact on health and wellbeing.
• “Work must be safe so far as is reasonably practicable.
• “Work is an effective means of reducing poverty and social exclusion, including that faced by indigenous populations and other currently disadvantaged groups. With appropriate support, many of those who have the potential to work, but are not currently working because of economic or social inequalities, illness or acquired or congenital disability, can access the benefits of work.
• “Work practices, workplace culture, work-life balance, injury management programs and relationships within workplaces are key determinates, not only of whether people feel valued and supported in their work roles, but also of individual health, wellbeing and productivity.
• “Individuals seeking to enter the workforce for the first time, seeking reemployment or attempting to return to work after a period of injury or illness, face a complex situation with many variables. Good outcomes are more likely when individuals understand the health benefits of work, and are empowered to take responsibility for their own situation.
• “Health professionals exert a significant influence on work absence and work disability, particularly in relation to medical sickness certification practices. This influence provides health professionals with many opportunities for patient advocacy, which includes, but is not limited to, recognition of the health benefits of work.

“Government, employers, unions, insurance companies, legal practitioners, advocacy groups, and the medical, nursing and allied health professions all have a role to play in promoting the health benefits of work.”

A major British study and subsequent statement concluded:  There are economic, social and moral arguments that work is the most effective way to improve the well-being of individuals, their families and their communities. There is also growing awareness that (long-term) worklessness is harmful to physical and mental health.”

Conclusions

It is probable that the positive health benefit of work is not a surprise to anyone. Work is healthy: mentally and physically.  The corollary is equally important and equally not surprising: worklessness is harmful to health.  Nevertheless, these are two different questions and each required research to establish that work is healthy and that not working is unhealthy. 

As we celebrate Labor Day, those who have jobs must know that they are fortunate.  But, the above reports demonstrate that we need a different attitude toward worklessness. We need to recognize it worklessness not just as an economic hazard for the individual and the country, but also as a health hazard for both.  Remember, “Not working for six months or more has been found to be an equivalent health risk factor to smoking 10 packets of cigarettes each day.”

The health hazard of worklessness compounds the economic effect of unemployment.  Not only is a large segment of the population not being productive and not being self-supporting, they are also not paying taxes and not contributing to the general national well-being. They are also increasingly utilizing healthcare resources because of the deterioration of health which is associated with worklessness.

Worklessness as a Public Health Concern

19% of the United States population is categorized as disabled. That is over 50,000,000 people.  Almost half of those categorized as disabled still work, albeit with limitations imposed by their disability.  These would not be categorized as “workless,” and where they are employed at jobs which provide personal satisfaction, their work promotes their health.  Many of those who receive disability payments can work.  To promote working among the disabled, the Social Security Administration has programs which allow beneficiaries to continue to receive payments while testing their ability to perform a job over a nine-month period.

If worklessness either because of bad economic times, personal disability, lack of job skills, or any other reason are viewed as a health problem, the dynamic of helping a person get back to work changes.  Getting them back to work is no longer an issue of getting people off the public welfare system or disability system; it is getting them back to work to promote their own health, well-being and longevity.  Worklessness is no longer approached only as a public policy or economic issue; it is now approached from the vantage point of promoting the individual’s health.

Health and Labor

Labor Day is an opportune time to think about the value of work and of health and of their relationship.  It also challenges us to look at the issues of public policy which affect both. On the one hand - perhaps the left hand - we have Hubert Humphrey’s November 4, 1977 statement, “the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life-the sick, the needy, and the handicapped.”  Since I first read this statement in a speech given by Dr. Don Berwick, I have been haunted by it.  I agree with it.  I embrace it.  It addresses the health side of the worklessness equation. 

On the other hand -- perhaps the right hand -- we have concern for people to be self-sufficient, to be self-reliant, to accept responsibility for their own lives and not to expect others always to take care of them.  I recognize this as a need of public policy as well.  I don’t know how to fulfill the needs implied by the left hand and yet to meet the needs of the right.  I do know that they are both right and both must be addressed.

If on this Labor Day, we recognize ourselves as our brother’s keepers and as brothers, we  recognized our need not to be “kept,” we will have accomplished something of significance.  It is obvious that the left hand and the right hand could be metaphors for our two major political parties.  The frustration is that they are both right, but they don’t talk to one another.  They maintain two simultaneous monologues without any dialogue.  The only solution to our health and labor issue is for the left hand to be interdigitated with the right and for the right to grasp the left.  It is then that a solution, which is good for all, can be found.

Happy Labor Day; stay healthy, engage yourself in productive, fulfilling work.