Jeffrey Pfeffer has an ambitious aspiration for his latest book. “I want this to be the Silent Spring of workplace health,” says Pfeffer, a professor of organizational behavior at Stanford Graduate School of Business. “We are harming both company performance and individual well-being, and this needs to be the clarion call for us to stop. There is too much damage being done.”
Pfeffer recently sat for an interview with Insights. The following has been edited for length and clarity.
I was struck by the story of Robert Chapman, CEO of Barry-Wehmiller, standing in front of 1,000 other CEOs and saying, “You are the cause of the health care crisis.”
It’s true. He takes three points and puts them together. The first point, which is consistent with data reported by the World Economic Forum and other sources, is that an enormous percentage of the health care cost burden in the developed world, and in particular in the U.S., comes from chronic disease — things like diabetes and cardiovascular and circulatory disease. You begin with that premise: A large fraction — some estimates are 75 percent — of the disease burden in the U.S. is from chronic diseases.
Second, there is a tremendous amount of epidemiological literature that suggests that diabetes, cardiovascular disease and metabolic syndrome — and many health-relevant individual behaviors such as overeating and underexercising and drug and alcohol abuse — come from stress.
And third, there is a large amount of data that suggests the biggest source of stress is the workplace. So that’s how Chapman can stand up and make the statement that CEOs are the cause of the health care crisis: You are the source of stress, stress causes chronic disease, and chronic disease is the biggest component of our ongoing and enormous health care costs.
Has this connection always been there, or has there been an evolution in workplace culture that got us to this point?
I think the connection as just described has always been there, because the physiology and etiology of disease have not really changed. But I would say that with all the evidence I’ve encountered — and it’s not perfect evidence — I’ve seen nothing inconsistent with the statement that the workplace has generally gotten worse.
Job engagement, according to Gallup, is low. Distrust in management, according to the Edelman trust index, is high. Job satisfaction, according to the Conference Board, is low and has been in continual decline. The gig economy is growing, economic insecurity is growing, and wage growth overall has stagnated. Fewer people are covered by employer-sponsored health insurance than in the past, according to Kaiser Foundation surveys. And a strikingly high percentage of people, even those covered by insurance, say they forgo treatment and medications because of cost issues.
I look out at the workplace and I see stress, layoffs, longer hours, work-family conflict, enormous amounts of economic insecurity. I see a workplace that has become shockingly inhumane.
Dying for a Paycheck, published by HarperBusiness and released on March 20, maps a range of ills in the modern workplace — from the disappearance of good health insurance to the psychological effects of long hours and work-family conflict — and how these are killing people.