If you really want to increase employees’ health and well-being, focus on job control and social support.

Workplace stress is exacting an ever-higher physical and psychological toll. It adversely affects productivity, drives up voluntary turnover, and costs US employers nearly $200 billion every year in healthcare costs. Many companies are aware of these negative effects, and some have gotten busy devising ways to counteract them. Efforts range from initiatives to encourage sleep, exercise, and meditation to perks such as nap pods and snack bars.

In the midst of all this activity, it’s easy to overlook something fundamental: the work environment, starting with the work itself. For many years, a number of researchers, including myself, have touted the benefits of better work practices for performance and productivity. In my new book, Dying for a Paycheck (HarperCollins, 2018), I’ve tried to show how two critical contributors to employee engagement—job control and social support—also improve employee health, potentially reducing healthcare costs and strengthening the case for them as a top management priority.

In this article, I’ll explore the research that connects these two elements to employee health, and describe some examples of organizations that are succeeding at providing the autonomy, control, social connections, and support that foster physical and mental well-being. Any company, in any industry, can pull these levers without breaking the bank. Today, though, too few do.

Job control

Studies going back decades have shown that job control—the amount of discretion employees have to determine what they do and how they do it—has a major impact on their physical health. Recent research also indicates that limited job control has ill effects that extend beyond the physical, imposing a burden on employees’ mental health, too. Organizations can guard against these dangers by creating roles with more fluidity and autonomy, and by erecting barriers to micromanagement.

Physical and mental health

One of the most notable research efforts in this area was the Whitehall Studies, conducted by British epidemiologist Michael Marmot and his team, which examined employees within the British Civil Service. Marmot’s team discovered that the higher someone’s rank, the lower the incidence of and mortality from cardiovascular disease. Controlling for other factors, it turned out that differences in job control, which were correlated with job rank, most accounted for this phenomenon. Higher-ranked British employees, like higher-ranked employees in most organizations, enjoyed more control over their jobs and had more discretion over what they did, how they did it, and when—even though they often faced greater job demands.

Additional Whitehall data related work stress, measured as the co-occurrence of high job demands and low job control, to the presence of metabolic syndrome, a cluster of risk factors that predict the likelihood of getting heart disease and type 2 diabetes. Employees who faced chronic stress at work were more than twice as likely to have metabolic syndrome compared with those without work stress.

Other research has also found a relationship between measures of job control and health. A study of 8,500 white-collar workers in Sweden who had gone through reorganizations found that the people who had a higher level of influence and task control in the reorganization process had lower levels of illness symptoms for 11 out of 12 health indicators, were absent less frequently, and experienced less depression. And that’s far from the only example of job control affecting mental- as well as physical-health outcomes. For example, a study of individuals at 72 diverse organizations in the northeastern United States reported statistically significant, negative relationships between job control and self-reported anxiety and depression.¹