Stress/Wellness/Healthcare Mgmt/Work-life Balance

1. Stress/Wellness/HealthcareMgmt/Work-life Balance Definition: Stress occurs when an individual cannot adequately respond to job or organizational stimuli without damage (e.g., fatigue, worry, heart disease). Established Research: Performance Stress (giving a speech, studying for a test) Conclusion: Nearly all work-induced stress is undesirable, not a bell-shaped curve

2. REASONS FOR MANAGING “STRESS” • Corporate self-interest • ● #1Fringe benefit? • ● Popular prescription drugs? • ● How did stress get linked to • health care costs? Control Data • 2. Liability; worker’s compensation • 3. Key people most affected • 4. Moral/ethical/humanistic reasons

3. Corporate Self-Interest: Reducing Health Care Costs • Control Data Corp. 1987 case • 2007: Overweight → 11.65 claims/100 FT Avg. weight → 5.80 claims/100 FT • Wellmark: Has offered financial awards for some lifestyle activities • Selection practices. Do not hire those who consume alcohol or smoke (e.g., Pella, Lucullan’s, Wellmark) • Choice of “carrot” vs. “stick”

4. LIFESTYLE POLICIESCOMPANYPOLICY Gannett, General Mills, Pepsi, Monthly surcharge for smokers Sauer-Danfoss, Iowa Telecom Macys, Gannett, GE Hy-Vee $10 Health Insurance reduction for nonsmokers GuideOne Discounts for not smoking or drinking; extra coverage when volunteering & church attendance Alabama, South Carolina $25/month Health Insurance surcharge for use of tobacco products or excessive weight

5. LIFESTYLE POLICIESCOMPANYPOLICY AmeriGas Get check-up or lose health insurance Mohawk Industries $100/month penalty for not participating in a health risk assessment Michelin Meeting healthy standards for BP, glucose, cholesterol, triglycerides, & waist size (35 women, 40 men) earn $1000 toward deductibles Turner Broadcasting First to not hire smokers Union Pacific (where legal to do so)

6. Sidebar on Employees Who Smoke • Smoking on decline in U.S: 18.9% of U.S. adults, 23% of Iowans, but growing world wide • Center for Disease Control says smoking costs the nation $167 billion • Federal studies show smokers cost an average business $3400 more per year because of increased medical expenses and absenteeism • Over a lifetime, employees who smoke incur $16,000 more in medical bills

7. Sidebar on Employees Who Smoke • Growing evidence that financial incentives can induce people to quit smoking • GE: 878 employees received info on smoking cessation. Divided into non-compensated and compensated groups. • One group got $100 for completing cessation program, $250 if they stopped w/in 6 months of being in the study and $400 if they remained smoke free 6 months later

8. Sidebar on Employees Who Smoke • Results % Smoke-Free Compensated Not Compensated End of First Year: 14.7% 5% At 18 months: 9.4% 3.6% • The “ship has sailed” with respect to smoking bans at work and in the community. Can obesity management be far behind?

9. Sidebar: Obese Employees Conference Board Data: • One in 3 adults is obese (BMI > 30) • Surgeon General says obesity costs the nation > $100 billion • Obesity accounts for 5-7% of health care costs. For a company of 1000 employees, an extra $395,000 • Programs to combat obesity on the rise (e.g., Google & Caterpillar put healthy food in vending machines, cafeterias charge less for healthy food) • Alabama and S.C. will charge employees w/BMI > 35 $25/month for insurance that is otherwise free

10. Reducing Liability and Worker’s Compensation Costs • Railroad origins • Extension of safe working environment (Health & Safety Work Act of 1974) • Stress accounts for as much as 14 % of occupational disease claims ■ Examples ■ Firms with less stress have fewer worker compensation claims • As work becomes increasingly mental & service-oriented, as opposed to manual, what will happen?

11. Key People Most Affected • Loss of highly valued senior people • Relations to stock prices and public confidence • Impact on negotiations • Hypothetical cost figures (next slide)

12. Stress Costs: Heart Disease Estimate (1) Number of employees 4,000 (2) Employees aged 45 to 64 (.25 of line 1) 1,000 (3) Estimated deaths due to heart disease per year (.006 x line 2) 6 (4) Estimated premature retirements due to heart problems per year (.003 x line 2) 3 (5) Personnel losses: Sum of lines 3 and 49 (6) Annual replacement costs for experienced_____ employees ($24,887 x line 5) $223,983

13. REASONS TO MANAGE STRESS • 1. Corporate self-interest: health care costs • 2. Liability; worker’s compensation • 3. Key people most affected • Moral/ethical/humanistic reasons • 1985: 27% firms offered stress mgmt • 1996: 40% • 2007: 68% but now labeled wellness

14. Job Stress somewhat predictable…. Occupational Stress Rankings High Stress Top 20Low Stress 230-250 U.S. President Music instrument repairer Firefighter Florist Corporate Executive Actuary Taxi driver Computer Programmer Surgeon Fork Lift Operator Real Estate Agent Medical records technician Stockbroker Janitor Traffic Cop/Highway Patrol Criteria: Overtime, quotas, deadlines, competitiveness, physical demands, hazards, initiative required, stamina, win-lose situations, and working in the public eye Source: Wall Street Journal, 1996; based on 250 jobs; updated by Jobs Rated Almanac, 11/28/12

15. TYPES OF STRESS 1. Origins of stress 2. Non-work stress 3. Work stress a. Air traffic controllers b. NASA workers c. OSHA layoff studies d. Accountants

16. A Managerial Model of Stress Antecedents Intermediary Health (Stressors/stress creators)Stress Outcomes Consequences • Physiological • Cholesterol • Triglycerides • Blood pressure • Blood glucose • Catecholamines • Free radicals • Behavioral • Job satisfaction • Career satisfaction • Life satisfaction • Performance • Absenteeism • Turnover • Accidents • Grievances • Physical Environment • Individual Factors • Work overload • Role conflict • Role ambiguity • Responsibility • for others • Underutilization • of skills • Resource inadequacy • Group Factors • Cohesion • Conflict • Satisfaction • Org. Factors • Climate • Technology • Control systems • Job Design Perceived and Objective Stress Measures • Coronary heart disease • Rheumatic • arthritis • Ulcers • Allergies • Headaches • Anxiety • Depression • Apathy • Nervous • exhaustion • Alcoholism • Individual Differences • (cognitive/affective) • Type A/B • Locus of control • Tolerance for • ambiguity • Need for achievement • Self-esteem • Corporate Practices • On-site child care • EAPs • Wellness programs • Individual Differences • (demographics & behavior) • Heredity • Age, Sex • Education • Occupation, Hours worked • Health status • Alcohol and tobacco use • Exercise and diet • Family support • Non-Organizational • Family relations • Economic status • Work/family conflict (moderator factors)

17. Antecedents of Stress (Stressors) where Managers Can Intervene (Column #1) Physical Environment Individual factors • ↑Work overload → ↑ Stress ■ Quantitative ■ Qualitative (KSAs) • ↑ Role conflict → ↑ Stress • ↑ Role ambiguity → ↑ Stress • ↑ Responsibility for others → ↑ Stress • ↑ Underutilization of skills → ↑ Stress • ↑ Resource inadequacy → ↑ Stress

18. Individual Differencesand Corporate Interventions Cognitive/Affective Differences • Type A/B • Locus of control • Tolerance for ambiguity • Need for achievement • Self-esteem Corporate Interventions • On-site child care • Employee assistance programs (EAPs) • Wellness programs

19. PERSONALITY TRAITS Type A High achievement orientation Aggressive Restless; impatient Constant sense of time urgency Type B No time urgency or resulting impatience Feels no need to display/discuss achievements Plays for fun and relaxation Can relax without guilt

20. CORRELATES OF TYPE A/B 1. As report more work overload 2. As work more hours 3. As have higher serum cholesterol ratings in college students 4. The “A” trait best predictor of CHD among those less than 49 years 5. Most damaging components of “A” are being distrustful and hostile

21. TYPE A and B EMPLOYEE BEHAVIORS AB Fast workers Patient Emphasizes quantity Tactful Works long hours Reflective Rarely creative Creative Sometimes makes poor Make careful decisions because they decisions work too fast

22. APPROACHES TO STRESS REDUCTION 1. Dissipation/Health Promotion a. Exercise b. Bio-feedback; massage c. Overload/role conflict reduction via concierge and “go to meeting” d. Newsletters 2. Selection & Placement 3. Training (conflict mgmt, time mgmt, lunch & learns, ADR, omsbudpersons) 4. Job Redesign & Work Scheduling (lessen role ambiguity, role conflict, reduce underutilization of skills)

23. Schaubroeck et al. Article • In a rare 7-year longitudinal study, the effects of job complexity and Type A personality are evaluated among police and fire dept. employees. • What are the 2 types of job complexity discussed? What is the dependent variable? • Re-state the central hypothesis of the study in every day language

24. Schaubroeck et al. Hypothesis Job Complexity • psychological • task-person •  Job Complexity • psychological • task-person  Cardiovascular disorder Type A/B Personality (true for As but not Bs) (moderator variable)

25. Schaubroeck et al. Article • Sampling: 303 firefighters & police in 1982 251 provided usable data Surveyed again in 1989, 171 (71%) return surveys 110 provide usable data (had to keep same job) • Measures: (1) 5-level Type A/B (high scores more Type A), (2) Survey items on cardio disorders and psychological complexity, (3) Control variables like body mass, and (4) Task-person complexity by DOT • What were the results (Table 1)? • Was the hypothesis supported (Table 2)?

26. High Predicted & found for Type A Predicted for Type B Job Complexity Found for Type B Low Low High Cardiovascular Disorder/Illness Schaubroeck et. al.

27. DeVries(2010) • Poses the Q: Could Americans’ poor health displace us as a world leader in productivity? • Reports survey results indicating that employers w/health programs have less sick leave, disability, & lower health care usage. •  Review 6 wellness tools: wireless technology, integrated solutions, telephone health coaching, programs to enhance participation, incentives, & expanded programs

28. Galinsky & Matos (2011)

29. Perryman et al. (2010) Take-Aways • Discusses CEO health and corporate well-being. Issues of personal privacy, corporate disclosure, succession planning & fiduciary responsibility of the board to shareholders may collide.   • The frequency of CEO resignations for health reasons is unknown. • The representational function of the CEO often results in s/he perceived as the embodiment of the firm. If the CEO is perceived healthy, so is the firm and vice versa

30. Perryman et al. (2010) • As public figures, CEOs may not have the same privacy rights as others. Authors imply they favor voluntary and prompt disclosures of CEO medical problems. • The SEC requires disclose of “material information” that can affect the market in publicly-held firms. Does CEO health qualify as material information? Brenda Barnes – Sara Lee • Being healthy can be seen as a BFOQ for the CEO job.

31. Perryman et al. (2010) • To prepare for unexpected health problems, have (1) a list of true potential internal and external successors and (2) a list emergency, interim successors. Not clear but the 2nd list seems to be temporary CEOs. • They offer guidelines clearly favoring more disclosure, based on idea that if CEO death depresses stock prices (shareholder wealth), CEO illness will do the same. Perhaps even worse because poor health entails uncertainty.