Job Stress Prevention & Control: Developing Best Practice
Tony LaMontagne, ScD, MA, MEd, from the McCaughey Centre, Melbourne School of Population Health, University of Melbourne (AUSTRALIA).
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Exposure to job stressors predicts a variety of serious effects on mental and physical health, as well as poor health behaviours. Given the widespread exposure to job stressors among working people, this translates to large preventable burdens of job stress-related illness and disease even after accounting for other known causes. It is inequitably distributed-groups most affected include younger workers, working women, and workers in lower skilled occupations and precarious employment arrangements such as contractors and temporary workers.
Feasible and effective approaches are available to address the root causes of job stress. The best approaches are comprehensive and systemic, targeting job stress by making organizational changes to the workplace. Despite the extensive evidence in support of these approaches, however, workplace practices continue to over-emphasize behaviour change by individual workers and coping skills, with inadequate attention to the reduction of job stressors.3
Best practice approaches for job stress interventions
Reducing Stress in the Workplace, An Evidence Review is a recently published, open-access document for policy-makers and practitioners summarizing the vast evidence on job stress and its impacts on human and organizational health. Its goal is to make it easier for employers, workers, and health professionals to follow international best practice recommendations for job stress prevention and control.1 The Report provides recommendations for best practice approaches to reducing job stress, as well as examples, web links and other references to specific resources. These recommendations and resources are organized under 7 best practice features distilled from an extensive review of the international evidence on job stress prevention and reduction.4 To be most effective at preventing and reducing job stress, interventions should:
- be founded on a solid evidence base with clear aims, goals and tasks;
- include a workplace risk assessment;
- be tailored to suit specific sectors, workplace sizes, and other contextual factors;
- be accessible and user-friendly to individuals at all levels of an organization;
- apply a systems or comprehensive approach, with mutually reinforcing components of the
- intervention aimed at working conditions, workers, and the organisation;
- facilitate competency building and skills development throughout the organization;
- be developed with the participation of those who are being targeted by the intervention.
Applying a systems approach to job stress interventions
Effective job stress interventions must use a comprehensive or systems approach to address both the causes and the consequences of job stress. This entails a combination of activities to reduce job stressors at the source (primary prevention), activities that change how workers perceive and respond to stressors (secondary prevention), and activities to treat stress-related illness and disability once it develops (tertiary prevention). These three types of changes are complementary and mutually reinforcing (see Figure 1). Workplace intervention should be complemented by policies and practices at other levels, as described in more detail elsewhere.5
The substantial disease burden that is related to job stress could be addressed by applying a systems approach to improving working conditions. In addition to being a concern for workers, unions, employers, occupational health and safety and workers’ compensation systems, job stress should be a matter for physical and mental health promotion agencies, government public health authorities, medical practitioners, community advocacy groups and others. An optimal public health response to job stress would encompass participation by the full range of stakeholders.
Figure 1 Examples of how to apply a job stress “systems approach” by combining multiple activities to address determinants and consequences at each point in the job stress pathway.
Tony LaMontagne, a former New England resident, currently is Associate Professor at University of Melbourne, Australia. He lectures and conducts independent research in the areas of work & health, mental health promotion, history and health, and social health. He is a CPH-NEW Research Affiliate.
1LaMontagne AD, Keegel T (2012). Reducing Stress in the Workplace, An Evidence Review. Full report (52 pp) and plain language summary version (20 pp) both available open access at: http://www.vichealth.vic.gov.au/workplace
2LaMontagne AD, Sanderson K, Cocker F (2010). Estimating the Economic Benefits of Eliminating Job Strain as a Risk Factor for Depression. Melbourne: Victorian Health Promotion Foundation. Full report (37 pp) and plain language summary version (13 pp) both available open access at: http://www.vichealth.vic.gov.au/jobstrain
3LaMontagne AD, Shaw A, Ostry A, Louie AM, and Keegel T (May 2006). Workplace Stress in Victoria: Developing a Systems Approach. Melbourne: Victorian Health Promotion Foundation. Full report (152 pp) and plain language summary version (24 pp) both available open access at: www.vichealth.vic.gov.au/workplacestress
4Leka S, Cox T (Editors) (2008). The European Framework for Psychosocial Risk Management: PRIMA-EF, Nottingham (UK): Institute of Work, Health & Organisations.
5Landsbergis PA, Grzywacz JG, LaMontagne AD (2011): Work organization, job insecurity and occupational health disparities. NIOSH Conference: Eliminating Health and Safety Disparities at Work 14-15 September, 2011 Chicago, USA (56 pp). Available at http://www.aoecdata.org/Conferences/HealthDisparities/whitepapers/Work-Organization.pdf
CPH-NEW is a Center for Excellence to Promote a Healthier Workforce of the National Institute for Occupational Safety and Health. CPH-News & Views is a semi-monthly column written by Center researchers on emerging topics related to healthy workplaces. These comments reflect thoughts of the individual researchers and do not represent conclusive research summaries, nor do they necessarily reflect a consensus among all Center personnel. We welcome your responses and discussion. Please send all questions and comments to CPHNEW@uml.edu.
CPH News and Views Issue 27
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