Working Ourselves Sick: Occupational Balance, Well-being, and Overwork
By: Émilie Lebel
Émilie is an emerging freelance writer specialising in health and social justice. Her knowledge base includes an Honours Bachelor of Health Sciences & Psychology (uOttawa, 2013), a Master of Health Sciences in Occupational Therapy (uOttawa, 2015), and a certificate in Concurrent Disorders (University of Toronto & CAMH, 2022) along with years of experience in community mental health and acquired brain injuries. Emilie is passionate about effective positive social change – which she works to spark through education and meaningful discourse.
Beginning in the 19th century, the era of Canadian industrialization saw economic activity evolve toward factory production. This changed the nature of work, transforming its tasks, schedules, and structure. Workers felt the full effects of the shift and demanded their working conditions be reviewed in order to adapt to these new labour realities.
As historian Matthew Barrett explains in his 2022 series All for 9 and 9 for All: The Illustrated Series, “In the 19th century, most Canadians worked 10 or more hours a day, six days a week, and often for just over a dollar per day. Many workers strove for more balanced lives with no more than nine hours devoted to labour, leaving more time for rest and recreation.”
Indeed, workers demanded the right to a better quality of life. “We are degenerating and sometimes spoiling our health by overwork,” they claimed (Barrett, 2022). One hour less of work each day could rebalance their lives by allowing for rest, leisure, and family time, they asserted.
Since then, studies have proved them right: work is intimately linked to health. And work–life balance is the key ingredient to well-being.
Work and Health
Work and health influence each other. For one, our health often determines how engaged one can be in work, or the conditions necessary for it to be an accessible option. In turn, our working conditions affect our health status. Of course, this impact is not only negative; for example, work can promote self-actualization, positive self-esteem, a secure income, and positive social interactions. However, too much work is undoubtedly bad for our health.
A study by Dembe, Erickson, Delbos, and Banks (2005) notes that long working hours are associated with an increased risk of:
- cardiovascular disease
- musculoskeletal disorders
- chronic infections
- general health problems and all-cause mortality
By their definition, a work week of 60 hours or more and any workday of 12 hours or more constitute such overwork – and put the worker at increased risk of developing such health conditions.
Similarly, long working hours increase the risk of work-related accidents. The researchers’ analysis shows that, compared to jobs requiring standard work schedules, the risk of work-related injury:
- increases by 37% within jobs with extended workdays
- increases by 23% in jobs with extended weekly hours
- increases by 61% in jobs requiring overtime
Because the researchers controlled for the effects of gender, age, occupation, industry, and region, the study makes it clear that these rates are a direct result of work overload rather than of the type of job, or of workers, with such schedules.
In fact, according to the World Health Organization, most of the burden of work-related disease is attributable to exposure to long working hours, which they define as 55 hours or more per week. They illustrate this in the following figure, where “DALY” stands for disability-adjusted life years – that is, years lost to premature mortality or lived with ill health and disability.
In both the case of disease development or of injury, the mechanism of action is the same: fatigue and stress. According to a recent study by Vidmar and Pyatak (2020), excessive engagement in daily activities known as “stressful” – at the expense of “restful” activities – would cause the accumulation of metabolic wear. Thus, resting would allow a certain amount of energy to be invested in strenuous tasks, after which we would have to refuel by resting again or risk overstressing our system.
It is this wear and tear – or overuse of the system – that leads to the development of disease. For example, Vidmar and Pyatak explain, repeated and continuous spikes in blood pressure cause microvascular damage, which then leads to atherosclerosis and predisposition to cardiovascular disease. So, they point out, this metabolic wear and tear “[has] been associated with symptoms typical of chronic stress such as fatigue, headaches, and sleep disturbances … [and has] also been associated with a greater frequency of long-term health and functional issues such as cardiovascular disease, mood disorders such as depression and bipolar disorder, and, in older adult populations, poorer physical functioning.”
Hence, we can only understand the demands of the workers. They cannot be a commodity to be worn out and replaced – as a machine. All people need rest, good health and a balanced life.
What Is Occupational Balance?
If overwork directly affects health, the room taken by these schedules in the balance of our lives is equally important. A study by Håkansson and Ahlborg Jr (2010) illustrates this well: according to their results, work-related health problems are associated with total workload and working conditions, but also with the perception of life balance.
Theorists and experts Christiansen and Matuska (2006) explain that, since the industrial revolution, more and more studies have investigated the issue of life balance. According to these authors (2008), it is best defined as a “satisfying pattern of daily occupation that is healthful, meaningful, and sustainable to an individual within the context of his or her current life circumstances.” In other words, occupational balance is concerned with the distribution of energy among various types of activities, such as work, leisure, rest, and sleep, to meet our physiological, personal, social, and spiritual needs.
In truth, it is about more than schedules. A balanced life must allow for fulfillment in the various roles that we find important. We need to be able to make choices based on our beliefs, values and priorities – and in doing so, give meaning to our lives.
Work–life balance in particular is a cause of imbalance and, therefore, of significant unhappiness. Christiansen and Matuska (2006) point out that “nearly half of U.S. workers report that their jobs interfere some or a lot with their personal lives, and nearly three quarters of working mothers and fathers feel they do not have enough time to spend with their children.” A significant level of stress is caused by such an inability to meet the demands of the roles we hold dear. Similarly, lack of time to socialize meaningfully with family and friends hinders the consolidation of social networks – which are essential to mitigate the effect of stress. Over time, this chronic stress and dissatisfaction may predispose us to a variety of chronic diseases and psychological disorders.
In fact, having enough energy left over to engage in leisure activities is one of the key predictors of women’s health at work, note Håkansson and Ahlborg Jr (2010). Yet, as Kantartzis and Molineux (2011) explain, dedicating time to rest and leisure is perceived differently following industrialization: it is now seen as time off from work and, as such, time that must be earned. Consequently, “there continues to be the perception that there are dangers inherent in non-structured leisure time, and that the majority of workers do not know how to use their free time … with the result that time spent on perceived ‘frivolous’ activities or ‘un-earned’ leisure may be reduced or experienced with some guilt.” Yet leisure can have the sole function of rest or of spiritual refuelling. Feeling as though one is undeserving of free time unfortunately only adds to the difficulties of balancing work and personal life.
Clearly, a more equitable division of our time is critical to health and well-being, through stress management, physiological rest, and engagement in meaningful activities. Overwork robs time needed to build healthy and rewarding lives. As the workers expressed in the revolutions of 1872, the right to rest is a matter of dignity.
Human Rights and Occupational Justice
Studies show the impact of overwork on health, as well as the effects of lack of time to invest elsewhere. On the other hand, the Declaration of Human Rights advocates for the right to rest and leisure, claiming there should be limits to working hours (Article 24), and advocates for a standard of living sufficient to enable health and well-being of oneself and family (Article 25). So, could engagement in spheres other than work be considered a fundamental human right?
Hammell and Iwama (2012) propose that every individual has a right to well-being; this, they assert, is a central principle of human rights. So, “the ability and opportunity to engage in occupations that contribute to well-being is an issue that concerns occupational rights.” Then, overwork can be associated with exploitation and oppressive conditions. Consequently, these authors advocate for occupational justice: that is, confronting the injustices and inequalities leading to such variability in working conditions and “free time.”
From this perspective, a just society would seek to ensure equitable access to occupations that support satisfaction, fulfillment, and health.
“To maintain the health and wellbeing of workers,” emphasize Peters, Dennerlein, Wagner, and Sorensen (2022), “government regulations mandating safer working conditions … as well as supportive leave policies, are an important step towards uniform protections across industries and jobs.” Especially as the industries whose employment remains most affected since the COVID-19 pandemic “typically employ economically disadvantaged workers, more women, workers from minority ethnic and racial backgrounds, and immigrant workers,” these authors explain. Their needs, such as reskilling and redeployment, will need to be addressed to preserve the health of these already vulnerable populations.
The Right to Free Time – Contemporary Demands
Since the COVID-19 pandemic, the structure of work has undergone drastic and rapid changes reminiscent of those in the industrial era. Many areas must adapt quickly, for example through automation, the use of new technologies, and teleworking. According to the analysis of researchers Peters, Dennerlein, Wagner, and Sorensen (2022), these new approaches must be carefully evaluated and implemented to avoid overwork and negative impacts on employee health.
What better time than this period of transformation to rethink the structure of work – and to recentre well-being at its core?
A non-profit organization, 4 Day Week Global, and a research organization focused on the future of work, Autonomy, are conducting massive projects to gather the data necessary for such a transition. Their position is simple: the typical work week should be only four days – and all for the same pay.
Technological advances and automation in the 21st century should make it possible to work less, they explain. Yet we are working more than ever before. This unnecessary surcharge prevents work–life balance; and despite all these efforts, productivity is declining. Indeed, workers are tired, overloaded, and have no time to recharge. So, they argue, this new model would have the paradoxical effect of maintaining productivity – or even of increasing it.
Two large-scale trials in Iceland (Haraldsson and Kellam, 2021) and the United Kingdom (Lewis, Stronge, Kellam, and Kituchi, 2023) expose a startling reality: the evidence supports their hypothesis. In both studies, several government and private companies have successfully reduced the required work hours while maintaining wages and profits. To do this, they had to redesign certain tasks, such as meetings, to improve their efficiency. The results show:
- maintained service delivery
- a 35% increase in revenue
- a 57% decrease in staff turnover
- increased well-being at work
- more cooperation within the work team
- reduced stress symptoms, both at work and at home
- reduced burnout levels in 71% of participants
- reduced anxiety and sleep disturbances
- more energy for exercise, socializing, and recreation
- more time with family
- the opportunity to complete household chores during the week, and therefore to enjoy the weekends
- more time for oneself
In short, working more does not equate working better. Allocating time for personal life will increase both quality of life and quality of work.
Following the publication of these results, the Icelandic unions and government have pushed the cause and obtained occupational justice: since 2021, 86% of its workers have contracts allowing fewer hours of work for the same salary.
What, then, of the future of work in Canada? Will we listen to our workers and reduce this unnecessary overwork?
Barrett, Matthew. Part 1 – All for 9 and 9 for All: The Illustrated Series. Defining Moments Canada: All for 9, (2022). definingmomentscanada.ca/all-for-9/illustrated-series/part-1.
Barrett, Matthew. Part 3 – All for 9 and 9 for All: The Illustrated Series. Defining Moments Canada: All for 9 (2022). definingmomentscanada.ca/all-for-9/illustrated-series/part-3.
Christiansen, Charles H. & Kathleen M Matuska. “Lifestyle Balance: A Review of Concepts and Research” in Journal of Occupational Science, 13:1, (2006, 49–61). http://doi.org/10.1080/14427591.2006.9686570.
Dembe, A.E., J.B. Erickson, R.G. Delbos, & S.M. Banks. (2005). “The Impact of Overtime and Long Work Hours on Occupational Injuries and Illnesses: New Evidence from the United States” in Occupational and Environmental Medicine, 62(9) (September 2005, 588–97). http://doi.org/10.1136/oem.2004.016667.
Håkansson, C. & G. Ahlborg Jr. “Perceptions of Employment, Domestic Work, and Leisure as Predictors of Health among Women and Men” in Journal of Occupational Science, 17:3 (2010, 150–157). http://doi.org/10.1080/14427591.2010.9686689.
Hammell, Karen R. Whalley & Michael K. Iwama. “Well-Being and Occupational Rights: An Imperative for Critical Occupational Therapy” in Scandinavian Journal of Occupational Therapy, 19(5) (2012, 385–394). http://doi.org/10.3109/11038128.2011.611821.
Haraldsson, Gudmundur D. & Jack Kellam. Going Public: Iceland’s Journey to a Shorter Working Week on Autonomy (2021). https://autonomy.work/wp-content/uploads/2021/06/ICELAND_4DW.pdf.
Hernandez, Raymond, Alaina Vidmar, & Elizabeth A. Pyatak (2020). “Lifestyle Balance, Restful and Strenuous Occupations, and Physiological Activation” in Journal of Occupational Science (2020). http://doi.org/10.1080/14427591.2020.1732229.
Kantartzis, Sarah & Matthew Molineux. “The Influence of Western Society’s Construction of a Healthy Daily Life on the Conceptualisation of Occupation” in Journal of Occupational Science, 18:1 (2011, 62–80). http://doi.org/10.1080/14427591.2011.566917.
Lewis, Kyle, Will Stronge, Jack Kellam, & Lukas Kituchi. The Results Are In: The UK’s Four-Day Week Pilot on Autonomy (2023). https://www.4dayweek.com/uk-full-report-2023.
Matuska, Kathleen M. & Charles H. Christiansen. “A Proposed Model of Lifestyle Balance” in Journal of Occupational Science, 15:1 (2008, 9–19). http://doi.org/10.1080/14427591.2008.9686602.
Peters, Susan, Jack T. Dennerlein, Gregory R. Wagner, & Glorian Sorensen. “Work and Worker Health in the Post-Pandemic World: A Public Health Perspective” in The Lancet Public Health 7 (2022, e188–e194). http://doi.org/10.1016/S2468-2667(21)00259-0.
World Health Organization and International Labour Organization). WHO/ILO Joint Estimates of the Work-Related Burden of Disease and Injury, 2000–2016: Global Monitoring Report (2021). Geneva: WHO.
Suggested Further Readings & Viewings
Lewis, Stronge, Kellam, Kituchi & al. (2023). The Results are in : the UK’s 4-Day Week Pilot. Autonomy. https://www.4dayweek.com/uk-full-report-2023