For most people, having a job is a huge part of their life. But working is more than just a way to make money, support a family and contribute to the economy.
On a personal level, work provides a normalcy and day-to-day rhythm that creates a sense of security and control, promotes self-esteem and meets important psychosocial needs. In short, work can — and should — contribute to good physical and mental health.
That notion is backed by considerable research. Gordon Waddell and Kim Burton, researchers in the United Kingdom, said work can pose a risk to physical and psychological health but unemployment is associated with poorer general health, higher mortality, psychological distress and mental health issues, as well as higher consumption of medication and health-care services.
Re-entering the workforce, on the other hand, leads to improved self-esteem, improved general health, better mental health and lower psychological distress, says their 2006 paper Is Work Good For Your Health and Well-Being?
With disability or illness contributing to about seven days lost per worker per year, according to 2010 data from Statistics Canada, and disability-related absences from the workplace representing anywhere from four per cent to 12 per cent of payroll, according to the 2000 report The Unheralded Business Crisis in Canada from the Global Business and Economic Roundtable on Addiction and Mental Health, many Canadian employers are looking for ways to ensure workplaces promote physical and psychological health.
Still, some employees will need to take time off because of injury or illness. And since work is a significant part of the health equation, getting these people back as soon as possible may be key to avoiding long-term disability and the potential of being away from work for an extended period.
‘Too many people think work should be avoided when unwell’
Employers may feel workers who are off sick or on disability should not come back to work until fully recovered, but encouraging an early return to work when possible could contribute to a speedier and sustained recovery.
Research shows when employees are welcomed back to work on a part-time basis after a health event, they tend to get well sooner than if they wait to be deemed 100 per cent fit.
In Working for a Healthier Tomorrow, a 2008 review of the health of Britain’s working-age population, Carol Black debunks the traditional views that it is inappropriate for a person to be at work unless he is 100 per cent fit, and that being at work impedes recovery.
“Too many people think that work is bad for health and should be avoided when unwell,” she writes, adding these misconceptions are often reinforced by family and friends, as well as employers and health-care professionals.
Employers need arrangements to enable an early return to productive employment, she says, “accelerating where possible, but never compromising, the individual’s sustained recovery.”
That’s not to say an early return to work is possible for everyone — if someone’s health is very compromised, it may not be easy to get back quickly. Decisions should be made on an individual basis.
To support a successful return to work, early intervention with collaboration and communication — among the employer, insurer, employee and health-care practitioners — is critical.
Once someone goes off on disability, the employer should stay in touch with the employee on a regular basis to maintain a connection between the employee and workplace.
The employer can provide updates on what is happening at work, ensure the employee feels valued and show a willingness for him to return to work.
Research shows the best predictor of return-to-work timing is the employee — not the doctor — so staying in touch also helps an organization gauge when a worker is ready to return and help prepare him to come back.
Although some people are able to jump back to work on a full-time basis, restricted duties and a flexible work schedule — such as part-time hours — can help an employee feel more comfortable about getting into the swing of things. It may take time to get up to full speed, but employees who return to work gradually are less likely to have a relapse.
Everyone at work is an essential part of the support system and those who return to work most successfully are those who had a supportive environment when they left work. Returning workers need to feel appreciated and receive support, not only from the boss but co-workers as well.
Insurer as quarterback
The insurer can be regarded merely as the payer of disability claims when someone goes off work but it can also act as a quarterback by encouraging a healthy workplace and helping employees with disabilities get back to work.
Insurers can ease communications between stakeholders, such as making sure a physician is onside and the employer knows when the worker is ready to return.
At the same time, insurers can advocate for options and services that meet an individual’s needs, and help determine the delicate balance between applying the disability option too quickly or having it drag on for too long.
Insurers also can provide the case management and vocational rehabilitation services needed to get people off disability and back to work. Medical treatment is just one element of rehabilitation, according to the 2008 paper Vocational Rehabilitation — What Works, for Whom and When? by Waddell, Burton and Nicholas Kendall.
For example, treatment for depression reduces the symptoms but does not impact return-to-work outcomes. Vocational rehabilitation, however, affects both work outcomes and symptoms since people feel better when they work. When work is taken away from them, they feel a sense of loss.
Physical reconditioning may be required when someone returns to a physically demanding job or to help employees prepare for non-physical demands associated with work. Reactivation programs that incorporate community-based activities such as a fitness program or volunteer work gradually build mental and physical stamina in preparation for an eventual return to gainful employment.
The positive link between work and health is a good reason to put more emphasis on keeping people at the workplace or getting them back quickly if they do fall ill or injured.
As an essential contributor to physical and mental health, work may be the best prescription for a speedy and sustained recovery.
Annette Gibbs is vice-president of North American work health strategies at Sun Life Financial Group Benefits in Toronto. She can be reached at Annette.Gibbs@sunlife.com or, for more information, visit www.sunlife.com.