Georg F. Bauer Oliver Hämmig. Bridging Occupational, Organizational and Public Health. A Transdisciplinary Approach

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2 Georg F. Bauer Oliver Hämmig Bridging Occupational, Organizational and Public Health A Transdisciplinary Approach

3 Bridging Occupational, Organizational and Public Health

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5 Georg F. Bauer Oliver Hämmig Bridging Occupational, Organizational and Public Health A Transdisciplinary Approach

6 Georg F. Bauer University of Zürich ETH Zürich Zürich, Switzerland Oliver Hämmig University of Zürich ETH Zürich Zürich, Switzerland ISBN ISBN (ebook) DOI / Springer Dordrecht Heidelberg New York London Library of Congress Control Number: Springer Science+Business Media Dordrecht 2014 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (

7 The book is dedicated to Prof. Felix Gutzwiller, former Director of the Institute of Social and Preventive Medicine of the University of Zurich, and Prof. Theo Wehner, Director of the Center for Organizational and Occupational Sciences at the Federal Institute of Technology (ETH) in Zurich, who supported us in our transdisciplinary research and in bringing together the fi elds addressed in this book.

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9 Contents 1 Bridging Occupational, Organizational and Public Health: A Transdisciplinary Approach... 1 Georg F. Bauer and Oliver Hämmig Part I Psychosocial Factors in Occupational and Organizational Health: A Key Public Health Issue 2 Social Inequalities in Work and Health in a Globalized Economy Johannes Siegrist 3 Towards Organizational Health: Stress, Positive Organizational Behavior, and Employee Well-Being Susan Cartwright and Cary L. Cooper 4 A Critical Review of the Job Demands-Resources Model: Implications for Improving Work and Health Wilmar B. Schaufeli and Toon W. Taris 5 The Role of Psychosocial Factors in Musculoskeletal Disorders Brigitta Danuser 6 The Impact of Social Capital on the Health and Performance of Organizations Bernhard Badura Part II Improving Public and Organizational Health 7 Capacity Building as a Key Mechanism of Organizational Health Development Susanne Hoffmann, Gregor J. Jenny, and Georg F. Bauer vii

10 viii Contents 8 Systemic Consulting for Organizational Health Development: Theory and Practice Georg F. Bauer, Katharina Lehmann, Anita Blum-Rüegg, and Gregor J. Jenny 9 Improving Organizational Health: The Case of Health Promoting Hospitals Jürgen M. Pelikan, Hermann Schmied, and Christina Dietscher 10 Integration of Work and Personal Life as a Key Factor for Individual, Organizational and Public Health Oliver Hämmig Part III Beyond Organizational Health: Social and Political Issues 11 Mental Health as a Complete State: How the Salutogenic Perspective Completes the Picture Corey L.M. Keyes 12 Recovery from Work During Off-Job Time Sabine A.E. Geurts 13 Beyond Paid Work: Voluntary Work and its Salutogenic Implications for Society Patrick Jiranek, Rebecca Brauchli, and Theo Wehner 14 Policy Approaches to Occupational and Organizational Health Stavroula Leka and Aditya Jain

11 Chapter 1 Bridging Occupational, Organizational and Public Health: A Transdisciplinary Approach Georg F. Bauer and Oliver Hämmig Abstract The book aims to better integrate the fast growing, differentiated knowledge base of the fields of occupational, organizational and public health. It intends to broaden the evidence-base, legitimacy and efficacy of related interventions and thus to increase their public health impact. To create an overview and common ground across disciplines, this chapter provides an introduction to the transdisciplinary approach pursued by the book. It shows current trends in economy and society and their implications for employees and their working conditions. The chapter highlights how the fields of occupational, organizational and public health may jointly address these trends by sharing more positive analytical perspectives and by linking occupational health issues to the larger organizational and societal context. The chapter summarizes the first part of the book highlighting the relevance of psychosocial factors at work, the second part showing strategies to improve them at the organizational level and the last part emphasizing social and political issues to be addressed as part of a larger public health strategy. Based on this summary, specific conclusions for future, more integrative research and practice in occupational, organizational and public health are drawn. Keywords Occupational health Organizational health Public health Transdisciplinary research Trends in economy and society Research implications Practice implications G.F. Bauer (*) O. Hämmig Division of Public and Organizational Health, Institute of Social and Preventive Medicine, University of Zürich, Hirschengraben 84, 8001 Zürich, Switzerland gfbauer@ifspm.uzh.ch; haemmigo@ifspm.uzh.ch G.F. Bauer and O. Hämmig, Bridging Occupational, Organizational and Public Health: A Transdisciplinary Approach, DOI / _1, Springer Science+Business Media Dordrecht

12 2 G.F. Bauer and O. Hämmig 1.1 Background: Current Trends in Economy and Society Over the past decades, several trends in the economy have strong implications on the nature of work, working conditions and workers health. Progressing globalization has led to greater competition, a need for increasing efficiency, and greater innovation pressure in products and services. New information, communication, and production technologies have further accelerated and intensified business processes. Particularly in Western countries, there has been a major and still ongoing shift from a production to a service and particularly knowledge society. Companies operating in this economic environment depend more than ever on highly qualified, motivated, flexible, and engaged employees who have a strong customer orientation broadly expanding the scope of workers health. These economic trends have been accompanied by profound changes in society. Collectively shared values and norms have lost much relevance in the course of the individualization of the society and the resulting pluralization of living patterns and family relations. Increased wealth gave rise to post-materialistic values and the desire for self-actualization. In this context, individuals are increasingly seeking self-determination, meaning, social identity and fulfillment both on and off the job generating a new challenge for a true, qualitative life domain balance. Regarding the workforce, demographic changes towards a higher educated and aging workforce with a larger proportion of women and part-time workers are key. Further, precarious working conditions are on the rise, such as limited work contracts, jobs sub-contracted to involuntarily self-employed people, involuntary parttime jobs, and poorly paid jobs. To keep the social security system affordable in times of economic crisis and demographic aging, the workability, performance, and productivity of employees need to be maintained until even raised retirement ages. All these trends have several implications for employees and their working conditions: Pace, intensity, and complexity of jobs and of organizational changes increase. Employment contracts and labor relations are less binding, resulting in increased job insecurity and precarious job situations. Social relationships at work become more unstable due to continuous restructuring in organizations and changing employers. Jobs become more emotionally and socially demanding, as employees have to increasingly assure high customer binding and satisfaction. Boundaries between the paid job, private activities, and recovery times are increasingly blurred. 1.2 Implication for the Fields of Occupational, Organizational, and Public Health Taken together, the trends summarized above have major implications for the fields of occupational, organizational, and public health. The World Health Organization (WHO) predicts that by 2020 five of the top 10 medical problems worldwide will

13 1 Bridging Occupational, Organizational and Public Health 3 Table 1.1 Disciplines contributing to occupational, organizational and public health Contributing disciplines Positive analytical perspectives Level of analysis Micro: occupational health Meso: organizational health Macro: public health Occupational Organizational Social epidemiology psychology psychology Occupational health Organizational Health sociology psychology sociology Occupational medicine Organizational behavior Health promotion Occupational safety Management sciences Health policy & hygiene Ergonomics Health economics Positive psychology Positive health Positive organizational behavior & scholarship Happiness Corporate social responsibility Salutogenesis Health equity Sustainability be stress related (Cartwright & Cooper in this volume, p. 30) with work and work stress likely playing a crucial role in this development. As a consequence, attention has to shift from physical, chemical, and biological aspects and health hazards at work towards health-related psychosocial and organizational demands and resources. Going beyond maintenance of physical workability, physical, mental, and social health as well as performance need to be promoted simultaneously in a sustainable manner. In face of the fast changing nature of jobs, organizations, and employment contracts, in the future stable occupational health and safety expert systems will not suffice. Instead, experts in the field need to qualify both organizations and their employees to jointly deal with ever changing work and health issues in a highly volatile environment. All these challenges can only be met by closer linkages between the core levels of analyses and the related disciplines contributing to occupational, organizational, and public health. As Table 1.1 and the contributions in the present book demonstrate, this linkage will be facilitated by an emerging movement towards a positive analytical perspective across the involved disciplines (Bauer & Jenny, 2012 ). On a micro-level, the traditional occupational health disciplines (occupational medicine, occupational hygiene and safety, ergonomics) were initially primarily concerned with physical health of employees. Boosted by increasing societal concerns, as of recently mental health is receiving more attention in these disciplines even beyond the specialized fields of occupational (health) psychology. On the macro-level, public health has long been concerned with social determinants of workers health, from the perspectives of social epidemiology, health economics, health promotion, and health policy. Recently, an increasing concern for public mental health can be observed. On the meso-level, the concept of organizational health is a newer development, building on knowledge from organizational psychology, organizational sociology, organizational behavior, and, more broadly, management

14 4 G.F. Bauer and O. Hämmig sciences. Moving beyond occupational health and safety expert systems, organizational health aims to link workers health issues to the larger organizational context and the overall organizational routine and performance. 1.3 Aim of the Book and Selection of Contributions The book aims to better integrate the ever increasing, differentiated knowledge base of the fields of occupational, organizational, and public health. For researchers and practitioners, this bridging is expected to trigger mutual learning, new ideas for filling knowledge gaps and for more integrated, trans-disciplinary intervention approaches. Overall, this integrative book will help to broaden the evidence base, legitimacy, and efficacy of occupational-, organizational- and policy-level health interventions and thus increase their public health impact. To achieve this aim, we invited contributions from experts from these fields with diverse and sometimes combined disciplinary backgrounds. To provide for some common ground and to complement the well-established deficit orientation on risks and diseases prevalent in the occupational health literature, we chose in particular authors that share an emphasis on a positive analytical perspective. Further, we chose the contributions based on their innovative approaches to tackling the key challenges in occupational and organizational health summarized above and on their relevance from a public health perspective. 1.4 Book Structure and Scope of the Single Contributions The contributions are grouped into three main parts: Considering the high mental and social demands in a knowledge-based service-sector economy, the first part of the book highlights the relevance of psychosocial factors at work. The second part provides an overview of how psychosocial factors can be improved by health interventions at the organizational level. Finally, the third part draws attention to key social and political issues to be considered as part of an overarching public health strategy to improve workers health. The five chapters in the first part of the book cover psychosocial factors at work from diverse perspectives. Siegrist, as a medical sociologist introduces the public health perspective by showing the strong social gradient of morbidity and mortality in the working population. As this inequality of health can at least partly be explained by inequalities in working conditions, Siegrist provides evidencebased policy recommendations concerning both mandated organizational level interventions for better jobs and macro-structural policies regarding education and

15 1 Bridging Occupational, Organizational and Public Health 5 rehabilitation. Cartwright and Cooper as stress researchers reinforce the public health relevance of work-related stress. They show that evidence regarding effective interventions is still limited partly due to a lack of agreement on key dimensions and levels of work stress to be considered among different scholars. They provide a strong justification and specific proposals for moving stress research towards a focus on positive health and on related organizational health interventions. Taking up the call for studying positive health outcomes, the occupational health psychologists Schaufeli and Taris provide a seminal, comprehensive update on the development, core assumptions, empirical findings, and future development of the well established Job Demands-Resources (JDR) Model. They show that personal resources play an important role in the JDR model via different pathways - whereas the role of organizational resources has received little attention until now. Besides raising key issues for future research on the JDR model (e.g., reciprocal and multilevel relations), the chapter also illustrates its practical application for tailored analyses in organizations. Danuser as an occupational physician introduces musculoskeletal disorders (MSD) that account for over 50 % of all occupational disease in the EU. She covers both the pathogenic path towards developing MSD and the opposite direction of recovery and return to work (RTW). As feeling pain is by itself one of the greatest stressors, and in the case of MSD is threatening the work ability particularly for non-skilled workers, Danuser concludes that MSD interventions are a key public health concern requiring early recognition and good coordination of various stakeholders. Looking beyond the individual worker, Badura as a sociologist points out the crucial role of social capital in organizations for health and productivity. He identifies social networks, leadership and culture (shared beliefs, values, and rules) as dimensions of social capital in organizations. Based on large survey and company performance data, he shows evidence that the cultural dimension of shared beliefs and values is most strongly related to performance outcomes in organizations. That last mentioned chapter leads to organizations as the central level of analysis and intervention. Thus, the second part of this volume shows how key psychosocial factors can be improved by health interventions on the organizational level. The first two, related chapters come from the interdisciplinary research division Public and Organizational Health that is editing this book. Hoffmann, Jenny, and Bauer introduce the idea that organizational health primarily develops through the ongoing interaction between employees and the organizations they work for. Consequently, occupational health interventions should build the capacities in organizations to continuously observe and improve this ongoing process. They identify key capacities and core capacity building principles to be considered by interventions. Building on this theoretical background, Bauer, Lehmann, Blum-Rüegg, and Jenny show how to implement the capacity building approach in practice through systemic consulting, e.g., by accounting for multiple perspectives, strengthening existing resources and supporting the organization in finding its own solutions. Managers are enabled to engage in a participatory optimization/renewal process with their own teams. Linking each step of this systemic consulting to capacity building principles is