Work culture matters when it comes to high blood pressure

Workers in manhole digging around a steel encased microtunnel.

Workers in manhole digging around a steel encased microtunnel. (CC BY 2.0)

Research points to ways that companies could make health interventions more successful

This story originally appeared on the University’s Bold Thinkers blog, which ran from May 2018 to Nov. 2019.

American adults spend more than eight hours a day working, according to 2016 data from the U.S. Bureau of Labor Statistics. That’s half of a person’s waking day. So when it comes to combating chronic and persistent health problems like high blood pressure, or hypertension, it makes sense that work is one of the first places health and wellness researchers look. According to research co-authored by San Francisco State Professor of Economics Sepideh Modrek, aspects of the work environment can contribute to the prevalence of hypertension. For those who run companies, Modrek says, that fact may hold lessons for how to best manage employees. 

“What we found was that job related psychological stress was a stronger predictor of hypertension than physical job demand,” she said. “Workplace culture was also related to hypertension prevalence, which was surprising.” 

Modrek and three other researchers who are part of a research consortium called the American Manufacturing Cohort examined health and injury claims as well as detailed work environment information from a number of aluminum manufacturing plants. This data informed the 2017 study, published in Health Affairs, which also looked at short- and long-term contributors to health, such as childhood experience, midlife environment and county information. Besides childhood experience, they found that the biggest factors that increased the prevalence of hypertension were the psychological demands and the social environment at work.

To measure a job’s psychological impact the researchers assessed how quickly employees needed to work to complete a task, whether employees performed multiple tasks simultaneously that were difficult to combine and whether there were conflicts between speed and accuracy.

The team looked at the social environment at work, too, noting whether employees felt recognized for their work and how they viewed management. In worksites where employees had favorable feelings toward management and felt valued, there was a lower prevalence of hypertension, they wrote in the study.

For companies, the benefits of supporting employee health are clear workers are more productive because they’re healthier, employees have fewer absences due to illness and the company has reduced health care costs, according to the study. Many companies invest in wellness programs that incentivize people to stay healthy by walking or adopting another healthy habit, Modrek says. But individual incentives are just one type of intervention, and other ways of motivating employees could have a wider impact.

“We’re arguing that the psychological demands of jobs and social context of workplaces matters for hypertension,” Modrek said. “If I lead a company and I’m thinking about investing in a wellness program and I overwhelm workers or have a work culture where nobody wants to be around each other, incentivizing people to walk at lunch isn’t going to do much. But if I have a good work culture and workers have some control over their work demands then these interventions are probably going to be more effective.”

What it boils down to is that companies need to adopt a workplace culture that truly supports health. “That’s really how we’re going to win the game of improving population-level health,” she said.