be less prone to sickness absence and it may also have other organizational benefits in
terms of employee relations. Exercise can be promoted at an individual or organizational
level. While large-scale, good quality evaluations of outcomes of worksite interventions
are rare, indications are that such interventions can be effective for both improving
physical health and reducing stress (Conn et al., 2009).
What type of intervention is most successful?
Removing stressors at source seems the most desirable and ethically acceptable approach
but there have been relatively few successful interventions of this kind because job
redesign operates in a complex context in which other factors can cancel out potential
benefits. This weak evidence base is not a justification to abandon this type of
intervention. Indeed, in the UK, any company that did so would be likely to fall foul
of the Health and Safety at Work Act (1974). Instead Murphy (2003) advocates using
a range of interventions. Many jobs are inherently stressful at times or include elements
that will be stressful for some employees, while other employees will be suffering as a
result of unavoidable stressors outside of work. The provision of a range of interventions
that are based on the best possible evidence and that combine both organizational change
and individual support would seem likely to offer the best chance of success.
SUMMARY
Social inequality is linked to poorer health within countries around the world, even
within affluent countries. In richer countries ill health and mortality are associated with
relative poverty. Evidence suggests that it is low SES causing ill health rather than vice
versa. Stress is implicated in this relationship. Those in lower SES positions are exposed
to more stressors and tend to be more vulnerable to their effects.
The workplace has been a dominant focus of stress research and a number of models
of work stress have been proposed. The JDC, JD-R and the ERI models have been
particularly influential. Together these models highlight the importance of having a
manageable level of work demands (or efforts) and the need for these to be balanced
by appropriate rewards, including recognition and status and the importance of
adequate levels of control over your job as well as other resources such as adequate
support from colleagues and management. There is evidence that a lack of these
components is related to increased coronary heart disease.
Changes in the nature of work have led to an increase in concern about poor
work–life balance. When work and family demands conflict or when work spills over
into home life it can have negative impacts on individuals and on other family
members. However work can also bring psychological benefits that may have positive
effects on home life.
There are a range of interventions to reduce stress, which include removing
stressors by organizational interventions such as job redesign, reducing the impacts of
stressors by stress management training, treating stressed individuals by counselling and
changing aspects of lifestyle to help people to be able to resist or cope with stress. All
can play a useful part in reducing the effects of stress at work as well as in other
environments.
86 STRESS AND HEALTH