Impact case study database

Chandola’s research on work, stress and wellbeing has shaped public policies on employment, contributing to the evidence base for European Union (EU) legislation to improve the precarious working conditions of EU employees, and to the new “Good Work Standards” adopted by UK national and local governments. In addition, it has been used by Trade Union and Living Wage campaigns to improve the working conditions of low wage and precarious workers in the UK.

1. Shaping employment policies at the European level

Research demonstrating that workers in poor quality and insecure jobs had higher levels of chronic stress biomarkers than their unemployed peers [3], was showcased in a study commissioned by the European Parliament’s Policy Department for Citizens’ Rights and Constitutional Affairs in 2017 to assess the nature and extent of employment precariousness. This was the first case study used by the European Parliament study as evidence that employee health is affected “ by the precarious social environment of individuals in unfavourable labour market positions” [A]. This policy document was the evidence basis for the European Parliament resolution to tackle precariousness and the abusive nature of fixed-term contracts. The resolution directly led to legal reform through the adoption of the EU Directive 2019/1152 on Transparent and Predictable Working Conditions, which set new rights for all EU workers and addressed insufficient protection for workers in more precarious jobs, such as online platform workers or on-demand workers.

Chandola’s research on the health and economic costs of work stress [1], was cited four times in critical reviews about the costs of work stress by the European Agency for Safety and Health at Work (EU-OSHA), demonstrating the strong ‘business case’ for preventing stress at work [B]. This review was used by EU-OSHA as part of their healthy workplace campaign in 2014 - 2015, which resulted in the joint EU-OSHA and Eurofound 2014 report on ‘Psychosocial risks in Europe: Prevalence and strategies for prevention’ and new guidance in 2018 for EU National Labour Inspectorates to improve workplace inspection procedures to address risk management measures with regard to workplace psychosocial risks. The 2014 EU-OSHA and Eurofound report documents the “shift from physical demands associated with manufacturing to psychosocial risks more typical of the service sector” based on the research findings that “poor psychosocial work environment may lead to work-related stress and to negative health and well-being outcomes” [B].

2. Shaping employment policies in the UK

The research [2] was cited in the 2018 Annual Report of the UK Chief Medical Officer who was concerned that “the rise of precarious, poor-quality work has created the extraordinary situation where being in poor quality work has been associated with higher levels of allostatic load (chronic stress related biomarkers) than peers who remained unemployed” [C]. In recognition of his expertise on the topic of work and health, Chandola was invited by Public Health England (PHE) to participate in policy discussions led by PHE and the UK Departments of Work and Pensions and Health and Social Care around the “work as a health outcome” programme [D]. Three face-to-face meetings were held by PHE and UK government departments on this policy agenda. This resulted in the 2019 Healthcare Professionals’ Consensus Statement on Health and Work, agreed by the Academy of Medical Royal Colleges, the Royal College of Nursing and the Allied Health Professions Federation. Chandola’s contributions to these discussions emphasised the importance of good work, not just any work, in the policy statement [D]. A recent assessment of the consensus statement’s influence stated that “it provides important symbolic evidence of the importance of the programme across clinical disciplines and government and that it has been widely used as a credibility tool” [D]. Chandola’s expertise is acknowledged in new resources for undergraduate medical training on work and health created by PHE and the Department for Health & Social Care [E].

The research [2] was also directly quoted in several of the London Mayor’s employment policies, including the Health Inequalities strategy document [F, p.110], the background research cited for both the London Healthy Workplace Charter and the Mayor’s Good Work Standard [F, p.349], and the Evidence Base for London’s Local Industrial Strategy [F, p.508 and 511]. These strategies led to the development of the London Healthy Workplace Award, an accreditation scheme to help employers create healthier workplaces. As stated in a press release from the Mayor’s Office, as of March 2020, “… more than 60 employers signed up to the Good Work Standard - meaning more than 200,000 employees benefit from good pay and the highest working conditions in a range of industries across the capital” [F, p. 634]. The Good Work Standard helps “ organisations attract and retain talent, reduce absenteeism and achieve higher levels of employee engagement, motivation and productivity” [F, p.635].

3. Reframing the public debate from the deleterious effects of unemployment to considering the health damaging effects of poor quality and precarious work

Research findings highlighting the impact of the last UK recession on work stress levels [1] had considerable media coverage, including the BBC news website (coverage 16.5 million), the UK Guardian newspaper (coverage 232,000), BBC Radio 4 Women’s hour (coverage 3.7 million) and Men’s Health magazine (coverage 246,000). This led to an invitation for Chandola to present his research at the 2011 meeting of the UK Work Stress Network (UKWSN), a charity and trade union based organisation which campaigns for the better protection of workers against work-induced stress. The UKWSN has over 500 members, including experienced caseworkers on work related stress, counsellors, occupational health workers and trades union officers. The network used the research [1] extensively in their campaign handbook on work stress and its debilitating effects on health and wellbeing [G], and distributed over 10,000 copies of this handbook to their members and at events. Feedback received stated how useful this handbook was in their efforts to improve working conditions in their organisations. The convenor of the network states “ This is the sort of evidence that our members could take back to their employers and organisations to make the case for improvements in their stress management policies…This has helped us deliver higher levels of training to Safety Representatives, Shop Stewards and conference delegates from the management and HR side” [G].

In addition, the research [1] has been used by mental health and employment professionals as important evidence in their resources to support line managers and workers dealing with work stress [H]. The Mindful Employer is a UK wide initiative run by Devon Partnership National Health Service (NHS) Trust, providing employers with easy access to professional workplace mental health training, information and advice. The research [1] has been used extensively in their website and training resources, which include a charter for ‘employers positive about mental health’, workplace mental health training, advice line for staff, and mental health publications [H]. This organisation has supported more than 2,000 employers, with over 1,000 of them having signed up to the charter.

The research [2] is being used by campaigners for improved job quality as evidence of how stressful jobs impact negatively on the health of workers, and the need for employers to increase wages to prevent negative health impacts. The Health Foundation, the second largest endowed foundation in the UK focusing on health, used the research to “ shift the debate on health” in their report on the wider determinants of health, which led to an ongoing discussion with Public Health Scotland and the special adviser to the Prime Minister on the quality of work [I]. Reports of this research [2] were published in at least 45 English language news stories from around the world in 2017. This included three UK Guardian newspaper editorials which called the research a “ landmark study” and questioned the UK government’s use of high national employment figures as an indicator of success, when the true cost to society for some of those jobs was to “ wear out workers mentally” [J]. The then UK Labour leader (Jeremy Corbyn) referenced the study [2] in his speech to the Trades Union Congress in Manchester, September 2017, which highlighted the dangers of the gig economy for health and wellbeing [J]. An analysis of the impact of the Living Wage on ten city regions in the UK by the Living Wage Foundation and the Smith Institute cites this research as part of the evidence that “ jobs that are insecure, low-paid and that fail to protect employees from stress and danger make people ill” [K].