In my life
Oh, why do I give valuable time
To people who don't care if I live or die?
- Heaven Knows I’m Miserable Now, The Smiths
The link between a person’s occupation and their physical and mental health has been well-studied and understood for more than a century. Full-time workers have the fewest damaging psychological factors and the healthiest behaviours: they experience less stress and depression, eat more healthily, are more physically active, and smoke and drink less (Rosenthal et. al., 2012). The link between mental health and occupation has been understood just as intimately, wherein when a worker is unemployed, inappropriately employed, or dissatisfied, they experience emotional illness. This is also seen where workers work in occupations with poor social status or prestige (Wolford, 1964). This may be due to factors as simple as the nature of the work, wherein occupational physical activity can meet the base physical activity needs of workers, like filling out their step counts, keeping their aerobic engagement going (Gotta get that Zone 2 Cardio in!) and thus having a protective effect on health so long as the occupational physical activity intensity is not too high (Cillekens et. al., 2020). Working people are healthier people, as the saying goes, and the better the work, the better the health effects. However, it’s not so simple.
Consider the State of Victoria, Australia. The youngest age at which someone can work is 15, if they want to work at McDonald’s or Officeworks or a supermarket. However, it’s possible to work earlier than that. Children younger than 15 (as defined by The Child Employment Act of 2003 (VIC)) can work in accordance with a permit and written parental consent, in a family business, or in a work experience arrangement. The Act allows a child between the ages of 11 to 13 to work delivering newspapers or goods or to perform light work that won’t harm their health, safety, development, or moral welfare. Kids still must go to school, and there are things a child cannot do, like sell life insurance, work on a trawler, or work on a construction site. The requirement for someone to start working full time is to have completed year 10 or to be at least 16 years old. That’s just the beginning, though. Having considered the minimum age at which someone can start working, what’s the maximum age beyond which someone can no longer work? There is none. Australia does not have an age beyond which a worker can no longer work, and employers cannot include a maximum retirement age in their employment contracts, according to the Age Discrimination Act of 2004. However, hiring managers and health and safety controllers reserve the right to decline or deny older workers employment if their age and physical condition present barriers to their ability to safely do work. Additionally, there are governmental, judicial, military, and other official roles which have mandatory retirement ages. This leads us to an interesting idea, that a worker in the private sector can start working from the age they’re eleven years old, and they do not need to stop until the day they drop dead.
In Australia, the average age to which a male will live is eighty years (Australian Institute of Health and Welfare, 2024). If a man were to work from the day he turned sixteen until the day he passed away, at a schedule of seven and a half hours per day, five days per workweek (Australian Bureau of Statistics, 2022), working approximately 47-49 weeks per year, let’s say 48 to split the difference, a worker will work 1,824 hours per year, over 64 years, to have worked 116,736 hours in their lifetime. Of course, people usually retire and leave the workforce before they drop dead, but we will proceed with that number for simplicity and dramatic effect. However, if we take the average age of retirement in Australia, being 57 years (Australian Bureau of Statistics, 2024), if the worker will start working fulltime by age 24 instead of sixteen (Victoria University, 2020), and apply the same calculus, that worker will have worked 60,192 hours in their lifetime. That seems a little more reasonable. Or is it?
People don’t work in a vacuum. Workplaces are physically separated from workers’ homes. Occupations require uniforms. Qualifications require training. Certifications require renewal, and participation requires health. To begin with, Australian workers don’t work in their homes. They need to commute. The average Australian spends 169 hours commuting to and from work (Real Insurance, 2022). If we add that to the earlier figure, we arrive at 65,769 hours per year spent on work and work-facilitating tasks. Now we’re developing something new, a notion that considering only the time spent at work develops an incomplete picture. Working life isn’t just about the time spent working, it’s about the ecosystem of obligations and responsibilities that attend a worker when they’re working. Our earlier figure of 65,769 is still made up of 60,192 hours related to work. That’s 91.52% - good enough to get into medical school. Let’s explore this ecosystem a little more. Workers are human and so they need to eat, so that they can sustain themselves. Workplaces generally do not provide catered lunches for workers, and so they must bring their own. The average shopping trip is estimated to be about 41min (Little Aussie Communities, 2024). Coles research indicates that the number of average weekly shopping trips per household is approaching three (The Nightly, 2024), so let’s call it a round three for simplicity’s sake. Multiplying 41min by 3 and then by the number of weeks, that’s 106 hours a year spent shopping, taking the net figure to 69,289 hours on work- and work-related tasks, with rounding. Now the figure’s at 86.87% work hours in all hours. Not good enough for med school, still a HD.
These figures are just those that can be inferred from readily available data, most of which is not academic. I couldn’t find any information on the amount of time people spend in training related to work roles, further education, personal care, or healthcare for occupation related injuries. This also doesn’t include time spent doing work related tasks outside of work hours, where 44% of Australian workers were found to work outside of scheduled hours to meet the expectations of their employer (Australia Institute, 2022). Participation at work is a necessity, but participation at work itself necessitates that the worker attends to their health and self-care; that a worker makes antecedent decisions that allow them to participate at work to the minimum standard required by their job. The worker needs to adjust their behaviours so that they are not exhausted, incapacitated, unwell, or otherwise unable to do their work. Is it the case that people who work are healthier because of the work, or because of the obligation that this work imposes on them to be healthier and therefore better workers in their roles? Is it the case that workers are healthier because they work, or because participation in the workforce for extended periods of time self-selects the population of workers to be more representative of people who aren’t disabled, neurodivergent, at greater risk of health and unwellness, or who are best able to conform to the ecosystem of demand that participation in the workforce requires? Is it the case that work makes people healthy, or that work imposes demands on the worker that are easily met by their social, cultural, and interpersonal networks, and that healthier workers are those who have healthier networks, more resources, and more time to take care of themselves when they’re not working?
Aside from spending time preparing for work, being a working person means being exposed to different stressors depending on the work being done, be they physical or psychological. A bank teller experiences different stressors compared with a blast miner. A social worker experiences different stressors compared with a surgeon. The bank teller, the miner, the social worker, and the surgeon are also likely to belong to different social classes, have different levels of educational and professional attainment, and be part of different communities. These educational, professional, and social contexts have different health-promoting or health-degrading effects depending on the social capital circulating within and retained by those systems (Kawachi, Kennedy & Glass, 1999). A person’s occupation and the way they go about it occupies the largest proportion of their waking hours and will consciously or unconsciously affect their decisionmaking regarding every large or small choice they make. If work is so central to human life, so determinant of human wellbeing, and so antecedent to so many measurable health outcomes, protecting the health of the community means protecting the health of the worker, of ensuring safety at work, of ensuring the dignity of the individual, of ensuring the sustainability of a person’s engagement with the work they must necessarily do to clothe, feed, and house themselves. The work a person does will define the life that person lives. Occupation is associated with relative social and financial privilege (Portwood & Fielding, 1981), waivers for loans and mortgages (Australia and New Zealand Bank, n.d.), and, at least with respect to my own professional trade association, other numerous little perks (Australian Physiotherapy Association, n.d.). The link between occupation, social class, and health outcomes are, again, not new topics of investigation, not novel, and their discussion here is not groundbreaking. It must still be said that the interaction between a person’s occupation, their state of health and wellbeing, and the effect these factors has on a person’s life and even lifespan is perverse. It is, to me, an existential horror that an individual person can be moulded like thin clay by the forces of the labour market, their industry, and a constellation of pushing and pulling factors that gradually and inevitably shape them, uplift and cast them down, and may which ultimately destroy them. To understand this is to understand that any discussion of health at an individual or societal level cannot be undertaken without also understanding the work that that individual and that society does.
When I finished training as a physiotherapist, I was expected to specialise in a field of physiotherapy. There are many specialist pathways – musculoskeletal physiotherapy that looks at physical injuries, cardiorespiratory physiotherapy that treats the heart and lungs, neurological physiotherapy that helps people with strokes and brain damage, and others. Not everyone gets back pain. Not everyone will have heart and lung disease. Not everyone will have a stroke or brain damage, but everyone will work. Everyone will work because they must work, because it is a societal expectation, because to access those things in the world that support health and human dignity, a person must work. A person must trade the finite time of their lives in the contemporary marketplace of skill, strength, or other scarcity to earn the money they need to live. This also goes for people who can’t work, but instead of spending their energy making a wage, people with disabilities, who need accommodations, and who can’t work must instead trade their time and their dignity appealing the government and those organisations responsible for care, so that they can at least still live. A person’s ability to live their life depends on their job. That same job can kill them, either quickly, or slowly. When a person’s job kills them quickly, it makes the evening news. When a person’s job kills them slowly, they’re as unaware of it as their families, their friends, and even their workplace. Some exceptions apply, as in the case of Blue Asbestos, Glyphosate, Tetraethyl Lead, and Dimethyl Mercury, but there are other exposures which have insidious cumulative effects. Sitting, strained postures, vibration, lack of natural light, stagnant air, mould, and sedentarism have accretive, synergistic effects on human physiology whose outcomes are as profound as poisoning, only much less dramatic. For all the hours a person must work, their body has to take that strain, meet the demand, and keep enough in the tank to go home.
What’s the point of spending your life at work if you’ve got no life left to live once the shift is over?
Today’s worker is technologized, but not empowered, working in environments where they and their employers are unaware of the effect that work has on their wellbeing (Oakman et. al., 2019), where workplace hazards might be ignored because stakeholders are unaware that a physical problem might be influenced by non-physical factors, by time, or by intensity, where workers may not be confident to speak up for themselves (Macdonald & Oakman, 2015) due to lack of knowledge regarding their rights, their risks, or their redress. A person’s work can empower their wellbeing as much as exacerbate their illnesses. A person’s career can protect as well as degrade their health and wellbeing. Protecting the public health means protecting the worker, because the workers are the public, and the workers are what makes the public work. There is no such thing as work-life balance because work is life – it occupies waking and restful hours, it informs our decisionmaking, defines our habits, and writes its effect into our bodies and our minds. To protect the worker means understanding the effects work has on that worker, to interrogate the meeting of the person with their environment and their task, and to balance those three factors against each other to ensure safety, sustainability, and dignity for the individual and for society at large.
None of these statements or ideas are new or novel. None of these ideas haven’t been investigated at least somewhat in academic literature. However, despite the implicit truth of these statements, the consequences aren’t fully grasped. The caring professions cannot provide care without attending to a person’s occupation as seriously as they consider family history or a person’s smoking and drinking history, for the protective or degrading effect.
If work makes life, then a better life can only be made with better working conditions and knowledge, and by designing better and health-protecting work.
References
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