COMPANIES UNDERSTAND THE COSTS of turnover and employee absence due to sickness. Companies also know the importance of discretionary effort, and many do surveys to measure employee engagement. But employer efforts to build more enticing workplaces often focus on the wrong things—“trinkets” and perks that can be quickly implemented, rather than important dimensions of the workplace itself that are more challenging, but more important, to change. For example, the profusion of perks offered by Silicon Valley and other high-technology workplaces seems to be a source of endless fascination for business journalists and others. As one source noted, “Lavish perks are as much a part of Silicon Valley lore as are unicorns and behoodied billionaires.” A search for “crazy employee perks” uncovered stories of companies offering employees “free helicopter rides, endless supplies of booze, on-site barbers, fitness classes, bike repair, and nap pods, ball pits, indoor basketball courts, arcade-size game rooms, and designated candy kitchens.”1
The companies that attract, retain, and motivate a great workforce, and the workplaces that keep their employees physically and mentally healthy, do so not by offering people cute amenities. People are not that easily seduced by mere trinkets; sleep pods, free food, and letting people bring their dogs to work cannot make up for stressful work environments.
What matters—for employee engagement and productivity and, more important, for employee physical and mental health—is the work environment and the work itself. Not having a boss who heaps scorn and abuse, because the health hazards of workplace bullying and incivility have been well documented.2 Having a private office or at least a workplace with comfortable temperature, good lighting, and acoustical privacy, so that the physical work environment does not impose stress.3 And, most important and the focus of this chapter, two crucial elements of a healthy workplace that any company, in any industry, can provide without breaking the bank—and therefore ought to offer to enhance employee well-being: job control and autonomy and social support. What follows is evidence on the importance of these two dimensions of work environments and some examples of how to create healthy workplaces that provide people autonomy and control and that promote the social connections and support that foster physical and mental health.
JOB CONTROL, AUTONOMY, AND HEALTH
In the 1970s, British epidemiologist Michael Marmot and his colleagues noticed an interesting fact: the higher someone’s rank in the British Civil Service, the lower the incidence of and mortality from cardiovascular disease (CVD, or sometimes CHD, as in coronary heart disease).4 Why might higher rank be positively correlated with better health? Marmot launched a series of longitudinal studies, called the Whitehall Studies—because the British Civil Service is administered out of a building named Whitehall—to understand the causes of this relationship between hierarchical rank and health. These were prospective cohort studies in which people were recruited to participate, assessed initially and then again over time, and their health status monitored. Of course, as is typical and inevitable in field research, this was scarcely a random sample of the British population and, moreover, for ethical and practical reasons, people could not be randomly assigned to job conditions that varied in the amount of job control provided. Nonetheless, the studies could and did control for people’s initial body mass index, blood pressure, cholesterol levels, blood glucose levels, age, gender, and many other factors that might affect health such as individual behaviors like smoking. Even with all those controls, social status, in this case measured by hierarchical rank, mattered for health. Why?
Research revealed that it was differences in job control, differences that are correlated with job rank, that explained the effect of civil service grade on CVD. Higher ranked British employees, like higher ranked employees in most organizations, enjoyed more control over their jobs and had more discretion over what they did, how they did it, and when, even though they often faced higher job demands. This finding makes intuitive sense, as the higher one is in an organizational hierarchy, the more discretion and decision-making power that individual typically has. In the second set of Whitehall Studies, Whitehall II, Marmot and his colleagues followed more than 7,300 people beginning in 1985 and ending in the period 1991 to 1993. They examined self-reported angina and also doctor-diagnosed narrowing of the coronary arteries. Marmot and his fellow researchers summarized their findings:
Compared with men in the highest grade (administrators), men in the lowest grade (clerical and office-support staff) had an age-adjusted odds ratio of developing any new CHD of 1.50. The largest difference was for doctor-diagnosed ischaemia (odds ratio for the lowest compared with the highest grade 2.27). For women, the odds ratio in the lowest grade was 1.47 for any CHD. Of factors examined, the largest contribution to the socioeconomic gradient in CHD frequency was from low control at work. Height [which is often taken to reflect the effects of early-life health and well-being] and standard coronary risk factors made smaller contributions.5
These results mean that, after adjusting for age (because health problems and mortality generally increase as people age), men and women in the lower ranks had about a 50 percent higher probability of reporting chest pain and angina and men had more than twice the likelihood of having physician-diagnosed narrowing of the arteries than those in higher ranks. Moreover, job control was the single most important predictor of developing heart disease—more important even than smoking, for instance, in accounting for developing CHD.
Of course, coronary heart disease is only one health indicator, albeit an important one. The Whitehall Studies also assessed how differences in absence from work because of sickness varied across hierarchical ranks. Marmot and his colleagues found that men in the lowest civil service grades had six times the rate of absence because of sickness than did men in the highest grade. For women, the differences were smaller but still important, with those in the lowest ranks being absent between two and five times as much as those in the highest.6 And the Whitehall data related work stress, measured as the co-occurrence of high job demands and low job control, to the presence of metabolic syndrome, a cluster of risk factors that predict getting heart disease and type 2 diabetes. Employees who faced chronic stress at work were more than twice as likely to have metabolic syndrome compared to those without work stress.7
Nor are the health effects of job control on health limited to British civil servants. The Wisconsin Longitudinal Study followed a random sample of more than ten thousand men and women who graduated from Wisconsin high schools in 1957. The long-term survey asked questions about health, job characteristics, and other important control variables such as education, childhood health, and individual health-related behaviors such as smoking and drinking. Of course, this is not a completely random sample, as in 1957 there were relatively few minorities among Wisconsin high school students and a substantial fraction of people did not finish high school. Nonetheless, the data permit reasonable assertions about causality because people provided information over time. One analysis followed people to study their changes in health between ages fifty-four (the 1993 survey) and sixty-five (the 2004 survey). During this eleven-year period, 7.4 percent of the women and 11.2 percent of the men died. The study assessed self-reported physical health as one outcome, but did not relate job characteristics or other variables to death. Nonetheless, the study found that job control in 1993 was statistically significantly related to self-reported physical health for women, though not for men, eleven years later.8
Other research has also found a relationship between measures of job control and health. A cross-sectional study of hospital employees in Europe reported that in Western Europe, there was a positive relationship between job autonomy and health.9 A study of 8,500 white-collar workers in Sweden found that people who had gone through reorganizations where the individuals had influence in the reorganization process and achieved greater task control exhibited higher levels of well-being compared to those with less influence and discretion. The higher-control group had lower levels of illness symptoms for eleven out of twelve health indicators, were absent less frequently, and experienced less depression.10 An Indiana University longitudinal study of 2,363 Wisconsin residents over a seven-year period found that individuals who were in jobs with high demands but low job control experienced a 15.4 percent higher mortality rate.11
Not surprisingly, job control affects mental health as well as physical health outcomes. After all, not being in control of your work environment is stressful and also sends a message of powerlessness, regardless of the jobholder’s salary or formal status. A study of almost seven hundred people from seventy-two diverse organizations in the northeastern United States reported statistically significant negative relationships between job control and self-reported anxiety and depression.12 The more job control people had, the lower their levels of anxiety and depression.
Why Lack of Job Control Is So Harmful
If you want to drive any organism—a rat, a dog, or a human being—crazy and create a whimpering, downcast, and helpless being, one of the surest ways is to administer random punishments, not linked to any specific behavior, or to in other ways impose capricious demands that remove people’s sense of control over their environment. I suspect most people who have worked for any length of time have suffered the effects of arbitrarily changing deadlines and work assignments, or criticism that seemed unwarranted by job performance and did not come with enough information to permit the individual to do better. During my research, some people told me how business trips got “rearranged” even while they were on the road, with no rationale provided. Others related stories of ever-evolving performance evaluation criteria that made it tough to know how to succeed at work. Still others talked about having workplace scouts sense the boss’s mood on arrival at the office, so employees could anticipate if they were going to be in for a good or bad day.
And someone told me the following story, which is all too typical: A leader inherited a team, and each of them had a P&L to manage. The one who was doing the best on her numbers, and was also seen by the organization (and her own team) as the best people manager, was fired. Under pressure by the appalled organization to say why, the leader told his second in command that he owed nobody an explanation.
When leaders act capriciously, people do not know what to expect or what to do. The results are both psychologically and physically devastating. The learned helplessness literature makes the case that although there are many events that we cannot control, “such uncontrollable events can significantly debilitate organisms; they produce passivity in the face of trauma, inability to learn that responding is effective, and emotional stress.”13 Little wonder that job control predicts morbidity and mortality, with higher levels of job control creating better health and longer life spans.
According to the learned helplessness literature, uncontrollable events adversely affect people’s motivation, their cognitions and learning, and their emotional state.14 And the reasons are logical. An absence of control reduces motivation. If through their actions people cannot predictably and significantly affect what happens to them, they are going to stop trying. Why expend effort when the results of that effort are uncontrollable, rendering the effort fruitless? That’s why research shows that severing the connection between actions and their consequences, leaving people with little or no control over what happens to them at work, decreases motivation and effort.
A person working for a company organizing digital health conferences told me that after presenting a preliminary agenda for an upcoming conference to their boss, the response was, “I don’t see a point of view. I need you to take this away and come back with something better.” The person described their reaction: “Along with just being overworked, that makes me not feel valued. Why bother when I’m not getting any help or feedback so I can do a better job?” Seemingly random criticism, as in this case, causes people to give up: “Why should I even continue?”
Or consider the case of learning. People are adaptive in that they learn, albeit imperfectly, from watching what happens to others and from their own personal experience—don’t put your hand on a hot stove or you will be burned, what various foods taste like, how to succeed in various environments. People’s ability to learn by observing the connection between actions and their consequences permitted them to attain some degree of mastery over their environment and provided evolutionary advantage. But the most fundamental principle of learning is that various actions produce reasonably predictable consequences, so people can comprehend what they need to do to achieve the desired results. Think about the difficulty of driving a car if randomly from one moment to the next the brake became the accelerator and then the transmission. Research shows that not only is learning difficult when outcomes are uncontrollable, but even worse, “experience with uncontrollability may produce a difficulty in learning that is actually successful. Uncontrollability may retard the perception of control”15 even if people have achieved some degree of mastery.
And an absence of job control leaves people feeling depressed. Part of feeling good about oneself comes from a sense of mastery and success that results from competently performing self-relevant tasks. But in a condition of low job control, people have less responsibility and discretion, resulting in not feeling as competent or successful. As a consequence, people are more likely to experience stress and depression. Particularly for previously successful people, experiencing failure on the job and not knowing what to do to fix the situation invariably leads to withdrawal, either by leaving the company or by expending less effort, or both. Moreover, not having control over what you do and what happens to you is stressful, and stress produces other negative emotional states such as depression and anxiety. Job control affects people’s ability to learn, their motivation, and their emotional states—and consequently, their physical and mental health.
WHAT IS JOB CONTROL AND WHY IS IT SO RARE?
When you’re a child, people—parents, teachers—tell you what to do. As you get older, you get more responsibility—a driver’s license, the ability to set your own hours for when you eat and sleep—and you begin to make choices that affect your life, such as what to study, where to live, with whom to associate, and how to spend your time each day. And then, one day, you get a job, and depending on your boss, your employer, and the design of your work, your choices about what to do and how to do it, at least while at work, can disappear, leaving you in an infantilized state. That’s too bad. People, at least most people, want to make decisions and use their experience and skills at work. When people cannot make decisions and do not have sufficient control over their work, they are stressed and suffer ill-health, as extensive evidence makes clear.
A Berkeley-trained lawyer working in the toy industry told me that many people in corporations are promoted based on abilities other than their skill at managing people, such as the capacity to manage a budget or being effective at meeting project deadlines, among other things. Because many managers can’t manage, in the sense of coaching and facilitating others to do their jobs better, one of the worst “sins” that this person and many other people encounter at work is micromanaging. When managers micromanage their subordinates, those individuals lose their autonomy and sense of control to the bosses who won’t delegate. The lawyer commented:
My current employer is very face time oriented. You’re expected to be here in your chair and if you’re not, that’s treated with suspicion. And telecommuting and flex time and all sorts of things are really looked down upon. And that’s demoralizing and disengaging. I need autonomy. I need to feel like I have some control, even if it’s just illusory or over small things. But some autonomy, so I can feel like I am exercising my free will as a human being over what happens to me during the course of my day. Living with micromanagers is no fun.
Work doesn’t have to be this way. At Patagonia, Dean Carter, the head of human resources, noted that the company’s founder and co-owner, Yvon Chouinard, thought of the company as a place where “everyone kind of knows the role that they need to do, and does that work independent of extreme management. He leads using a principle he calls ‘management by absence.’” Patagonia helps to ensure there won’t be micromanagement by having “a really flat organizational structure. We try to have more people than a manager can micromanage. That’s all by design.” A Patagonia leader in their information technology unit noted that their founder had written a book, Let My People Go Surfing, and that one of the company’s values is that “when the conditions are good for doing those outdoor sports [surfing in Ventura, skiing in Reno], allowing people to go and take advantage of them.”
One of the four leadership principles at Zillow is “empowering your team.” As a learning and development person from the company said, “the manager’s role is to support the team and be there to help remove roadblocks, not to be the dictator.” Heather Wasielewski, who runs human resources at Landmark Health after working for more than a decade at DaVita, noted: “If somebody feels like the work that they’re doing is not valued, if they personally don’t feel like they have a voice at the table, if they feel like they’re dictated to or micromanaged, they’re going to feel less fulfilled and more tired.”
People often believe that providing job control is possible only for some jobs, and for some people. But that is not the case—every job and person can be given more decision-making discretion and latitude to control their work. Collective Health, a San Francisco–headquartered company focusing on health benefits administration, is also concerned about the health of its own workforce. Andrew Halpert, a physician hired into the company in the role of senior director of clinical and network solutions, told me how Collective Health had designed the jobs of “patient advocates,” the people who answer the phones to resolve customer issues that aren’t readily solved. Of course, the company, competing in a tight labor market for talent, has what he referred to as “table stakes” in the recruiting world—the nice work space, healthy food, and so forth. But the company also hires different types of people and gives them more autonomy and influence. Halpert noted:
Unlike most of the health plans in which their call center is going to be in a midwestern state staffed by people who have been doing call center work for years, we’re hiring kids out of top universities like Stanford but also Penn and UC Davis. The typical profile is someone who majored in human biology and maybe wants to pursue a medical career but meanwhile wants a job and to work for an interesting start-up. Then you say, “How are you going to keep smart people engaged and happy and not burnt out and dissatisfied?”
First of all, we train them really well. And they have really good technical tools so they’re able to do their job. But at the end of the day, a lot of what they’re doing is talking on the phone to people. One thing we do is we move people physically around on the floor every few weeks, so it feels a little different. We also rotate them into different types of tasks. So one week they’re doing coordination of benefits issues, and one week they’re working on out-of-area problems. So they’re seeing more of the big picture.
The person who runs the group tells people that as soon as they identify an issue, to surface it and work with people in other groups such as engineering to resolve it. In other words, they’re empowered to work with the team to resolve the issue they’ve discovered. If you have smart people, and they’re actually thinking and they have the right tools, they will solve issues more efficiently. Otherwise, the issue comes back again and again and then there’s an appeal. On the “how much did I pay” criterion it looks like it’s more expensive, because the Collective Health call costs more because it’s being handled by someone who is better qualified and better paid who is also spending more time resolving the issue. But we solve problems, unlike other systems where claims and problems just go on with a life of their own.
Empowered people working with their teammates to create a better experience for the customers has several positive outcomes. First, the system provides a benefit, health insurance that the clients’ employees see as a real benefit and not as a hassle, thereby increasing employee retention. Second, this way of organizing work and empowering people increases Collective Health’s own employee retention by providing people with more interesting and impactful work. And third, this arrangement is more efficient at resolving problems that don’t just go on and on and find their way to the desks of human resources people in the client organizations.
As the preceding example illustrates, job control affects employers, not just employees and their health. Research going back decades consistently shows that job autonomy—the amount of discretion you have to determine what you do and how you do it—is one of the most important predictors of job satisfaction and work motivation, frequently ranking as more important even than pay.16 Job autonomy also positively affects job performance,17 in part by increasing motivation and partly by permitting people to use all of their capacities and information to do the work in the best way possible.
As with many other situations discussed in this book, there is no real trade-off between designing jobs to improve people’s health and designing jobs that increase motivation and performance for the benefit of employers. Jobs that provide individuals more autonomy and control serve to increase their motivation, job satisfaction, and performance—and also make individuals healthier and live longer.
Why Isn’t There More Job Control and Autonomy?
If job control is good for people and providing people discretion as to how to do their jobs is also good for their employers, why aren’t delegation and discretion more widespread in the workplace? Why do so few people have much control over what they do and when and how they do it? Research on workplaces shows that in many countries, job autonomy has been decreasing.18 That decrease in autonomy, made possible in part by increased computer monitoring of work of many types ranging from how many calls someone handles in a call center to how many patients a doctor sees and how many tests a physician orders, is one reason that surveys by Gallup and other major human resource consulting firms consistently provide evidence of widespread employee disengagement from and dissatisfaction with their work.
The question of what limits job autonomy is precisely what social psychologist Robert Cialdini, two doctoral students, and I set out to study almost twenty years ago. Our intuition was that people like to feel good about themselves and their efficacy and competency—they are motivated to self-enhance—and therefore individuals engage in motivated cognition to develop beliefs and perceptions that ratify their sense of competence. Two psychological consequences arise from these self-enhancement motives. First, individuals frequently suffer from an illusion of control, believing that because they have touched something or intervened in a situation, the outcome is or will be better because of their intervention. The classic illusion of control studies demonstrated that people held inappropriately higher expectations of success in affecting random events.19 Second, because people like to think well of themselves and believe in their ability to positively affect outcomes, individuals tend to evaluate work products more positively if they had a higher level of intervention—or perceived intervention—in the production of the work. Simply put, individuals hold a faith in the effectiveness of their supervision over the work of others.
To test these ideas, we ran an experiment with three conditions. Two people came to an experimental session and expected that one would be a supervisor (randomly determined) and the other person would be doing some work, in this case, producing a rough draft of an advertisement for the Swatch watch. Both participants were actually supervisors, but each assumed that there was a counterpart in another room working on the task. In the control condition, people saw only a final advertisement. In the surveillance condition, they saw an intermediate draft of the advertisement and could fill out a standardized feedback form and make comments but were told that because of communication difficulties, the person in the other room would not get their input. In the feedback condition, they saw the identical intermediate draft advertisement, filled out the feedback form, and believed that the person in the other room received their guidance. In all three conditions, people at the end of the study saw the identical advertisement and rated that ad, themselves as supervisors, and their subordinates.
People who believed that they had given feedback on the work to their “subordinate” rated the ad, themselves, and their subordinate about twice as highly compared to those who only saw the final advertisement, with the surveillance condition falling in the middle. This difference is not only statistically significant, it is substantively meaningful to rate things twice as good simply because the person doing the rating had the illusion that they were providing some minimal level of oversight. And it turns out just being in the study influenced people’s judgments. People who did not participate in the study at all rated the advertisement even lower, suggesting that merely participating in the study caused people to evaluate the advertisement more positively. If people rate themselves, their subordinates, and the work product more highly just because they believe they have had some intervention in its creation, no wonder it is so difficult to delegate. When people cede control to others, they perceive those others and themselves as less effective and the work product as inferior compared to when they provide supervisory oversight.20
While psychological biases may make delegation difficult, research on both job performance and health effects suggests that job control is a crucial workplace dimension affecting both health and productivity. And as the case of frontline employees at Collective Health and decades of research on job autonomy illustrates, it is possible to design more autonomous work in all sorts of jobs.
SOCIAL SUPPORT AND HEALTH AND WELL-BEING
In a video describing the DaVita culture, one woman explains how, when confronted with breast cancer, work colleagues launched bake sales to raise money for her and brought her food, lots of food. A single mom describes, almost in tears, how the company and coworkers helped her after she was hit by a car in a crosswalk and broke her pelvis, leaving her scarcely able to care for her young child. In both instances, what is clear is that the individuals appreciated not just the specifics of the help they received but, as important, the sense that they were part of a community. Adhering to the company’s Three Musketeers’–based motto, there would be “all [coming together] for one.”
If job control is one important aspect of a healthy workplace, social support is another. Research going back to the 1970s consistently demonstrates a connection between social support and health.21 Having friends protects “your health as much as quitting smoking and a great deal more than exercising,” even though survey evidence suggests that the “number of Americans who say they have no close friends has roughly tripled in recent decades.”22
The evidence shows that social support—having family and friends who people can count on, and having close relationships—has both a direct effect on health and also buffers the effects of various psychosocial stresses and strains on people’s health, the so-called buffering hypothesis. For instance, one review noted that “people who were less socially integrated had higher mortality rates” and that “individuals with low levels of social support have higher mortality rates . . . especially from cardiovascular disease. . . . However, there is also preliminary evidence linking support to lower cancer . . . and infectious disease . . . [and] mortality.”23 A 2012 Gallup survey of people in 139 countries showed that even after controlling for age, education, gender, and marital status, people who reported having family and friends who they could count on in times of trouble were more satisfied with their personal health.24
Studies and meta-analyses—statistical aggregations of numerous independent empirical research reports—consistently find evidence for both the direct effects of social support on health and evidence that social support helps buffer the adverse effects of stress,25 including workplace stress,26 on disease.27 Moreover, more recent research has uncovered some of the specific physiological pathways through which social support affects health. Utah health psychologist Bert Uchino described evidence linking social support to changes in “cardiovascular, neuroendocrine, and immune function,” with social support correlated with more positive “biological profiles” for these “disease-relevant systems.”28
None of these findings should be surprising. People’s need for social contact, for affiliation, to be with other people has been repeatedly demonstrated. One review of this literature noted that “people form social attachments readily” and “resist the dissolution of existing bonds. Belongingness appears to have multiple and strong effects on emotional patterns and on cognitive processes.”29 Isolating individuals as in solitary confinement in prisons is a harsh punishment, considered by some to overstep legal boundaries. Separating prisoners of war as a way of breaking them and getting them to reveal secrets is a well-established practice because it is often effective. Social support and social relationships promote well-being. Which raises the question of precisely how companies can and do promote a culture of strong interpersonal relationships and social support.
First, Do No Harm
Workplaces often have practices that make things worse in terms of building relationships and providing support. Changing the environment to make things better is not that hard—stop doing the things that create toxic work environments.
Possibly the most important suggestion: get rid of forced ranking, the grading-on-the-curve performance review process made famous—and still embraced by—former General Electric CEO Jack Welch. As Financial Times writer Andrew Hill noted, so-called stack ranking has been blamed for Microsoft’s “lost decade,” and Microsoft’s employees often mention forced ranking as the most destructive process inside the company. One of the costs: infighting and reduced collaboration.30 The effect of forced ranking to reduce collaboration and teamwork is one reason why consulting firm Deloitte argued that forced ranking is dead, unpopular with both evaluators and the people being evaluated and increasingly abandoned by companies.31
But beyond the effect on teamwork and collaboration, pitting people against each other weakens social ties among employees and reduces the social support that produces healthier workplaces. Although there is not yet systematic evidence of the effects of forced ranking on health nor data on how evaluating people against each other diminishes social support, clearly pitting people against each other increases internal competition. For instance, at ride-sharing company Uber, forced ranking created a competitive culture that employees described as unfair and like a black box, fostering uncertainty and increasing the stress that comes from being subject to a capricious and uncertain review process.32
And then there’s GE. As one former senior GE manager recounted to me:
Everybody was fighting for turf. Everybody was fighting to control things and own things. Immediately I had to kind of fight to hold on to my turf for the job that I had been hired to do. . . . You assumed that there were only going to be so many people who got promoted. You almost had a celebrity death match, like with Jim, who was my peer. It was this idea that probably Jim or I would get promoted, no matter how good we both were. That kind of cage-fighting mentality was in the culture. You climb up, you climb up, you climb up, and then you get spit out. You get fired, and the next group of young punks are coming up trying to take your job.
The stress from the internal competition—and the fact that this internal competition created a rat race in which people worked crazy hours and traveled excessively—took a toll on this individual and many others that he knew.
Another common condition of contemporary workplaces also contributes to an absence of social support: organizational chaos and a lack of feedback and particularly positive reinforcement. Companies run very lean in terms of the number of managers, which makes providing any sort of positive feedback and social support difficult because people are too busy to take care of others. For instance, a graduate with a degree in advertising got a job at Ogilvy & Mather as her first job. In part because the part of the company where she was working was growing very rapidly and people didn’t have time to mentor or provide much help for a new graduate, she felt “uncared for.” She commented, “If someone had said something like, ‘you did a great job on this,’ the next time I’d do an even better job. I definitely needed the reinforcement that wasn’t there.”
With some modest investment in the process of management so people would have senior support and guidance, and with the elimination of practices like forced curve ranking that set people against each other in an environment of intense internal competition, companies would be well on their way to eliminating harm from work arrangements that diminish social support.
Provide Support for People Having Difficulties—and to Everyone
As we have already seen, economic insecurity is an enormous source of stress, and stress is related to ill-health. Many workplaces have embraced a transactional approach to their workforce—people are seen as factors of production and the emphasis is on trading money for work, with not much emotional connection between people and their workplaces.
However, companies that seek to build an environment of social support often implement programs and activities that do two things: first, demonstrate that the company itself is committed to providing support for its workforce, and second, letting people engage in activities that demonstrate mutual caring for each other. In addition to providing tangible support, these actions signal to employees that others are there to help in times of trouble—and that emotional support and sense of connection to bosses and colleagues can be as important as any other benefit.
SAS Institute, often found near the top of best places to work lists and a company whose business strategy is premised on long-term relationships with its customers—and its employees—signals in ways large and small that it cares about its employees’ well-being. For instance, soon after a program manager joined the company, he learned his mother had terminal cancer. The company located nursing care and coworkers helped build a wheelchair ramp at her house. When a SAS employee died in a boating accident one weekend, the question was what would happen to his children, currently enrolled in company-subsidized day care? How long would they be permitted to stay? The answer: as long as they wanted to and were age-eligible, regardless of the fact that they no longer had a parent employed by the company.33 And perhaps nothing signifies SAS’s commitment to its employees’ well-being more than its investment in a chief health officer whose job entails not just running the on-site health facility but ensuring that SAS employees can access medical care that can keep them healthy and care for them if they get sick.
Southwest Airlines has always had a culture of caring for each other as well as taking care of the customer.34 The large health-care and dialysis company DaVita has the DaVita Village Network, which “gives teammates the opportunity to help each other during times of crisis, such as a natural disaster, an accident, or an illness through optional payroll contributions and DaVita provides funding to match up to $250,000 per year.”35 When southwest Florida was hit by a series of hurricanes in 2004, a dialysis administrator noted, “The DaVita Village Network provided our housing while our homes were uninhabitable and provided funding for food until we were able to get back on our feet.”36
Google, particularly while Laszlo Bock was running human resources, offered support for its employees who went above and beyond what was required or even expected just because it was the right thing to do. As Bock wrote, “Not everything we do falls neatly into our framework of efficiency, community, and innovation. Some programs exist purely because they make life better for our people.”37 Such as Google’s decision in 2011 to increase maternity leave in the United States to five months. But perhaps the company’s death benefits program is the most extraordinary:
In 2011 we decided that if the unthinkable happened, the surviving partner should immediately receive the value of all the Googler’s unvested stock. We also decided to continue paying 50% of the Googler’s salary to the survivor for the next ten years. And if there were children, the family would receive an additional $1,000 each month until they turned nineteen, or twenty-three if they were full-time students.38
The cost was trivial, according to Bock, “about one-tenth of one percent of payroll.” But the psychological payoff is enormous. As Bock described, “In 2012 our benefits team received this anonymous e-mail from a Googler”:
I’m a cancer survivor and every six months I have a scan to check if the cancer is back. You never really know when the news is going to be bad . . . so while I’m laying on that scanner bed I write and rewrite the e-mail to Larry [Page] asking that my stock continue to vest for my family, even though I’m going to die.
When I got your e-mail about the new life insurance benefits it brought tears to my eyes. Not a day passes that I’m not appreciative of this company that does so many thoughtful and impactful things to my life. This . . . is one of those things and it goes on the already long list of reasons I’m proud to work at Google.39
To be clear, Bock and Google were focused on doing things to build community. Bock believes that “a sense of community helps people do their best work.”40 These instantiations of social support foster employee physical and psychological health. They also signal to employees that they are valued, and thus help in the company’s effort to attract and retain people to the organizations.
Create a Culture of Community
People are more likely to like and help others with whom they share some sort of unit relationship, to whom they feel similar, and with whom they are connected, including being connected through shared experiences. The evolutionary logic is that a survival advantage accrues to those who can quickly ascertain friend from foe, us from them, and those with whom they share genetic similarities. Thus, it makes sense that similarity is a fundamental basis of interpersonal attraction41 and people almost automatically help others and comply with requests from those with whom they share even incidental and random characteristics such as birthdates or fingerprint patterns.42 Companies can readily, if they so choose, create a culture that builds a sense of community and fosters shared connections.
First, fix the language, so that people are less separated by title, and use language that is consistent with the idea of community. DaVita sometimes refers to itself as a “village.” The company’s CEO often calls himself the “mayor” (as a leader of a village might be called). Employees are constantly referred to as “teammates,” and certainly never as “workers,” a term that denotes both a somewhat lower status and also people who are distinct from the “managers” or “leaders.”
Second, encourage shared connections through social and other events. At DaVita academies, training and socialization events that bring together a few hundred people at a time from within a region, people were organized into teams to design and perform skits, often in costumes—sometimes quite silly costumes. As one employee commented in a video profiling the company, people develop a deeper connection when they sing a song together, do a skit together, or act silly together—engaging in actions that reduce interpersonal barriers.
Or if you don’t want to go that far, have people eat together and share other social interactions. Many companies have cafeterias that not only save time by people eating without having to go off-site but also bring people into contact and create a sense of community by sharing meals. At Patagonia, people enjoy the same types of outdoor recreation. That plus the long tenure of many employees has built a sense of community, as an executive in their Reno facility explained:
There is this sense of community at Patagonia. I think that . . . encouragement to get out and do the things that we’re passionate about, combined with the fact that a lot of people here have worked for Patagonia for many years . . . means that the relationships and the mission of the organization are as or more important than the day-to-day work. That’s a unique feeling to any organization I’ve been a part of.
Organizations sometimes offer their employees volunteer opportunities to help local nonprofits. The workplaces thereby derive the benefits that accrue from having people who may not otherwise work together doing something for a common goal. A 2013 UnitedHealth survey found that 76 percent of people who had volunteered in the last year felt that volunteering had made them feel healthier and that 78 percent said that volunteering reduced their stress level. And 81 percent of employees who volunteered through their workplace “agreed that volunteering together strengthens relationships among colleagues.”43
Holiday and birthday parties, and events that celebrate shared successes such as product launches or other business milestones—almost anything that brings people into contact in a pleasant and meaningful context—helps build a sense of shared identity and strengthens social bonds. Southwest Airlines is famous for its Halloween parties where people dress up and have fun.44 Former CEO Herb Kelleher was famous for dressing up—sometimes as Elvis Presley. Having fun together builds social bonds and a sense of community.
The message of this chapter is simple, although it is too infrequently implemented. Giving people more control over their work life and providing them with social support fosters higher levels of physical and mental health. And these management practices also enhance employee retention and engagement, providing a payoff both to the company and to its people.