“Profound changes in the ways in which work is organized and carried out have taken place over the last 200 years, particularly in the Western world and more recently in the rapidly industrializing nations of Asia. Farming and craftwork, which predominated for many centuries, were largely replaced by the industrial revolution, and with it, skilled workers who had once exercised substantial control over their work processes were replaced by lower-skilled labor in new machine- based production technologies . The introduction of Taylorism at the beginning of the 20th century—a new “scientific” approach to maximizing productivity— further reshaped the workplace by breaking down complex, traditional craft-based work processes into small, individual tasks to be performed in a specified amount of time, in a repetitive manner, and controlled by supervisors or mid-level management, leading to the birth of the assembly line. And while originally used for manufacturing, this lead to the assembly line mode of work organization has been transposed to service-sector and white-collar office jobs and to centralized multinational organizations which now divide up work tasks and processes often across national borders. The result of these and other 20th century developments: deskilled workers in many occupations with the power to control the production process increasingly concentrated in the hands of employers and management.
Clearly influenced by globalization, the transformations in work and work organization that began 200 years ago are now accelerating so much as to even be considered another industrial revolution . Globalization has included, among other things: outsourcing of labor to developing countries; feminization of the work force; increases in unemployment, under- employment, and employment insecurity; increases in temporary, part-time, flexible labor—“precarious work”; and a sharp increase in the economic gap between the rich and the poor (see chapter 2). In the 1998 Tokyo Declaration, occupational health experts from Europe, Japan, and the United States described this new world of work—“organization restructuring, mergers, acquisitions and downsizing, the frantic pace of work and life, the erosion of leisure time and/or the blending of work and home time” —and the motor behind it: “. . . driven by economic and technological changes aiming at short-term productivity and profit gain” .
The social and economic forces brought about by global economic competition are determining the ways in which work is unhealthy, how noxious it is, and who are most exposed. In fact, these changes disproportionately affect people in lower socioeconomic positions, particularly women and immigrant ethnic minority groups, whose health is already more vulnerable. Women are becoming the poorest component of the workforce, and in turn, the most numerous, being employed in low- income service-sector and manufacturing jobs (see chapter 2). Migrant workers searching desperately for employment are being pulled into developed nations where they often become part of disadvantaged minority groups concentrated in the lowest-skilled work and marginal sectors of the economy that offer minimal or no benefits, such as health insurance.
In industrialized countries, this globalization of the economy over the last 30 years has led to a second round of new systems of work organization, such as lean production , and the intensification of work through increased work demands on a reduced workforce.
Consider some of the following data:
• one-third or more major organizations broadly reduced their workforce in the 1990s and between January 1999 and December 2001;
• 9.9 million jobs were eliminated, and temporary employment multiplied six-fold to nearly three million between 1982-1998 [10, pp. 184-185];
• the average work year for working age couples in the United States has increased by nearly 700 hours in the last two decades of the twentieth century , more hours per year than any other industrialized country. Time away from home, due to commuting, has increased significantly while vacation time has decreased .
Although little addressed in the United States, these changing working conditions are negatively affecting worker health, indicating that the gains of “lean” production for employers come at a high cost to workers’ health (see chapters 6 and 7). For example, in a 2007 U.S. survey, about three-quarters (74%) of workers at all occupational levels reported feeling stress from work . And this stress proves very costly: disability reported as due to job stress in 1997 (23 days) was four times greater than the median for all other injuries and illnesses combined . In a 1998 study of 46,000 workers, health care costs were nearly 50% greater for employees reporting high levels of stress in comparison to those who were “stress-free” .
While the causes of ill health may be in question, the spiraling costs of employee health—both due to work injuries and payment of health insurance—has moved health and work to front and center stage. Clearly, not all stakeholders (e.g., management, labor, employees, government) share the same interest in protecting worker health [12, 15], with many in management/business seeing it primarily as a cost and a drain on profits. More recently, however, efforts are being made to redefine worker health as an investment and source of profit. This book addresses how these social and economic processes are changing both work and the health of working populations.
Notwithstanding the abundant problems around work in developing countries, this book focuses mainly on the detrimental health effects experienced by working people in industrialized countries, particularly in the United States, albeit with the aim that this knowledge can be applied in developing countries as well.
Taken from: Schnall PL, Dobson M, Rosskam E, Editors Unhealthy Work: Causes, Consequences, Cures. Baywood Publishing, 2009.