The Healthy Workforce

Rachel Salaman: Now near the start of your book, The Healthy Workforce, you say that COVID-19 showed us that, quote, "Worker health has much less to do with having access to fruit and Pilates lessons than we ever imagined." Now, we may come back to the fruit and pilates later, but what are the other factors that determine worker health?

Cary Cooper: Well, I think health and wellbeing at work really started a few years ago. In fact, it started roughly during the recession of 2008 to 2015, when a lot of people lost their job and organizations began to think, "Listen, we're very mean and lean now." You know, 20-30 percent of staff in the finance sector had lost their job during this period of time – not just the finance sector, many sectors – and they were saying, "What do we have to do to keep people in the organization to reduce labor turnover, because we're so mean and lean in terms of staff now that we need to retain and attract talent."

So, the driver started then, between 2008-2015. But some of the organizations thought that the driver there to retain particularly the Millennials – and now, by the way, the Z Generation – the driver there was, you know, the pilates stuff, the mindfulness at lunch, the beanbags, ping pong tables, you know, Silicon Valley writ large. But soon they began to realize, HR began to realize, and occupational health began to realize, that this wouldn't retain people, that that was just ... it wasn't that important.

Nice to have sushi at your desk and massages. However, this isn't what actually drives productivity, this isn't what drives retention, keeping people in the workplace, not losing them and attracting new people, and that the factors that were [keeping people] really came to the fore.

It started to come to the fore, as it were, before the pandemic, before March 2020. But during this last two years, that's had a major impact because we have had people working remotely, feeling job insecure, people who've been furloughed. The management of people became the critical issue. You know: how do you manage people who are working remotely, or in the future, by the way, in a hybrid model, some from home, some in an office and mixed workplaces, as it were? And do we have the right kind of line management to do this?

So, I think really, we've left the fruit and pilates lessons, and we're now into thinking about health and wellbeing, employee health and wellbeing, as a strategic issue for organizations. Many organizations in the U.K., in Europe and the U.S. now have Directors of Health and Wellbeing – some who even report directly to the CEO, some who report to the HR Director, and some who report to occupational health. This is the big change, it's now become a big, big issue.

Rachel Salaman: And just for people who might be wondering, "Well, doesn't that still mean fruit and pilates?" What are these Directors of Health and wellbeing doing in their workplaces?

Cary Cooper: Strategically what they're doing is this: number one, doing audits of your employees to find out how they perceive the organization, wellbeing audits.

We have the instruments to do that, we have the psychometrics to do that – getting people to talk about the hours they work, the way they're managed by their particular boss, whether they are allowed to have flexible working or not, and it goes on and on and on.

And if you collect that data... In a sense it's like going to a GP, you're going to your internist – internist in the U.S. or GP – you don't want that person to be writing out a prescription for you before you've opened your mouth. What you want is that person to take bloods, to take your blood pressure, in other words, to do a diagnostic to find out about you. Well, the same thing applies in the whole area of employee health and wellbeing. The first step is, how do employees perceive the organization – and there are instruments, psychometric tools and things to do that, dead easy. That's one.

Once you have that information, you start to plan a strategy. So, if you find out that mainly your line managers are perceived as being command and control types: they're not very socially sensitive, they manage you by fear – "have you read your contract recently?!" – as opposed to by recognition and in a kind of positive way, that could be one thing you find. And then you have to think about how you strategically are going to deal with this in the organization. How are you going to deal with your line manager who has no EQ, emotional intelligence?

So, you're going to have to do training, you're going to have to think about how you select managers and recruit them in the future, to ensure that they have parity between their people skills and their technical skills. Because do you know what we do in the West? In the West for sure, throughout the whole of Europe, North America, many developed countries, you find that people get promoted and recruited based on their technical skills, not their people skills.

Well, that's becoming a big issue if, in the future, we're going to have hybrid working – and we are, all the evidence is in that direction now in most developed countries, and even developing countries – how are you, as a manager, going to manage people, some who are going to be in the workplace, some are going to be working from home? How are you going to recognize when they have mental health problems, when they have unmanageable workloads, unrealistic deadlines? How you going to do that? Unless you get socially sensitive, "EQ'd" line managers, this is not going to be successful. So that's one element of it.

Another I think important issue is the whole issue of having autonomy and control, and being managed in a way where the line manager gives you more autonomy and control to manage your life, your work life, given the nature of the role you play.

In other words, an important part of any healthy workplace is to ensure that there's a good psychological contract between the employer and the employee, and/or your boss and you, about, you know, giving you the autonomy that you need to do your job and feel valued and trusted and managed properly.

So, there's a whole range of things that could make up a strategy, but that is derived from finding out how employees perceive the organization. So, the first step is really the important one, which is getting employee voice, and doing it in a safe way. And then building a strategy based on what you find.

Rachel Salaman: Now you touched on productivity there. How does worker health relate to productivity, and how can you measure it?

Cary Cooper: Yes. Productivity is a kind of difficult outcome measure in many occupations, but there are studies – and we have that in our book, The Healthy Workforce – there are many studies now where you can measure, objectively, output, i.e. performance, productivity, which show that there's a very strong link between employee health and wellbeing and their individual productivity.

It makes logical sense, doesn't it? If productivity is what I produce in my environment, say in an hour or in a week, it's my output – there are lots of ways of measuring it. It's varied by sector, by specific job, but it's fairly logical that if I'm a happy bunny, if I am job satisfied, if I feel my line manager recognizes my worth, values me, gives me autonomy, ensures I don't work excessively long hours, gives me manageable workloads, realistic deadlines, etc. I'm going to perform better in that hour and in that week.

So, the evidence has mounted. What we do in our book, The Healthy Workforce, is we look at this evidence for the first time, we bring it all together. Nobody's done that. What we've seen in the past is people saying, "Healthy workers, if you create the right kind of culture, a wellbeing culture, it will produce improved health outcomes." But to impress and to get senior leaders to change behavior, to move in the direction of employee health and wellbeing, and creating the right kind of culture that people value, you have to show them that it actually hits the bottom line, you have to create the evidence.

And I'm all for evidence! And we take a look at all the studies where you can measure objectively people's performance, outcome and productivity – the evidence shows a very strong link between health and wellbeing.

Rachel Salaman: Yes, indeed. Now you've touched a few times on the kind of move towards hybrid working that you expect to stay. This obviously presents a few challenges for managers, who might feel at one remove, or more than one remove, from the health of their workers if they're not really seeing them and they're not noticing their attitude, and how they're sitting at their desks and highlighting any issues that might be obvious if they were all working on one place. What are the challenges that have come with remote working for managers in this context?

Cary Cooper: Well, you're absolutely right, Rachel, for sure hybrid working produces challenges for any line manager, from shop floor all the way up, because some people will be working from home, some people work in an office, there's going to be a blended thing.

By the way, hybrid working does not mean what we've been doing, which is remote working. It's not 100 percent remote, and all the evidence is 1 or 2 percent of people want 100 percent remote. The vast majority just want the autonomy to work with their boss, with their organization, to find the model that fits them and themselves – that fits the organization, given the nature of the role they play, and fits their own personal life, that's what people want. But it will be a challenge because you won't have people there all the time. How do you recognize when people have a mental health issue?

Take the year before COVID hit. Fifty seven percent in the U.K. of all long-term sickness absence was for what we call the common mental disorders, stress, anxiety and depression. That's the U.K. but that's in every developed country in the world, by the way, that's the same. If you look at the OECD figures, it shows that the leading causes of long-term sickness absence in almost all the OECD countries is not muscular skeletal – backache and the like, which it used to be 20 or 30 years ago – it is for anxiety, depression and stress. So, this is a really big challenge: to recognize it, and that's another challenge that this line manager will have in a hybrid working environment because they won't be in the office all the time. Therefore, it's fundamental that line managers have more EQ training, trying to develop social interpersonal skills.

I mean, if I was doing it, say I was an HR Director of a company, here's what I would do. In the workplace we're going to into, hybrid working, mental health is still a challenge as the leading cause of sickness absence, trying to get productivity and performance up and all of that. If I was doing it, I would look at my whole manager or workforce, from shop floor all the way up to our manager roles. I'd say, "You know what, we know that those 30 percent of the people there really have these skills naturally." We haven't trained them, we haven't selected them on it, we selected them on technical skills, but you know they're damn good line managers. How do we know it? Because labor turnover is very low, their health records, if you look at occupational health, are pretty damn good. We have the evidence that tells us that those people are producing pretty well.

We know that there's 40 percent of people who could do better and are trainable, maybe 50 percent are trainable, but they don't have ... They're technically really good, but they could use the social and interpersonal skill development training that's available, EQ training and the like. That would help them in the world we're going into, right? To help them recognize when people aren't coping so well, how to manage people who are in a hybrid model, etc. etc.

And then the real challenge of course is there may be 20 percent who should be in a technical role and not in a people role because they're untrainable. We have that, that's the reality of life. So, we have a challenge there. So, I think the training is going to be very important in the future for people, if they're going to run this kind of hybrid model, look after the mental wellbeing of people, hit the bottom line, to do everything that they need to do in this new world of work.

Rachel Salaman: Do you think that, in a hybrid model, more of the time that is spent face-to-face in the office will or should be spent on worker health? Simply because, when the workers are working at home, there just isn't that observation going on.

Cary Cooper: Yes, I think you're right. I think what should happen if you're a line manager and you ... Remember, people want to commune with their colleagues. You know, one thing we missed in this two-year pandemic that we've had, and the lockdowns and everything, is we missed our colleagues –we didn't realize how much human beings meant to us. That is, I think, really important. Therefore, when they do come in, I think it's important that all line managers make sure that they have one-to-ones with these people, and not necessarily about work. You know, not about, "How are you getting on with your job?" But, "How's the family? What's going on?"

One thing I thought was good about the pandemic was that people actually were sharing a lot more when they were doing virtual meetings. Every time I had a virtual meeting with a team, or a group of people, the first thing that everybody talked about was the personal circumstance they had. You know, "My daughter has COVID. My father is in hospital with it," da-da-da, and that went on a lot. And that was good because normally if you're in a meeting, in an office, you wouldn't have done that. You're playing a role out in the office and you're trying to be very professional. So that was quite a good part of the virtual world, in a way: people were more revealing because they knew other people were experiencing the same problem, you know.

I think, therefore, the line manager has to, when individuals come in, make sure that they do one-to-ones with everybody when they come in, every week, find out about how they're getting on and everything else. But to do that they need the skills to do that. That's not easy, and lots of people... You know, again, 30 maybe 40 percent, if we're lucky, have it naturally, those social skills naturally. Probably 60 percent don't have them and need training on it, or need to be put in a role that's more technical rather than a people management role. We have to just be honest about that.

Rachel Salaman: Yes, and I suppose managers have to step up and say that themselves, don't they? Like, "I was really good at accounting or whatever, and I really find managing people a challenge, can I please go back to a senior accounting role?!" Or something.

Cary Cooper: Exactly. It's not their fault, in a way, because they were hired because they're really good accountants or good marketing people. But, you know, when it comes to actually managing, you get into a managerial role – promoted into one or recruited into one when you didn't have it before – you have issues.

By the way, pre-COVID we should have been doing this. But all this has done, this pandemic, is accelerated the move toward flexible working, which was beginning anyway, and we now realize the weak points in our organizations and what we need to do about it. Also, hours of work, we now realize what the evidence told us pre-COVID: working people consistently long hours will damage their health. That evidence is totally clear.

So, a long-hours culture is not good, and that's why we're moving toward four day working weeks, flexible working – even Netflix and Virgin Airlines had flexible holidays! In other words, take as many holidays as you can, as long as you can achieve your objectives. You have to feel comfortable and secure in your job, I guess, to be able to take that up. But I think we're moving toward better balance in our lives between work and home and our own personal health.

You're listening to Expert Interview, from Mind Tools.

Rachel Salaman: Now one challenge I think for managers is, if an employee is going through a difficult personal issue that's affecting their mental health and productivity, let's say something like a divorce, how much leeway should they be given in terms of lighter hours or workload? What's fair to their colleagues?

Cary Cooper: Well, most big organizations – but this is a problem for SMEs, small and medium size – most big organizations have EAPs, Employee Assistance Programs, counseling services. If somebody is having a problem... And incidentally, I did an evaluation of these where we looked at all the EAPs in the U.K. and evaluated their effectiveness, and what we found is... I mean, first of all, the evidence is they tend to work. In other words, they help people – if organizations have them and people call them up, and they can do it now online, they can do it virtually, through the virtual world, Skyping, Zoom, the like, and/or face-to-face – if they use them, it's very helpful.

And when I did my study, we found that 60 percent of the people who went to an EAP went with personal problems, not work-related problems. But those two worlds are intertwined, aren't they? So, if you're having trouble at home, you go into the workplace, you're not going to be immune to that spilling over in some way, therefore, it's in the interest of the organization to have an EAP, to enable people who have problems... And that's one way to deal with it.

The big issue though is, SMEs, who employ the majority of people in the U.K., it's not the big companies or big public sector bodies. I think in the private sector it's something like two out of three employees are employed by the SME sector and not the large corporates. OK, so the SMEs, we have to find a solution to help them, because they tend not to have big HR departments or occupational health, and they need help on managing people who have problems – whether they're mental health problems, personal problems, because it will affect their work. There are more and more EAP providers out there who are opening their services up to the SME sector. So that's happening now and that's good news. So, I think that's one way of dealing with it.

The other way of dealing with it, of course, for line managers... Look, a line manager can't do everything. You can't be a counselor, a technical person in whatever your expertise is, and deliver to the bottom line, and do all the other things that are demanded of line managers. But they should be aware when people aren't coping, they should be made aware of when people are having problems.

You see that Fred, who normally in a team meeting is pretty robust, pretty jolly, has a good sense of humor, all of a sudden, they're withdrawn and that's been going on for weeks. So, a good line manager, outside, would say, "Hey, how you feeling? I notice you're not yourself, anything wrong?" But again, you have to have the social skills to do that.

And then that line manager should try to find help for that person, because, unless it's specifically work related, the reason that person's low is because something, a part of his or her job, was taken away from them that they really loved, and once he shares that then the line manager can maybe do something about it, but if it’s about a divorce, if it's about bad marital problems, then all the line manager can do is send them and ensure they know about the EAP and to go get help. And if they don't have an EAP, to get them help anyway – find a way of getting help by going to HR, going to occupational health if they have it.

As I said, increasingly the SME sector is providing these kinds of services now because the providers are seeing they can make money out of the SME sector, in a sense. So they've entered that arena, but it's still not widespread.

Rachel Salaman: So, what's the best argument you've heard or thought of yourself to persuade employers to invest in a healthy workforce?

Cary Cooper: OK. I was working with a company, through my ex-university spin-off company, Roberts & Cooper, a company in a particular sector, it was in construction, absolutely excellent. What they did is every time they did things, they collected data on the impact of that intervention, whatever it was.

So, say, for instance, you say that that part of the business, one part of the business, is working excessively long hours, all right. And then you go and you intervene and you say, "OK, that's it, we've got to get a cap on these hours, this is making people ill, we've collected the data on it." All right. And then you look at what the evidence is pre- and post- that intervention, and by the way, that's what organizations are doing and that's what directors of health and wellbeing in companies in the developed world, in the United States, in Europe, should be doing more of.

You know, if you're going to do training of line managers and you're going to improve their EQ, does it pay off to the bottom line? And you can show the organization. That particular company that I'm talking about I went to the senior leadership team on several occasions with the data, "We did this and this is the impact it had." And sometimes it wasn't particularly positive and then you'd say to yourself, "Well why didn't that intervention work? Well, it didn't work for that and that reason, so we're going to change it and we're going to do that. Ah-ha! That does work now."

If you show chief finance officers and CEOs, you don't probably have to tell the HR directors because they are into this now, big time – in almost all of the developed world now, they understand health and wellbeing is really significant now – but if you can convince the CEO and the CFO that it hits the bottom line, that what you're doing makes a difference, you're retaining people more, your labor turnover figures have declined, your productivity, if it's measurable, has improved, your stress-related sickness absence – which is the leading causes of long-term sickness absence – has declined, and you put monetary figures to all of that, it works.

That's what we're recommending in our book, that people develop a strategy, do interventions that improve the health and wellbeing – because we all have problems in all our organizations of one sort or another – change it, look at what the impact of that change is, don't just do it and say, "Well we've done it."

And this is based on employee voice again, employees telling you how they perceive their organization. If 70 percent of people in a particular department say that their line manager is a bully, that's a problem. You've got to correct that problem: it will affect your productivity, it will affect your labor turnover, and it will affect the health of people. If another one says, "We're working 60-hour weeks, and it's damaging my family, my relationship with my family." And you get enough people saying that, you aggregate your data when you do these wellbeing audits, and then you find a way to deal with that as an issue.

Rachel Salaman: And earlier we talked a little bit about the fruit and pilates approach and the limitations of it, in fact. But in your book, you do have quite a big chunk dedicated to health promotion initiatives in the workplace. So how useful are they as part of the big picture?

Cary Cooper: OK. For me, there's two elements to employee health and wellbeing, a healthy workforce. One element is, what can the organization do to create the right kind of culture?

So, I get up in the morning and I love going to my job, you know. I feel motivated, I feel valued by my line manager, I feel valued by my colleagues, I love my job, I love what I do. And yes, there are bits of my job I don't like but it comes with the territory. So that's the kind of thing, that's the organizational element, and that's one set of factors: it's about the hours of work, whether people have manageable workloads, realistic deadlines, have a clear idea of what their job is about, they're not contacted by email at weekends and while they're on holiday.

By the way, that's become big: techno stress. And there are lots of studies done on this now, that one of the biggest drivers of illness in the workplace is being constantly contacted by their organization, and that's why the French have the "right to disconnect" law – managers cannot send emails out of office hours to their subordinates. That means at night, weekends, or while they're on holiday, and that right to disconnect is going into a whole range of countries now.

So, what the organization can do to create the right culture for you, and try to prevent you getting ill from something that is happening in the workplace. Then the other bit is about you managing your own health and wellbeing as an individual. And that's what the pilates is like and that's what mindfulness is about, and that's what exercise is about and all of that.

The worry I have is when organizations have these great wellbeing days, where you have smoothies and massages and mindfulness, and they think that's wellbeing. And they think they've done their business, "I've done it, we do wellbeing because we have these great wellbeing days and everybody has fun for a day." I've been to tons of those, by the way. And yes, you know what, I love it! I love smoothies, I like having a massage, I enjoy the mindfulness bit, which I've done myself from time to time, and I do exercise. But that is not creating the culture of wellbeing.

The organization has to look at what it can do to make people feel valued, trusted, that they feel they're cared about, that the organization is committed to their health and wellbeing. Of course, they're also committed to being a productive company, an efficient company or organization, whether it's in the public or private sector, obviously. But they have that commitment.

The other bit is fine. I don't mind the wellbeing days as long as they're doing the other stuff.

Rachel Salaman: Sir Cary Cooper, thanks very much for joining us today.

Cary Cooper: Well thank you very much, Rachel.

Rachel Salaman: The name of Cary's book again is, "The Healthy Workforce: Enhancing Wellbeing and Productivity in the Workers of the Future," and it's co-written with Stephen Bevan. You can hear Cary talking about his book "Building Resilience for Success" in a previous Expert Interview podcast on the Mind Tools site.

I'll be back in a few weeks with another Expert Interview. Until then, goodbye.

Buy your own copy of "The Healthy Workforce" from the Mind Tools store.

Note: Mind Tools is a product of Emerald Works, which is part of the Emerald Group along with Emerald Publishing, but we only choose books to feature in Book Insights and Expert Interviews that we think are suitable and worthwhile for our audience, irrespective of publisher.