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The Health Benefits of Work (Part 3)

In summary, there is no hard evidence to support the proposition that “work” is therapeutic. Additionally, there is no scientific reason why work should be therapeutic. This shouldn’t be at all surprizing, considering the vast array of activities that can constitute work, and the many diseases and ailments that can be visited on workers.

“Work” can encompass everything from vigorous and inherently dangerous exertion, to purely sedentary activities. Contrast the work of an offshore drilling rig roughneck with a microbiologist, the latter peering into a microscope all day, hardly lifting nothing heavier than a glass slide. Consider the two completely different workplaces, and hours of work, and the different personal qualities, physical and mental, required of each job.

Consider then all of the physical and mental diseases that can befall one. Cancer and heart attack at one extreme, and a bad cold at the other. Is it any wonder that there is no statistical data or even reasoning to support the claimed health benefits of work? If work was “generally” therapeutic, it would be recommended in all cases, and not reserved for people on workers compensation payments.
But hold on, there’s more. WorkCover limits its claims about work to “good work”:

Good work is beneficial to health and therapeutic to recovery.

So what is this good work? What is bad work? How to tell the difference? Waddell’s paper is the source of the concept of good work:

Firstly, work is generally good for your health and well-being, provided you have ‘a good job’. Good jobs are obviously better than bad jobs, but bad jobs might be either less beneficial or even harmful. It is then important to consider what constitutes a good job. […] The evidence reviewed here suggests that, in terms of promoting health and well-being, the characteristics that distinguish ‘good’jobs and ‘good’workplaces might include:
• Safety
• fair pay
• social gradients in health
• job security
• personal fulfilment and development; investing in human capital
• accommodating, supportive & non-discriminatory
• control/autonomy
• job satisfaction
• good communications

This list is tentative, but clearly goes far beyond physical and mental exposures, demands and
risks. Further research is required into the characteristics of a ‘good’ job, and further consideration is required of the links between good jobs, health and productivity to support the principle that ‘good health is good business’ [34-35]

If you’re thinking that this “tentative” list of possible characteristics of “good work” doesn’t seem scientific or medical you’re right, it isn’t. There is not one part of the “health benefits of work” that is based on science.

What use is being made of the unproven, and unprovable “health benefits of (good) work”? Well it has turned up recently in the standard WorkCover forms. Here is an excerpt from the latest “PROGRESS certificate of capacity”:

Having considered the health benefits of work, I find this worker to have:
full capacity for work from[    ] but requires further treatment
some capacity for work, from [       ] to[      ] performing:
pre-injury duties modified or alternative duties workplace modifications
pre-injury hours modified hours of hrs/day days/wk
no capacity for any work from[      ] to[      ]

The certificate therefore requires general practitioners to endorse a matter for which there is no direct scientific evidence when issuing certificates to injured workers. There is an identical provision in the “FIRST certificate of capacity” and “FINAL certificate of capacity”.

Further even if it were true that good work did have a therapeutic effect on patients, how is a GP to determine if he/she is sending the worker back to good work when the definition of good work is still tentative? If a worker is not getting “fair pay” or “autonomy” does that mean they may be going back to “bad work”. Maybe there should be a box on the form: “Danger – Bad Work”.

So much for good work.

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