by Michael Blanding

Joel Goh and colleagues estimate that workplace stress is responsible for up to 8 percent of national spending on health care and contributes to 120,000 deaths a year. Is better management the fix?

Our work can literally make us sick. Long hours, impossible demands from bosses, and uncertain job security can take their toll on our mental and physical well-being, leading to stress-induced aches and pains and anxiety. In extreme cases, the consequences can be worse—heart disease, high blood pressure, alcoholism, mental illness.
Even so, the connections between job pressures and health—and what management can do to address the problem—have been little studied.

“We have not placed a lot of emphasis on the role of workplace stress in the high cost of health care”

"We have this body of research that shows workplace stress is very bad for health, and we have this other information that says our health costs are way above that of other countries," says Joel Goh, Harvard Business School assistant professor of business administration in the Technology and Operations Management unit. "But traditionally in the US we have not placed a lot of emphasis on the role of workplace stress in the high cost of health care."
In recent years, General Motors spent more on health care than it did on steel, and across the country, companies are struggling to find affordable plans for their workers, in some cases dropping health coverage or raising premiums on employees in order to combat escalating costs. On the other hand, companies are implementing health programs in an effort to keep workers healthy—and productive.

But those programs can only work if companies aren't at the same time undermining them with stress-inducing management practices.
"Health care programs are no good if your guy is so stressed that he can't take advantage of them," says Goh.

Making the stress-health connection

Unlike in Europe, little or no data exists in the US that correlates exposure to workplace stress with health outcomes or health care costs. Goh tackles that gap in a new working paper, The Relationship Between Workplace Stressors and Mortality and Health Costs in the United States, written with Stanford business professors Jeffrey Pfeffer and Stefanos A. Zenios.
Goh specializes in developing complex mathematical models that can aid decision making, especially in the presence of uncertainty. "The idea that we can structure the world mathematically and use that to make decisions is very interesting to me," he says. "The world is not deterministic—there is a randomness built into it. And yet, by using robust optimization techniques we can tackle a wide range of problems."
After working for a few years analyzing business operations, he settled on the field of health care as an area where he could really make a difference. "There is no lack of problems in health care, and I think that someone with a structured analytical background can make a unique contribution," he says. Goh has used mathematics to examine such issues as adverse drug interactions and cost-effectiveness of cancer screening. "Structuring the world mathematically can lead to insights and ideas that might not be obvious," he says.