Inventing our future Collective action for a sustainable economy

I: General socio-economic, cultural and environmental
conditions
4.5 Chapter 3 demonstrated a strong correlation between poor health outcomes and deprivation. But
what is it about weak economies and social exclusion that translates into poor health outcomes?
There are many different dimensions and in the paragraphs that follow, we examine three key ones:
the nature of work and employment, education and learning, and broad environmental conditions.
Work and employment in the East of England
4.6 In the East of England – as elsewhere – work and employment are key elements of a dynamic economy.
Hence it is no coincidence that Goal One from the Regional Economic Strategy is concerned with
building a skills base that can support a world class economy: skills, work, employment and economic
prosperity are thoroughly intertwined.
Relationship between work and health
4.7 As well as being integral to the economy, work is a primary source of status; often it is the way
in which people are defined, both by others and by themselves. At an individual level, work and
employment provide purpose, social support, structure and a means of participating in society, as
well as income. 31 For all of these reasons, people’s experience of – and patterns of engagement in –
work have important implications for their health. The links are well-established, but complicated: 32
• Work which provides job satisfaction and allows individuals discretion, security and control over
their working lives seems to confer considerable health benefits (and the reverse is also true).
This appears to manifest itself during mid-life, a period during which social inequalities in health
are especially apparent.
• An absence of work – in the form of unemployment – produces negative health effects. It impacts
on psychological well-being, social participation and physical health. Impacts tend to be especially
acute late into an individual’s career. They are also problematic in the early years of employment;
this in turn can have a substantial influence over the remainder of the life course.
• The threat of unemployment/redundancy is closely correlated to increased illness, health service
use and hospital admissions. 33
4.8 One influential and robust examination of the relationship between work experiences and health
outcomes was based on a longitudinal study 34 of the English civil service. This demonstrated that
stress at work results from an imbalance between the psychological demands of work on the one
hand and the degree of control over work on the other. In seeking to improve health outcomes,
it made the case for a better balance between effort and reward. The latter was measured in three
different ways: esteem, career opportunities (including job security and promotion prospects) and
financial remuneration. 35
31 ‘The Future of Work-Life Balance’ part of the Economic and Social Research Council (ESRC) ‘Future of Work’ Programme Seminar Series.
32 Work, non-work, job satisfaction and psychological health: Evidence Review HDA, March 2005.
33 Worklessness and health – what do we know about the causal relationship? HDA, March 2005.
34 A longitudinal study is one which focuses on the same group of people over a long time period.
35 Work, Stress, Health: The Whitehall II Study CCSU/Cabinet Office/UCL, 2004.
A Regional Health Strategy for the East of England 43