Work and Leisure

134 Jiri Zuzanek1983). Similarly, in a case-controlled study, Alfredsson et al. (1982) reportedthat individuals in occupations characterised by a hectic work tempo and lowlevel of control over work had an increased risk of myocardial infarction.A 1997 Finnish Quality of Working Life Survey showed that 69 per cent ofemployees reporting high levels of time pressure frequently experiencedfatigue, 50 per cent complained of exhaustion, 45 per cent had sleeping problemsand 19 per cent felt depressed (Lehto 1998). Analyses of Canadian andDutch time-use data also found that feelings of time pressure contribute toinsomnia and lower levels of self-assessed health (Zuzanek and Beckers1998). According to Cooper and Cartwright (1994), in the United Kingdomalmost half of all premature deaths can be attributed to lifestyle and stressrelatedillnesses, and the American Institute of Stress identified stress as acontributing factor in 75 to 90 per cent of all illnesses. Robinson and Godbey(1997) report that people who feel rushed rate their health lower than thosewho do not. The stress that accompanies ‘sped-up’ styles of life, the authorscontinue, is a major cause of early death. In Japan, similar concernshave resulted in a public debate over the phenomenon of ‘karoshi’, which istranslated as ‘sudden death from overwork’ (Nishiyama and Johnson 1997).There are sceptics, however, who dispute the effects of time pressure onhealth and specifically on cardiovascular diseases. Gleick (1999) contendsthat three decades of attention from cardiologists and psychologists havefailed to produce any ‘carefully specified and measurable set of charactertraits that predict heart disease,’ or to demonstrate that people who changetheir Type A behaviour will actually lower their risk of heart disease. ‘Ifthe Type “A” phenomenon made for poor medical research,’ Gleick continues,‘it stands nonetheless as a triumph of social criticism’ (Gleick 1999:17–20).Can time-use and population health surveys shed new light on these disputedissues? The answer to this question is a qualified one. To date, few timeusesurveys have been used to examine relationships between time pressure,stress and health in any detail. National population health surveys are rich inhealth-related information, but usually short on questions dealing with timeuseand time pressure. To complicate the situation, the effects of time pressureand stress on health are often indirect, and a paucity of longitudinal studiesmakes it difficult to establish the direction of causality between time pressure,work overload, stress and physical health.Given these limitations, the analyses below are focused on a few questionsthat may contribute to a better understanding of the key links andcomponents in the complex ‘time pressure–stress–health’ relationship. Thequestions addressed are:• How do work overload and time pressure affect health?• What are the effects of psychological stress on mental and physicalhealth?