Stress Management: Work Related Stress And Major Health Concern

Stress is a major health concern in America today, and it is especially prominent among American workers. Studies have shown that over 94% of American workers have reported work-related stress and that over 61% of these American workers are ready to quit their jobs because of it (Milenkovic, 2019). Occupational stress poses different physiological effects involving hormones as well as pathological effects because of the suppressing of the immune system. It also leads to decreased productivity at work, increased costs for companies, and promotes negative coping behaviors which further increase work-related stress.

There are a variety of cultures made up of their own unique characteristics that influence how each individual thinks or behaves within their lives. When it comes to the topic of stress, specifically stress in the workplace, different cultures tend to view and manage it differently. There are different factors that make up work-related stress including a workers’ sense of control, but psychosocial factors like “emotional demands, demands of hiding emotion, sensorial demands … organizational influence, trust, the social community at work… work-life balance, and negative acts (such as violence or bullying)” are some important contributors to stressful workdays as well (Hsu, H.C., 2018). The level of stress per occupation goes deeper than just the stressors themselves. It is the internal makeup of the individual that determines how these stressors will affect their physical and psychological health. Different cultures, such as gender, age, and socioeconomic status can have a huge impact on how one copes with work-related stress, but luckily they have the ability to rely on certain ethical laws to help relieve the burdens of the stress within the workplace.

Scientific Inquiry

The body experiences many physiological changes when it is exposed to any form of stressor, especially stressors that are work-related. What the body tends to do is activate our “General Adaptation Syndrome” or our “GAS”, which consists of three stages: alarm, resistance, and recovery or exhaustion (Copstead & Banasnik, 2013). The alarm stage is also referred to as the “fight-or-flight” response, “because it provides a surge of energy and physical alterations to either evade or confront danger” (2013). This stage is responsible for triggering the hypothalamus of the brain to secrete corticotropic-releasing hormone (CRH) resulting in a cascade of events activating the SNS (sympathetic nervous system) (2013). This causes a release of essential hormones such as catecholamines and glucocorticoids to be secreted into the bloodstream causing a variety of inflammatory effects (2013). The resistance stage does not progress until the pituitary gland is activated by the cascade of events mediated by CRH being released from the hypothalamus (2013). Copstead and Banasik explain that the resistance stage involves the body trying to adapt to the physiologic changes occurring by its “allostatic return to homeostasis” (allostasis), meaning all body mechanisms are working together to bring the body back within the normal range (2013). Every system or physiologic effect triggered by the stressor is in full force in this stage trying to fight the stressor and calm the body down. If allostasis takes into effect and the body responds well to the stressor, it will enter the recovery stage. If not, it moves onto the exhaustion stage where “the body is no longer able to effect a return to homeostasis after prolonged exposure to noxious agents” (2013). The exhaustion stage emphasizes that the body’s continuous response to stress proves to be more damaging than the stressor itself (2013). This response includes secreted, inflammatory mediated hormones that pose a plethora of effects on the body which damage the immune system and can then lead to increased susceptibility to disease and infection.

Hormones play an essential role in responding to stressors and produce profound effects when they are secreted into the bloodstream. The body triggers multiple pathways to release certain hormones, but the “sympathetic-adrenal-medullary system” and the “hypothalamic-pituitary-adrenal system” (HPA) are extremely important. The sympathetic-adrenal-medullary system releases the catecholamines norepinephrine and epinephrine into the bloodstream (2013). These hormones produce a range of effects including the elevation of cardiac output, heart rate, blood flow, blood pressure, and myocardial activity (2013). They also inhibit insulin secretion and decrease gastric acid secretions (2013). The HPA axis leads to the stimulation of the anterior pituitary gland to secrete glucocorticoids such as cortisol (2013). Cortisol is an anti-inflammatory hormone, but “chronic elevations can lead to the immune system becoming “resistant”, an accumulation of hormones, and increased production of inflammatory cytokines that further compromise the immune response” (Morey, J. N., Boggero, I. A., Scott, A. B., & Segerstrom, S. C., 2015).

When the body experiences stress and is exhausted from compensation, the immune system is hindered, and we become immunosuppressant. As was previously mentioned, if our bodies do not make it past the “recovery” stage, they instead settle in the “exhaustion” stage, which is categorized by what is called “allostatic overload” (2013). Allostatic overload is a fancy term for the wear and tear on our bodies when compensating for the exposure of the stressor (2013). Science has shown that excessive catecholamine levels are linked to certain cardiovascular pathologies such as hypertension, stroke, and myocardial infarction (2013). Stress also causes “hair loss, emotional tension, burnout, mouth sores, insomnia, asthma, heart palpitations, neuromuscular movement disorders, muscle contraction backaches, tension headaches, digestive disorders, and irritable bladder” (2013). Stress is also a key factor in contributing to certain psychological disorders. Cells in the amygdala tend to hypertrophy (an increase in size or function) and undergo “remodeling”, which results in an increase in fear, anxiety, and other mood disorders (2013). It is appropriate to say that stressors, especially work-related stressors, heavily contribute to the suppressing of the immune system and the damaging effects that are posed on the body.

Mathematical and Analytical Inquiry

Constant stress within the workplace leads to decreased work performance. Surveys have shown that 41% of stressed workers say that stress leads to a loss of productivity (2019). This loss of productivity can hinder the relationships with one’s boss, coworkers, clients, patients, etc. Which can then continue to add more stress within their work. The American Institute of Stress states that 51% of stressed, American workers are “mentally checked out” at work (2019).

Stress can have a significant impact on one’s ability to perform certain tasks and can lead to a lack of concentration and decreased motivation (Davey, A., Shukla, A, Sharma P., Davey, S., 2019). There are a variety of occupations that require different levels of focus and productivity, however, when it specifically comes to working in jobs associated with health care, it is important that one does not let the stress of the job cause a mental block so they can avoid hindering their performance when caring for their patients. Patients are usually sick and vulnerable, and they depend on health care workers for care and support. It is essential that the stress of the job itself does not affect the care that is needed for them. A few of the causes associated with occupational stress include a heavy workload (accounts for 39% of the cases) and a lack of clarity of their supervisor’s expectations when experiencing any form of change at work (accounts for 31% of the cases) (2019). The decrease in productivity has lead to 61% of American workers being ready to quit their jobs (2019). Work-related stress makes day-to-day life unenjoyable for those suffering. They might turn to become absent more frequently, or they might turn to quit their jobs as a solution for their problems.

Occupational stress is a major issue concerning the costs of the company. Work-related stress causes 120,000 deaths and results in $190 billion in healthcare costs annually (2019). This averages about 5-8% of total national healthcare spending associated with stress at work (2019). According to some calculated estimates, “job stress has been the main factor in 70% of absenteeism cases and nearly wasting of 10% of the country’s gross domestic product” (Davey, A., et al., 2019). Those who are suffering from work-related stress tend to simply turn to increase the frequency of their absence or quit their jobs in order to avoid the complications that are associated with stress. Companies need to accommodate those who decide to not show and/or quit their jobs due to stress by spending about 75% of workers’ annual salaries to cover the costs of absenteeism, the decrease in productivity, and the replacement of workers (2019). That is another stressor within the workplace itself. Those who work with the people who are experiencing stress from work are also affected partly because their hard-earned money is being taken away from them to cover the costs of those absent or gone. They are now forced to deal with the stress of receiving less pay while working more hours because of their stressed-out colleagues. Those who suffer from work-related stress report that this stress has carried on within their homes and that the added stress within their homes turns them into negative coping mechanisms, which adds more fuel to the fire.

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54% of people have said that their home life has been affected due to occupational or work-related stressors (2019). It is common for people to use their home as their “safe haven” in times of stress, however, it is not easy relying on the comfort of one’s home if they are bringing the stress of their occupation into it. 76% of workers have reported that stress from work affects their personal relationships (2019). Affected workers tend to turn to their loved ones for support, but they end up taking that work-related stress out on them instead. This overload of stress has also led those affected to cope in unhealthy, negative ways. 46% percent of women tend to turn to food and eat more because of their stress (2019). 19% of men are reported to have sex more frequently risking the chance of developing a sexually transmitted disease, and 12% of men have turned to illicit drugs for a sense of ease (2019). These unhealthy coping behaviors are extremely taxing on the body and cause the body unnecessary stress that adds to the stressors of working.

Cultural Inquiry

Culture can be defined in a variety of ways, but many view culture as “shared patterns of behaviors and interactions, cognitive constructs and understandings that are learned by socialization” (Zimmerman, K.A., 2017). Cultures of men and women tend to experience different levels of stress within the workplace and tend to have different reactions when they experience work-related stress. Men “are more likely to occupy higher positions”, while women tend to work in low-paying, unstable jobs on top of caring for duties within the home, which just further adds to the stress (Rivera-Torres, P., Araque-Padilla R.A., & Montero-Simo, M.J., 2013). Women tend to react heavily with their emotions when initially contacted with stress while men tend to use more logic in the matter (Mayor, E., 2015). Women seem to “experience more chronic stressors than men and consider stressors as more threatening” (Mayor, E., 2015). This is mainly because “masculinity, in particular, is related to better physical and mental health … better self-assessed general health, [and] less physical symptoms” (Mayor, E., 2015). Having better overall health makes it easier to cope when stress is introduced. When it comes to coping, men tend to lean towards “active coping” where problem-solving is the main engaging factor, while simultaneously ignoring “avoidance coping” which is strictly a more emotional coping mechanism used by women (Mayor E., 2015). Not only do men and women differ in terms of stress effectiveness and management, but age also makes a difference in how one copes as well.

Age has a major impact on how one perceives and manages their stress levels. There are a variety of factors that add influence to the differences of younger versus older-aged workers. For example, younger workers have reported experiencing more stress regarding the workplace with certain factors being of influence including “being in a physically demanding job, greater self-related work pressure, not being able to work at home, [and] feeling tired before work” compared to older groups (Hsu, H.C., 2018). The fact that younger workers tend to experience more work-related stress compared to older adults can be stemmed from the possibility that “younger workers are still learning to fit into the working environment or that older workers are more resilient in adapting to a changing environment” (Hsu, H.C., 2018). Being more resilient to the stressors experienced has been shown to reduce the degree of burnout at work (Hsu, H.C., 2018). It has also been recorded that younger workers have more work-family conflicts with more discriminatory experiences at work as well (Hsu, H.C., 2018). Although younger workers experience more work-related stress, they tend to manage it better compared to older adults because older workers seem to have less psychological well-being compared to younger adults (Hsu, H.C, 2018). Older workers’ “declining health and creativity with age could affect their potential to deal with work challenges”, which makes coping with work-related stress much more difficult (Hsu, H.C., 2018). There are different health training programs to encourage “new methods and creative thinking” and to provide social support for workers of all ages so they could have more beneficial work experiences and work outcomes (Hsu, H.C., 2018). Socioeconomic status also plays a role in the intensity and management of stress within the workplace.

Although one would think that living in a lower socioeconomic status would increase the levels of stress within the workplace, studies have shown otherwise. Low SES individuals tend to have more accompanying stress outside of the workplace while those with higher SES jobs tend to report more stress within the actual work itself. Certain results have shown that “in comparison to high SES individuals, those with lower SES reported greater happiness at work, less self-reported stress, and less perceived stress” (Damaske, S., Zawadzki, M. J., & Smyth, J. M., 2016). Older workers have reported, “feeling unable to meet work demands, fewer work resources, and less positive work appraisals” (Damaske, S., Zawadzki, M. J., & Smyth, J. M., 2016). Both high and low SES jobs provide different stressors which influence the stress that is experienced within the workplace. For example, high SES jobs “typically come with greater job demands, including more responsibility, more time demands, greater interpersonal conflict, and greater conflict over the use of authority” compared to those with low SES jobs who “experience low job control and little schedule control” (Damaske, S., Zawadzki, M. J., & Smyth, J. M., 2016). These different work-related stressors produce different effects on a person, which can then urge them to turn to their legal rights for support.

Ethical Inquiry

“According to the World Health Organization, workers who are stressed are more likely to be unhealthy, poorly motivated, less productive, less safe at work, and at risk for depression and anxiety disorders” (Zabawa, B.J., 2019). It is important for employers of any company “to ensure that as much assistance, training, support, and guidance is offered to staff as possible so that stress at work can be avoided” (Morris, 2019). Employers are taught through various training programs and Employee Assistance Programs (EAPs) to initially address the issue of work-related stress (Occupational Safety and Health Administration, n.d.). These EAP programs teach employees about “stress, the effects of stress on health, and personal skills to reduce stress, …and provide individual counseling for employees for both work and personal problems” (Occupational Safety and Health Act, n.d.). Although these training programs have been enforced as preventative measures, some employees still feel the burden of workplace stress on top of these measures being implemented.

Many employers are made aware of the issue at hand but fail to alter the working environment to accommodate for the stress received. Because of this, many employees suffering from work-related stress turn to legal action to take effect. They rely on their rights and the laws that protect them. The different laws provide assistance that also “help[s] to create work environments that reduce employee stress” (Zabawa, B.J., 2019). For example, one does have the right to make a legal claim such as a personal injury or constructive dismissal claim for stress against their employer (Landau, P., 2010). This presents the issue to the employer, who can possibly grant the employee Statutory Sick Pay (SSP) in order for them to take time off to manage their chronic stress (Landau, P., 2010).

People experiencing work-related stress also turn to certain laws such as the Occupational Safety and Health Act (OSHA) and the Americans with Disabilities Act (ADA). The OSHA helps to “provide guidance on how to prevent workplace violence” with some of these guidelines including “getting a commitment from management, asking employees to participate in decision-making, and conducting a worksite analysis” (Zawaba, B.J., 2019). The OSHA provides safety to its employees while requiring them to work together, which teaches them the basics of teamwork. The greater effectiveness of working as a team can promote better support among coworkers when the work environment deems to be too stressful. Employees suffering from long-term stress in the workplace also turn to the Americans with Disabilities Act (ADA). The ADA “support[s] the need for more comprehensive wellness programs that include reducing stress and its various causes” (Zawaba, B.J., 2019). The ADA “prohibits employers from discriminating against individuals who have, had, or are perceived to have a disability as to terms, conditions, and privileges of employment” (Zawaba, B.J., 2019). The ADA protects people with disabilities due to stress that has been acquired within the workplace (2019).

There are also other worker’s compensation laws to not only help reduce the amount of stress within the work environment but also help protect against any form of discrimination amongst employees. Some examples are Title VII, which “prohibits employment discrimination based on an employee’s gender, race, ethnicity, national origin, or religion” (Zawaba, B.J., 2019) and the Age Discrimination and Employment Act (ADEA), which “prohibits discrimination against employees age 40 or older” (Zawaba, B.J., 2019). These worker compensation laws protect those who might be receiving chronic amounts of stress due to bullying among coworkers and thus reduces the risk of acquired stress within the workplace.