Health and quality of working life: current trends

Přijat k publikování / Received for publication 16. 11. 2024

Introduction

Health is a cornerstone of general wellbeing and has profound implications for societal prosperity and economic development. The World Health Organization (WHO) defines health not merely as the absence of disease or infirmity but as a state of complete physical, mental, and social wellbeing (WHO, 1948). In today’s developed world, maintaining good health has become increasingly challenging due to factors such as lifestyle changes, environmental stressors, and socio-economic pressures. Non-communicable diseases like cardiovascular diseases, cancer, and diabetes have risen sharply, attributable principally to behavioural risk factors such as tobacco use, unhealthy diet, and physical inactivity (WHO, 2023).

Workplaces play a pivotal role in influencing physical and mental health outcomes, not only because individuals spend a significant portion of their lives working. Work environments can either exacerbate or mitigate health risks; occupational hazards, high job demands, and stressful work conditions contribute to health deterioration, while supportive workplaces can promote healthy behaviours and wellbeing (Clougherty et al., 2010). Employers thus hold substantial responsibility in shaping health outcomes through organisational policies, workplace culture, and the provision of health-promoting resources.

In the Czech Republic, as in most developed countries, there have been considerable shifts in work patterns, lifestyle choices, and health behaviours. The transition from traditional industries to service-oriented sectors has altered the nature of work, often increasing sedentary behaviours and reducing physical activity levels among employees (Cedefop, 2024). At the same time, unhealthy dietary habits and smoking, although with decreasing prevalence, present ongoing challenges to public health and place increasing strain on health systems (OECD, 2023).

In a recent study, we explored the associations among quality of working life indicators, measured through the Subjective Quality of Working Life index (SQWLi; Vinopal, 2011), and health in the Czech Republic (Štěpánek, 2022). The research highlighted a significant correlation, particularly between mental health and QWL, suggesting that employees with better mental wellbeing reported higher satisfaction across various work-life domains. Building upon these findings, the present study examines longer-term trends in health determinants in the Czech Republic. By incorporating additional health behaviours—including smoking, fruit and vegetable consumption, and physical activity—we seek to provide a more holistic view of the health landscape. We also compare the trends with those across Europe.

Health factors

The determinants of health extend beyond individual biology to encompass lifestyle choices, social interactions, and the conditions in which people live and work (Marmot & Wilkinson, 2005). Among lifestyle choices, smoking, diet, alcohol consumption, and physical activity stand out as significant contributors to health status. While smoking and excessive alcohol consumption increase mortality and morbidity mainly directly, diet and physical activity have substantial indirect effects, particularly through obesity, high blood pressure, cholesterol, and blood sugar levels, further increasing their importance for long-term health (Brauer et al., 2024). Recent research also highlights a close association with mental health in both directions; poor lifestyle habits can worsen mental health, and poor mental health may negatively influence lifestyle choices (Grajek et al., 2022; Hautekiet et al., 2022).

Figure 1 shows the most recent population-representative data on the prevalence and changes in key lifestyle risk factors and obesity. Smoking prevalence has been decreasing over time but still remains above the EU-27 average and is one of the leading preventable causes of morbidity and mortality worldwide. It is associated with a range of chronic conditions, including cardiovascular diseases, respiratory illnesses, and various forms of cancer (WHO, 2019a). Although low levels of alcohol consumption have not been shown to have significant negative impacts—and may even have some protective effects—excessive alcohol consumption is an important risk factor for population health, with only slight decreases observed over time.

Adequate consumption of fruits and vegetables is associated with a reduced risk of chronic diseases and improved overall health (Boeing et al., 2012). However, most of the Czech and European population still fails to meet the recommended intake levels of five portions of fruit and vegetables per day, often due to lifestyle factors, socio-economic constraints, or lack of awareness. As shown in Figure 1, there was virtually no change in risk prevalence, although the proportion of individuals who eat no fruit or vegetables at all slightly decreased.

Lastly, the prevalence of both low physical activity and obesity has been increasing over time in line with overall lifestyle changes, posing an increasingly pressing population-level issue.

Figure 1: Prevalence of behavioural risks in the Czech Republic and EU-27 average, 2014 to 2019 comparison (Source: Eurostat, 2024)

Critically, there is an uneven distribution of risk in the population, perhaps best characterised by variance across income groups. Figure 2 shows a comparison of the five risk factors across income quintiles, highlighting the higher overall risk for low-income groups, driven particularly by low physical activity and higher obesity rates. On the other hand, the levels of dietary risk, smoking, and alcohol consumption are mostly equivalent across the five groups. This dynamic adds nuance to the overall picture; while the risks are prevalent in the population as a whole, vulnerable groups in society require particular attention.

Figure 2: Prevalence of behavioural risks in the Czech Republic in 2019, by income quantile (Source: Eurostat, 2024)

Changes in overall health

The underlying risk factors have direct implications for overall physical and mental health, which, in turn, affect an individual’s overall quality of life. Figures 3 and 4 show the changes in self-reported overall physical health and depressive symptoms in the Czech Republic and the EU-27 over time, as well as the variance across income groups.

Self-reported physical health remained relatively stable from 2014 to 2022, with slight fluctuations, particularly around the COVID-19 pandemic, where the share of individuals reporting very good health increased but subsequently partially returned to previous levels. There is a clear socio-economic gradient in physical health: individuals in higher income quintiles are more likely to report good health compared to those in lower income quintiles. As outlined above, this may be due to differences in access to healthcare services, nutritious food, safe living conditions, and opportunities for physical activity (Marmot, 2010).

 
Figure 3: Overall self-reported physical health in the Czech Republic, over time and by income quantile (for 2023 data) (Source: Eurostat, 2024)

Mental health trends are somewhat more concerning. Although the prevalence of depressive symptoms in the Czech population is distinctly below that of the EU-27 average, mental health problems have been on the rise, increasing from 6% to 8% between 2014 and 2019. Further analysis again highlights a pronounced inverse relationship between income levels and the prevalence of depressive symptoms, with just 3% of the highest-earning individuals showing depressive symptoms compared to 16% among the lowest earners. Lower-income individuals may face heightened financial insecurity, limited access to mental health services, and increased exposure to stressors, all contributing to poorer mental health outcomes (Butterworth et al., 2011).

 
Figure 4: Prevalence of depressive symptoms in the Czech Republic, over time and by income quantile (for 2023 data) (Source: Eurostat, 2024)

Health and quality of working life

As shown in Štěpánek (2022), there is a direct link between physical and mental health and the overall quality of working life (see Figure 5). Specifically, individuals reporting worse physical and mental health are more likely to report lower satisfaction with their overall QWL. However, the importance attributed to different aspects of working life remains relatively consistent across health categories, suggesting that while health status affects satisfaction levels, it does not significantly alter what employees consider important about their work.

Figure 5: Distribution of importance of quality of working life domains and satisfaction with them, by overall physical and mental health status (Source: Adapted from Štěpánek (2022) - Colour-coding represents individual’s health status. See the original paper for data definitions and more information)

As discussed in the original paper, the existing literature suggests that this is in fact a bi-directional relationship, i.e., that poor health can affect quality of job opportunities, impaired cognitive function, lower motivation, and strained work relationships, hence decreasing quality of working life. At the same time, given the average time spent working each day and the effect of work on individual’s mental state both at and outside of work, quality of working life – i.e., the combination of the work environment, time requirements, relationships at work, and more – clearly affects individual’s physical and mental health as well.

The intricate link between health and quality of working life emphasises the pivotal role employers play in maintaining a healthy workforce. Employers can initiate comprehensive health promotion programmes that address key lifestyle factors. For instance, providing smoking cessation support, including access to counselling and nicotine replacement therapies, can significantly reduce smoking rates among employees (Cahill et al., 2014). Establishing smoke-free policies further reinforces a culture of health and protects non-smokers from second-hand smoke.

Nutritional interventions in the workplace can improve dietary habits. Employers might offer healthy meal options in cafeterias, provide fruit and vegetable snacks, and organise nutritional education sessions (Bertéus Forslund et al., 2012). Such initiatives have been shown to increase the intake of nutritious foods and reduce the consumption of unhealthy options.

Promoting physical activity is another area where employers can make a substantial impact. While cycling to work is less common in the Czech Republic compared to countries like the Netherlands or the UK, other interventions can be effective. Organising workplace fitness classes and encouraging regular movement breaks can help reduce sedentary behaviour. More importantly, flexible work arrangements, such as adjustable schedules or remote working options, can enable employees to incorporate physical activity into their routines more effectively (Kelliher & Anderson, 2010).

Addressing mental health issues is perhaps more challenging. Employers should foster an organisational culture that promotes interest in mental health issues, encouraging open dialogue and support-seeking behaviours (Corrigan et al., 2014). Providing access to mental health resources, such as employee assistance programmes, counselling services, and stress management workshops, can help employees cope with psychological challenges (Nigatu et al., 2016). Training managers to recognise signs of mental distress and respond appropriately is also essential.

Implementing these health-promoting strategies can yield significant benefits for businesses. Improved employee health is associated with increased productivity, reduced absenteeism, and lower healthcare costs (Goetzel & Ozminkowski, 2008). Enhanced job satisfaction and morale can lead to better staff retention and a more positive organisational climate. Moreover, companies that prioritise employee wellbeing may gain a competitive advantage in attracting talent and enhancing their corporate reputation.

From a societal perspective, healthier workforces contribute to broader public health goals by reducing the burden of chronic diseases and associated healthcare expenditures. Employers’ efforts to improve health can complement government initiatives and support the achievement of national health targets.

Socio-economic disparities in health, as highlighted by the differences in health outcomes across income quintiles, necessitate tailored interventions. Employers should ensure that health promotion activities are accessible and relevant to all employees, regardless of their occupational level or income. This may involve offering programmes during paid work time or addressing specific barriers faced by lower-income employees.

Conclusion

The still high prevalence of smoking, inadequate fruit and vegetable consumption, low physical activity levels, and increasing obesity rates have been an increasing public health concern. While people’s overall perceived physical health has remained mostly constant over time, worsening mental health and its link to quality of (working) life add to the list of issues for the employers and the policymakers.

Building upon the findings of Štěpánek (2022), which showed a link between mental health and QWL, this research argues that employers play a key role in promoting health and enhancing the quality of working life. By implementing evidence-based interventions that address key health determinants—such as smoking cessation programmes, nutritional support, opportunities for physical activity, and mental health resources—employers can significantly improve employee well-being. These efforts not only benefit individual employees but also yield positive outcomes for businesses through increased productivity, reduced absenteeism, and improved staff retention.

Key to this effort is addressing socio-economic disparities in health through targeted interventions that are accessible to all employees, regardless of income level. Employers should adopt inclusive strategies that consider the specific needs and barriers faced by different groups within the workforce.

Dedikace

References

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Vzorová citace

ŠTĚPÁNEK, Martin. Health and quality of working life: current trends. Časopis výzkumu a aplikací v profesionální bezpečnosti [online]. 2024, roč. 17, č. 3-4. Dostupný z: https://www.josra.cz/vydani/clanek/health-and-quality-of-working-life-current-trends. ISSN 1803-3687.

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