By Joseph G. Grzywacz

Wake Forest University School of Medicine

Advocates are increasing interested in the potential health implications of workplace flexibility, largely for practical reasons. Public health advocates have observed that pressing health problems, like the obesity epidemic in adults and children and the growing burden of depression, have followed social and economic trends that have made adults’ daily work and family lives more complex. These advocates suggest that solutions that simplify adults’ daily work and family lives, like allowing workers to work from home or “flex” their schedule, may have substantial public health implications. Organizational advocates are interested in health because it underlies organizational costs (e.g., insurance claims) and workers’ ability to perform on the job. Flexibility, to the extent it can be linked to health, therefore may provide a very concrete way of bolstering organizational success.

Research on workplace flexibility and health is accumulating; however, important limitations impede strong conclusions about the health-related implications of workplace flexibility. Two issues, in particular, are important. First, most research to date uses cross-sectional designs, so we don’t know if flexibility contributes to health or if health influences the types of work arrangements people find themselves in. Second, research focuses almost exclusively on perceived flexibility. Workers’ perceptions of flexibility are important; however, they are also difficult to interpret (particularly in observational studies) because it is unclear if environmental factors or personal factors contribute to variation in perceived flexibility. Put another way, it is unknown if perceived flexibility reflects something the organization has done or is doing, or if it represents an attribute of the individual, like sense of control, that shapes reporting and interpretation of events.

The goal of my Alfred P. Sloan Foundation funded project is to explore the potential health implications of workplace flexibility. To achieve this goal, existing data from adults employed by a large pharmaceutical company were used to: 1) determine if formalized flexible work arrangements (i.e., compressed workweeks, flextime, telework) and informal flexibility (i.e., perceived flexibility) are associated with health; 2) delineate if formalized flexible work arrangements and informal flexibility are associated with lifestyle behaviors; and 3) identify if formalized flexible work arrangements and informal flexibility contribute to changes in lifestyle behaviors or health. The data used to accomplish these aims focuses on longitudinal self-report data from health risk appraisals, and incorporates data from the organization’s human resources system (e.g., type of flexible work arrangement, job grade) as well as archived data (e.g., sickness disability days).

Data analyses are in the early stages. Simple comparisons indicate differences in several domains of health by flexible work arrangement: part-time workers and remote workers have generally better health, workers with flexible schedules have intermediate levels of health, and individuals working compressed work weeks have the poorest health. However, changes in health do not differ by flexible work arrangement. Changes in health are associated with perceived flexibility: individuals who reported less flexibility in 2005 than 2004 reported poorer self-rated health and more health-related impairment at work. Preliminary analyses suggest that recovery behaviors like exercise and sleep may account for these health effects.

We are now beginning to refine our analyses. We are developing models focused on health outcomes with direct implications for businesses, like impaired work performance and work-loss time. Other analyses are focusing on health behaviors, particularly those like exercise and adequate sleep that sustain health, as well as clinical behaviors like colorectal cancer screening and mammograms that are particularly important in an aging workforce. Collectively, the results of these analyses will provide information about the potential of workplace flexibility to improve the health and performance of working individuals.