Science Space
Health Impact Assessment (HIA) in Employment Strategies
The Institute of Preventive Medicine (IMP) of the Faculty of Medicine of Lisbon (FML) / University of Lisbon (UL), in partnership with the Doutor Ricardo Jorge National Health Institute, IP (INSA) and the High Commission for Health (ACS), is carrying out a multi-year project (2009-2014) with the following stages:
• Identify health determinants connected to employment and work-family balance;
• Study health and social inequalities;
• Carry out risk assessments in a psycho-social context to ascertain the relative weight of health determinants targeted at risk and protection factors;
• Make recommendations and develop a risk management programme in the context of mental health promotion and prevention of mental illness, stemming from analysis fuelled by the best available data;
• Assess the health impact to test the aforementioned programme, using models and tools that will emphasize the mental component as an integral part;
• Implement the programme in the company.
The aim is to have a better understanding of how work is organized and of associated psycho-social and biological factors that influence the gradient between health and disease. Individual response to stress may be linked to the sense of coherence and resilience in the workplace, and chronic exposure to stress may affect health in a myriad of behavioural, biochemical, hormonal and metabolic ways.
Workers exposed to the demands of the workplace and family life are at high risk of presenteeism (decreased work quality and productivity), physical and mental disease and absenteeism. Employment policies have a positive or negative impact on the mental health of individuals and on health equity.
Both health determinants and health impact assessment are key areas listed in the National Health Plan and which were reinforced in the Portuguese EU Presidencies, and which are relevant for the information to be given to decision-makers and in choosing and implementing healthier public policies.
In this context, following a cross-sectional exploratory study of a sample of workers of a selected company in the municipality of Lisbon, the following will be identified and analysed using appropriate tools and methodologies: socio-demographic characteristics, individual and family characteristics, type of job and psycho-social environment in the workplace, impact on health and psychological morbidity, absenteeism, productivity and health inequities. The objective is to promote health at work, in collaboration with Occupational Health, Primary Health Care (CSP) and other sectors outside Health.
This project is an innovative contribution to change health and social conditions; to identify prolonged absenteeism predictors and presenteeism indicators; to invest in the training of professionals from several sectors in the areas of health impact assessment and evaluation of psycho-social risk, in terms of health across all policies; to share good practice and knowledge experience at national and international levels; to improve employment policies and strategies and organization of work, maximizing resources and changing behaviours, with an impact on public health, on the actual health systems and on the economy.
Maria João Heitor
Head of Psychiatry Department
Bibliographical References
Artazcoz, L. et al. (2005) Social inequalities in the impact of flexible employment on different domains of psychosocial health. Journal of Epidemiology and Community Health 59, 761-767.
Cooper, C., Dewe, P. (2008) Well-being – absenteeism, presenteeism, costs and challenges. Occupational Medicine 58, 522-524.
Grzywacz, J.G., Carlson, D.S. (2007) Conceptualizing work-family balance: Implications for practice and research. Advances in Developing Human Resources, Vol. 9, no. 4, 455-471.
Heitor dos Santos, M. J., Pereira Miguel, J.M. (2009) Avaliação do impacte de políticas e medidas de diferentes sectores na saúde e nos sistemas de saúde: Um ponto de situação. Revista Portuguesa de Saúde Pública, vol. 27, no.1, 5-17.
Kivimaki, M., Vahtera, J. et al. (2003). Temporary employment and risk of overall and cause-specific mortality. American Journal of Epidemiology, vol. 158, Issue 7, 663-668.
Marmot, M. & Wilkinson, R. (eds.) (2006) Social Determinants of Health. 2nd edition. Oxford: Oxford University Press, 97-130.
OECD (Organization for Economic Cooperation and Development (2004) Babies and Bosses: Reconciling work and family life. New Zeland, Portugal and Switzerland. Volume 3. Direcção-Geral de Estudos, Estatística e Planeamento.
Project coordinator: Maria João Heitor, Maria de Fátima Reis, Maria do Céu Machado, José Pereira Miguel
Operational team: Maria João Heitor, Joana Carreiras, Marta Godinho, Pedro Aguiar
Data on absenteeism associated with mental health problems
40% of absence from work due to illness
70 million days lost each year
Annual cost: £8.8 billion.
Source: Cooper & Dewe, 2008
• Identify health determinants connected to employment and work-family balance;
• Study health and social inequalities;
• Carry out risk assessments in a psycho-social context to ascertain the relative weight of health determinants targeted at risk and protection factors;
• Make recommendations and develop a risk management programme in the context of mental health promotion and prevention of mental illness, stemming from analysis fuelled by the best available data;
• Assess the health impact to test the aforementioned programme, using models and tools that will emphasize the mental component as an integral part;
• Implement the programme in the company.
The aim is to have a better understanding of how work is organized and of associated psycho-social and biological factors that influence the gradient between health and disease. Individual response to stress may be linked to the sense of coherence and resilience in the workplace, and chronic exposure to stress may affect health in a myriad of behavioural, biochemical, hormonal and metabolic ways.
Workers exposed to the demands of the workplace and family life are at high risk of presenteeism (decreased work quality and productivity), physical and mental disease and absenteeism. Employment policies have a positive or negative impact on the mental health of individuals and on health equity.
Both health determinants and health impact assessment are key areas listed in the National Health Plan and which were reinforced in the Portuguese EU Presidencies, and which are relevant for the information to be given to decision-makers and in choosing and implementing healthier public policies.
In this context, following a cross-sectional exploratory study of a sample of workers of a selected company in the municipality of Lisbon, the following will be identified and analysed using appropriate tools and methodologies: socio-demographic characteristics, individual and family characteristics, type of job and psycho-social environment in the workplace, impact on health and psychological morbidity, absenteeism, productivity and health inequities. The objective is to promote health at work, in collaboration with Occupational Health, Primary Health Care (CSP) and other sectors outside Health.
This project is an innovative contribution to change health and social conditions; to identify prolonged absenteeism predictors and presenteeism indicators; to invest in the training of professionals from several sectors in the areas of health impact assessment and evaluation of psycho-social risk, in terms of health across all policies; to share good practice and knowledge experience at national and international levels; to improve employment policies and strategies and organization of work, maximizing resources and changing behaviours, with an impact on public health, on the actual health systems and on the economy.
Maria João Heitor
Head of Psychiatry Department
Bibliographical References
Artazcoz, L. et al. (2005) Social inequalities in the impact of flexible employment on different domains of psychosocial health. Journal of Epidemiology and Community Health 59, 761-767.
Cooper, C., Dewe, P. (2008) Well-being – absenteeism, presenteeism, costs and challenges. Occupational Medicine 58, 522-524.
Grzywacz, J.G., Carlson, D.S. (2007) Conceptualizing work-family balance: Implications for practice and research. Advances in Developing Human Resources, Vol. 9, no. 4, 455-471.
Heitor dos Santos, M. J., Pereira Miguel, J.M. (2009) Avaliação do impacte de políticas e medidas de diferentes sectores na saúde e nos sistemas de saúde: Um ponto de situação. Revista Portuguesa de Saúde Pública, vol. 27, no.1, 5-17.
Kivimaki, M., Vahtera, J. et al. (2003). Temporary employment and risk of overall and cause-specific mortality. American Journal of Epidemiology, vol. 158, Issue 7, 663-668.
Marmot, M. & Wilkinson, R. (eds.) (2006) Social Determinants of Health. 2nd edition. Oxford: Oxford University Press, 97-130.
OECD (Organization for Economic Cooperation and Development (2004) Babies and Bosses: Reconciling work and family life. New Zeland, Portugal and Switzerland. Volume 3. Direcção-Geral de Estudos, Estatística e Planeamento.
Project coordinator: Maria João Heitor, Maria de Fátima Reis, Maria do Céu Machado, José Pereira Miguel
Operational team: Maria João Heitor, Joana Carreiras, Marta Godinho, Pedro Aguiar
Data on absenteeism associated with mental health problems
40% of absence from work due to illness
70 million days lost each year
Annual cost: £8.8 billion.
Source: Cooper & Dewe, 2008
