Why are some people never ill? And how can employers and employees cut sick days?

Having worked for Bramwith Consulting for the last eight years, I have had zero sick days, so I am naturally rather sceptical when someone calls in sick. I’ve worked for companies who record absences from work, both holiday booked and sick days, and can see that some people have over 10 sick days per year, every year. Have you ever wondered why some people are always sick and others are always healthy?  I have. Is it genetics or psychological? Is it cultural? And what can we do as employees and employers to stay healthy?

Some context: why genuine sickness and “taking sickies” are such a problem for employers?

A small business with 75 employees could save £500,000 a year by tackling sickness absence, according to a simple calculator provided by The British Heart Foundation.

The annual cost of UK workplace absence is £18 billion, according to a 2017 report from the Centre of Economic and Business Research. With an aging workforce, the report predicts that absence could cost the UK economy £21bn in lost productivity by 2020. There are also indirect costs of absenteeism such as hiring temporary staff or overtime and lost service or production time.

These are staggering figures, yet government figures point to an improving trend in sickness absence. About 137m working days were lost from illness and injury in 2016, said the Office for National Statistics (ONS), equivalent to 4.3 days per worker, the lowest rate since 1993, when it was 7.2 days.

Direct comparisons with other countries are difficult as monitoring and approaches differ and there appears to be little research looking at the issue world-wide. However, in 2013, research from accountancy firm, PwC said that workers took the following average sick days per year:

  • UK – 9.1 days
  • US – 4.9 days
  • Asia-Pacific – 2.2 days
  • Western Europe – 7.3 days

Where comparisons exist, it’s more likely that a country’s statutory approach to sick pay can impact on the numbers and so can paid leave entitlement. In 2011 the Kronos Global Absence Survey looked at full-time and part-time employees in the U.S., Canada, the UK, France, Australia, Mexico, China and India.  When it came to employees admitting to calling in sick when they were not sick, the poll found China led the regions surveyed, with 71 percent of employees admitting to “pulling a sickie”, 43 percent in the UK, and France had the smallest number with only 16 percent. France had the most generous paid leave entitlement whereas China had the least…..

And why were they falsely claiming to be ill?  In the Kronos survey, the overwhelming response in every region was that employees felt stressed and therefore needed a day off: 71 percent in Canada, 62 percent in the U.S, 60 percent in China, 57 percent in the UK, 53 percent in France, 51 percent in Australia, 46 percent in Mexico and 44 percent in India. Other reasons included needing to take care of a sick child, having too heavy a workload and not having enough paid leave.

There is a growing awareness of mental health issues globally and mental health problems seem to be on the rise, without adequate understanding, compassion or means to help those affected. So when we are talking about people being ill or “taking sickies” we are referring to those with both physical and mental illnesses. As mentioned, stress alone accounts for a large proportion of sick days directly or indirectly.

Are some people inherently healthier?

In short, no….and yes. In our lifetime, we will all get around 200 colds, though it does appear that some people are struck down worse than others and some recover quicker. Saying this from researching, there doesn’t appear to be any evidence to back this us, “it’s pretty much hearsay and self-reporting,” says Dr Natalie Riddell, a lecturer in immunology at the University of Surrey and spokesperson for the British Society for Immunology. “I need more evidence before I can believe these people really exist.”

“Some of us inherit a set of immune system genes that are particularly good at dealing with one particular virus” explains Daniel Davis, professor of immunology at the University of Manchester. “But that is not to say that you or I would have a better or worse immune system. All it means is that you would deal with a particular flu virus better than me. There is an inherent diversity in how our immune systems respond to different diseases and that diversity is essential to how our species survives disease.”

 

So why are some people ill less and are better at fighting off illness?

Ann Robinson, GP and Guardian newspaper contributor comments: “Maybe people at the top end have been primed through early exposure to bugs, fully vaccinated, and so on,” Robinson says. “Each person is wired to be slightly better at fighting off some illnesses and slightly worse at fighting off others” is how Davis explains it. Davis points to growing evidence that our gut microbiome – the range and quantity of microbes in our guts – impacts the immune system. So there is a link between diet and immunity? “It’s a hot topic,” Davis says, carefully. “Although gut microbiome directly affects the immune system, precisely how isn’t yet clear.”

Have you ever wondered why doctors and nurses are never ill or rather aren’t ill more often considering their daily exposure to every illness imaginable? The argument continues that there daily interaction with bugs gears their bodies up to a level of immunity to getting sick. You could say that there body has been immunised against other bugs through interaction and their body is on high alert. This also shows the importance as a child of having interaction with other children, getting those colds and bugs which allows us all to be more immunised against illness in later life.

 

So if it isn’t down to genetics, then how can we remain healthier and get better (and back to work) quicker

1. Good nutrition“Recent evidence suggests that good nutrition is essential for our mental health and that a number of mental health conditions may be influenced by dietary factors.” according to https://www.mentalhealth.org.uk. The argument follows that eating nutritious, healthy food affects both short term and long term development management and prevention of specific mental health problems such as depression, schizophrenia, attention deficit hyperactivity disorder and Alzheimer’s disease. It is stated that nearly 2/3rds of people who do NOT report daily mental health problems, eat fresh fruit or fruit juice every day, compared to less than half of those who report mental health problems. The office fruit bowl is a natural way firms look to pump their staff full of good food, ensuring they stay healthy.

2. Exercising regularly – According to the NHS website It’s essential to “exercise regularly if you want to live a healthy and fulfilling life into old age. It’s medically proven that people who do regular physical activity have”:

  • up to a 35% lower risk of coronary heart disease and stroke
  • up to a 50% lower risk of type 2 diabetes
  • up to a 50% lower risk of colon cancer
  • up to a 20% lower risk of breast cancer
  • a 30% lower risk of early death
  • up to an 83% lower risk of osteoarthritis
  • up to a 68% lower risk of hip fracture
  • a 30% lower risk of falls (among older adults)
  • up to a 30% lower risk of depression
  • up to a 30% lower risk of dementia”

Not only is in universally proven that people who exercise regularly are physically healthier, but they are also happier, have higher self-esteem, have better sleep quality and energy so are less prone to mental health issues. “If exercise were a pill, it would be one of the most cost-effective drugs ever invented” says Dr Nick Cavill, a health promotion consultant.

What counts as regularly exercising? To stay healthy, adults should endeavour to be active daily and achieve at least 150 minutes of physical activity over a week. This can include, walking, cycling, running, basically anything that raises your heart rate, breathe faster and feel warmer (moderate intensity activities). Furthermore, vigorous intensity activities (working your heart harder) has even more health benefits above moderate intensity activities. So maybe walk to the station rather than getting the bus and ideally run home from work rather than getting the train.

More and more firms have gyms on-site or offer gym membership to their staff as a staff incentive but also a means to keep them healthier and in work more regularly! Have you noticed that increasingly successful people are super fit, many running marathons, doing “Iron Mans”. Healthy body equals a healthy mind and vice-versa.

3. The power of the mind in keeping healthy and healing you – A placebo is anything that appears to be real (such as taking a sugar pill when you’re ill) that medically has no positive impact on getting you better. “The placebo effect is more than positive thinking — believing a treatment or procedure will work. It’s about creating a stronger connection between the brain and body and how they work together” says Professor Ted Kaptchuk of Harvard-affiliated Beth Israel Deaconess Medical Center, whose research focuses on the placebo effect.

Placebos won’t lower your cholesterol or shrink a tumour. Instead, they work on symptoms modulated by the brain, like the perception of pain. “Placebos may make you feel better, but they will not cure you” says Kaptchuk. “They have been shown to be most effective for conditions like pain management, stress-related insomnia, and cancer treatment side effects like fatigue and nausea.”

This brings to a head the idea of people thinking they are ill or healthy and using positive thinking or use of a placebo to make them better quicker. So if you view yourself as a “healthy person, who is never ill”, this becomes a bit of a self-proclaimed prophecy and the opposite also applies.

4. Quality sleep – There is a clear link between sleep and your mood and resulting health. This works both ways, so when you are stressed and unhappy you find it hard to sleep, and when you don’t sleep, you are stressed, unhappy and more susceptible to physical illness. Dr Lawrence Epstein sums this up:

“Poor or inadequate sleep can cause irritability and stress, while healthy sleep can enhance well-being. Chronic insomnia may increase the risk of developing a mood disorder, such as anxiety or depression. Poor sleep and feelings of depression or anxiety can be helped through a variety of treatments, starting with improved sleep habits, and, if needed, extending to behavioural interventions and an assessment for a sleep or mood disorder.”

There is a difference between lots of sleep and quality sleep. It’s important for your body and (probably more importantly) your brain, to relax, turn off or go into automatic so to speak and this means allowing your brain to go into a deep REM sleep. Stress is an inhibitor of this, as is alcohol, caffeine and other drugs so cut them out in the afternoon and evening in particular. Having a long, uninterrupted sleep is vital to staying healthy and when you are ill, getting better.

Finishing work at a reasonable hour is an important part of this, allowing employees to get home, unwind before going to bed, allowing them a good night sleep, ready to attack their next day with gusto.

5. Reduce stress – Unfortunately everyone will have to manage stress as a daily part of their personal and professional lives. The ratio of where the stress comes from will vary from person to person and from one day to another, so once we accept that stress is a by-product of life, it’s important to find ways to manage it as a person and as an employer of people.

Stress creates a sense of urgency at work and ensures employees work effectively and efficiently but too much pressure creates a negative environment and lowers performance. Managers need to check frequently and keep an eye out for the signs of over stressed workers to find out how their team are coping with their workloads and re-assign tasks accordingly.

6. Lower working hours equals more productivity – According to the Guardian newspaper, more than 6 million British workers work more than 45 hours per week. By comparison, workers in the Netherlands work five hours a week less and the Germans work 6 hours less than the British according to the OECD. Germany in particular is renowned for having the best economy in Europe, so this does raise the question of employers introducing a more productive but shorter working week?

The answer is yes. Productivity output per working hour actually improves with shorter hours. Across the world’s richest countries, higher productivity correlates with lower working hours (see also OECD data). Ford’s original workers were found less productive working more than 40 hours a week, a situation likely to be even more the case for people who work with knowledge rather manually – who ever had their best ideas when they were exhausted?

All this means that we may well be able to work a shorter week and get just as much done. The 20th-century British economist John Hicks said: “It has probably never entered the heads of most economists … that hours could be shortened and output maintained.” Less hours at work, more time to relax, exercise and less need to “take sickies”!

 

All these points seem pretty logical but what do you think? Do you agree with my 6 points? Do you or your employer have any other ideas of keeping everyone healthy and getting back to work quicker? Please comment here or e-mail me (Ben) at b.riley@bramwithconsulting.co.uk


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