By Ruth Brousseau and Irene Yen

Work and health are two important aspects of individual lives. In a public health context, the phrase "work and health" often connotes occupational health and safety. When The California Wellness Foundation’s board of directors decided upon Work and Health as a priority area, it stretched this traditional meaning of "work and health" by funding a broad array of interventions to improve the health of Californians through approaches related to employment.

Through the many funding applications we have reviewed, grants we have made and conversations we have held with researchers and practitioners around the state, we have identified a number of important connections between the domains of work and health in addition to the traditional public health starting point of occupational health and safety. The purpose of this paper is to share what we have learned about the multiple relationships between work and health and some of the challenges we face working in this area.

Work is clearly an important component of most Californians’ lives. In the year 2000 the California economy is booming, bringing unprecedented levels of employment to most of our citizens. There are 16 million people employed in our state, which equals nearly three-quarters of the population ages 18 to 64.¹ Many people work long days. Nearly three in 10 people (29%) are working more than a standard 40 hours per week year-round, amounting to about one-third of employees working the equivalent of a 15-month year.² Yet in the midst of this unprecedented prosperity some 800,000 are unemployed, and welfare reform and time limits have underscored the importance of obtaining work for those who do not have jobs.

Work is also very much a part of family life. Because of changing patterns of employment over the last thirty years, particularly among women, work and family life are closely intertwined. Fifty-four percent of mothers with children under the age of 18 living with them are employed. Moreover, as the 1998 federal welfare reform provisions begin to take full effect, some 700,000 adult aid recipients, most of them mothers with young children, are already entering the workforce or beginning to make the transition to employment.

Work affects neighborhoods and communities. The presence or absence of work and how it is distributed has an influence on the quality of life within the geographic boundaries that people consider home. Consequently, people’s social networks, neighborhoods and communities also affect the resources upon which people can rely to find a job and move up economically. Clearly, work is a critical plank in people’s place in society.

A healthy workforce is also important to a healthy economy. Health expenditures in California were estimated to be $137 billion in 1996, accounting for approximately 12 percent of California’s gross domestic product. Private employers bear a significant portion of those costs, including mandated contributions to short- and long-term disability insurance as well as workers compensation and voluntary provision of health insurance benefits. They must also absorb the cost of workdays lost to illness and other conditions such as depression, which can undermine productivity.

Given the central importance of work in the lives of individuals, families, communities, neighborhoods and society, we believe that it is important to understand its multiple relationships to health. The approach we use below is threefold: l) to describe some of the connections between work and health in the research literature; 2) to provide a brief outline of TCWF’s grantmaking in this area to date, and 3) to share some initial observations about possible challenges for funders who might choose to work in this dynamic area.