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Thursday, June 24, 2021

Work Hours are Deadly?

Bad news for those of us putting in those long hours? The British Broadcasting Corporation (BBC) recently reported that "Long working hours (are) killing 745,000 people a year, study finds." That is a fair number, but that conclusion must be tempered with the caveat that it is a worldwide figure. There are 7.8 billion people on this planet, so that is not even close to one percent of the population; in fact, it is about one one-hundredth of one percent. There are those who see population growth alone as a threat to health and welfare, but that is for another day. 

The BBC article cites a World Health Organization report, which may cause some to pause. The WHO response to the pandemic has not been overwhelmingly positive. Some have been critical of the varying mask advice, others of the bureaucracy. The organization is said to be currently considering a color-coded pandemic threat scale, which may be as useful as the National Terrorism Advisory System. Ask yourself if you know how your behavior is supposed to change when the terrorist advisory color changes. What would a color-coded pandemic scale add to our knowledge? Would its implementation or deployment be more seamless than other WHO performances the last 18 months?

This WHO global study is focused on 2016 and the headline is somewhat misleading. Those 745,000 people actually died "from stroke and heart disease" which is being attributed to "long hours" at work. That can be a problem with academic research, and with news headlines that oversimplify conclusions (purposefully or as a result of brevity). There is no cause and effect per se here, but an association of work hours and the frequency of stroke and heart disease. Essentially, they gathered self-reported work-hour information from patients who suffered those events and drew correlative conclusions. 

Essentially, stroke and heart attack victims tend to work longer hours. That could be a cause and effect or could be an interesting correlation instead. This may be a faulty cause and effect fallacy, post hoc, ergo propter hoc. If it is not, one might expect that the article would provide greater insight as to the actual causation. Stated otherwise, were similar people (age, gender, socio-economics) who did not suffer stroke and heart attack surveyed regarding work hours? 

If it turned out that a similar percentage of that whole population segment (age, gender, socio-economics) worked long hours without the particular medical complaint, you might doubt the cause and effect, or perhaps at least question what else might contribute to the heart attack and stroke risk. Is it possible that people who work long hours are less likely to have time for exercise? Do people working long hours tend to eat less healthy (fast) food? Is it likely that people working long hours may have other socio-economic similarities worthy of study and consideration?

The BBC reports those who worked "55 hours or more a week" presented a "35% higher risk of stroke and a 17% higher risk of dying from heart disease" than those who worked "5 to 40 hours." But, that work hour distinction was the solitary study focus. Most of those who passed away were men, and there was predominance in the geography of Asia and the Pacific Rim. Thus, the headline might read "Long work hours fatal for men" or some other similar oversimplification. 

Fortunately, the report concludes, only about 9% of the population works these "long hours." There was concern because of perceptions that the pandemic resulted in many working more hours rather than less. The advent of telecommuting alone is said to have resulted in an increase as people took that two hours per day of commuting time and devoted it to productive work. Some believe the eight-hour workday evolved to ten as a natural consequence for some workers. Others note that some employment became sporadic in the pandemic, leading some to undertake second jobs. 

Notably, there are also those who appear disinclined to return to work. Small businesses report struggles in finding employees. I recently called to order a pizza at a small-town, local favorite while traveling. The phone went unanswered and I presumed it had closed. The next night, I found it open. When I inquired, the manager described closing on Mondays as a consequence of the inability to hire workers. This is certainly anecdotal. But, as I meander through life here in paradise, it seems every business has a "help wanted" sign out. So, whether the increased work hours are or are not a defacto result of the pandemic may be worthy of discussion and debate. 

The BBC continues, characterizing the report as concluding that working long hours are "estimated to be responsible for about a third of all work-related disease." It claims the impacts of work are twofold. First, longer hours create physiological stress on the body. However, more intriguing, the authors conclude that longer work hours contribute to "health-harming behaviors such as tobacco and alcohol use, less sleep and exercise, and an unhealthy diet." Why not ask those surveyed "Do you smoke," or "Do you exercise?"

Thus, in the end, the conclusions of work hours being unhealthy are actually conclusions about personal choices. The physiological stress on the body is one thing. That is worthy of consideration and study. Is work causing that stress? And, taking a page from our workers' compensation constructs, is that work stress any greater than those people experience in their non-occupational environment? This is a tighter examination of causation than this particular study finds worthy. 

But more importantly, this final conclusion leads us back to the probability that its conclusions are fallacy. Longer work hours somehow contribute to tobacco and alcohol use? The more one works, the more likely one is to smoke? There is no scientific support cited for any cause and effect there. These are, at least until proven otherwise, not cause and effect. They are concurrent findings. It may be that smoking and alcohol use are more prevalent in the socioeconomic groups that work long hours. Coincidence is not causation. That long hours are similarly associated with poor diet, without more, may also be a coincidence without correlation. It is unfortunate that the news would conclude causation without more.

Certainly, there is easier acceptance of the "less sleep and exercise." These are two things that require time. If one is engaged in long hours of work, in a world of finite minutes, there are fewer minutes each day for sleep and exercise. That is a logical conclusion. However, I know many people who work very long hours and yet still find ample time to both sleep and exercise. Therefore, we return to the assumption that coincidental findings equal causation. 

In the end, the article and study may cause us to ask questions. In a very superficial sense, perhaps it reminds us of what is important. Eating right, avoiding alcohol and tobacco, and getting rest are important to health. Finding time in the daily routine for each is critical to avoiding health concerns. Beyond this, whether longer work hours cause our less healthy decisions in those regards remains questionable. And, in the end, the reporting on this WHO study leaves me with more questions about their science than answers. 

Coincidence does not equal causation. Inferences are not necessarily proof, and when we stack inferences upon inferences the strength of our conclusions may be questioned, as the court explained in Inmon v. Convergence Employee Leasing in 2018. We have to watch those headlines, ask some questions, and keep asking those who preach consensus to instead show us the science. That is, simply, what science demonstrates that work is killing almost a million people each year? Not what science demonstrates that work hours cause smoking. Our skepticism should be piqued. Show me the science! Can we rationally expect better of science or journalism?