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Is Your CPA Firm's Culture to Blame for Higher Health Costs?

Posted on: Tuesday, 2 November 2004, 03:00 CST

Although ever-increasing health-care premiums affect most employers now, there may be other factors at play to explain them. In fact, a new study finds that how your firm addresses gender issues among your staff could affect health-care costs.

Creating Healthy Corporate Cultures for Both Genders suggests that differences in the way health care is managed for men and women put both at risk for cardiovascular problems, depression, and higher susceptibility to infectious diseases. All of this creates higher health-care costs for employers-and a less healthy workforce.

The report was commissioned by LLuminari, Inc. (Wilmington, Del.; www.llurninari.com), a national health education company comprised of physicians and health experts committed to women's health both in the workplace and with families. The results maintain that although women are at a higher health risk than men from workplace stress, the underlying workplace culture of stress and conflict affects the physical and emotional health of both men and women.

LLuminari's research uncovered four factors that have a major influence on employees' health. Over time, as stress-related health issues arise, these factors will affect your firm 's health-care costs:

1. High demand. This refers to having too much to do in too short a time for too long a period.

2. Low control. This factor refers to having too little influence over the way your job is done on a dayto-day basis.

3. High effort. This means having to expend too much mental energy over too long a period.

4. Low reward. This means receiving inadequate feedback on performance and no acknowledgement or recognition for work well done.

* The theory and CPA firms. This is an intriguing theory to AOMAR, and seems as though it would be especially applicable to today's higherpressure CPA firm environments, where stress has become a given for all and women are expected to conform to what many consider the "male-oriented" workplace value of sacrificing one's personal life for the sake of the business.

(For a look at personal and health-related issues caused by a stressful work environment, see the sidebar, "How to Heal an Unhealthy Work Environment and Firm Culture." And for a better understanding of the characteristics that distinguish a male- oriented from a female-oriented culture, see the sidebar, "Where Does Your CPA Firm Fit In?")

How male and female CPAs deal with stress seems to be part of the universal trend found in the Lluminari study. "Research has shown that women and men respond differently," says LLuminari expert Alice Domar, Ph.D., assistant professor of obstetrics/gynecology and reproductive biology at Harvard Medical School.

"Women also report having more to worry about each day. Men on average worried about three things on a daily basis (their immediate family, job, and money)." In contrast, women worried about up to 12 areas, including immediate family, job, money, their extended family, the home, the social and academic lives of their children, social connections with neighbors and friends, and more, Domar adds.

Focus on prevention to save health and money. Prevention is more cost-effective than treating the complications of an illness, notes Marianne Legato, M.D., founder and director of the Partnership for Gender-Based Medicine, Columbia University, and one of the study's leading advisers. "It's an interesting idea to reduce stress in the workplace, especially along gender lines, as a way of improving employees' health and helping to contain health-care costs. There's no question that the price we pay for a chronically unpleasant experience at work is a rising bill for the illnesses that result."

Take a look at your firm's culture, and consider the fundamental differences between women and men that affect their health. This can have a positive impact on employees' health, believes Elizabeth Browning, CEO of LLuminari. "Male and female managers who are sensitive to gender differences will have the ability to bring out the best in both genders, and this will go a long way toward reducing stress in the workplace and improving all employees' health."

The study shows how this can be done. You must address the following:

* Excessive work demands are strongly related to illness among women.

* Ten percent of employees are so physically or mentally tired at the end of the workday that it spoils their non-working time.

* Twenty percent of respondents believe that work regularly interferes with their responsibilities at home and keeps them from spending time with their families.

* Nearly 50% of women respondents fail to take their allotted vacation time.

* Sixty-two percent of respondents believe employers make no effort to minimize stress, and 50% feel their employer cares little about their well-being.

* Women report nearly 40% more health problems than their male counterparts and noticeably higher stress.

* Men and women emphasize entirely different values as being important in the workplace. To men, pay and benefits, achievement and success, and status and authority are the most important values. Women give high rankings to friends at work, relationships in general, recognition and respect, and communication and collaboration.

* Fifty-four percent of respondents indicated that they "often" or "always" return home from work in a state of fatigue, and almost 50% go into work in a state of fatigue.

* Forty percent said they experience distress due to too much pressure or mental fatigue at work.

* Men and women value similar things at work, but prioritize them differently. And, not surprisingly, women understand what men value much better than men understand what women value, which is why workplaces may be more unhealthy for women.

Another noteworthy point: "The conditions of fatigue and stress noted in the study are fueled in part by the differences in how men and women manage people," says P. Michael Petersen, president of Workplace Consultants, Inc. and a professor of health promotion at the University of Delaware, who conducted the survey on behalf of LLuminari, Inc.

The design of a job and the degree of control or influence employees have in their positions are critical components of a perceived healthy culture, he adds. The top five work-related causes of stress and ill health identified by respondents in the study are:

1. Mentally tiring work.

2. Time pressure.

3. Too many changes within the job.

4. Inadequate feedback.

5. Lacking influence on the job and how it is done.

Set the tone for a healthier workplace by understanding the gender-based cultural drivers of your firm. Browning says the first step is to conduct a thorough assessment of the culture in which your people operate. Questions to consider:

* How do men and women respond to your firm's culture?

* Is your firm culture predominantly male-oriented? Is it female- friendly?

* In your firm, do people believe presence equals commitment?

* Are members of your firm comfortable taking their vacation time?

* If people are permitted to leave the building to smoke, would you be as comfortable allowing them to leave the building to take a walk?

Remember, being female-friendly must go beyond offering maternity leave or flextime. Browning offers the example of organizations that schedule meetings at 7:00 a.m. or 6:00 p.m., which makes it difficult for both female and male employees to juggle work and family responsibilities.

"Every organization wants to be successful and depends upon its employees to make [that] happen," Browning notes. "But success should be viewed over the long term. A healthy organization can go the distance. If we value our people, the best metric of success should be the health of the employees."

The bottom line: Browning believes that leaders must understand how cultures that typically evolve based on male models can become healthy for both genders. "The answer [to fighting increases in health-care costs] isn't just about gyms and healthier choices in the cafeteria. The study shows that a complete solution must address workplace culture and its link to a healthy workforce."

How to Heal an Unhealthy Work Environment and Firm Culture

Improving training and job design and reducing workplace stress are important tasks that can contribute significantly to the promotion of health and wellbeing, the prevention of work-related psychological disorders, and a decrease in health-care costs, according to the National Institute for Occupational Safety and Health and the American Psychological Association. The following symptoms suggest you or members of your firm are overworked and thus more likely to become ill:

Mental symptoms:

* Rushed, stressed, helpless

* Abused, abusing

* Nervous

* Depressed

* Angry and upset

* Careless and reckless

* Unable to concentrate

* Physical symptoms:

* Poor eating habits

* Drinking too much

* Over-medicating

* Lack of exercise

* Sleep poorly

* Prone to infections

* Accident-prone

* Cardiovascular risk

Social symptoms:

* Inability to form and maintain relationships

* Isolated

* Quarrelsome and argumentative

Economic symptoms:

* Waste time

* Likely to damage things

* Often absent

* Less creative

* Less productive

* Less efficient

* Less courteous with clients

* High medical and drug claim costs

(Source for both sidebars: LLuminari, Inc.)

Where Does Your CPA Firm Fit In?

The key for firms intent upon improving stressful working condit\ions and limiting illness is to blend the strengths of male- and female-oriented cultures to achieve optimal health for both the firm and its members.

Qualities of a female-oriented culture. It assumes that work is done in conjunction with other people and that the business must recognize the importance of human relationships and communication in order to be successful. It defines success not just by how much money is made, but by the strength of the relationships among firm members and the ability to balance work and family.

Qualities of a male-oriented work culture. It assumes that work is done for the purpose of achievement and fortune, and that to be successful the firm must recognize the importance of achieving results. It defines success primarily by how much you achieve in terms of profit, market share, status, and influence.

Copyright Institute of Management & Administration Nov 2004

Source: Accounting Office Management & Administration Report

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