With schools due to reopen soon, many of us will also be returning to work after the summer holidays. For those suffering from health issues especially, the past weeks will have provided a well-needed break from the daily grind, or what the French would colourfully refer to métro-boulot-dodo (metro-work-sleep).
That chronological straitjacket may be in the process of being loosened, however. Some of the world’s biggest companies, Google included, are now offering sleep pods to help with workers’ sleep issues, while Spain passed a law this year allowing women suffering from severe period to take menstrual leave. Increasingly, corporations are also taking measures to accommodate employees with different neurological profiles. So, are timetables and workplaces based on our individual biologies the way forward?
Considering biological factors
That interrogation arose five years ago, when I was pregnant. I experienced a chronic condition myself and tried to adjust in my work as a professor at a school of management. As an expert in work and employment practices in the workplace, I knew companies may offer flexible work arrangement to accommodate the social life of their employees. But what about their health?
Before turning to that question, we could do well with identifying how our bodies differ from one another. Looking at current research from various scientific disciplines, it is possible to distinguish between three broad biological conditions that have repercussions on people’s ability to work:
Chronic illnesses. Common debilitating conditions include diabetes, cancers, mental illnesses as well as lung, gastrointestinal and cardiovascular diseases. In 2021, more than one third (35.2%) of people in the EU) reported suffering from a long-standing health problem. Women are particularly exposed through their biological cycles including periods, pregnancy and menopause.
Neurodiversity. Not all brains pan out the same way. Some go on to develop autism, Down syndrome, attention deficit disorder with or without hyperactivity, dyslexia, dyspraxia and other conditions beginning with dy. Like chronic illnesses, neurodevelopmental differences affect a significant sample of the population, with one in ten people in the world impacted.
Circadian rhythms. Far from a myth, the reality of early birds and night owls has long been backed by science. Research shows that health predispositions mean our most productive hours vary from one individual to another. Going against one’s rhythm can upset sleep, metabolism as well as cardiovascular and immune systems.
Band-aid solutions
While 33% of European workers say that their health is at risk because of their employment activity, arrangements to accommodate our bodies are lacklustre at best. Although remote working is often thought to empower employees to manage their health more effectively, we also now know that it can act as a double-edged sword by undermining their right to disconnect.
More formal solutions are also riddled with shortcomings. In France, where I come from, an employee struggling with chronic health issues or a neurodiverse condition can apply for the status of disabled worker, which is conferred following a medical examination. The label then compels the workplace to accommodate the employee – for example, by providing a flexible schedule to a worker suffering from severe insomnia, an adapted desk for another suffering from a spinal injury, or by excluding the employee from particular types of activities.
That’s for the theory. In practice, workers are often reluctant to apply, partly due to the procedure’s medical complexity and cost, which is not covered by the national health insurance. Too often, the status also carries too heavy a stigma, with many opting out for reasons of pride. Finally, there is a real chance that companies, particularly small business, will not be able to accommodate the employee’s demands, and therefore lay them off for ineptitude.
For want of a medical diagnosis, certain employers may negotiate special employment terms with some employees. This is what is known in management literature as “i-deals”. For instance, work schedules or remuneration can be defined according to the employee’s preferences. The problem is that this solution hinges on the bargaining power they have over their employer. Hence, so-called key employees may get what they want by contrast with employees who are seen as underperforming.
To my knowledge, no government has yet thought out work policies to optimise our respective circadian rhythms. Rather, their focus is on limiting the damage of night- and shift work. While we could imagine to allocate early or late shifts to individuals whose metabolisms are better suited to it, the practices are not based on chronotype diversity. Instead, a growing number of companies offer the possibility of flexible working to their employees on the condition that they fulfil their obligations.
When teamwork takes the hit
Inevitably, such arrangements come at the cost of the company’s teamwork and collective productivity. Indeed, how can one possibly go about juggling the needs of a person working from home due to chronic pain, with those of another who comes in at midday while colleagues are there by 9 a.m.? And that’s without forgetting that colleague’s exemption from using certain work tools due to their neurodiversity.
Not to mention that managers in charge of overseeing these arrangements have their own health issues to contend with. Nearly half of French managers (48%) report that they are stressed at work. They are over-represented in terms of sick leave, and have scored 2 to 5 percentage points higher than the employee average since 2018. Nearly a quarter of managerial staff (24%) report using sleeping pills or anti-depressants compared to 18% of employees.
Retraining managers
In April, the French government released a report, “Rethinking work”, aimed at sparking a debate with trade unions on these questions. It found that transforming managerial practices will be essential if companies are to “[give] employees more responsibility, autonomy and recognition” and calls for a shift from a “culture of control to a culture of trust”. Recommendations include training to raise managers’ awareness over possible health issues. The idea is to create and maintain a culture of risk prevention in work situations.
On the one hand, raising managers’ awareness of health issues has shown some promise. For example, research on the retention of employees suffering from rheumatoid arthritis showed the importance of managers having knowledge or personal experience of the disability in terms of introducing policies that would be beneficial to both employee and employer.
If that approach is to be successful, managers will also need to abandon the idea of being the perfect supervisor and accepting their limits.
Collective, not individual solutions
But training managers anew is hardly a silver bullet. For one, it still results in an uncoordinated organisation. Moreover, when I reviewed the past 40 years of research on flexibility practices in 2021, I found that companies’ organisation suffered biggest setbacks when they tailored work arrangements for specific individuals rather than for the collective of workers.
Looking away from a frazzled patchwork of individual solutions, an increasing number of companies and governments are contemplating organisational shifts benefiting all, including in terms of working days. In February 2023, Belgium became the first country to legislate to enable employees to choose to work four-day weeks if they want it, providing they worked the same hours as in a day-week. Others are also following suit, with trials having taken place or about to take place in Spain, Portugal, Sweden, Iceland, Germany and the United Kingdom. The latter was the object of a scientific study with results showing that British companies have been able to transition to four-day weeks (with reduction in working-week hours) without losing productivity.
Placing the onus on the organisation of the whole company, or even country, has the merit of protecting team work, while also liberating time for caregivers. It can also prevent envy toward what can be perceived as the material privileges of those living with a condition. After all, this is the same logic that drove French politicians in 1945 to vote for the same family allowances to be distributed based on the number of children, regardless of income; if all citizens benefited from the welfare state, then support for it would be stronger, or so the left and right argued at the time.
Most will agree that those living with chronic illness, neurodiversity or/and different circadian rhythms deserve our full support.