Working From Home May Have Negative Health Consequences

By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board

Employees who work from their homes instead of an office or other location is not a new phenomenon. In the 1980’s and 1990’s some industries began to employ workers who worked exclusively from home. No doubt you first received a telemarketing or sales call several decades ago. Very likely that call was initiated by a home-based worker. Advances in technology, computing, and cell phones contributed to the viability of home-based work. But the COVID-19 Pandemic of 2020 ushered in an entirely new era of work from home when virtually overnight many businesses were shuttered, and a significant number of employees began working from home.

A survey conducted between May 21 and May 25, 2020, by researchers with the Stanford Institute for Economic Policy Research found that 42% of the US workforce was working from home while 33% were not working and only 26% remained working from their employers’ premises, primarily as essential worker. The researchers also observed that only 51% of the US workforce can work from home. These individuals were primarily professionals, managers, and financial workers who were easily able to perform their jobs on their computers by videoconference, email, and phones. The remaining nearly half of the US workforce—those employed in retail, healthcare, transportation, and manufacturing—can only perform their jobs from a traditional worksite. (Bloom, N. How Working from Home Works Out, SIEPR, 2020).

Although the COVID-19 Pandemic was declared officially over in the US on May 11, 2023, a significant number of employees continue to work from their homes either on a full-time basis or at least several days a week. Bloom, supra, predicts that post-pandemic, employees will work from home one to three days per week, accounting for 20% of the workforce on any given day. While some research has assessed the productivity of work from home, few studies have looked at the health consequences associated with working from home. A recent study conducted by researchers at the School of Nursing, University of Michigan, Ann Arbor; the School of Nursing, University of Chicago, Chicago; and the School of Nursing, University of California, San Francisco, examined how working from home may affect health behaviors and mental health. The study, Exploring the Characteristics and Health Outcomes of Working from Home: Analysis of the 2021 California Health Interview Survey Data, was published in the November 27, 2023, edition of the American Journal of Industrial Medicine [https://onlinelibrary.wiley.com/doi/10.1002/ajim.23556]. It finds that working from home may negatively affect health behaviors and mental health outcomes.

The Goal of the Study

The study’s authors candidly admit that the significant trend seen during the COVID-19 pandemic of large percentages of the US workforce suddenly shifting to working from their homes was unprecedented, unexpected, and implemented without consideration of what all the consequences might be—foremost, any health consequences. Their goal was to examine whether there are any health-related differences between employees who work from their homes (“WFH”) and employees who do not work from home (“Not WFH”). Such information is especially important as the prediction of a post-pandemic “hybrid” (i.e., employees who work from home one to three days/week) US workforce is becoming more of a reality than a mere forecast.

The Research Methodology

The study used data from the 2021 California Health Interview Survey (CHIS), which is the largest state health survey in the US. Each year CHIS interviews more than 20,000 households and collects health data on adults, adolescents, and children to better understand the health and healthcare needs of California’s population, (https://healthpolicy.ucla.edu/publications/Documents/PDF/2021/CHIS-2021-Making-an-Impact.pdf). The authors used the CHIS adult data and excluded adults who were either unemployed or looking for work. Altogether, the dataset included 12,438 individuals. This group was then divided between those who WFH and those Not WFH. Of the 12,438 adults included in the study, 39% were WFH and 61% were Not WFH.

Demographic and biological measures, such as age, sex, race, and body mass index (BMI), were recorded. The study also recorded 14 broad industrial categories ranging from agriculture, which encompasses forestry, fishing, hunting, and mining to educational services, which includes healthcare and social assistance. Thirteen occupations were then chosen, as follows: (1) computer, engineering and science; (2) construction and extraction; (3) education, legal, community service, arts and media; (4) farming, fishing and forestry; (5) healthcare practitioners and technical; (6) installation, maintenance and repair; (7) management, business and financial; (8) military specific; (9) office and administrative support; (10) production; (11) sales and related; (12) service; and (13) transportation and material moving.

Next, two health outcome variables were considered. First, “health behaviors,” which included smoking, alcohol consumption, and fruit-related nutrition—i.e., the number of times fruit is eaten per week and in the past month. The second outcome variable was mental health. That variable was measured by use of the Kessler 6-Item Psychological Distress Questionnaire (K-6), which the study’s authors describe as a globally accepted tool to identify serious mental illness. It records feelings such as nervousness, hopelessness, restlessness, worthlessness, and depression by frequency that can be added together, and a high score is an indication of severe distress.

The Findings

First, the study found that age, sex, marital status, educational level, annual household income, and BMI differed significantly between the WFH group and the Not WFH group. The majority of those in the WFH group were aged 30-39, had annual household incomes of more than $150,000 and worked predominately in the occupation sector of computer, engineering, and science. In contrast, the majority in the Not WFH group were aged 50-64, had an annual household income of between $50,000 and $99,999, and worked in the service sector. These findings are not especially surprising. What does come as a surprise is that those in the Not WFH group had better overall health outcomes than their WFH counterparts, except for smoking. That is, more individuals in the Not WFH group either never consumed alcohol or had not consumed alcohol for long durations of time. Similarly, they had higher levels of fruit nutrition, meaning that they consumed more fruit by week and by month in comparison to the WFH group. In terms of mental health issues, the Not WFH group experienced less mental distress. The only health variable in which the WFH group showed a better health outcome than the Not WFH group was in terms of smoking.

Of particular interest, the authors reported on previous research that has shown that early career workers (i.e., those with less than five years job duration) are vulnerable to safety and health risks at work. In this study the authors made what they characterize as a critical finding—the necessity of managing mental distress in early career workers in both the WFH and Not WFH groups. They recommend regular evaluation of mental distress in early career workers and the establishment of a management system that can connect those with high distress to resources such as employee assistance programs.

Should Employers Be Concerned?

It seems quite likely that a steady percentage of our workforce will continue to WFH at least several days per week. Bloom, supra, is adamant that WFH is here to stay, but predicts it will be at a frequency of one to three days per week, which can ease the stress of commuting, enable workers to use their WFH days for quiet, thoughtful work and use their time in the office for collaboration and meetings. While Bloom’s prediction seems reasonable, should employers be concerned about the health consequences of WFH?

Although this study did find that overall health outcomes apart from smoking were better in the Not WFH group than those who WFH, likely that finding would be significantly ameliorated by a post-pandemic WFH paradigm limited to one to three days per week. However, this study underscores the need for employers to be vigilant especially with workers in the early years of their careers (less than five years), as these workers are more vulnerable to safety and health risks, including mental health, whether they are WFH or Not WFH.

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