Multiple long-term conditions

Health and work

Exploring the impact of employment on our health


The links between health and work are complex. There is good evidence that employment can have a positive impact on health, resilience and wellbeing and that unemployment has the opposite effect.

But employment is only a positive driver of our health if it is ‘good work’. Good work, as defined by CIPD, the professional body for experts in people at work, is fairly rewarded, giving people the means to securely make a living. It also allows for work-life balance, provides a supportive environment, gives employees a voice and choice to shape their working lives and is physically and mentally healthy.

Some forms of employment, involving jobs that are precarious, low-paid, physically demanding or dangerous and unsupportive workplaces where people face discrimination, have an adverse effect on mental and physical health. The work that keeps our country going is done by essential workers, whose roles are often characterised by low pay, shift work and job precarity.

These features of ‘bad work’ have a negative impact on health. In fact, it is the nature of our work that makes us ill, on top of the effects of living on a low income. Poor health outcomes and persistent problems in the structure of the labour market, such as the well documented issues around recruitment and retention in the health and social care sector, are consequences of bad work.

After I left, not working meant my mental health went down even more. I don’t like doing nothing. I need to be active.

Yvonne Retired nurse, Lambeth

Employment uncertainty and precariousness

Since the economic downturn, opportunities to access good work in Lambeth and Southwark are limited for some and have all but vanished for many. Recent unemployment and new precarity are on the rise.

In the ‘gig economy’, with the prevalence of zero-hours contracts rising, work in our boroughs is often insecure and poorly paid. Hours are long and anti-social, with night shifts increasingly common in a 24-hour society.

For people living with the risk of long-term health conditions this type of uncertain and precarious work, which is stressful, disruptive to sleep and diet or physically demanding, combined with an arms-length, unsupportive relationship with an employer can force them to drop out of the workforce.

Disproportionate health impact

In places like ours where precarious work is widespread, the impact that bad work or joblessness and uncertainty can have on mental and physical health is profound. This burden is disproportionately shouldered by Black communities, and there are more Black communities in Lambeth and Southwark than in other parts of London. In fact, the share of Black residents is the highest in the country in Lambeth (25.9%) and Southwark (26.9%), only exceeded by the neighbouring borough of Lewisham (27.2%).

In neighbourhoods in Lambeth and Southwark where a third or more of the population are from Black communities, unemployment and ill health are more common than in other parts of our boroughs.

Wider inequalities create a disproportionate health and economic burden for Black people in our place, suggesting that systemic racism is a driver in the relationship between health and work in Lambeth and Southwark.

What we're doing

We’re exploring how good work can be harnessed as a positive force for health, slowing progression to multiple long-term conditions early on in the lives of people who experience structural disadvantage.

We want to work with employers to use their enormous influence on health, not just by tackling bad work head on but by actively building healthier lives through the workplace. So, we are:

Inviting local employers to work with us to make jobs better for people’s health, through deliberate design.

To do that, we need to:

  • Build employers’ understanding that investing in health pays off for business and their staff, especially for and with people in lower income roles.
  • Give employers the tools to talk about health with their workers, opening up positive dialogue about health and wellbeing. Normalising health-related conversations between employee and employer and removing the fear and risk associated with sharing information about health, is critical to preventing and managing long-term conditions at work and ensuring job retention.

Investigating how good work and genuine opportunities to advance professionally can offer paths out of precarious employment for people at risk of developing multiple long-term conditions.

  • We focus on investing in and working with organisations led by and connected to Black communities, to open up access to good work and improve health in these communities.

We’re inviting others to work with us to explore what good work can do for the health of our essential workers. In the wake of the COVID-19 pandemic, those that have kept London going should be central to its inclusive economic recovery, benefitting from it, rather than paying dearly with deteriorating health.

We’re looking to work with partners and employers across different sectors to find pragmatic ways to protect and improve the health at work of people at the highest risk of progression to multiple long-term conditions.

Read the 'Easing Pressures' report

Explore how work, money and homes can make our cities healthier and fairer

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