Managerialism: A workforce health hazard in human service settings

Abstract

Background This study assesses the relationship between managerialism and health among human service workers. Methods A total of 2154 New York City human service workers participated in an electronic survey that included validated measures of a system of work organization (the Organizational Commitment to Managerialism scale [OCTM]) and a work stressor (the Effort Reward Imbalance scale [ERI]), and single items about physical, mental, and behavioral health. Controlling for demographic variables, logistic regression models were used to predict health outcomes assess the potential role of ERI as a mediator. Results Managerialism was associated with increased risk of high blood pressure, neck and back pain, gastrointestinal difficulties, sleeping disorders, anxiety, and depression. Mediation analyses suggested that the effects of managerialism on health were partially explained by ERI. Conclusions Managerialism in human service agencies significantly increased the risk of adverse physical and mental health. Increased levels of a work stressor helped to explain part of this association.

Occupational psychosocial factors and cardiovascular disease.

“…As described in Figure 16.1, systems of work organization can increase work stressors, and thus risk of illness. For example, NYC social workers working under NPM (a form of public sector "lean production") had a greater risk of depression (odds ratio [OR] = 1.45), anxiety (OR = 1.59), hypertension (OR = 1.15), and sleeping problems (OR = 1.55; Zelnick et al, 2022). A 7.5-year follow-up of Finnish public employees found a relative risk (RR) of 2.0 for CVD mortality (95% CI [1.0, 3.9]) among survivors of major (vs. no) downsizing (Vahtera et al, 2005).…”

Taking Care at Work: Gender, Coping, and Anti-Violence Work During COVID-19

“…Workplace stressors emerge in a range of potentially overlapping contexts, from unsafe working conditions and administrative surveillance to hostile organizational climates and poor relationships with coworkers (Kahn, 1987; Zelnick et al, 2022). Even things that feel more nebulous, like the temporal elements of working hours, affective exchanges in client encounters, and mismatched metrics of “productivity” or “positive outcomes” between workers and institutional norms (Zelnick & Abramovitz, 2020), can increase stress by destabilizing workplace routines and creating inconsistencies (Parikh et al, 2004).…”

“…Even things that feel more nebulous, like the temporal elements of working hours, affective exchanges in client encounters, and mismatched metrics of “productivity” or “positive outcomes” between workers and institutional norms (Zelnick & Abramovitz, 2020), can increase stress by destabilizing workplace routines and creating inconsistencies (Parikh et al, 2004). These stressors can build towards a plethora of secondary effects, including somatization, adverse physical and mental health conditions, and burnout 1 (Parikh et al, 2004; Zelnick et al, 2022).…”

“…Quantitative role overload is the result of workers having too many things to accomplish and/or not having enough time to accomplish necessary tasks. In the face of increasing documentation accounting service providers’ adherence to workplace “benchmarks” (Zelnick et al, 2022), workers may literally need to distinguish between the “necessary” task of engaging with clients or filling out appropriate paperwork for grant reports. Qualitative role overload occurs when the task's needed level of quality exceeds workers’ abilities or accessible resources (Ivancevich & Matteson, 1980).…”

“…Our paper explores how service providers have adjusted to this “new normal,” drawing from scholarship on various coping styles (Menaghan & Merves, 1984; Parikh et al, 2004), organizational stress (Kahn, 1987; Zelnick et al 2022), and street-level bureaucracy theory (Lipsky, 2010; Maynard-Moody & Musheno, 2022). We specifically highlight shifting coping mechanisms in the anti-violence workplace.…”