Stress and illness: call to action

Editor—The prospective study by Chandola et al on chronic stress at work as a risk factor for the metabolic syndrome adds a further public health imperative to reduce the significant morbidity from chronic stress at work.¹

Last month a BUPA insurance survey found that seven million Britons feel so ill with “worry” that they seek medical help.² In the employed population the British Occupational Health Research Foundation found that the largest, and growing, cause of work related ill health is now mental ill health.³

A number of remedial interventions such as cognitive behaviour therapy have been looked at, generally in individual sick employees. In terms of the social gradient of illness described among civil servants,¹ individual interventions worked best with employees in high-control jobs.³ Employers have a legal duty of care to protect the health of all their employees, and the Health and Safety Executive has published management standards aiming to reduce stress at work.⁴ In terms of reducing chronic stress, it may help to consider change at the level of positive wellness for the whole organisation, perhaps using a social engagement model with dynamic learning-in-action.⁵