Trends in psychosocial work conditions and policy responses concerning work stress in Taiwan Yawen Cheng, ScD Associate Professor Institute of Health Policy and Management, College of Public Health, National Taiwan University The 43 rd APACPH Conference, Korea,.
Recent social and labor market conditions Pop size: ~ 3 millions Rapid Industrialization since 6s De-industrialization since the 8s Manufacturing industries moving out Influx of cheaper commodities from other countries Influx of foreign blue-collar workers from SE Asian countries To lower down unemployment rates, government adopts policies Creating temporary jobs in the public sectors (but low-pay jobs) Encouraging outsourcing and temporary agency workers (but insecure jobs)
Significance of work stress problems Cases of karoshi (sudden death from overwork) reported frequently in Taiwan in recent years Most cases had cardiac or cerebrovascular causes of death Controversies over the definition of karoshi and claims for workers compensation Growing public s concern and anxiety on work stress 3
International comparisons of averaged yearly working hours () 4 5 3 3 6 65 7 8 7 35 74 88 85 855 8 74 738 745 747 76 777 7 6 658 588 5 4 Yearly working hours France Denmark Germany Finland Netherlands Australia United Kingdom Sweden Brazil Canada USA Japan China Mainland Philippines Malaysia Taiwan Singapore Thailand Indonesia India Mexico Hong Kong Korea Source: IMD WORLD COMPETITIVENESS ONLINE 5 -
Photos taken by Yawen Cheng (May, ). 5
Protests on Labor Day in Taipei (May, ) Main themes -Regulations on working hours -Regulations on outsourcing &dispatched work -Improvements in OSH & labor inspection 6
Study Objectives Part I: To examine the trends in psychosocial work hazards Unemployment rates Working hours Psychological job demands Job control Part II: To review recent development concerning the compensation and prevention of stress-related health problems. 7
Part I: National Surveys National survey conducted by Council of Labor Affairs every 3-4 years 4, 8,, 4, 7, Target population: Paid employees Employers and self-employed (included in 7, ) Sampling schemes representative samples 4 strata by urbanization level Households randomly sampled from each stratum From selected households, residents who were paid employees were recruited For analyses: age restricted to 5~65 years old ~ 8, men and 6, women 8
Assembly line workers -A typical high strain job
Year 4 8 4 7 Perceived job stress level Perceived stressors at work ( item, multiple choices) Job demands (fast, excessive, not enough time, concentration for long time, hectic) 7 6 7 5 Job control 3 Type of wage (fixed, floating, piece-rated) Employment insecurity 6 Organizational justice 7 Self-rated health SF 36 (mental health, vitality, general health) 5/4/5 CBI (personal & work & client ) 6/4 5/5/6 Over-commitment 5
Results (): Changes in male and female unemployment rates in Taiwan
Results (): Changes in average working hours in Taiwan (hours/week)
Results (3): Changes in prevalence of workers with long working hours ( 6 hours per week) in Taiwan 3
Results (4): Changes in Job Demands (5 items) 4
Results (5): Changes in Job Control 5
Results (6): Changes in perceived high job stress 6
Regression coefficients of major psychosocial work-related factors with adjustment of age, employment grade, physical work demands, and working hours 7
Part II: Policy responses concerning work stress Adaptation, cognition, coping, behaviors Impacts on family, Community & society Job Stressors early symptoms Illnesses/ disability Injuries; Safety issues Proactive primary Reactive primary Secondary Tertiary 8
Workers compensation schemes and compensated occupational injuries and diseases in Japan, Korea and Taiwan
Compensated work-related CVDs in Taiwan, Korea and Japan: 87-
Compensated work-related mental disorders in Taiwan, Korea and Japan: 87-
3 Compensated occupational diseases in Taiwan: 87-4 6 8 4 6 8 4 6 8 3 8 5 8 6 8 7 8 8 8 3 4 5 6 7 8 3 4 5 6 7 8 Number od cases Unclassified Stress-related Musculoskeletal Respiratory diseases & complications Other
International comparisons of compensation rates for occupational diseases Number of compensated cases 5 4 3 478 Taiwan () Number of cases Compensation rate (cases/, insured) 8,874 5.3 7 Japan (8) 3,365 4 Germany (6) 8,7 63 Korea () 8,65 Denmark (5) 67,5 Sweden (6) 77 8 5,83 Finland (5) 5,4 France (6) 3 5 5 5 Compensation rate (cases/, insured) 4
Summary of findings Perceived level of job stress and recognized OD due to overwork increased. Averaged working hours and prevalence of employees with long working hours have been in decline. Levels of job control declining. 5
Possible explanations for the increases in recognition of overwork hazards Changes in working conditions other than working hours Work intensification, decrease in job control, intensified performance evaluation, stagnating wages, precarious employment and job insecurity Changes in employees attitude towards work and workers compensation system Social and political factors 6
Policy responses to work stress problems Responses to stress claims for compensation Overall, occupational diseases are severely underrecognized in Taiwan. The government has promulgated and amended criteria guidelines for stress-related diseases, mainly cardiovascular and cerebrovascular diseases, and recently mental disorders. Recently, labor inspection has targeted on the compliance of working hour regulations. Few prevention strategies are undertaken to reduce or to manage psychosocial work hazards. 7
Implications for OSH policy Recognition and guidelines for compensation Long working hour is only one of many factors that contribute to work stress. Should learn from the experiences from other countries. Prevention strategies Regulation on working hours will not sufficient to cope with work stress problems. Need to incorporate labor policy into health policy; regulations on labor conditions and a wider range of psychosocial hazards will be needed. 8
Thank you for your attention. Yawen Cheng, ScD Institute of Health Policy and Management, National Taiwan University Email: ycheng@ntu.edu.tw homepage: http://homepage.ntu.edu.tw/~ycheng/index/