Friday, December 23, 2011

Another explosion reported in a Chinese Manufacturer that supplies Apple

For the third time in little over a year an explosion has rocked a factory that supplies parts in the manufacturing of various Apple devices. The explosion injured 61, and sent 23 to the hospital. Fortunately, there were no fatalities. 

This particular plant (which supplies back panels needed in the manufacturing of IPads), according to Pegatron Chief Financial Officer Charles Lin, “…had not started operations yet. Part of the facility is still under pre-operation inspection and part is running trial production.” 1 
Chinese suppliers are under tremendous pressure from Apple to increase supply to keep up with worldwide demand for IPhones and IPads. Manufacturing the aluminum shells is, admittedly, not without risk. The shells need to be polished and the powder used in this process is potentially explosive - requiring a factory environment with adequate ventilation. Still, providing such an environment is not rocket science.

It is not hard to see that under pressure to increase production companies are cutting corners. In this case, a plant which has not yet “started operations” has already experienced an explosion injuring 61 people.

Who is responsible for this (preventable) disaster? Is it the company which rushed, recklessly, into trial production a facility not yet ready for prime-time, the Chinese government with its lax supervision of various regulations (or perhaps no regulations at all), or is it Apple computer corporation which turns a blind eye to the practices of its suppliers so that they may sell a million or so more iPhones and IPads. Apple Corporation made $7.31 billion dollars in profits in their 3rd Qtr. 2011 financial year alone.

Perhaps there are others who deserve mention.  Please share your take on this tragedy.

Peter Schnall

1 “Apple supplier Pegatron hit by China plant blast” By Clare Jim and Argin Chang, Reuters. 

Wednesday, October 26, 2011

Disney: American Dream or Nightmare?

                                                                                    By: Peter Schnall & Erin Wigger
The name Disney is highly evocative for many Americans. Some think of their favorite childhood movies – Bambi, Pinocchio, Snow White, Lion King, etc., others call to mind one of Disney’s 14 worldwide theme parks and resorts. Disney  has, over the last 70 years become a part of what many conceive as the American Dream.

Today,  when someone wins a Publisher’s Clearing House award, or the Superbowl, what do they think to scream? Many things I’m sure but, “I’m going to Disneyland” has become a catch-phrase for people who, for whatever reason, have come into enough money or fame to finally elevate themselves into the class of people who can afford to have the magical experience of a Disneyland adventure.

But there’s a darker side to Disney Corporation, which has a long history of labor disputes. As reported by Steve Lopez of the LA Times on October 19th, something new and unwanted has made an appearance in the perfect world called Disneyland. Disney Corp. has begun a new chapter in electronic monitoring of some of its workforce in the form of large TV screen displays in the work area. Workers at Disney’s Paradise Pier Hotel in Anaheim have labeled the large flat-screen monitors in the laundry room the “electronic whip.” This screen, displayed for all to see, visually tracks worker progress by giving “efficiency” percentages in green - for those who are at or above expected productivity - and red for those below it. Not only does this cause anxiety for workers in general, it pits them against one another in a minute-by-minute race to be on  top. Workers complain of putting off or missing toilet breaks in order to keep up.

If you look to the left  on our blogsite you’ll see snippets from Charlie Chaplin’s movie Modern Times. After reading Lopez’s article on the electronic monitoring of Disney Hotel Workers, Charlie’s satire of the industrial production line appears, once again, prophetic.

This Disney tale is one example of “lean going mean.” Though the Foxconn plants (see earlier blogs re Foxconn) are many thousands of miles away, this speeding up of the workplace has become widespread. Known to be detrimental to worker health, the ever-increasing push to produce more and faster keeps workers locked in a social and biological struggle to meet inhuman demands under inhumane working conditions. But speed ups and social isolation created by competition between workers is just the tip of the iceberg. Workers at Disney not only complain about the pace, they also complain of low wages, job insecurity, lack of respect and the injustice of having to put on a “happy face” and give, even the most slovenly of guests, a “magical experience” when they themselves are looking at dwindling wages and increased health care costs (see psychosocial stressors blog #2).

Friday, October 7, 2011

Why America's unquestioning idolization of Steve Jobs is inappropriate

Steve Jobs, the co-founder of Apple Computer Corporation died today October 6 2011 at the age of 56 from a rare form of cancer of the pancreas. His death has been accompanied by widespread expressions of admiration for the man and his accomplishments. These accomplishments include the creation of Apple Computer Corporation, apple computers, the iPod, iphone and ipad as well also NEXT computer corporations and Pixar animations including Toy Story.   He overcame numerous adversities in his climb to success and fame including being fired from Apple Computer Corporation by a man he hired to manage the company for him while he focused his energies on developing new products.  It is probably fair to say of Steve Jobs that he exemplifies much of what many Americans think is the best about America; opportunity to rise from nowhere to stardom, no silver spoon in his case but lots of hard work and a eye on the goal.  I admired him.  He seems like a good man, there are no terrible stories about him, his company is respected and he is idolized by many.   The cofounder of Apple, Wozniak says, perhaps a bit tongue in cheek, that he'll "be remembered for the next hundred years as the best business leader of out time." 

You may be wondering, “where’s the beef”?  Those of you who have read my recent blogs will know that Steve Jobs is a pivotal figure in one of the most important aspects of globalization – the offshoring and outsourcing of production to the developing nations of the world. Just as Apple has grown in recent years so have the companies that supply apple with the parts and machines that make Apple a successful corporation. One company that supplies Apple is Foxconn a Chinese firm which now employs more than 1 million workers and is one of the fastest growing companies in the world. They manufacture Ipads and Iphones for Apple. If you have read my earlier blogs you realize that one focus has been on the terrible working conditions at Foxconn Corporation in China. Long work weeks – 12  hours a day x 6 days a week, military like working conditions, low wages, and low employee morale has led to more than 15 suicides in the past year.  One might argue that Foxconn is not Apple. After all, Apple has a “code of practice and conduct” that they claim they hold each company to. Yet, there is little doubt that the pressures to produce products at Foxconn at competitive prices has contributed to these working conditions.  

And now we return to Steve Jobs – the pioneer and great business man – and ask what role does he play in this process that leads to these desperate conditions for Foxconn employees and what responsibility does he have for the conditions that face working people at Foxconn and for that matter in China as a whole? This question is one that has troubled scholars. How much are individual’s (regardless of their position in society) responsible for the exploitation that occurs at the hands of a capitalist economy and how much are they mere “cogs in the wheel” whereby their hands are forced by the pragmatics of business, growth and accountability to shareholders. Some would say that a man with the power of Steve Jobs could have turned his attention and made a difference to the working conditions at Apple’s subcontracted companies.  Why he didn’t consider encouraging Apple to pull its contracts with Foxconn is a story we may now never know. 

Saturday, September 10, 2011

Robots to Play Crucial Role in Foxconn Future Expansion

by Peter Schnall & Erin Wigger

Foxconn is planning to add one million robots to its workforce within the next three years. This is alarming news for those concerned about China’s working class citizens. Foxconn has been growing at an enormous pace, has doubled its workforce over the last few years and is now ranked third largest employer in the world. They are faced with rising labor costs which they have attempted to address through increased productivity of its workforce and also by expanding west to China’s Chengdu province - home to a still large population of poor agricultural workers and a new source of inexpensive, unorganized labor.

News reports have been appearing in the press for the past five years about Foxconn workers’ struggle for higher wages and better working conditions. Few gains were made by workers however until 2010, when Foxconn received a large amount of bad publicity due to the suicides of 11 of its workers. The sensationalism of the story was due in part to the collective and public nature of the suicides (which involved workers in similar fashion leaping to their death from the roof of Foxconn buildings), paired with the fact that Foxconn’s Shenzhen plant is the major manufacturing headquarters of the popular Apple iPhone and IPad.

Foxconn responded to the public outcry resulting from these deaths by raising the salary of its workers and installing netting around the roofs of its buildings to forestall further suicides. They also required workers to sign a “no suicide” clause in their work contract, which prevents their families from receiving a death benefit.

But Foxconns’ dilemma hasn’t been resolved. As its work force continues to swell so does the threat of organized worker activities. (Of course, Foxconn workers like all other workers in China are represented by an official Chinese Union answerable to the Chinese government and which fails to represent the interests of workers in almost every case. But the threat of organized resistance poses a serious problem for Foxconn: how to continue increasing productivity while lowering costs in a competitive economy.

With pressure to produce still more coming from Apple and other end users and the company complaining of low profit margins, Foxconn has now sought to increase its production processes by means of robotics. According to Terry Gou, the company’s founder and chairman, Foxconn already makes use of some 10,000 robots and sees many benefits in expanding its use of robots. Gou plans to use the new robots to perform tasks such as spraying, welding and assembling. He projects that utilizing up to 1 million robots will improve the working conditions at his plant for Foxconn workers by eliminating those parts of the production process which are repetitive and menial, effectively elevating it’s workforce into positions with increased skill-level and value.

But will the modernization of Foxconn’s plants into a futuristic, automated factory actually mean better working conditions for China’s workers, or just a loss of jobs? Gou’s argument seems to favor the hypothesis of Skill Biased Technological Change (SBTC), which purports to positively favor a shift from an un-skilled labor force to skilled workers. SBTC has, however, become the center of debate on the unequal distribution of power in the workplace (management vs. workers) and the increasing inequality of wealth between social classes in Capitalist societies.

How can Foxconn reduce costs if they hire robots unless their “employment” is accompanied by the layoff of workers (workers being the most expensive part of the production process)?

Despite Gou’s words to the contrary, workers at Foxconn’s plants remain skeptical. Tania Branigan of The Guardian reports that some workers question whether Gou’s announcement was sincere. "I am suspicious," said Liu Kaiming, of the Institute of Contemporary Observation, which supports workers in Guangdong, "Machines can do it, but think about the cost … overall, workers are still much cheaper. This is probably just for sensational effect, [to] put pressure on workers."

And it is difficult to imagine that the small and hard-won improvements workers have fought for at Foxconn are not under attack. In essence, how can workers complain of labor practices which cause them to feel like machines – enforced silence on the production line, short or non-existent breaks, etc – when the company can literally replace them with robots capable of working 24-hours a day without complaint?

In the long run, replacing humans with robots seems a dead-end process. After all, robots are unlikely candidates to purchase the products of their own labors. Without a well-paid labor force capitalism lacks a market for its goods. This problem is a flashback to the issues raised by Jeremy Rifkin in 1995 in his book “The End of Work: The decline of the Global Labor Force and the Dawn of the Post-Market Era” in which he argued that many jobs are never coming back and that we should prepare for a world without work. Of course, the emergence of China and the employment of millions there has been the major argument against his thesis. More on this in a later entry…

Monday, August 29, 2011

Swedish Capitalist Learn U.S. Labor not so Cheap

I reported on a union organizing effort at the Ikea’s Swedwood Danville Plant in Virginia. I am delighted to follow-up that blog and report that on August 6th, by a 221-69 vote, workers voted to unionize with the Machinists Union (IAM) overcoming strenuous anti-union efforts by Ikea’s subsidiary.  As Tawanda Tarply, a worker at the plant, stated in an article at “We were fed up with wages, safety concerns, overall communication. We wanted to be treated with respect”.  Swedwood used a point system to penalize workers handing out points to a maximum of 9 (at which time workers were fired) for infractions including non-approved restroom breaks (1 pt.), as well as 1 point to a man who collapsed from heat exhaustion and was carried from the plant on a stretcher  IAM has said previously that the Danville plant is the most dangerous furniture-manufacturing factory in the U.S., with 1,536 days lost from work due to injury since 2007.  Check out their excellent video on Swedwood HERE. As you might expect, management is dragging their feet in agreeing to reach the bargaining table having put off till September a first meeting with the union and agreeing to only 2 days of available meeting time.

The Swedwood plant may be just the tip of the iceberg. Another Ikea affiliated subsidiary, the nearby EBI LLC plant, has been resisting a unionization attempt. Apparently the company has been successful as  workers on Monday August 9, 2011 voted against representation by the United Steelworkers in an NLRB-supervised election by a vote of 281 (no) to 118 (yes).  This defeat re-emphasizes how difficult it is to organize in “Right-to-work” states (see map taken from the National Right to Work Legal Defense Foundation website).

The U.S. affiliated plants are not the only ones complaining that Ikea is failing to live up to its own Code of Conduct.  This summer’s meeting of the Congress of European retail unions saw a statement from the group criticizing Ikea’s failures. Workers in Spain, Turkey, and the U.S. have all been protesting working conditions at Ikea plants.  But, perhaps we should not be too hard on Ikea, after all their failure is in part due to high expectations they themselves have set. The Ikea Code of Conduct was, after all, developed for its suppliers. IKEA was an early and high profile leader in openly addressing issues of social and environmental responsibility in the supply chain. IKEA's motto is "low prices, but not at any price."

A footnote about the organization that brings us the Right-to-work map above. The National Right to Work Legal Defense Foundation is a leading proponent of right to work laws supporting what they call “The Right to Work” principle--which asserts idea that every American should be able to work for a living without being compelled to belong to a union.  Critics from organized labor have argued since the late 1970s that while the National Right to Work Committee purports to engage in grass-roots lobbying on behalf of the "everyday worker", the National Right to Work Committee was formed by a group of southern businessmen with the express purpose of fighting unions, and that they "added a few workers for the purpose of public relations" (see Wikipedia

I hope that the victory at Swedwood is symbolic of rising resistance of workers to the increasingly exploitative working conditions faced by all Americans today.

Sunday, June 26, 2011

Globalization, Foxconn and the Chinese working people. What is the problem?

by Peter Schnall and Erin Wigger

We begin herein a series of blogs looking at the relationship between the processes of globalization and the worldwide development of industrial production as they impact on work organization and affect the lives of working men and women. Central to this exploration will be an in depth look at Foxconn, one of China’s foremost companies, which we will use as an example of issues related to globalization. China has one of the fastest growing economies in the world and has become over the past several decades one of the most powerful countries in the world. While China has always been rich in natural resources, the secret to its success is not a product of its agricultural production or natural resources, but it’s immense population which provides a large, well-trained and inexpensive (relative to the Western world) workforce..

Of China’s many rapidly growing companies, one stands out from the rest; among the Fortune Global 500 with $102 billion in revenue in 2010 and now with almost 1 million workers, Foxconn and it’s parent company Hon Hai have set the standard which many other companies now follow. Founded in 1974 by Terry Gou (currently Chairman and President), the Taiwanese company set out to provide businesses with alternatives to more expensive electronics manufacturing. According to the Foxconn Global website, Foxconn has achieved remarkable sales and growth figures. Between 2009 and 2010 the company’s consolidated revenues grew 52.98% to NT$2.997 trillion (US$104.6 billion) (CNA English News).

CAGR = compound annual growth rate

Image from Foxconn Global website: Milestones

Now the largest electronics manufacturing company in the world and the fifth largest company worldwide in number of employees after Walmart, China National Petroleum, State Grid, & the U.S. Postal Service – Foxconn supplies companies such as Apple, Dell, Hewlett-Packard and Sony with notebooks, desktop computers, monitors, smart phones, iPads and other popular products. “Foxconn has 13 mainland factories in nine cities in China. Planned factories include expanding sites at Chengdu in Sichuan province, Wuhan in Hubei province, and Zhengzhou in Henan province.” (Wikipedia) The first of these plants was its Shenzhen plant, which opened in 1988. Since then, it has become Foxconn’s largest plant, a walled city of more than 1.15 square miles including 15 factories, its own fire department, worker dormitories and a small city of restaurants and shops, all located on one property.

Although the plant is responsible for a large portion of the company’s overall success, it has also been the subject of repeated reports of worker mistreatment. It was in the news repeatedly last year after it experienced a number of suicides – 14 to date.  Foxconn responded to the suicides by raising wages 66%, boosting its number of counselors, and making stress management programs available to workers. It also built safety netting around its factory to prevent further suicide attempts and, for a short while, asked its workers to sign an anti-suicide pact. Foxconn has also responded to the suicides at the plant with claims it’s number of suicides, per capita, are not much higher than China’s national average, implying the suicides are not really a problem.

Suicides and employee discontent at the Shenzhen plant are not the only problems facing Foxconn. Foxconn has also been accused of discrimination against main-land Chinese workers and the forcing of many rural farmers off their land to make way for the huge factory developments currently heading farther and farther inland. Foxconn’s Chengdu plant is one of these. You might have already heard of the Chengdu plant; it appeared in the news last month after three workers were killed in an explosion caused by inadequately ventilated combustible dust. Built in the rural southwestern province of Sichuan, Chengdu was rapidly converted into a facility to make iPads in response to high demand from Apple. Currently staffed by 80,000 workers, Foxconn is looking to add another 220,000 workers at the Chengdu facility in coming years.

The cluster of suicides, the explosion at Chengdu, and the long-standing complaints by workers raise serious questions for some. Why did this group of young workers commit suicide? Did Foxconn’s work environment and employee policies play a role in these deaths? What are the labor practices at Foxconn? Is there a connection between Foxconn’s rapid growth, its labor practices and the explosion at Chengdu? Many newspapers and watch-dog groups such as SACOM (Students and Scholars Against Corporate Misbehavior) have charged the company with “dangerous working environment, inadequate measures on work safety, excessive and forced overtime work, and that workers are deprived of a social life.” Can these accusations be substantiated  and what is Foxconn’s defense? 

In subsequent blogs we will look at these issues regarding Foxconn. And beyond Foxconn, we need to ask if these problems are limited to Foxconn or are these issues typical of China? Finally, we want to raise the question about the relationship between these working conditions in Chinese factories and the overall process of globalization? Stayed tuned for subsequent blogs, the first of which will examine what is publicly known about working conditions at the Shenzhen plant.


Saturday, May 21, 2011

Peter's Award Presentation Speech for Bob Karasek on the occasion of his LIFETIME CAREER ACHIEVEMENT AWARD at the 2011 Work and Health Conference

One nice thing about a blog is that you can post personal stories. I want to share with you an event that occurred Thursday May 19th 2011 at the APA/NIOSH sponsored Work, Stress and Health 2011 Conference which I am attending in Orlando Florida. I was given the honor of introducing Bob Karasek on the occasion of his being awarded the Career Achievement Award by the organizers of the conference. It is the highest honor our profession can bestow on our colleague.

Here is my presentation to Bob on the occasion of his APA/NIOSH Career Achievement Award – May 19 2011

The Job strain hypothesis was formulated 35 years ago and first tested in a paper appearing in the July issue of the AJPH in 1981. Since then Job strain has become the most widely researched psychosocial model in the world, currently being used in 1220 projects in 65 countries.

For four decades now Robert Karasek has championed the JCQ, and the dual hypotheses of job strain as a risk factor for illness, and the active-passive quadrant dimension as a predictor of  active learning, human development and social involvement. Each hypothesis has generated important insights into our world of work.

One major reason for the importance of the job strain model resides in the fact that it provides a connection between work organization, and health. It places the individual and his perceptions of his work environment in the forefront of the issues demanding our attention while echoing in a more modern lexicon Marx’s ideas of alienation. It underscores the fact, as well as the degree to which traditional economic analyses of work with their emphasis on productivity, and wealth production ignore the negative human consequences of work in its current form.

Bob, your active role in theory and research has impacted many concerned about work and health. From individuals concerned that their work environment was potentially dangerous, to labor organizations striving for healthy working conditions, to businesses interested in maximizing productivity and to governments setting social policy, all have been impacted by ideas advanced by you Robert often working in collaboration with your lifelong colleague Tores Theorell.

Bob, one of your greatest accomplishments has been the support you have provided to a large number of your colleagues. As you know, much of my own work has been both inspired and shaped by your ideas about the work environment. While I have known you since our participation in the ECHDG in the 1970’s my first involvement in research after leaving the practice of medicine was when I joined your Columbia Job Heart project and with which I worked for 1 year in 1980. My experience working with you Bob, as well as Tores Theorell, Dean Baker, Carl Pieper and Joe Schwartz led me to seek a post-doc to further my training in epidemiology. My thesis proposal ultimately morphed into the 14 year long NYC Worksite BP study in collaboration with Dr. Thomas Pickering (PI) in which you and Jeff Johnson were both active participants.

Over the decades Bob, you and I have collaborated on many projects. From research at Cornell to papers for the AJPH to revisions to the JCQ (now soon to be JCQ 2.0), and conferences from Japan to Amsterdam. I hope that this collaboration will continue for at least another 20 years or longer. Also your work is not yet finished. I found, after an informal poll of your colleagues, that a 2nd edition of your book "Healthy Work" (Basic Books 1990) which builds on your last 20 years of research and experience is wanted from you and Tores.

I want to thank you now Bob for your support and the inspiration you have provided me and many others over the past 4 decades.

Both Tores and I have collaborated on a salute to you, composing a song in your honor, which Tores (the only professional musician among the 3 of us) has volunteered to perform.

For Bob when he received his life time career award in May 2011

Melody by Cole Porter: My heart belongs to daddy

(was sung by Eartha Kitt)

He´s such a man, he knows it all
He started the MODEL, it´s rolling
Demand-control - he made us recall
Why our work is not always strolling

Equilibrium, his newest world
Is offering all of us insight
Once again he is throwing light
He is always on a height

He is father of the DC model
In the seventies he triggered us
Cause he knew the way to coddle
Lots of data and computer-based fuss

Now he harvests all the progress
Let him beam and glory with pride
Dear Bob, we like your success
Let us celebrate now at your side

From Töres Theorell

Wednesday, May 18, 2011

What is wrong with Long Live 120/80 --- Part 1 of a 2 part answer

I am assuming that the creators of the advertisement are referring to the blood pressure of the healthy appearing young woman holding her young child and not to the child. Long live 120/80 cannot mean the child's blood pressure since 120/80 would be incredible high for such a youngster. Now I cannot know for sure the mind of the advertiser but i think it is fair to assume they are suggesting the a BP of 120/80 is desirable and that it would be great if this woman continued to have such a BP for an extended period of time.

With these assumptions as my starting point - what is the problem?

The problem begins with the fact that a BP of 120/80, which is a national average in some studies, is neither healthy nor ideal. The authors are making a serious error or equating normality/average with health, a rather common error in medicine.

In fact 120 over 80, representing the systolic and diastolic blood pressures and which are the highest and lowest bp's achieved by the heart during each heart beat, are acknowledged by all major medical institutions, including the AHA, as less than ideal. The Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure the organization responsible for hypertension treatment guidelines stated that BP's of 120-129 systolic over 80-84 diastolic were "prehypertension". (JAMA 2003:289;2560-2571) Ideal or optimal BP is less than 120/80 and in fact the lower one's blood pressure the better (subject to the limitation that very low blood pressures do not cause symptoms).

What no one wants to say is that there is a linear positive relationship between blood pressure levels in a population and increasing risk of stroke and heart attack (the two main consequences of hypertension) and that this increasing risk is apparent even when comparing groups with average bp of 120/80 to those with 110/70 and they in turn are at higher risk than those with 100/60 mm hg. There is no specific # that discriminates the healthy from the unhealthy. Studies, including the Framingham Heart Study (the most famous American epidemiologic study of heart disease), find that as much of 40% of the risk of stroke and heart disease occurs among people with BP's less that 140/90. Also, as we age as a population the average BP increases yearly with increasing risk.

The problem, however, of what is a healthy blood pressure is complicated by a second even more serious problem in the measurement and diagnosis of blood pressure. All of these BP criteria are derived from studies of casual blood pressures, that is bp's taken of patients in a doctors office after several minutes of waiting and relaxing. It is believed these bp's represent accurately what a person's true average underlying bp is and that it is this bp that is the determiner of risk of heart disease.

Recently studies of individual's ambulatory blood pressure obtained using automated monitors that can measure blood pressure while individuals are at work, home, play, and sleep have demonstrated that it is one's average ambulatory bp, especially ones work time ambulatory bp, that is the best predictor of subsequent disease (and not one's casual office obtained bp). And, unfortunately, there is a big discrepancy between most peoples casual office obtained bp's and what their bp is at work. So much so that millions of American are being misdiagnosed as 1) either having hypertension when they do not; that is their bp is up in the doctors office but normal when they wear an ambulatory bp monitor at work (what is called White Coat Hypertension) or 2) there is a failure to diagnosis hypertension because many people have normal bp's in their doctor's office but when they wear an ambulatory bp monitor it is found that their bp is elevated at work and/or at home. Researchers call this problem "hidden hypertension".

Much of this problem of mis-diagnosis could be avoided if individuals routinely were provided with an opportunity to wear an ambulatory bp monitor but the health industry is reluctant to pay for this expense despite the fact that literally millions of people are being mis-diagnosed. Taken together these problems of equating normal/average with healthy and our inaccurate diagnostic methodology means millions of Americans are either being over treated for hypertension they do not have or not being treated for hypertension which is apparent at work but not in the doctors office. This is a major public health disaster.

In Part 2 of this blog we will address the issue of the role that work plays in the creation of the problem of hypertension and how knowing more and doing something about working conditions might provide one pathway to controlling the hypertension epidemic.

Monday, May 9, 2011

What is wrong with this advertisement appearing in the LA Times on Sunday May 8th 2011?

I will provide an answer to this question tomorrow which will get into the problems that medicine as a profession has with the measurement, diagnosis and labeling of health conditions in our industrial society. Yes, there is something seriously wrong here. Can you leave me a comment and tell me what it is? 

Saturday, May 7, 2011

An introduction to Globalization and Unhealthy Work

The following blog is the first in a series looking at globalization. The major part of the blog is a reproduction of my abstract THE ROLE OF GLOBALIZATION IN THE DEVELOPMENT OF UNHEALTHY WORKING CONDITIONS, which I will present at the NIOSH, sponsored conference Work, Stress and Health 2011 to be held May 19-22 at the Doubletree Hotel in Orlando Florida. The focus of the meeting is "Work and Well-Being in an Economic Context.  You can visit the APA's website for more information about the meeting.

It may be helpful to the reader to understand that my training is in Medicine and Epidemiology. I study health outcomes (epidemics) for clues to their causes (my main research interest has been examining the impact of working conditions on hypertension and obesity). Research done by myself and many of my colleagues world-wide strongly supports the conclusion that working conditions influenced by the processes of globalization are having a substantial impact on many health outcomes. In my abstract below I outline the basic argument. In subsequent blogs this perspective will be expanded utilizing topical news events to highlight relevant issues. (see for example Blog's #2 and #3 posted earlier for examples of this approach).

Finally, I plan to create a dictionary of relevant terms to help the reader understand the issues. So we will be defining various concepts as we go along and adding this to a blog that consists only of definitions. Aspects of globalization such as offshoring, outsourcing, and contingent labor, inter alia and of work organization and psychosocial stressors such as long work hours and job strain inter alia will be defined.

Finally, here is my abstract!


Cardiovascular Disease (CVD) has become the #1 cause of morbidity and mortality in the world. More than 1.1 billion people have coronary artery disease and another 1 billion have hypertension, exceeding even poverty as the primary cause of ill-health and death. The recent large increase in the prevalence of CVD in China ( a non-existent disease in China 50 years ago) and other developing countries provided further evidence that CVD, as an epidemic and public health crisis, is of rather recent origin - rooted in the structure of modern societies and associated with industrialization and globalization. This conclusion is supported by the observation that the "traditional" risk factors for CVD such as hypertension, hypercholestrolemia due to diets rich in fat, cigarette consumption, obesity and diabetes are all of recent historical development as well.

The processes of globalization - the steadily increasing inter-dependency of world economies, production, trade, technology and culture - is having an enormous impact on work, work organization and the health of working people. There is now increasing competition among nations and between corporations, as resources grow more scarce. The ongoing need for corporate profitability drives restructuring and downsizing, outsourcing, more and more precarious labor and increasing job insecurity, as well as increased time pressure and intensification of work. Companies search for the cheapest labor markets creating a "race to the bottom" for wages.

These changes in work organization, in turn, give rise to psychosocial stressors such as job strain, effort-reward imbalance, emotional labor, threat-avoidant-vigilant work, organizational injustice, long work hours and work weeks, and shift work, which increase stress and can lead to chronic illnesses, including mental and physical health problems. Psychosocial stressors play important roles in promoting CVD risk factors such as obesity and hypertension.

Research findings explicating the inter-relationship between capitalist economic developments, globalization, changes in work organizations, psychosocial stressors and CVD risk factors will be presented. The economic consequences of these changes and the implications for the health of working people will be discussed and a strategy for promoting healthy work will be presented.

Tuesday, April 19, 2011

Interventions in the Workplace to reduce psychosocial stressors

This blog is the first of a series that will address ways to intervene at the workplace to reduce psychosocial stressors and create a healthier workplace. Our colleague Dr. Tores Theorell, who with Dr. Robert Karasek created the Job Strain model (a leading model of workplace psychosocial stress) has been conducting research intended to shed light on improving the workplace. Here is his blog (at the end of the blog is a short list of references for those interested in more information on this topic). Dr. Theorell is Professor Emeritus in Psychosocial Environmental Medicine, Karolinska Institute, Sweden

How do we increase empathic awareness in managers of the importance of
psychosocial environment at work?

I have been involved in research on adverse psychosocial working
conditions and their effects on employee health since the late 1960's. 

There is no doubt that a change in attitude and knowledge among managers
could be of fundamental importance to the improvement of psychosocial
working conditions for workers in the US and in the whole world. Of course
working with the whole organisation may even be better but to start with
the managers could be a good idea. Peter Schnall and others have discussed
this in the book Unhealthy Work. According to their findings many managers
do not know and even more importantly do not seem to see the importance of
psychosocial working conditions to the health of their workers. They are
also unaware of their organisation´s extensive financial costs caused by
unhealthy working conditions. But how to change such attitudes? In our
first experiment which was evaluated using a controlled design (Theorell et
al Psychosomatic Medicine 2001, see above, open access) a good education
program was used lasting for a year. The manager education was mandatory
for all managers in the ”experimental” part of the organisation. They met
every second week at the work place for a short lecture lasting half an
hour and then split up in discussion groups with 7 participants in each.
The two-week period between sessions was used for practical application and
discussions with manager colleagues and other colleagues. Another part of
the organisation with very similar work tasks and organisation served as
control group. Measurements of psychosocial working conditions and morning
plasma cortisol were performed both in the managers themselves and in their
employees in both groups. During the study year, the morning plasma
cortisol decreased in the employees in the experimental group whereas no
change at all was seen in the comparison group. Also the standard measure
of decision authority showed a significantly better development in the
employees in the experimental group. It should be pointed out that a
strength in this study was that the participating managers were all working
in the same organisation and they supported one another during the process.

I would, however, like to bring your attention to a recently published
article from our group which brings up a topic that could be of major
importance to our ways of dealing with psychosocial work environments. This
project will be discussed in the upcoming Work and Stress congress in
Orlando, Florida, in May 2011. It describes an RCT (randomly controlled design)
experiment comparing two manager education programs and their effects on employees.

Participating managers had to accept in advance that they would be
randomized. A three-day course introducing good management principles was
the start for both groups. They were then randomized to two groups.
Managers attending these two different kinds of education lasting for a
year were followed as well as their subordinates (four subordinates for
each manager) with measurements before start, after one year and then after
a follow-up period of 6 months. Sessions of similar length took place
approximately once a month in both groups. A good established manager
education program (very similar to the one used in the previous study) in
this case constituted the “comparison” condition and it was compared with a
program which included exposure to art experiences (poetry “amplified” by
music) designed to evoke discussions regarding choices in ethically
difficult situations. Group discussions and diaries were used very actively
to structure these ethical discussions. Significantly more beneficial
effects on the employees (mental health using standardised questionnaires
and plasma levels of DHEA-s, a hormone with regenerative/anabolic function
as well as plasma cortisol) were observed half a year after the end of the
two programs after the "new" program compared to the "established"
(actually very good) one, indicating (as one would logically think) a
slightly delayed effect of the program on the employee conditions. Season
effects (May compared to follow-up in November) were balanced by the

It is speculated that effects on empathy were more pronounced on the
managers in the new program with artistic components. Our results indicate
that the employees also seem to experience that there is a change in
attitude (more courage and more agreeableness) in their managers compared
to the employees in the other group. The artistic component represents an
educational principle to be tested in other manager education programs.
However such programs have to be carefully adapted to specific
circumstances. They could perhaps be used as a supplement to other
education. In the comparison between the two programs it should be
mentioned that in the second study the participating managers were “loners”
in the sense that they did not come from one and the same organisation and
accordingly they did not have support from colleagues in the process. This
may be less important in the artistic program in which more individual
effects were likely to arise.

Psychother Psychosom 2011;80:78–87 DOI: 10.1159/000321557 (open access):
Health Effects on Leaders and Co-Workers of an Art-Based Leadership Development Program
Julia Romanowska, Gerry Larsson, Maria Eriksson, Britt-Maj Wikström, Hugo
Westerlund and Töres Theorell, Department of Public Health Sciences, Karolinska Institutet, Stress Research Institute, Stockholm University, Department of Leadership and Management, Swedish National Defense College, Stockholm , Sweden, and Akershus University College, Faculty of Health, Nutrition and Management, Oslo , Norway

Some of our more recent publications are the following:

Theorell, T., Emdad, R., Arnetz, B. and Weingarten, A-M. Employee effects
of an educational program for managers at an insurance company.
Psychosomatic Medicine, 63: 724-733, 2001.

Theorell, T., Oxenstierna, G., Westerlund, H., Ferrie. J., Hagberg, J. and Alfredsson, L. Downsizing of staff is associated with lowered medically certified sick leave in female employees. OEM 60: e9, 2003.

Theorell, T. Democracy at work and its relationship to health. In:
Research in Occupational Stress and Well being.  Emotional and
Physiological Processes and positive intervention strategies. Eds. Perrewé, M.L. and Ganster, D.C. Elsevier, vol 3, 323-357, 2004.

Liljeholm Johansson, Y. and Theorell, T. Satisfaction with work task
quality correlates with employee health. A study of 12 professional
orchestras. Medical Problems of Performing Artists. 18; 141-149, 2003.

Kivimäki, M., Theorell, T., Westerlund, H., Vahtera, J. and Alfredsson, L. Job strain and ischaemic disease: does the inclusion of older employees in the cohort dilute the association? The WOLF Stockholm Study. J Epidemiol Health. 62; 372-374, 2008.

Theorell T. Psychosocial factors in research on work conditions and health in Sweden. Scand J Work Environ Health. 2007;33 Suppl 1:20-6. No abstract available. PMID: 18389569

Hanson, L., Theorell, T., Oxenstierna, G., Hyde, M. and Westerlund, H.
Demand, control and social climate as predictors of emotional exhaustion
symptoms in working Swedish men and women. Scand J Public Health. 36(7),
737-43, 2008

Hagerman, I., Rasmanis, G., Blomkvist, V., Ulrich, R. And Theorell, T.
Influence of intensive coronary care acoustics on the quality of care and
physiological state of patients. J Acoust Soc Am. 123(5); 3094, 2008.

Nyberg, A., Westerlund, H., Magnusson Hanson, L., & Theorell, T.
Managerial leadership is associated with self-reported sickness absence and sickness presenteeism among Swedish men and women. Scand J Publ Health. 26; 803-811, 2008.

Nyberg, A., Alfredsson, L., Theorell, T., Westerlund, H., Vahtera, J. and
Kivimäki, M. Managerial leadership and ischaemic heart disease among
employees: the Swedish WOLF study. Occup Environ Med. 66;1, 51-55, 2009.

Magnusson Hansson, LL., Theorell, T., Bech, P., Rugulies, R., Burr, H.,
Hyde, M., Oxenstierna, G. and Westerlund, H. Psychosocial working
conditions and depressive symptoms among Swedish employees. Int. Arch.
Occup Environ Health. 82; 951-960, 2009 2009.

Theorell, T. Anabolism and catabolism. In: Research in occupational stress
and wellbeing, vol 7. Current perspectives on job-stress recovery. Eds.
Sonnentag, S., Perrewé, P.L., and Ganster, D.C. pp 249-276, 2009.

Hasson D, Theorell T, Liljeholm-Johansson Y, Canlon B. Psychosocial and
physiological correlates of self-reported hearing problems in male and
female musicians in symphony orchestras. Int J Psychophysiol. 74; 93-100,

Theorell, T., Andreeva, E., Leineweber, C., Hanson Magnusson, L.,
Oxenstierna, G., and Westerlund, H. Restructuring and employee health. 5th Int. Vilnius Conf., EURO Mini Conference, Sept 30 – Oct 3, 2009, Vilnius, Lithuania.

Leineweber, C., Westerlund, H., Theorell, T., Kivimäki, M., Westerholm, P. and Alfredsson, L. Covert coping with unfair treatment at work and risk of incident myocardial infarction and cardiac death among men: prospective cohort study. 2011 May;65(5):420-5. Epub 2009 Nov 24

Theorell, T., Bernin, P., Nyberg, A., Oxenstierna, G., Romanowska, J. and
Westerlund, H. Leadership and employment health. A challenge in the
contemporary workplace. In: Contemporary Occupational Health Psychology.
Global perspectives on research and practice. Vol 1. Ed. Houdmont, J. And
Leka, S. Wiley-Blackwell. J Wiley & Sons. 46-58, 2010.

Sunday, April 10, 2011

Where Swedish Capitalists go for CHEAP labor

I didn't know whether to laugh or cry as i read a story today from the front page of the Los Angeles Times about Ikea. Hats off to Nathaniel Popper for this story and to the Times for publishing it.

Of course, outsourcing to foreign countries to find the least expensive labor is not news. As my readers undoubtedly know U.S. companies, among others, have been moving capital to places like China for several decades where workers are paid extremely low wages to manufacture goods for both the U.S. public and other populations. A good book on this subject which I highly recommend is Alan Tonelson's "The Race to the Bottom" Westview Press 2002 which documents this process in detail and the negative consequences for labor forces in both the "developed" and "developing" nations of the world.

But i digress. Ikea, a famous Swedish company, which is the subject of this blog, has a long well-standing reputation as a good employer with high standards of employment. Its workforce in Sweden is entirely unionized and there is even a code of conduct know as IWAY which guarantees workers the right to organize and stipulates that all overtime be voluntary. In fact, in 2008 Ikea had the third highest reputation as a good company (right after Toyota and Google (of course, Toyota is no longer #1 but that's a blog for another day)) in the world according to Reputation Institute's Global Pulse 2008 (this reputation is built on 7 pillars from which a company can create a strategic platform for communicating with its stakeholders on the most relevant key performance indicators. These dimensions are: Products/Services, Innovation, Workplace, Citizenship, Governance, Leadership, and Performance).  Ikea pays its workers in Sweden a minimum wage of $19/hr and a government mandated five weeks of paid vacation. No wonder they have a good reputation. 

So what's the problem. It turns out that Ikea opened an enormous assembly plant in the U.S. in Danville, Va in 2008 with incentives from the state of Virginia in the amount of $12 million. And now, surprise-surprise, there are labor problems with complaints of racial discrimination, a union organizing campaign that is being fiercely opposed by management, and high levels of turnover from among the new employees who are complaining of eliminated raises, a frenzied work-pace and mandatory overtime. Danville employees start with an $8/hr wage with 12 vacation days (8 of the 12 days on days determined by the company).

Incidentally $8 is above the minimum for both Virginia and the U.S. where the minimum wage now is $7.25/hr. Oh yes, we should also keep in mind that 17% of the U.S. workforce has no paid vacation time (See Joe Robinson, Work to Live 2003). So thing could be worse.

But this is outsourcing coming home to roost.  Here is this large international firm identifying the U.S. labor market as a place to invest its capital so that it can hire lower wage workers and make bigger profits. And why pick Virginia for their new plant? Perhaps its due, in part, to the fact that it is one of 22 states (mostly Southern) with "right to work" statutes which prohibit agreements between labor unions and employers making membership or payment of union dues or fees a condition of employment, either before or after hiring. Of course, the purpose of "right to work" laws is to weaken unions and lower wages (6.5% less on average in "right-to-work" states). And another consequence is that states with "right to work" laws according to the U.S. Dept of Labor in general have a higher rate of workplace fatalities (19 of the top 25 are right to work states). Metro Council Democrats Say No to Right to Work for Less

So no unions, anti-union laws, low wages, work intensification, few paid holidays, etc. etc. Is the U.S. becoming the new CHINA!

Friday, April 8, 2011

Working Hours and CVD risk - some new findings

Here are some new science findings that should concern working people. An interesting article authored by Mika Kivimaki and colleagues using data from the Whitehall Study* appeared in the Annals of Internal Medicine** this week.

The authors report, that above and beyond the traditional Framingham Heart Risk score, that working long work days  (beyond a normal 8 hour work day) increases the risk of a coronary event. The risk increases stepwise up to 11 hours. This finding is an interesting echo of a study published by Haiou Yang, myself and several colleagues in the fall of 2006 at the University of California at Irvine. Our study found a relationship between long working hours during the week (increasing #'s of hours of work per week > 40 per week) were associated with an increase in self-reported hypertension in the CHIS (Calif Health Interview Survey) conducted by UCLA.

Readers should be aware that the Framingham risk score is derived by adding up the total risk due to exposure to the "traditional" risk factors for heart disease in particular weight, smoking, cholesterol, blood pressure and diabetes. Both of these articles are suggesting that there are other factors such as longer working hours that above and beyond traditional risk factors are contributing to the likelihood of having a heart attack.

Also i want to point out that the design of both of these studies does not rule out the possibility that even an 8 hour work day or a 40 hour work week may contribute to the development of heart disease. Both of these studies compared increased hours to either the typical work day or typical work week. Unfortunately, there were no subjects available working less than 8 hours a day in the Whitehall study or 35 or less hours in the CHIS study for comparison. 

Not only are long work days and work weeks associated with heart disease but there is accumulating evidence that a number of other organizational and psychosocial work related factors are playing an important role in the development of hypertension and heart disease.  For much more on this topic stay tuned for further blogs or pick up a copy of our book "Unhealthy Work: causes, consequences and cures" published in 2009 by Baywood Publishers.

Readers should note that the Whitehall study has access to data on other work related risk factors including psychosocial variables such as job strain which were not included in the analyses done in this paper. It will be interesting to see future studies where all of these variables are included.

*The original Whitehall Study investigated social determinants of health, specifically the cardiorespiratory disease prevalence and mortality rates among British male civil servants between the ages of 20 and 64. The initial study, the Whitehall I Study, examined over 18,000 male civil servants, and was conducted over a period of ten years, beginning in 1967. A second phase, the Whitehall II Study, examined the health of 10,308 civil servants aged 35 to 55, of whom two thirds were men and one third women. A long-term follow-up of study subjects from the first two phases is ongoing.

** Article appeared in the news this week on April 5th 2011 based on the report in the Annals of Internal Medicine.

Tuesday, April 5, 2011


Welcome to the blog of the Center For Social Epidemiology. The purpose of this blog is to present, for discussion, information related to working conditions and their impact on health. This blog will discuss globalization, its influence on the modern organization of work and it's role in the decline of health in working people internationally. We hope that you find this blog helpful in your search for information and understanding, whether it is personal or professional.