Healthy Workplace 

 Tarra sits down for a live podcast interview in the Haworth Showroom in Chicago with authors of “The Healthy Workplace Nudge,” Dr. Mike O’Neill and Rex Miller, to discuss what can create a healthy workplace, less stress, and a more healthy life.

I’m Mike O'Neill, I work for Haworth. I lead our local research and our workplace strategy departments.  The main focus of my research has been trying to make the connection between the impact of the design space on people’s health, performance, and stress. This book has been a wonderful opportunity to explore, in some more depth and in a bigger context, some of these issues. 


I’m Rex Miller. I actually grew up in Arlington Heights, went to the University of Illinois, and went down to Texas. My company is called Mindshift, and we provide research and pull people together for collective research projects on topics that seem to be stuck.  We cover topics like workplace engagement, getting projects delivered on time within budget,  how not hate each other at the end of the project, and this whole challenge of health and wellbeing.   We also go out and look at what we call “outliers” - people who are breaking the rules and getting better results. Then we synthesize it, make thought leadership into market leadership, and provide training companies that actually want to do this new stuff.  I like to think we provide adult supervision for grown-ups that can’t get along.

Let’s talk about stress in the workplace. 
Mike: Well I’ve been looking at stress in the workplace for many years.  In actuality, our jobs are very, very risky. The problem is that our bodies are wired in a way that when you have a stressful experience at work, your body releases some hormones automatically – and you have no control over this. Cortisol and some adrenalines, things like that, you have no control over. Now, those are designed to pump up your body. They affect your muscles, they hit your heart, your heart rate increases, all this stuff happens. This is the fight-or-flight syndrome. That was designed for back in the day, when we were hunting mastodons or running from saber-toothed tigers back in the caveman days. That served a useful function. You got a shot of those things, and you could run real fast or perform superhuman duties.  And now, you don’t get to burn that stuff up, it just sits in your bloodstream. And this cortisol and so forth, it circulates around for about 24 hours before your kidneys can clear it out. That’s in time for you to go back to work and get another shot. So over time, even though it’s just a slightly elevated level of these hormones, it’s extremely caustic, and it’s very bad for your body. It’s known as the gateway to disease, to coronary heart disease and cancer, horrible things.


Rex: 78% of employees report that work is the number one source of either high or very high stress. And work is now the number five leading cause of death. Deaths go up 20% on Mondays. So something’s going on, and we’re starting to see in the younger generation, the millennials, all kinds of autoimmune disorders showing up. [...] These are because with chronic stress, you get a permanent pathway built in that stays on all the time. So it’s fight-or-flight, all the time. And it doesn’t shut off.


Where is that stress coming from? 
Rex: It’s everywhere. It’s the devices you’re handling. It’s all the stimulation, it’s the overstimulation. It’s the financial challenges. It’s the choices, the over-choices. It’s just part of the modern condition, and it’s exacerbated because of the work environment performance. And we need to get a handle on that. So what we’ve seen is there’s lots of things that you can do in the workplace to reduce stress, that your employer can do, design can do that, because stress is essentially friction points, or things that elevate that cortisol. 

Mike: Right. And the other thing is a personality characteristic some people have more than others, and it’s this concept that’s called rumination. Rumination is where you think about things over and over and over. And I have to say, it almost seems like a generational characteristic. Millennials seem to replay everything, and it’s almost like creating your own traumatic cycle and you can’t stop playing it. The problem with that is that people who ruminate a lot are at work, and they’re stressed out all day. Something happened that stressed you out. What do you do? You go home, you binge watch, because you’re trying to keep yourself from thinking about that and replaying that tape over and over. 
The problem is, when you’re replaying that tape over and over, you’re triggering more stress. That’s just as bad as when you experienced it. So one of the things we actually talked about earlier today is, in terms of design, is there something we can do with people when they come home from work, design or process or something about your work or life, that helps you to shut off that rumination off somehow? Because it’s just as damaging as actually going through it.

Rex: [...] The worst thing you can do is be watching something all the way up to bedtime or reading an email before bedtime. It’ll take two hours for your mind to shut off to do that. So we have to start learning some of these new practices and patterns. Bedrooms should not be for anything else but a couple activities, and tv’s not one of them. That space, it’s a cue, it’s a safe place or it’s not, and we have to learn how to do that kind of thing.

Mike: Make your bedroom a place of refuge, have books and magazines there. Don’t have your digital inputs.












Why are millennials less healthy than the last generation? 

Rex: First of all, obesity is starting at a much earlier age. You never heard about childhood diabetes when we were growing up. 1984 is when we shifted as a nation to consuming more calories on average. So the previous 100 years, we had been consuming 400 less calories, or in other words, in 1984 we jumped up 400 more calories a day per person on average. And then there’s the kinds of foods we were beginning to eat. So you look around at all of immediate meals, the microwave, things like that. I was outdoors playing all the time, and now we’ve got video games and an indoor, sedentary lifestyle.
I was just in a college that did a health risk assessment on all of them. This is a vegan college. They serve no meat. And so here are the health stats: 20% of the 18-year-olds coming in are obese or overweight. 40% are going to graduate obese or overweight. 60% do not eat breakfast in the morning, 60% get less than six hours of sleep at night. When I graduated, I was in the best physical health in my life. But that’s not the case for this generation. So they’re already starting out 10 to 15 years ahead of the unhealthy curve than my generation.

Mike: So if you think about the cost of that for an organization, it used to be, you came into a professional organization when you were maybe 21, 22 years old, and the assumption was that your healthcare costs would be nominal for at least the first 20 years you were there. Then, of course, as you age, there are naturally things that happen. That was the expectation. Now look at the health and the cost burden on companies. If people are coming in, age 21 and 22, already with these chronic diseases, what shape are they going to be in in 20 years? It’s scary.


What is the importance of sleep? How much sleep should we be getting? 
Rex: The bottom line is when I started getting quality sleep, like today, I got high recovery. I didn’t realize that I’m moving slowly, lethargically. That felt normal. The difference was night and day. [...]  Everybody has a different sleep cycle and sleep rhythm. So anywhere from six and a half to eight is somewhere in the optimal, depending on your sleep rhythm. But it’s the quality of sleep. You may be in bed for eight hours, but if you watch tv for two hours, you are still awake, so you didn’t get good sleep.


Mike: Think of all the ads you see on tv or on the media in general for beds. It’s this huge business. It used to be that you bought a mattress and that was about it. Now they’re electronic, they move up, they do all that stuff. People are so sleep-deprived that they’ll search for anything. And those are not inexpensive solutions either.


What are some of the solutions that you found during your research in order to combat these problems? 

Mike: Any athlete, when they train, they train very intensively, then they build in periods of respite, because you can’t build yourself up without reconstruction time, mentally and physically. So it’s always built into any athlete’s regime.  So if you think of all of us as workers, you go into work, you work out early in the morning because you’re so efficient, you get that out of the way, then you blast off into work. You’re on full blast all day, and then you go home, maybe it’s time to make dinner or it’s time to do something else. You’ve got to interact with all this stuff. So you’re on all day.  You’re actually going into work each day and you’re supposed to perform like an athlete. But there’s no respite built in. And we just assume we can do that, but that’s one of the parts of the problem that causes the sleep deprivation and some of these other issues. You’re just worn out.


Rex: We’re designed to work in rhythms, just like sleep. It’s a cycle. So through the day, your energy will ebb and flow in about a 90-minute cycle. Dr. Mike this afternoon said, “Hey, I’m going to go take a walk, take a break.” So taking true breaks is important, every 45 to 90 minutes. Your brain doesn’t have nerve endings, so it doesn’t know when you’ve burnt it out. So if you’re doing focus work for 90 minutes, you’re hurting yourself. And take a true nap – I do that. I go in the car, for 20 minutes, no more, so you don’t go into deep sleep. I manage my energy more than my time now and I look at where I’m optimal, and then I do my most important work. Focus work is very important, it’s very rejuvenating, so I make sure I have no interruptions, no emails, no calls before 10:30 in the morning.I do focused, quality work. The average person’s focused work is about 15 minutes long with three interruptions. Getting true focused work is healthy for you, being interrupted is unhealthy. Taking respites throughout the day, getting good sleep, getting properly hydrated – just look at what athletes do, and do that at work. [...] It’s basic stuff, but the environments give us all the wrong cues.

Mike: Focus and attaining flow, that is rejuvenating, and it’s something that we talk about with top athletes. Well, as workers, we can be in flow too. It seems like over the last ten years or so, offices have been almost purposefully designed to delegitimize your right to focus to work. [...] It’s all about being in constant interaction with people. And it drives you nuts. And so what do you hear? “Oh, where were you on Friday?” “Oh, I stayed at home and I finally got some work done.” What does that say about the office space, right? People are so desperate that they’re actually removing themselves from the unceasing stimulation to just get a break. 


So what are things that offices can do? What have you found in your research that designers should know when designing office spaces?
Mike: I think that we’ve created spaces that the pendulum has swung to the point of being absurd in making spaces that are highly densified. Everybody’s jammed together, it’s all wide open, and there’s no place to go. They do that to save money. I get that, that’s a legitimate business need. But you have to take some of that space that you’ve gathered up and reallocate it to create other types of refuge spaces, whether that refuge space is a place to just chill and contemplate, or just a little focus room. The other part of that is management culture too, because you have to have a culture where people aren’t expected to sit at their bench or in their cube. [...] It’s management practices, it’s designing a space to provide the opportunities for that, it’s so very important. And you as designers, I’m sure you’re already moving in that direction.

Rex: The behaviors the space communicates gives permission for the cues. Those are nudges. [...] There’s lots of design cues that you can put in. Another thing that you can think about is employee experience.Companies are looking at every touch point. The client comes to the parking lot, what’s the experience like? So think about every single touch point an employee has, and it’s either a friction point, a neutral point, or a positive experience. So how do you begin thinking through that journey through the day, all the flows, all these things are touch points that are design questions that reduce friction overall. And it becomes a positive experience. So that’s another design area. So the nudges, the friction points, and then creating a healthy building to begin with. 

What are your most impactful changes that you can make when you’re in an existing building? 
Rex: I think a lot of them are the behavior changes. Starting to shift the behavior and the habits and the norms, and those don’t cost anything. 

Mike: Think about changed management. I would argue that that does cost. [...] But at the same time, it’s a pretty small cost, compared to the impact, and I would say some of the projects I’ve been involved with are doing significant change to the workspace. We would do the move and then track them after that, and we were seeing kind of negative results from that. After the fact, hiring changed management in there to do some training. [...] We’re all in this industry and we think about stuff all the time, so we just assume people know how to use these wonderful spaces we create, and it really isn’t true. 

After you start implementing these changes, what’s the time stamp where you start to really see improvements?
Rex: It is a soft metric. I would recommend companies looking at leading indicators. These are behavior and attitude things. Those are the ones that eventually end up in lagging indicators.

Mike: We wait typically at least 90 days after a move, especially because a lot of stuff that can skew the results could be the technology still not working right, you know, it takes time to get the bugs out. You want to make sure you have a level playing field where people are really back to work. Some of the metrics we look at are people’s ratings of their happiness and their own sense of wellbeing. We rated it on where people put themselves on their life life ladder, which is a ten-rung ladder where if you’re on the first rung it’s as bad as it can get and ten is like nirvana. We also look at the frequency of reported stress symptoms, which is not sleeping the night before, being drowsy at work, upset stomach. This is your body telling you, “I am under stress,” and those sort of leading indicators of future health problems. [...] And actually, the truth is, doing good science, the time that you wait after a move should be equivalent to before the move that you took the pre-move survey. Let’s say you did the pre-move survey two months before the move, theoretically, you should wait two months after the move. 

What’s your challenge for the millennials?
One thing you can do that would really make a big difference is begin removing the stigma about talking about stress, because in my generation, stress is a badge of honor. I’m sure each one of you has something going on health-wise in your family. We never talk about that at work. And that was one of the things that I personally went through that really woke me out to the fact that, “Gee, everybody’s going through something, but we never talk about it at work.” All we do is, I’m going to tell you, “Hey I’m going to take an extra 30 minutes at work,” and you kind of nod and say, “OK.” But outside of that, we don’t talk about it, we don’t rally around each other through all these types of things. So one powerful thing is just moving this conversation to get us to talk about what is stress doing to us, these health issues that we have to deal with, it can be normal. These are normal things we’re dealing with.


Mike: I do think a challenge to the millennial generation is to get ahold of your stress and get social support for it. For people working under very high-stress occupations, the key driver of lower stress and better health is psycho-social support. I do see a lot of that in the work environment, but maybe one of the things is to not hesitate to bring up if you have a health issue. It shouldn’t be stigmatized. 

What are some baby steps we can take? 
First thing is get the conversation started with a book like ours – or another book. Just get the conversation started. The second is to create cohorts, support teams, people who are going to support doing the same thing together. Learn about different areas of health together. Eating, sleeping, just doing everything together. We have a whole chapter in the book on how to start a movement as a second chair person if you’re not in a leadership role. [...] These are things you can do. Start with baby steps, but just start doing it. 

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