Most of the articles in this chapter deal with aspects of the work environment that are proximal to the individual employee. The focus of this article, however, is to examine the impact of more distal, macrolevel characteristics of organizations as a whole that may affect employees’ health and well-being. That is, are there ways in which organizations structure their internal environments that promote health among the employees of that organization or, conversely, place employees at greater risk of experiencing stress? Most theoretical models of occupational or job stress incorporate organizational structural variables such as organizational size, lack of participation in decision making, and formalization (Beehr and Newman 1978; Kahn and Byosiere 1992).

Organizational structure refers to the formal distribution of work roles and functions within an organization coordinating the various functions or subsystems within the organization to efficiently attain the organization’s goals (Porras and Robertson 1992). As such, structure represents a coordinated set of subsystems to facilitate the accomplishment of the organization’s goals and mission and defines the division of labour, the authority relationships, formal lines of communication, the roles of each organizational subsystem and the interrelationships among these subsystems. Therefore, organizational structure can be viewed as a system of formal mechanisms to enhance the understandability of events, predictability of events and control over events within the organization which Sutton and Kahn (1987) proposed as the three work-relevant antidotes against the stress-strain effect in organizational life.

One of the earliest organizational characteristics examined as a potential risk factor was organizational size. Contrary to the literature on risk of exposure to hazardous agents in the work environment, which suggests that larger organizations or plants are safer, being less hazardous and better equipped to handle potential hazards (Emmett 1991), larger organizations originally were hypothesized to put employees at greater risk of occupational stress. It was proposed that larger organizations tend to adapt a bureaucratic organizational structure to coordinate the increased complexity. This bureaucratic structure would be characterized by a division of labour based on functional specialization, a well-defined hierarchy of authority, a system of rules covering the rights and duties of job incumbents, impersonal treatment of workers and a system of procedures for dealing with work situations (Bennis 1969). On the surface, it would appear that many of these dimensions of bureaucracy would actually improve or maintain the predictability and understandability of events in the work environment and thus serve to reduce stress within the work environment. However, it also appears that these dimensions can reduce employees’ control over events in the work environment through a rigid hierarchy of authority.

Given these characteristics of bureaucratic structure, it is not surprising that organizational size, per se, has received no consistent support as a macro-organization risk factor (Kahn and Byosiere 1992). Payne and Pugh’s (1976) review, however, provides some evidence that organizational size indirectly increases the risk of stress. They report that larger organizations suffered a reduction in the amount of communication, an increase in the amount of job and task specifications and a decrease in coordination. These effects could lead to less understanding and predictability of events in the work environment as well as a decrease in control over work events, thus increasing experienced stress (Tetrick and LaRocco 1987).

These findings on organizational size have led to the supposition that the two aspects of organizational structure that seem to pose the most risk for employees are formalization and centralization. Formalization refers to the written procedures and rules governing employees’ activities, and centralization refers to the extent to which the decision-making power in the organization is narrowly distributed to higher levels in the organization. Pines (1982) pointed out that it is not formalization within a bureaucracy that results in experienced stress or burnout but the unnecessary red tape, paperwork and communication problems that can result from formalization. Rules and regulations can be vague creating ambiguity or contradiction resulting in conflict or lack of understanding concerning appropriate actions to be taken in specific situations. If the rules and regulations are too detailed, employees may feel frustrated in their ability to achieve their goals especially in customer or client-oriented organizations. Inadequate communication can result in employees feeling isolated and alienated based on the lack of predictability and understanding of events in the work environment.

While these aspects of the work environment appear to be accepted as potential risk factors, the empirical literature on formalization and centralization are far from consistent. The lack of consistent evidence may stem from at least two sources. First, in many of the studies, there is an assumption of a single organizational structure having a consistent level of formalization and centralization throughout the entire organization. Hall (1969) concluded that organizations can be meaningfully studied as totalities; however, he demonstrated that the degree of formalization as well as decision-making authority can differ within organizational units. Therefore, if one is looking at an individual level phenomenon such as occupational stress, it may be more meaningful to look at the structure of smaller organizational units than that of the whole organization. Secondly, there is some evidence suggesting that there are individual differences in response to structural variables. For example, Marino and White (1985) found that formalization was positively related to job stress among individuals with an internal locus of control and negatively related to stress among individuals who generally believe that they have little control over their environments. Lack of participation, on the other hand, was not moderated by locus of control and resulted in increased levels of job stress. There also appear to be some cultural differences affecting individual responses to structural variables, which would be important for multinational organizations having to operate across national boundaries (Peterson et al. 1995). These cultural differences also may explain the difficulty in adopting organizational structures and procedures from other nations.

Despite the rather limited empirical evidence implicating structural variables as psychosocial risk factors, it has been recommended that organizations should change their structures to be flatter with fewer levels of hierarchy or number of communication channels, more decentralized with more decision- making authority at lower levels in the organization and more integrated with less job specialization (Newman and Beehr 1979). These recommendations are consistent with organizational theorists who have suggested that traditional bureaucratic structure may not be the most efficient or healthiest form of organizational structure (Bennis 1969). This may be especially true in light of technological advances in production and communication that characterize the postindustrial workplace (Hirschhorn 1991).

The past two decades have seen considerable interest in the redesign of organizations to deal with external environmental threats resulting from increased globalization and international competition in North America and Western Europe (Whitaker 1991). Straw, Sandelands and Dutton (1988) proposed that organizations react to environmental threats by restricting information and constricting control. This can be expected to reduce the predictability, understandability and control of work events thereby increasing the stress experienced by the employees of the organization. Therefore, structural changes that prevent these threat-ridigity effects would appear to be beneficial to both the organization’s and employees’ health and well-being.

The use of a matrix organizational structure is one approach for organizations to structure their internal environments in response to greater environmental instability. Baber (1983) describes the ideal type of matrix organization as one in which there are two or more intersecting lines of authority, organizational goals are achieved through the use of task-oriented work groups which are cross-functional and temporary, and functional departments continue to exist as mechanisms for routine personnel functions and professional development. Therefore, the matrix organization provides the organization with the needed flexibility to be responsive to environmental instability if the personnel have sufficient flexibility gained from the diversification of their skills and an ability to learn quickly.

While empirical research has yet to establish the effects of this organizational structure, several authors have suggested that the matrix organization may increase the stress experienced by employees. For example, Quick and Quick (1984) point out that the multiple lines of authority (task and functional supervisors) found in matrix organizations increase the potential for role conflict. Also, Hirschhorn (1991) suggests that with postindustrial work organizations, workers frequently face new challenges requiring them to take a learning role. This results in employees having to acknowledge their own temporary incompetencies and loss of control which can lead to increased stress. Therefore, it appears that new organizational structures such as the matrix organization also have potential risk factors associated with them.

Attempts to change or redesign organizations, regardless of the particular structure that an organization chooses to adopt, can have stress-inducing properties by disrupting security and stability, generating uncertainty for people’s position, role and status, and exposing conflict which must be confronted and resolved (Golembiewski 1982). These stress-inducing properties can be offset, however, by the stress-reducing properties of organizational development which incorporate greater empowerment and decision making across all levels in the organization, enhanced openness in communication, collaboration and training in team building and conflict resolution (Golembiewski 1982; Porras and Robertson 1992).

Conclusion

While the literature suggests that there are occupational risk factors associated with various organizational structures, the impact of these macrolevel aspects of organizations appear to be indirect. Organizational structure can provide a framework to enhance the predictability, understandability and control of events in the work environment; however, the effect of structure on employees’ health and well-being is mediated by more proximal work-environment characteristics such as role characteristics and interpersonal relations. Structuring organizations for healthy employees as well as healthy organizations requires organizational flexibility, worker flexibility and attention to the sociotechnical systems that coordinate the technological demands and the social structure within the organization.

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The organizational context in which people work is characterized by numerous features (e.g., leadership, structure, rewards, communication) subsumed under the general concepts of organizational climate and culture. Climate refers to perceptions of organizational practices reported by people who work there (Rousseau 1988). Studies of climate include many of the most central concepts in organizational research. Common features of climate include communication (as describable, say, by openness), conflict (constructive or dysfunctional), leadership (as it involves support or focus) and reward emphasis (i.e., whether an organization is characterized by positive versus negative feedback, or reward- or punishment-orientation). When studied together, we observe that organizational features are highly interrelated (e.g., leadership and rewards). Climate characterizes practices at several levels in organizations (e.g., work unit climate and organizational climate). Studies of climate vary in the activities they focus upon, for example, climates for safety or climates for service. Climate is essentially a description of the work setting by those directly involved with it.

The relationship of climate to employee well-being (e.g., satisfaction, job stress and strain) has been widely studied. Since climate measures subsume the major organizational characteristics workers experience, virtually any study of employee perceptions of their work setting can be thought of as a climate study. Studies link climate features (particularly leadership, communication openness, participative management and conflict resolution) with employee satisfaction and (inversely) stress levels (Schneider 1985). Stressful organizational climates are characterized by limited participation in decisions, use of punishment and negative feedback (rather than rewards and positive feedback), conflict avoidance or confrontation (rather than problem solving), and nonsupportive group and leader relations. Socially supportive climates benefit employee mental health, with lower rates of anxiety and depression in supportive settings (Repetti 1987). When collective climates exist (where members who interact with each other share common perceptions of the organization) research observes that shared perceptions of undesirable organizational features are linked with low morale and instances of psychogenic illness (Colligan, Pennebaker and Murphy 1982). When climate research adopts a specific focus, as in the study of climate for safety in an organization, evidence is provided that lack of openness in communication regarding safety issues, few rewards for reporting occupational hazards, and other negative climate features increase the incidence of work-related accidents and injury (Zohar 1980).

Since climates exist at many levels in organizations and can encompass a variety of practices, assessment of employee risk factors needs to systematically span the relationships (whether in the work unit, the department or the entire organization) and activities (e.g., safety, communication or rewards) in which employees are involved. Climate-based risk factors can differ from one part of the organization to another.

Culture constitutes the values, norms and ways of behaving which organization members share. Researchers identify five basic elements of culture in organizations: fundamental assumptions (unconscious beliefs that shape member’s interpretations, e.g., views regarding time, environmental hostility or stability), values (preferences for certain outcomes over others, e.g., service or profit), behavioural norms (beliefs regarding appropriate and inappropriate behaviours, e.g., dress codes and teamwork), patterns of behaviours (observable recurrent practices, e.g., structured performance feedback and upward referral of decisions) and artefacts (symbols and objects used to express cultural messages, e.g., mission statements and logos). Cultural elements which are more subjective (i.e., assumptions, values and norms) reflect the way members think about and interpret their work setting. These subjective features shape the meaning that patterns of behaviours and artefacts take on within the organization. Culture, like climate, can exist at many levels, including:

1. a dominant organizational culture
2. subcultures associated with specific units, and
3. countercultures, found in work units that are poorly integrated with the larger organization.

Cultures can be strong (widely shared by members), weak (not widely shared), or in transition (characterized by gradual replacement of one culture by another).

In contrast with climate, culture is less frequently studied as a contributing factor to employee well-being or occupational risk. The absence of such research is due both to the relatively recent emergence of culture as a concept in organizational studies and to ideological debates regarding the nature of culture, its measurement (quantitative versus qualitative), and the appropriateness of the concept for cross-sectional study (Rousseau 1990). According to quantitative culture research focusing on behavioural norms and values, team-oriented norms are associated with higher member satisfaction and lower strain than are control- or bureaucratically -oriented norms (Rousseau 1989). Furthermore, the extent to which the worker’s values are consistent with those of the organization affects stress and satisfaction (O’Reilly and Chatman 1991). Weak cultures and cultures fragmented by role conflict and member disagreement are found to provoke stress reactions and crises in professional identities (Meyerson 1990). The fragmentation or breakdown of organizational cultures due to economic or political upheavals affects the well-being of members psychologically and physically, particular in the wake of downsizings, plant closings and other effects of concurrent organizational restructurings (Hirsch 1987). The appropriateness of particular cultural forms (e.g., hierarchic or militaristic) for modern society has been challenged by several culture studies (e.g., Hirschhorn 1984; Rousseau 1989) concerned with the stress and health-related outcomes of operators (e.g., nuclear power technicians and air traffic controllers) and subsequent risks for the general public.

Assessing risk factors in the light of information about organizational culture requires first attention to the extent to which organization members share or differ in basic beliefs, values and norms. Differences in function, location and education create subcultures within organizations and mean that culture-based risk factors can vary within the same organization. Since cultures tend to be stable and resistant to change, organizational history can aid assessment of risk factors both in terms of stable and ongoing cultural features as well as recent changes that can create stressors associated with turbulence (Hirsch 1987).

Climate and culture overlap to a certain extent, with perceptions of culture’s patterns of behaviour being a large part of what climate research addresses. However, organization members may describe organizational features (climate) in the same way but interpret them differently due to cultural and subcultural influences (Rosen, Greenlagh and Anderson 1981). For example, structured leadership and limited participation in decision making may be viewed as negative and controlling from one perspective or as positive and legitimate from another. Social influence reflecting the organization’s culture shapes the interpretation members make of organizational features and activities. Thus, it would seem appropriate to assess both climate and culture simultaneously in investigating the impact of the organization on the well-being of members.

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There are many forms of compensation used in business and government organizations throughout the world to pay workers for their physical and mental contribution. Compensation provides money for human effort and is necessary for individual and family existence in most societies. Trading work for money is a long-established practice.

The health-stressor aspect of compensation is most closely linked with compensation plans that offer incentives for extra or sustained human effort. Job stress can certainly exist in any work setting where compensation is not based on incentives. However, physical and mental performance levels that are well above normal and that could lead to physical injury or injurious mental stress is more likely to be found in environments with certain kinds of incentive compensation.

Performance Measures and Stress

Performance measurements in one form or another are used by most organizations, and are essential for incentive programmes. Performance measures (standards) can be established for output, quality, throughput time, or any other productivity measure. Lord Kelvin in 1883 had this to say about measurements: “I often say that when you can measure what you are speaking about, and express it in numbers, you know something about it; but when you cannot measure it, when you cannot express it in numbers, your knowledge is a meagre and unsatisfactory kind; it may be the beginning of knowledge, but you have scarcely, in your thoughts, advanced to the stage of science, whatever the matter may be.”

Performance measures should be carefully linked to the fundamental goals of the organization. Inappropriate performance measurements have often had little or no effect on goal attainment. Some common criticisms of performance measures include unclear purpose, vagueness, lack of connection (or even opposition, for that matter) to the business strategy, unfairness or inconsistency, and their liability to be used chiefly for “punishing” people. But measurements can serve as indispensable benchmarks: remember the saying, “If you don’t know where you are, you can’t get to where you want to be”. The bottom line is that workers at all levels in an organization demonstrate more of the behaviours that they are measured on and rewarded to evince. What gets measured and rewarded gets done.

Performance measures must be fair and consistent to minimize stress among the workforce. There are several methods utilised to establish performance measures ranging from judgement estimation (guessing) to engineered work measurement techniques. Under the work measurement approach to setting performance measures, 100% performance is defined as a “fair day’s work pace”. This is the work effort and skill at which an average well-trained employee can work without undue fatigue while producing an acceptable quality of work over the course of a work shift. A 100% performance is not maximum performance; it is the normal or average effort and skill for a group of workers. By way of comparison, the 70% benchmark is generally regarded as the minimum tolerable level of performance, while the 120% benchmark is the incentive effort and skill that the average worker should be able to attain when provided with a bonus of at least 20% above the base rate of pay. While a number of incentive plans have been established using the 120% benchmark, this value varies among plans. The general design criteria recommended for wage incentive plans provide workers the opportunity to earn approximately 20 to 35% above base rate if they are normally skilled and execute high effort continuously.

Despite the inherent appeal of a “fair day’s work for a fair day’s pay”, some possible stress problems exist with a work measurement approach to setting performance measures. Performance measures are fixed in reference to the normal or average performance of a given work group (i.e., work standards based on group as opposed to individual performance). Thus, by definition, a large segment of those working at a task will fall below average (i.e., the 100% performance benchmark) generating a demand–resource imbalance that exceeds physical or mental stress limits. Workers who have difficulty meeting performance measures are likely to experience stress through work overload, negative supervisor feedback, and threat of job loss if they consistently perform below the 100% performance benchmark.

Incentive Programmes

In one form or another, incentives have been used for many years. For example, in the New Testament (II Timothy 2:6) Saint Paul declares, “It is the hard-working farmer who ought to have the first share of the crops”. Today, most organizations are striving to improve productivity and quality in order to maintain or improve their position in the business world. Most often workers will not give extra or sustained effort without some form of incentive. Properly designed and implemented financial incentive programmes can help. Before any incentive programme is implemented, some measure of performance must be established. All incentive programmes can be categorized as follows: direct financial, indirect financial, and intangible (non-financial).

Direct financial programmes may be applied to individuals or groups of workers. For individuals, each employee’s incentive is governed by his or her performance relative to a standard for a given time period. Group plans are applicable to two or more individuals working as a team on tasks that are usually interdependent. Each employee’s group incentive is usually based on his or her base rate and the group performance during the incentive period.

The motivation to sustain higher output levels is usually greater for individual incentives because of the opportunity for the high-performing worker to earn a greater incentive. However, as organizations move toward participative management and empowered work groups and teams, group incentives usually provide the best overall results. The group effort makes overall improvements to the total system as compared to optimizing individual outputs. Gainsharing (a group incentive system that has teams for continuous improvement and provides a share, usually 50%, of all productivity gains above a benchmark standard) is one form of a direct group incentive programme that is well suited for the continuous improvement organization.

Indirect financial programmes are usually less effective than direct financial programmes because direct financial incentives are stronger motivators. The principal advantage of indirect plans is that they require less detailed and accurate performance measures. Organizational policies that favourably affect morale, result in increased productivity and provide some financial benefit to employees are considered to be indirect incentive programmes. It is important to note that for indirect financial programmes no exact relationship exists between employee output and financial incentives. Examples of indirect incentive programmes include relatively high base rates, generous fringe benefits, awards programmes, year-end bonuses and profit-sharing.

Intangible incentive programmes include rewards that do not have any (or very little) financial impact on employees. These programmes, however, when viewed as desirable by the employees, can improve productivity. Examples of intangible incentive programmes include job enrichment (adding challenge and intrinsic satisfaction to the specific task assignments), job enlargement (adding tasks to complete a “whole” piece or unit of work output), nonfinancial suggestion plans, employee involvement groups and time off without any reduction in pay.

Summary and Conclusions

Incentives in some form are an integral part of many compensation plans. In general, incentive plans should be carefully evaluated to make sure that workers are not exceeding safe ergonomic or mental stress limits. This is particularly important for individual direct financial plans. It is usually a lesser problem in group direct, indirect or intangible plans.

Incentives are desirable because they enhance productivity and provide workers an opportunity to earn extra income or other benefits. Gainsharing is today one of the best forms of incentive compensation for any work group or team organization that wishes to offer bonus earnings and to achieve improvement in the workplace without risking the imposition of negative health-stressors by the incentive plan itself.

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Contingent Workforce

The nations of the world vary dramatically in both their use and treatment of employees in their contingent workforce. Contingent workers include temporary workers hired through temporary help agencies, temporary workers hired directly, voluntary and “non-voluntary” part-timers (the non-voluntary would prefer full-time work) and the self-employed. International comparisons are difficult due to differences in the definitions of each of these categories of worker.

Overman (1993) stated that the temporary help industry in Western Europe is about 50% larger than it is in the United States, where about 1% of the workforce is made up of temporary workers. Temporary workers are almost non-existent in Italy and Spain.

While the subgroups of contingent workers vary considerably, the majority of part-time workers in all European countries are women at low salary levels. In the United States, contingent workers also tend to be young, female and members of minority groups. Countries vary considerably in the degree to which they protect contingent workers with laws and regulations covering their working conditions, health and other benefits. The United Kingdom, the United States, Korea, Hong Kong, Mexico and Chile are the least regulated, with France, Germany, Argentina and Japan having fairly rigid requirements (Overman 1993). A new emphasis on providing contingent workers with greater benefits through increased legal and regulatory requirements will help to alleviate occupational stress among those workers. However, those increased regulatory requirements may result in employers’ hiring fewer workers overall due to increased benefit costs.

Job Sharing

An alternative to contingent work is “job sharing,” which can take three forms: two employees share the responsibilities for one full-time job; two employees share one full-time position and divide the responsibilities, usually by project or client group; or two employees perform completely separate and unrelated tasks but are matched for purposes of headcount (Mattis 1990). Research has indicated that most job sharing, like contingent work, is done by women. However, unlike contingent work, job sharing positions are often subject to the protection of wage and hour laws and may involve professional and even managerial responsibilities. Within the European Community, job sharing is best known in Britain, where it was first introduced in the public sector (Lewis, Izraeli and Hootsmans 1992). The United States Federal Government, in the early 1990s, implemented a nationwide job sharing programme for its employees; in contrast, many state governments have been establishing job sharing networks since 1983 (Lee 1983). Job sharing is viewed as one way to balance work and family responsibilities.

Flexiplace and Home Work

Many alternative terms are used to denote flexiplace and home work: telecommuting, the alternative worksite, the electronic cottage, location-independent work, the remote workplace and work-at-home. For our purposes, this category of work includes “work performed at one or more ‘predetermined locations’ such as the home or a satellite work space away from the conventional office where at least some of the communications maintained with the employer occur through the use of telecommunications equipment such as computers, telephones and fax machines” (Pitt-Catsouphes and Marchetta 1991).

LINK Resources, Inc., a private-sector firm monitoring worldwide telecommuting activity, has estimated that there were 7.6 million telecommuters in 1993 in the United States out of the over 41.1 million work-at-home households. Of these telecommuters 81% worked part-time for employers with less than 100 employees in a wide array of industries across many geographical locations. Fifty-three% were male, in contrast to figures showing a majority of females in contingent and job-sharing work. Research with fifty US companies also showed that the majority of telecommuters were male with successful flexible work arrangements including supervisory positions (both line and staff), client-centred work and jobs that included travel (Mattis 1990). In 1992, 1.5 million Canadian households had at least one person who operated a business from home.

Lewis, Izraeli and Hootsman(1992) reported that, despite earlier predictions, telecommuting has not taken over Europe. They added that it is best established in the United Kingdom and Germany for professional jobs including computer specialists, accountants and insurance agents.

In contrast, some home-based work in both the United States and Europe pays by the piece and involves short deadlines. Typically, while telecommuters tend to be male, homeworkers in low-paid, piece-work jobs with no benefits tend to be female (Hall 1990).

Recent research has concentrated on identifying; (a) the type of person best suited for home work; (b) the type of work best accomplished at home; (c) procedures to ensure successful home work experiences and (d) reasons for organizational support (Hall 1990; Christensen 1992).

Welfare Facilities

The general approach to social welfare issues and programmes varies throughout the world depending upon the culture and values of the nation studied. Some of the differences in welfare facilities in the United States, Canada and Western Europe are documented by Ferber, O’Farrell and Allen (1991).

Recent proposals for welfare reform in the United States suggest overhauling traditional public assistance in order to make recipients work for their benefits. Cost estimates for welfare reform range from US$15 billion to $20 billion over the next five years, with considerable cost savings projected for the long term. Welfare administration costs in the United States for such programmes as food stamps, Medicaid and Aid to Families with Dependent Children have risen 19% from 1987 to 1991, the same percentage as the increase in the number of beneficiaries.

Canada has instituted a “work sharing” programme as an alternative to layoffs and welfare. The Canada Employment and Immigration Commission (CEIC) programme enables employers to face cutbacks by shortening the work week by one to three days and paying reduced wages accordingly. For the days not worked, the CEIC arranges for the workers to draw normal unemployment insurance benefits, an arrangement that helps to compensate them for the lower wages received from their employer and to relieve the hardships of being laid off. The duration of the programme is 26 weeks, with a 12-week extension. Workers can use work-sharing days for training and the federal Canadian government may reimburse the employer for a major portion of the direct training costs through the “Canadian Jobs Strategy”.

Child Care

The degree of child-care support is dependent upon the sociological underpinnings of the nation’s culture (Scharlach, Lowe and Schneider 1991). Cultures that:

1. support the full participation of women in the workplace
2. view child care as a public responsibility rather than a concern of individual families
3. value child care as an extension of the educational system, and
4. view early childhood experiences as important and formative

will devote greater resources to supporting those programmes. Thus, international comparisons are complicated by these four factors and “high quality care” may be dependent on the needs of children and families in specific cultures.

Within the European Community, France provides the most comprehensive child-care programme. The Netherlands and the United Kingdom were late in addressing this issue. Only 3% of British employers provided some form of child care in 1989. Lamb et al. (1992) present nonparental child-care case studies from Sweden, the Netherlands, Italy, the United Kingdom, the United States, Canada, Israel, Japan, the People’s Republic of China, Cameroon, East Africa and Brazil. In the United States, approximately 3,500 private companies of the 17 million firms nationwide offer some type of child-care assistance to their employees. Of those firms, approximately 1,100 offer flexible spending accounts, 1,000 offer information and referral services and fewer than 350 have onsite or near-site child-care centres (Bureau of National Affairs 1991).

In a research study in the United States, 44% of men and 76% of women with children under six missed work in the previous three months for a family-related reason. The researchers estimated that the organizations they studied paid over $4 million in salary and benefits to employees who were absent because of child-care problems (see study by Galinsky and Hughes in Fernandez 1990). A study by the United States General Accounting Office in 1981 showed that American companies lose over $700 million a year because of inadequate parental leave policies.

Elder Care

It will take only 30 years (from the time of this writing, 1994) for the proportion of elderly in Japan to climb from 7% to 14%, while in France it took over 115 years and in Sweden 90 years. Before the end of the century, one out of every four persons in many member States of the Commission of the European Communities will be over 60 years old. Yet, until recently in Japan, there were few institutions for the elderly and the issue of eldercare has found scant attention in Britain and other European countries (Lewis, Izraeli and Hootsmans 1992). In America, there are approximately five million older Americans who require assistance with day-to-day tasks in order to remain in the community, and 30 million who are currently age 65 or older. Family members provide more than 80% of the assistance that these elderly people need (Scharlach, Lowe and Schneider 1991).

Research has shown that those employees who have elder-care responsibilities report significantly greater overall job stress than do other employees (Scharlach, Lowe and Schneider 1991). These caretakers often experience emotional stress and physical and financial strain. Fortunately, global corporations have begun to recognize that difficult family situations can result in absenteeism, decreased productivity and lower morale, and they are beginning to provide an array of “cafeteria benefits” to assist their employees. (The name “cafeteria” is intended to suggest that employees may select the benefits that would be most helpful to them from an array of benefits.) Benefits might include flexible work hours, paid “family illness” hours, referral services for family assistance, or a dependent-care salary-reduction account that allows employees to pay for elder care or day care with pre-tax dollars.

The author wishes to acknowledge the assistance of Charles Anderson of the Personnel Resources and Development Center of the United States Office of Personnel Management, Tony Kiers of the C.A.L.L. Canadian Work and Family Service, and Ellen Bankert and Bradley Googins of the Center on Work and Family of Boston University in acquiring and researching many of the references cited in this article.

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