"We find that job insecurity increases the odds of reporting poor health by about 50 percent, high job demands raise the odds of having a physician-diagnosed illness by 35 percent, and long work hours increase mortality by almost 20 percent," they reported in a recent issue of Behavioral Science and Policy. "Therefore, policies designed to reduce health costs and improve health outcomes should account for the health effects of the workplace environment."

Among other conclusions of their analysis of 228 previous studies of the effects of workplace stress factors on health:

• Unemployment and low job control have significant associations with all of the health outcomes, as does an absence of health insurance for those outcomes for which there are sufficient numbers of studies. With the exception of work–family conflict, all of the work stressors examined are significantly associated with an increased likelihood of developing a medical condition, as diagnosed by a doctor.

• Psychological and social aspects of the work environment, such as a lack of perceived fairness in the organization, low social support, work–family conflict, and low job control, are associated with health as strongly as more concrete aspects of the workplace, such as exposure to shift work, long work hours, and overtime.

• The association between workplace stressors and health is strong in many instances. For example, work–family conflict increases the odds of self-­reported poor physical health by about 90 percent, and low organizational justice increases the odds of having a physician-­diagnosed condition by about 50 percent.

"Wellness programs are great at doing what they're designed to do," Joel Goh, an assistant professor at Harvard Business School, told the Boston Globe. "But they're targeting [employee behavior], not targeting the cause of stress. There are two sides of the equation and right now we focus on one side. We're trying to call attention to the other side [of the equation], which is the effect of managerial practices."

The researchers used the second-hand-smoke comparison as a way to focus attention on the job-related factors that can influence employee health. With smoking now outlawed at virtually all U. S. workplaces, that threat to worker health has been eliminated. Whether the 10 factors identified by the study can be successfully mitigated without serious impact on the bottom line remains to be seen. But, Goh said, the financial benefits of better employee health could offset the cost of making work less stressful.

"We're not prescribing methodology to mitigate stress, but we're trying to open up conversation to say 'these things matter," Goh said. "Assuming an employer cares about their employee for benevolent or bottom line reasons, we think this is something many employers haven't thought on about."