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Fairness in the workplace relates to health over time

Research demonstrates a link between how staff perceive the fairness of their treatment and their health


Fairness at work is an important concern for employees, employers and society. A research collaboration between Stockholm University and the University of East Anglia recently explored how perceptions of fairness and health relate to each other over time.

This research suggests that employees who feel unfairly treated are more likely to develop health problems. Also, individuals with health problems are more likely to view their employer’s treatment of them as unfair.

What’s new?

Fairness has been described as the glue that holds employer and employee together. Individuals care about fairness for several reasons.

Firstly, it ensures the predictability and favourability of their outcomes. If the processes that are in place to decide on pay, promotions, and work schedules are based on accurate information, are unbiased, and apply to everyone, employees can be sure they are receiving their fair share.

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Secondly, individuals are concerned with fairness because it gives them information about their status in the organisation and caters to their self-esteem.

Fairness communicates that they have a good relationship with their employer and are recognised as valuable participants. These perceptions elicit pride in group membership, and can fulfil the psychological needs of belonging and affiliation.

Research has shown that employees who feel fairly treated in their workplace trust their employer, enjoy their work, and are more dedicated to their workplace. Also, they are more likely to help colleagues, are more willing to go through difficult times with the organisation, and stay with the business for a longer time.

However, when feeling unfairly treated staff are more likely to hold back ideas, and even engage in negative behaviour such as leaving early, coming in late, taking long breaks, stealing, sabotage, or showing aggression.

In a relatively new strand of research fairness perceptions have also been linked to health outcomes. Studies suggest that perceptions of injustice are associated with an increased likelihood of burnout, depression, physical health problems, and negative lifestyle choices such as exercising less and smoking and drinking more.

However, there are only a few studies investigating justice as a dynamic construct; i.e. something that can be subject to change over time. In particular, associations between changes in justice perceptions and health have hardly been studied.

In this research we focused on procedural justice perceptions in relation to self-rated health, which is a strong predictor of future morbidity and mortality, functional decline, disability, and utilisation of healthcare.

Using data from four data collection waves covering a timespan of six years we were able to study whether the development of procedural justice perceptions over time (procedural justice refers to the fairness of the process that leads to decision outcomes), is linked to the development of self-rated health perceptions over time.

Key findings

  • In our sample people’s health status declined slightly over the time period. Similarly, justice perceptions decreased slightly on average over time. Both of which is not surprising, as the period between 2008 and 2014 was marked by recession, increase of downsizing and organisational changes, and other major changes due to globalisation.
  • Participants with better health at the start of the survey had a slower rate of decrease in their health over time.
  • Our results indicate that individuals with higher procedural justice perceptions reported better health. Also, older people reported worse health. Employees working in non-manual labour jobs and people who were married or cohabiting rated their health as better. We did not find gender differences in terms of health status.
  • The results suggest that self-rated health improved at any given point in time as procedural justice increased relative to initial procedural justice. That is, when fairness perceptions increased over time individuals rated their health as better. When fairness perceptions decreased over time the health ratings of individuals went down.
  • Additionally, because establishing causality by actually showing that justice perceptions caused changes to health is difficult, we also analysed whether health predicts justice perceptions. The argument is that when individuals struggle with health problems or feel down and exhausted they may perceive their environment in a negative light, and they may get treated differently by colleagues and superiors. Results suggest that individuals with consistently better health reported more favourable scores of procedural justice. Also, perceptions of fairness are higher for older people and for men.
  • When health changed over time justice perceptions altered relative to that change; i.e. when health got better justice perceptions increased, and when health got worse, justice perceptions decreased. Therefore it may be that injustice perceptions and health problems form a vicious circle: when employees feel unfairly treated this affects their health negatively, which in turn makes them perceive their work environment more negatively, which then affects how fairly others at work treat them and so on.

From research to reality

This study shows that justice has an effect on employee health over time and consequently organisations should be aware of the relevance and importance of the fairness of decision-making processes in the workplace.

Individuals on sick leave are costly. Dame Carol Black’s 2011 report stated that more than 140 million working days are lost to sickness absence in the UK every year. This mounts up to £9 billion that employers pay and £13 billion the state pays annually for health-related benefits.

With business margins getting increasingly tighter these are costs business simply can’t afford. So organisations may need to take fair treatment through transparent decision-making and organisational procedures seriously if they want to minimise costs related to health problems and sickness absence.

This is particularly important in light of the research’s finding that employees with past or present health problems perceive their organisation as less fair as time goes by when it comes to procedural justice. Organisations may need to give extra attention to these individuals, be it by monitoring their fair treatment, the way they are included in the workplace, or how their integration, their voice, and their insight into things that happen in the organisation are guaranteed.

Perhaps organisations need better routines for individuals with health problems or higher sickness absence rates so that over time these individuals are not left behind.

Constanze Eib is a lecturer in organisational behaviour at Norwich Business School, University of East Anglia.

Claudia Bernhard-Oettel is associate professor in psychology and a senior lecturer in the Department of Psychology at Stockholm University.

Constanze Leineweber is an associate professor in psychology and a researcher at the Stress Research Institute at Stockholm University