Research Updates

RTW-land has a social capital

Gabrielle Lis

Teams built on trust and cooperation - i.e. teams with high social capital - have less long term sick leave than teams in which suspicion and unfairness are the norm.

Social capital is a term for the trust and reciprocity that develop when people treat one another fairly. When social capital is high, you can expect to see people collaborate and take collective action for mutual benefit. When social capital is low, you can expect to see suspicion and self-interest trump cooperation.

In the workplace, social capital can accrue between co-workers of equal standing, as well as up and down the organisational hierarchy. Measuring social capital at work involves looking for things like levels of trust, justice, collaboration and reciprocity, as well as whether there is a fair division of labour.

Researchers are starting to suspect that workplace social capital influences health, as well as recovery and return to work. Various studies have established an association between low levels of workplace social capital and negative health outcomes such as depression and hypertension. However, the number of studies is relatively small, and the research has tended to measure social capital as either an individual phenomenon, or an organisation-wide phenomenon.

Danish experts led by Eszeter Török of the University of Copenhagen argue that it makes more sense to measure social capital within work teams. According to these researchers, "Workplace social capital implies frequent interaction and active collaboration between employees, and this may vary between work-units within a particular workplace."

Török and her team surveyed more than 34,000 hospital workers in Denmark, including nurses (42%), administrative staff (19%), other health staff (14%), doctors and dentists (12%), service and technical staff (10%) and educational staff (3%). Each worker was a member of one of more than 2,300 work teams included in the research. Around 70% of the participants were full-time workers, and 76% were women.

All the hospital workers completed a questionnaire about social capital, generating an individual social capital rating. Then, each work team was given an overall social capital score, based on an aggregate of the individual ratings of team members. Twelve months after the initial questionnaire, the researchers accessed payroll data, looking for instances of long term sickness absence, defined as 29 or more consecutive days off work.

The results of this study provide more evidence of the close tie between social capital and recovery and RTW outcomes.

The researchers found that social capital clustered in work teams, with individual workers generally giving similar ratings as their teammates. Some teams had high social capital while other teams at the same hospital had low social capital. Individuals working in a team with high levels of social capital were at lower risk of long-term sickness absence than those in a team with low levels. The greater the dose of social capital, the less sickness absence recorded.

Based on this one study, we don't know for sure that social capital actively prevents sickness absence, although the researchers did control for other factors that might have muddied the results. Despite this uncertainty, the researchers decided to assume, for argument's sake, that social capital does play a preventative role. Based on this assumption and the results of the research, they calculated that one third of all long-term sickness absences in Danish hospitals could be prevented by increasing social capital within work teams. 

How does social capital pack such a punch?

Again, we don't yet have definitive answers. Török and team suggest that, in work groups with high social capital:

  • Healthy behaviours might spread from person to person;
  • It might be easier to find modified duties, and co-workers might be more willing to take on additional work tasks to support the injured worker; and
  • Workers might demonstrate more empathy and respect for one another, making it easier to cope with physical and emotional stress.  

Other research has established that attitudes about sickness absences are contagious, with workers considering colleagues' leave-taking when making decisions about their own.

Török's study is particularly compelling because of the large number of workers who participated. It provides strong evidence that there is a connection between social capital and sickness absence. Now, we need more research to help establish whether this relationship is causal or simply correlational.

Watch this space.

Original research

"Work-unit social capital and long-term sickness absence : a prospective cohort study of 32 053 hospital employees." Török, Eszter; Clark, Alice Jessie; Jensen, Johan Høy; Lange, Theis; Bonde, Jens Peter; Bjorner, Jakob Bue; Rugulies, Reiner; Hvidtfeldt, Ulla Arthur; Hansen, Åse Marie; Ersbøll, Annette Kjær; Rod, Naja Hulvej. In: Occupational and Environmental Medicine, Vol. 75, 2018, p. 623-629.  

The researchers also published a correction to some calculations, which does not alter the results reported here.