Promoting Health and Wellbeing in the Changing Workplace

Work has always carried some degree of risk – but for much of the 20th century, those risks were primarily physical: machinery, chemicals, repetitive strain. Today, the picture is far more complex. The modern workplace presents a different kind of threat – one that is invisible, cumulative, and deeply tied to how work is organized, managed, and experienced. Psychosocial risks – rooted in poor work design, inadequate management, and toxic social dynamics – are now recognized as among the most significant occupational health challenges of our time. Addressing them requires more than a wellness poster on the wall. It demands a comprehensive, evidence-based approach to health and wellbeing that operates at every level of the organization.

From physical hazards to psychosocial risks: a broader view of workplace health
Theoretical models that explain how work stress damages health
The Demand-Control-Support model
The Effort-Reward Imbalance model
Why both models matter
Workplace interventions: acting at every level
Individual-level interventions
Group-level interventions
Organizational-level interventions
The role of managerial support in workplace health
Building a comprehensive workplace health strategy

From physical hazards to psychosocial risks: a broader view of workplace health

Traditional occupational health focused almost entirely on protecting workers from physical harm. But the scope of workplace health has expanded significantly. According to the European Agency for Safety and Health at Work (EU-OSHA), psychosocial risks arise from poor work design, inadequate organization, and poor social context – and they can result in negative psychological, physical, and social outcomes. Stress, anxiety, and depression now represent the second most common work-related health problem affecting European workers.

These risks are not minor inconveniences. Research published in PMC confirms that the workplace psychosocial environment influences wellbeing through multiple pathways – most commonly through the physiological effects of chronic stress, which results from a persistent imbalance between job demands and an individual’s capacity to cope. Left unaddressed, this chronic imbalance can contribute to cardiovascular disease, musculoskeletal disorders, burnout, and depression.

The American Industrial Hygiene Association (AIHA) identifies common psychosocial hazards as including excessive workloads, role ambiguity, bullying, lack of managerial support, and job insecurity. What is critical to understand is that these hazards are not simply individual problems – they are organizational ones, and they must be addressed as such.

Theoretical models that explain how work stress damages health

To understand how psychosocial hazards translate into poor health outcomes, occupational psychologists have developed several theoretical frameworks. Two of the most widely researched and applied are the Demand-Control-Support (DCS) Model and the Effort-Reward Imbalance (ERI) Model. These models do more than describe stress – they provide a diagnostic lens for identifying which workplace conditions are most harmful and how to intervene.

The Demand-Control-Support model

Originally developed by Robert Karasek in the 1970s and later extended to include social support, the DCS model proposes that job strain results from a specific combination of high demands, low decision-making control, and low social support. A comprehensive review in Social Science & Medicine confirms that the highest risk of illness is expected in employees facing high demands, low control, and low social support – a condition sometimes called “iso-strain.” Conversely, employees with high demands but high control and strong support are more likely to experience active, motivating work rather than harmful stress.

The model has direct practical implications. If an organization can increase an employee’s sense of control – through greater autonomy, participation in decision-making, and clarity of role – it can buffer the harmful effects of high workload. Social support from supervisors and colleagues functions as an additional protective layer. This is why managerial behavior is not just a “soft” issue; it is a health issue.

The Effort-Reward Imbalance model

Developed by Johannes Siegrist, the ERI model takes a different but complementary angle. It focuses on the reciprocity of the employment relationship: when workers invest high effort but receive insufficient reward – whether financial, through recognition, or in terms of job security and career prospects – the resulting imbalance generates significant stress. Research in the Scandinavian Journal of Public Health found that the ERI model carries strong predictive validity across a wide range of health outcomes, and that it captures dimensions of workplace stress that the DCS model alone does not.

The ERI model also introduces the concept of overcommitment – a personal coping pattern in which employees persistently overinvest in their work despite insufficient returns. Overcommitment compounds the risk, worsening the experience of stress even when external demands are moderate. Studies have shown that overcommitment, even in the absence of an objective effort-reward imbalance, can independently generate psychosocial stress.

Why both models matter

These two models are not competing – they are complementary. Research from China’s Henan Province, examining over 5,000 workers, found that high job strain (from the DCS model) and high effort-reward imbalance operated independently to predict depressive symptoms, and that their combined presence posed a greater risk than either alone. Used together, the models give organizations a richer map of where work-related stress is likely to originate and what interventions are most likely to reduce it.

Workplace interventions: acting at every level

Understanding the sources of work-related stress is only half the equation. The other half is doing something about it. Effective workplace health promotion requires interventions at three distinct levels: individual, group, and organizational. Research from the University of Oxford’s Wellbeing Research Centre, drawing on a systematic review of over 3,000 academic studies, concludes that organizations create the most meaningful change when they combine multiple interventions across all three levels rather than relying on any single strategy.

Individual-level interventions

Individual-level approaches aim to build personal resources and coping capacities. These include stress management training, mindfulness-based programs, resilience workshops, and time management training. A major review published in The Lancet Public Health in 2025, covering 88 reviews and 339 meta-analysed effect estimates, found that mental health and stress reduction were the most frequently studied targets in workplace health promotion, accounting for 36% of all interventions reviewed.

However, individual-level interventions have limits. Critics note that programs focused purely on changing employee behavior risk placing the burden of systemic problems on individuals – what has been described as “changing the worker, not the workplace.” This does not mean individual interventions are without value, but they are most effective when paired with structural changes at the group and organizational levels.

Group-level interventions

Group-level interventions target the social and relational environment of work – the immediate team, department, or workgroup. These include team-based training, peer support programs, group coaching, and participatory workshops where employees collectively identify and address sources of stress. A scoping review published in the Annals of Work Exposures and Health found that group-level interventions incorporating multiple components – including training sessions, online tools, and feedback mechanisms – successfully improved mental health outcomes such as depression, anxiety, stress, and emotional exhaustion among employees in high-demand, low-autonomy roles.

Critically, these interventions work best when they are not imposed top-down but are co-designed with the employees involved. Worker participation is not just good ethics – it is a driver of effectiveness. A systematic review published in Work & Stress found that interventions giving workers greater control and voice more reliably improved wellbeing across all domains – mental health, job satisfaction, and work-family balance – regardless of the specific intervention type.

Organizational-level interventions

Organizational-level interventions address the structural conditions of work itself – job design, workload, working hours, reward systems, management practices, and workplace culture. These are the most powerful interventions because they target the root causes of psychosocial risk rather than their symptoms.

A systematic overview of reviews published in PMC found strong evidence that changes in working time arrangements – such as flexible scheduling and reduced mandatory overtime – improve employee health and wellbeing. Moderate-quality evidence also supports interventions that increase employee influence over their tasks and work organization. These findings are consistent with the DCS model: when workers gain more control, health outcomes improve.

Other critical organizational strategies include clear goal-setting so employees understand what is expected of them, fair and transparent reward systems that address effort-reward imbalances, anti-bullying and anti-harassment policies with genuine enforcement, and leadership development that equips managers to recognize and respond to psychosocial hazards early. The Canadian Centre for Occupational Health and Safety (CCOHS) identifies effective leadership as one of the most important organizational factors shaping employee mental health – noting that good leadership increases morale, trust, and resilience, while reducing sick leave and early retirement.

The role of managerial support in workplace health

Managers sit at the intersection of organizational policy and individual employee experience. They translate organizational culture into daily reality. A manager who communicates clearly, distributes workloads fairly, recognizes employee contributions, and creates psychological safety directly reduces the psychosocial risk exposure of their team. Conversely, poor management is itself a significant psychosocial hazard.

CCOHS research shows that leaders who focus narrowly on outcomes – with little attention to team dynamics or individual wellbeing – are more likely to hear staff health complaints and see higher rates of absenteeism and presenteeism. Training managers to recognize early signs of stress, to conduct regular wellbeing check-ins, and to model healthy work behaviors is therefore not a luxury – it is a core component of any serious workplace health strategy.

Safe Work Australia’s Code of Practice explicitly requires employers to consult workers about psychosocial risks and involve them in decisions about control measures. This is both a legal requirement and a practical imperative: employees have the most direct knowledge of the stressors in their environment, and involving them produces better risk identification and more effective solutions.

Building a comprehensive workplace health strategy

Promoting health and wellbeing in the modern workplace is not a program – it is an ongoing organizational commitment. The most effective approaches share several features: they address psychosocial hazards as seriously as physical ones; they use theoretical models like the DCS and ERI frameworks to diagnose problems accurately; they intervene at individual, group, and organizational levels simultaneously; and they involve employees as active participants, not passive recipients.

Research on evolving psychosocial risk management underscores that the real goal is to move beyond risk assessment toward a culture of ongoing management – one where identifying hazards is the beginning of a change process, not the end of it. Organizations that treat wellbeing as a strategic priority – embedding it in their structures, leadership practices, and daily culture – not only protect their people but build more resilient, productive, and sustainable workplaces.

What do you think? If you were tasked with improving wellbeing in your workplace, which level of intervention – individual, group, or organizational – do you think would have the greatest impact, and why? And considering the Demand-Control-Support and Effort-Reward Imbalance models, which framework more accurately captures the stressors in work environments you are familiar with?

References

PDF 📄

Table of Contents

From physical hazards to psychosocial risks: a broader view of workplace health 🔗

Theoretical models that explain how work stress damages health 🔗

The Demand-Control-Support model 🔗

The Effort-Reward Imbalance model 🔗

Why both models matter 🔗

Workplace interventions: acting at every level 🔗

Individual-level interventions 🔗

Group-level interventions 🔗

Organizational-level interventions 🔗

The role of managerial support in workplace health 🔗

Building a comprehensive workplace health strategy 🔗