Dying for a Paycheck by Jeffrey Pfeffer [Book Summary – Review]


Hazardous professions are nothing new. It is understood that occupations such as coal mining or manufacturing are physically hazardous to our wellbeing, and laws have been placed in effect to restrict their detrimental effects. 

But what’s frequently disregarded is white-collar workers ‘ mental wellbeing. Health has been found to be adversely impacted by pressure from overwork, unemployment, or lack of job management. The workplace environment is putting unnecessary stress on millions of Americans, from a higher likelihood of heart attacks to higher rates of depression. 

It doesn’t need to be like this. To ensure that their workers are living happy, healthy lives, business owners need to make important changes in the workplace. And what’s more, this contributes to a win-win situation; improved efficiency and healthier jobs mean better earnings.


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Chapter 1 – Our well-being can be negatively affected by stressful work environments, but it doesn’t have to be. 


In the office, most of us have endured discomfort. The numbers approve. In reality, data reveals that tension in the workplace is getting progressively worse and shows no indication of decreasing. A whopping 80 percent of Americans face daily stress at work, the American Institute of Stress stated.

But if tension at work is such a common problem, then what are the implications? 

The job can, in short, be dangerous to one’s well being. For instance, Salesforce is supposed to be one of the best firms to work for in the United States, according to Fortune magazine. But multiple employee eyewitness accounts suggest a different side of the company. 

One anonymous worker who entered the business as a consultant was quickly forced to take antidepressants to deal with the demanding work climate. Her constantly changing timetable and requesting work meant she frequently had to work on weekends or travel for work. She wound up spending around $2,000 per month on psychiatric treatment and a fitness instructor to deal with all this. 



But not everyone, especially in the fast-growing gig economy, can accommodate such coping mechanisms. 

Vulnerable short-term contracts and sometimes poor salaries describe the gig economy; others have estimated that 40 percent of the American workforce will be gig economy employees by 2020. Combined with little to no paid days off, the economic instability of such jobs led to a study of 93 research indicating that gig-economy jobs lead to reduced workplace safety, as well as a reduction in the general wellbeing of employees. 

But things don’t need to be like this. 

Aetna is an admirable instance of businesses seeking to do it better. CEO Mark Bertolini formed a passion for wellness after he experienced a horrific skiing accident in 2004. This made him reconsider the approach of his organization to the well-being of workers. 

Aetna introduced a minimum hourly wage of $16 in 2015, leading to a 33 percent pay rise for the lowest performers in the organization. This, along with increased health care for workers and free yoga courses, resulted in 28 percent less depression and 20 percent higher sleep quality reported by workers.

Moreover, the corporation’s welfare expenditures reduced, illustrating that providing for the well-being of workers will result in a win-win scenario on all sides of the paycheck. 

Unfortunately, firms like Aetna are rare and far between. Workplace tension draws an immense toll on individuals globally, as we can see in the following sections. 


Chapter 2 – In the United States, the price of occupational tension is horrific; it’s the fifth-highest reason for death.


Everyone understands that secondhand smoke is toxic. Because of that, in the United States, smoking in public spaces such as restaurants is progressively banned. Distressingly, the team of researchers of the writer discovered that tension caused by the workplace is almost as deadly as breathing secondhand cancer-causing smoke. 

And why do politicians not legislate against this fatal tendency?

Workplace tension is currently the fifth-highest reason for death in the United States, totaling 120,000 annual avoidable deaths. The writer and his research colleagues arrived at this alarming statistic after a thorough review of evidence related to public health and working conditions. 

So how does depression in the workforce lead to so much misery?

This is partly because the workplace is not just the place where people spend time making money in the United States, it is also typically where they receive their health care. This indicates that of those 120,000 deaths, at least 85,000 are due to a shortage of health care, whether by unemployment, temporary jobs, or even a lack of coverage offered by the employer. 



Approximate 28,000 deaths are related to pressures from work overload, lack of job management, or social support in the workplace for those in jobs. Global rivalry, contributing to higher working hours, is the cause. The advent of mobile technologies also means that it is increasingly anticipated that workers will be “online” and work outside working hours. 

Our physical well-being is impaired by all this elevated stress, with several studies demonstrating the connection between stress and illness. Stress in men, for instance, leads to increased chances of many forms of cancer.

Financially speaking, the expense of stressful occupational activities culminated in an excess cost of mental healthcare of $190 billion, or around 8% of overall US healthcare spending. 

If the United States were to pursue a strategy comparable to its widely evolved European counterparts, at least the majority of these deaths would be stopped. Currently, in Europe, occupational deaths are half as frequent as they are in America. Why?

Because the highly developing countries of Europe prefer to spend more money on hospitals as they grow richer, contributing to improved wellbeing and lower levels of environmental deaths, even in the workplace. 

If the United States wanted to integrate itself more tightly with European regulations and healthcare programs in the workplace, the government will be able to reduce 60,000 deaths and healthcare expenses by around $63 billion. 


Chapter 3 – Layoffs amount to a lose-lose outcome for both employers and workers.


The new management agreed to close down their New York factory after ArcelorMittal bought indebted Bethlehem Steel in 2008. This implied the 260 employees of the plant were all laid off. 

Disaster struck three weeks later: a 56-year-old former employee, George Kull, suffered a heart attack and died. His 55-year-old colleague, Don Turner, suffered a similar fate shortly afterward. He worked for years at the factory.

These horrific incidents are a direct consequence of the layoffs and economic instability they create, as well as resulting mental health concerns. A similar pattern, supported by solid scientific data, as demonstrated by numerous research in developing countries: unemployment results in people dying. 

One such research of 13,000 American adults who experienced heart attacks between 1992 and 2010 showed that following a work loss, almost 70% of cases occurred. Moreover, those who had endured more than four job layoffs in the span were 63 percent more likely than those who hadn’t had a heart attack. 

In other highly developed countries, the same pattern can also be noticed. 

Swedish research, for instance, tracked workers laid off by firms who closed their doors between 1987 and 1988. They discovered that rates of suicide in the study doubled in the four years since losing their jobs. Some other Swedish research concluded that the consumption of alcohol of those laid off increased by 400 percent after 20 weeks of unemployment.



The tragic absurdity of it all? As a consequence of layoffs, businesses themselves often lose out. There are several layoff costs: severance pay, potential litigation, lowered morale of those not laid off, and diminished efficiency. 

Apart from these expenses, layoffs do not also address the underlying challenge facing companies: the issue is not high costs, but a lack of profits. And layoff notices also coincide with declining stock prices; this can not be shocking, since layoffs mean that firms are quite obviously not in the best condition. 

Then what solution is there? 

Well, take the shutting of US airspace that happened since 9/11. To offset the lost sales, virtually all major airlines started laying off workers, 80,000 in total. 

Yet there was one carrier standing out: Southwest. They offered refunds to any clients who requested them rather than laying off people and also maintained a pledge to shell out $179 million in a profit-sharing agreement for jobs. 

Southwest was in fine condition at the end of 2001. It had not only a prosperous year, but its market capitalization was still higher by 2002 than the rest of the industry combined! 


Chapter 4 – The American health care scheme leaves millions of individuals uncovered and thus creates a high human expense.


Health insurance has been embodied by all highly developed countries as a basic human right that can not be subjected to market competition. With the exception of the United States, they are all highly developed economies. 

Regrettably, in the United States, an estimated 50,000 persons die annually because they do not have access to treatment, or can not finance it. 

For starters, just think about women struggling with breast cancer.

The research found that their odds of not surviving the illness increase by a significant 49 percent because they became uninsured. And long-term research of 9,000 Americans of all ages between 1988 and 2000 revealed that there is a 40 percent higher risk of death for any uninsured person. 

Another instance group is the casino staff in Atlantic City. 

The town has been losing half of its casino workers since 2011. Worse, many of the existing jobs were canceled or decreased by their related health insurance, with employers alleging financial difficulties.

A study conducted by a union representing casino workers from Atlantic City showed that 72 percent of its employees had difficulty covering their expenses due to high health care rates, and half had experienced depressive symptoms. 



Unfortunately, the declining availability of employer-provided benefits is a pattern that shows no sign of declining. When health care becomes more and more competitive, it is difficult for more businesses to afford to provide it to their workers. 

In 2011, 40 percent of companies did not provide workers with benefits, up from 30 percent in 2000. And even as employers have benefits, workforce payments from 2001 to 2011, from $355 to $921 a year, rose threefold. 

What can businesses do under such bleak conditions to ensure that their employees are safe while preserving profit margins? It is not just that healthier workers are more efficient, after all. Companies that display that they care about their staff also encourage loyalty and commitment and increase the preservation of jobs. 

Companies can include on-site physicians in the absence of a major legislative change toward universalized healthcare and away from competitive private insurance markets. This circumvents the need to negotiate with costly insurance providers, thus ensuring inexpensive and effective workplace benefits and lowered-cost or even free job benefits.

Companies with as few as 400 employees have transitioned to this system and found that absences have been decreased and earlier disease prevention has been allowed. 


Chapter 5 – Giving workers control of their job, along with social encouragement, helps them to succeed. 


These days, employee benefits are popular. Whether it’s free liquor on-site or playing rooms, advantages inspired by Silicon Valley are progressively applied to modern offices.

Yet such facilities are also materialistic and the increased amounts of tension encountered in the workplace will not be overcome alone. True change in the workplace requires time and commitment. 

Having an influence on one’s work life is an important aspect leading to employee satisfaction. 

In the 1970s, this was seen as British experts found variations in the probability of having heart disease from civil servants. They observed that chest pain was 50 percent less likely to be identified by higher-ranked civil servants. This was strongly associated with the amount of power they were granted in their careers, with higher-ranking civil servants getting greater say over what they were working on and who and when they were doing it. 



Loss of power in one’s job will cause people to feel powerless. If, say, a famous boss is dismissed at a company, and no explanation is given, workers experience higher stress levels because they have no control over the adverse situation. An Indiana University research showed that there was a 15.5 percent elevated chance of mortality for people in difficult, challenging occupations with low degrees of power. 

But things don’t need to be this way. 

Take, for instance, the outdoor fashion company Patagonia. The organization employs flat hierarchical frameworks that don’t make micromanagement space. Employees are prompted to take hours off work to enjoy recreational activities while the weather permits outdoors. Such a mindset in the workplace encourages them to act where and as they wish to. 

In ensuring the welfare of workers, social support in the workplace is just as essential. Research has repeatedly demonstrated that it is beneficial for one’s well-being to have a solid social support network with close friends. 

But how do workplaces lead to emotions of this kind? 

Firstly, corporations should stop their employees’ graded performance ratings. This causes workers to contend, rising infighting and reducing cooperation with each other. 

Secondly, engage in long-term employee partnerships. 

When they revealed a radical life insurance program for workers and their families, Google did so in 2011. The family will earn all the remaining stock of the employee and part of their salary for ten years following the death of an employee.

These efforts encourage a sense of belonging in the workplace, alleviate tension on workers, and improve psychological well-being. 


Chapter 6 – People are not expected to die for a paycheck; we should do a great deal to guarantee that this doesn’t happen. 


There are also clear reasons why firms should treat their workers as relatives, as has been seen. Good jobs are more competitive, more loyal, and live longer lifetimes. 

But what can we do to alter the present situation in which earnings are favored above the satisfaction of staff?

Firstly, start evaluating the morale of workers. 

This can be accomplished through the self-reporting of employees about their wellness. Just frequently ask staff a simple question: “How good is your health overall?” Thus, by promoting self-reporting, organizations can better keep track of only when workers are unwell. 

Thus, by promoting self-reporting, organizations can better keep records on only when workers are ill. Knowing whether workers feel ill or down will help employers change the environment of the workplace accordingly. 

Secondly, harmful corporations need to be pointed out openly. 

The social impact in an unsafe workplace should be publicly disclosed in the same manner that businesses that handle the environment poorly are progressively branded, polluters. Companies will be inspired to make their workplaces better by being pointed out. No business wants to be identified as terrible for the health of humans.

Lastly, corporations should be required to cover the health expenses for which they are accountable. 

Take, for instance, Walmart. The company’s poor pay and patchy health benefits take a toll on the well-being of a workforce. Their strategy also requires workers to focus on public hospitals, which Walmart does not have to cover the burden. One research reported that public welfare spending amounted to $455 million annually for Walmart workers.



Firms should be required to shell out a certain percentage of employee healthcare costs to mitigate this transfer of expenditures to the public. In 2007, San Francisco did exactly that, announcing that workers had to contribute $1.37 per hour per healthcare worker. 

Outcome? The cost of emergency rooms was significantly reduced, as nurses became more able to avoid sickness in primary care instead of at the last minute.

Businesses and politicians must understand at the end of the day that there is a spiritual dilemma at risk. A hundred and twenty thousand persons are practically dying for a paycheck every year so that corporations can make more profits. And if people die because of jobs, their honor is stripped from them. This has got to change.


Dying for a Paycheck: Why the American Way of Business Is Injurious to People and Companies by Jeffrey Pfeffer Book Review


Around 120,000 Americans die each year because of tension at work. Instead of employers, the US health care scheme puts an undue amount of health costs on workers, forcing many Americans to be uninsured, pay massive medical bills, or even die. The same happens to layoffs, leading to a variety of health concerns. Yet a healthy working atmosphere can be developed by allowing workers greater autonomy of their jobs, along with enhanced social support. Merge this with increasing care costs to managers rather than workers, and we will potentially reduce the number of deaths linked to employment in years to come. 

Recognize that there is no trade-off between profit margins and employee well-being. 

These are going together. In addition to lower turnover rates, healthy workers mean improved morale and commitment. Spending more on occupational healthcare leads to reduced costs for employers, as healthier workers are less vulnerable to absences and lengthy hospital stays. And, morally, of course, if more employers take proper care of their workers, fewer workers would struggle with workplace-related injuries or even death.


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Savaş Ateş

I'm a software engineer. I like reading books and writing summaries. I like to play soccer too :) Good Reads Profile: https://www.goodreads.com/user/show/106467014-sava-ate

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