Workplace Culture as a Social Determinant of Health
For professionals working in human services or social impact, addressing Social Determinants of Health (SDoH) is key in interrupting the root causes of unequal health outcomes, including chronic illness, exposure to toxins, and life expectancy. SDoH refers to the conditions in which people live, work, and interact that shape their well-being: factors like generational poverty and trauma, economic stability, education quality, healthcare access, and the built environment.
With increasing interest in the role employment and the workplace can have in fostering employee wellness, there is a growing focus on how employers can offer resources that help employees manage stress and emotions at work. However, this does not necessarily address how the workplace environment itself can be an SDoH.
Workplace health and safety laws in the U.S. emerged largely as a response to the dangerous conditions imposed by factory owners during the Industrial Revolution. The late 1800s saw frequent factory accidents, mining disasters, and worker deaths, which sparked labor movements and public outrage. Eventually, the establishment of the Federal Occupational Safety and Health Administration (OSHA) in 1970 created comprehensive minimum national standards for workplace safety.
The historical emergence of workplace safety regulations demonstrates how organizational practices directly shape health outcomes, positioning workplace culture as a critical social determinant of health. Just as unsafe physical conditions in factories led to immediate injuries and deaths, modern organizational cultures can create conditions that impact long-term health through chronic stress, psychological strain, and behavioral patterns. When organizational culture prioritizes productivity over worker wellbeing, normalizes excessive demands, or maintains rigid hierarchies that limit worker autonomy, the resulting environment can contribute to poor health outcomes just as much as social determinants like economic instability or limited healthcare access.
Recent research published in the International Journal of Environmental Research and Public Health (2022) provides concrete evidence that workplace culture has measurable biological effects. The study found that employees reporting workplace isolation had higher levels of certain stress-related biochemical markers, specifically dopamine and its metabolite 3-methoxytyramine. Conversely, those who reported positive workplace cultures showed lower levels of these stress indicators (Shuck et al. 2022). This research helps establish a direct link between workplace environment and physical health outcomes.
While vicarious trauma is well-documented in helping professions, the health impacts of workplace culture extend far beyond secondary trauma exposure. Poor organizational transparency, limited autonomy, lack of trust, and diminished self-efficacy create chronic stress conditions that affect workers across all identities and roles. These conditions can contribute to or exacerbate various health conditions that often go unreported or unrecognized as workplace-related.
A report from The Health Enhancement Research Organization (HERO) emphasizes that while employers have focused on workplace wellness for over thirty years, many traditional programs have shown underwhelming results. These programs often concentrate on individual behavior change while failing to address the underlying environment and culture within the workplace. Approximately 5-8% of annual healthcare costs are estimated to be associated with aspects of workplace culture and leadership (Allen et al. 2016).
The impact of toxic workplace culture extends beyond individual health outcomes to create substantial societal costs. When mission-driven organizations lose talented staff to health-related turnover, communities lose valuable resources and institutional knowledge. The financial burden includes not only direct healthcare costs but also the lost potential of individuals forced to step back from vital community work due to health impacts.
How Culture Impacts Strategy
At MindOpen, we work with many organizations where leadership is very concerned about employee well-being and understands that physical, emotional, and financial care are interconnected and essential for employees at all levels to do their best work. Yet well-intentioned efforts and policies can be received very differently by employees. One example is efforts to build out pay equity policies, which requires retroactive review and proactive application of new systematized guidelines over time.
In one organization in a service field experiencing an unprecedented staffing crisis due in part to systematic underfunding at the federal and state levels, efforts to develop fair and transparent salary bands were slower than expected. Yet staff expressed satisfaction with the process. In another organization with relatively more resources, a long-awaited and successful alignment of salary parity was not met with the hoped-for improvement in morale, and turnover actually increased. What was the difference?
Close observation and analysis of employee experience patterns over time revealed that communication norms of consistency, transparency, humility, and self-awareness were essential ingredients in such major organizational change. Even when the change itself is seen as positive, the overall experience does not have the intended improvement in morale without the intangible environmental elements that lower employee stress. While organizational culture is never one-size-fits-all, we know a lot about the transferable success factors and how to cultivate them in unique ways for each organization's context.
Workplace Culture as a Protective Factor in Stressful Times
Research shows that certain organizational factors can help buffer the health impacts of trauma-exposed work. High levels of transparency in decision-making, a strong sense of self-efficacy among staff, trusted relationships between colleagues and leadership, and clear protocols for addressing workplace stress can significantly mediate negative health outcomes. When these protective factors are absent, the risk of adverse health impacts increases substantially.
Connection stands as a core value in creating healthy workplaces. A workplace that lacks supportive relationships and equitable opportunities fails its people. Without connection, employees are left feeling isolated, disengaged, and undervalued. Without compassion, we risk ignoring the structural barriers that keep some from accessing the tools they need to succeed.
Critical thinking becomes transformative in this context. It invites us to challenge the status quo, reframe harmful narratives, and center the voices of those most affected. What if we reimagined workplaces not as sources of stress but as spaces for collective care and empowerment? What if we acted with courage to address inequities head-on, creating policies and practices that honor the full humanity of each team member?
The connection between workplace culture and health outcomes is clear. What's your organization's next step? During this time of great instability and crisis in the fields of human services and social impact, focus on what is in your control in creating an environment for health. By themselves, one-off professional development sessions, retreats, or meditation apps are bandaids for a hurting culture. Just as each person we serve deserves to be treated as a whole person no matter what issues they are facing, we need to see our organizations as whole systems where each decision reflects and reverberates throughout. We cannot change everything that is hurt at once, but when we make conscious, intentional decisions about where to focus change efforts, we are reshaping and adapting the capacity for a healthy culture in mission-driven work.
Footnotes
Shuck, Brad, Joy L. Hart, Kandi L. Walker, Jayesh Rai, Shweta Srivastava, Sanjay Srivastava, Shesh Rai, Aruni Bhatnagar, and Rachel J. Keith. 2022. “Workplace Culture and Biomarkers of Health Risk.” International Journal of Environmental Research and Public Health 19 (19): 11920. https://doi.org/10.3390/ijerph191911920.
Allen, Judd, Ralph Colao, Jennifer Flynn, Sue Grauer, Jessica Grossmeier, Dan Krick, Tina Lankford, et al. 2016. “Health Enhancement Research Organization Culture of Health Study Committee DEFINING a CULTURE of HEALTH KEY ELEMENTS THAT INFLUENCE EMPLOYEE HEALTH and WELL-BEING.” https://hero-health.org/wp-https://www.mdpi.com/1660-4601/19/19/11920?utm_source
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