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The Future of Work and Health.

The Future of Work and Health

The Future of Work and Health is the result of a report prepared by the Institute for Alternative Futures in conjunction with the Washington Business Group on Health for the U.S. Office of Disease Prevention and the National Institute of Occupational Safety and Health. The goal of the sponsors was to identify the most important trends in work and workplaces, especially in relation to worker health.

The authors begin by identifying eight trends impacting work practices and health care over the next quarter of a century. These include (1) the elimination of many information and service jobs due to automation, (2) the elimination of many management tasks and jobs due to the development of expert systems, (3) the replacement of people by robots and computer-assisted design in manufacturing, (4) an increase in the proportion of elderly people coupled with a decrease in elderly (and general) morbidity, (5) a wide variety of "alternative" health care practitioners coupled with routine self-care, (6) greater control of toxic exposures and the potential for desensitizing workers through genetic engineering, (7) a dramatically expanded informal economy where the concepts of work and purpose have changed and welfare services have been recaptured by churches, families and communities, and (8) a remaining underclass not so stricken by unrest as it might be if not for the strength of the informal economy.

The book is logically organized, starting with demographics, then proceeding to discuss trends that are shaping tomorrow's work and workplaces, and the future of health and health care financing and practices, respectively. Finally, the implications that work and workplace trends and health and healthcare trends hold for the promotion of health in the workplace is considered.

Risk management and insurance teachers and practitioners will probably be most interested in the forecasts for future health care financing and the predictions that are made about workplace health promotion activities. As the workforce ages, companies can expect increases in health care costs attributable to the increasing number of retirees. This could imply that long term benefits may be gained by instituting health promotion programs early and designing them to be attractive to a broader range of workers and their families. Increased job sharing will challenge employers to design appropriate programs and benefits. Greater diversity in health care delivery should lead to better control of health care costs as currently "nonconventional" providers and therapies begin to compete with the medical establishment for patients. Decentralization, both political and corporate, may result in community health promotion programs becoming the primary resource for most employers as they seek to encourage a healthy workforce. Insurance companies will be challenged to design coverages to meet these new conditions and demands.

The Future of Work and Health would make good reading in a seminar course in management, insurance and health administration. It identifies trends, but steers clear of painting a single picture of the way things will be. It emphasizes that the future will be the result of choices made in the present. Consistent with its purpose, it makes few specific recommendations. (One welcome exception is a call for a hard look at occupational safety and health regulations.) There are many figures and tables, and most of them are readily understandable and enhance the text. An extensive bibliography, organized around "the future of work" and "the future of health" should prove to be very valuable for students.

A weakness in The Future of Work and Health is its insistence that computerization will cost jobs, a proposition that is not true. Computers change jobs so that incumbent workers may need to be replaced, but the number of jobs in the economy is not diminished by computers. A related weakness (not the fault of the authors, since they necessarily had to limit the scope of their topic) is that the future of work is not examined from the standpoint of the future of education, which certainly will have a powerful impact on tomorrow's workforce.
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Author:Goldin, E.C.
Publication:Journal of Risk and Insurance
Article Type:Book Review
Date:Jun 1, 1989
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