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Health Affairs

A recent Health Affairs article advances a set of ethical criteria for employer-based programs that penalize unhealthy behaviors. Given their growing prevalence and the ethical controversy they stir, the need for ethical guidance is urgent. The authors’ recommendations are thorough and thoughtful, but also have weaknesses that throw into question the practical utility of their guidelines and the ethical acceptability of penalty programs more basically.
Steven D. Pearson and Sarah R. Lieber justify employer-based penalty programs on grounds that unhealthy behaviors impose economic harm on others. Employees who refuse to take steps to healthier living made available by the employer should, they argue, be held responsible in the form of financial penalties. This employee responsibility goes hand in hand with the employer’s responsibility to be good stewards of a limited pool of health care resources, a responsibility that includes developing programs that:
1) penalize only informed and voluntary refusals to take up health promoting opportunities made available by the employer,
2) inform employees of the reasons for the program and provide adequate notification of its implementation,
3) involve employees in the implementation and administration of the program,
4) ensure fair and equal access to health promotion opportunities and resources,
5) create an opt-out appeals process, and
6) set penalties at a level commensurate with employees’ salary level with the goal of motivating behavior change, not driving them out of the insurance plan.

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The requirement that penalty programs target only employee decisions to “not take steps made available to them to try to improve their health” is morally significant for two reasons.
First, it precludes from penalty biometric outcomes over which people can exercise little control. As the authors point out, human health has socioeconomic, environmental, biological, and genetic origins. Behaviors also contribute to the development of disease, but health behaviors are constrained by social forces beyond an individual’s control. This ethical concern to not hold people responsible for that which they cannot control also grounds the authors’ exclusion of some behaviors, such as smoking, because of the addictive nature of tobacco.
Second, this requirement tries to address the vastly different resources and opportunities employees have to direct toward a healthy lifestyle. Different income levels, job duties, family circumstances and responsibilities, and social networks all influence one’s time for, ability to, and interest in adopting a healthier lifestyle. By requiring the employer to address workplace resources and conditions, the authors are trying to ensure that employers “level the playing field” and thereby create a fair and equal opportunity for all employees to adopt health-promoting opportunities.
Thoughtful as these criteria are, practical and ethical problems remain. First, the requirement that penalties apply only to voluntary refusals to take up health promoting opportunities suggests that employers can assess with accuracy and fairness when behavior is free and unencumbered.
As philosophers have noted, the question of free will is an old and unresolved problem, and the authors should not be unduly criticized for not solving it. But they offer little advice as to what sort of mechanisms should be put in place to make such evaluations, which promise to be complex. As with health outcomes, health behaviors have early developmental origins, are bound up in culture and class in complicated ways, and are constrained not just by work conditions but by life circumstances.
Complexity does not preclude collective decision-making on these matters, as other public policy models that assess levels of voluntariness and guilt and assign appropriate punishment demonstrate. Judges and juries come to mind.
But the very suggestion of a judicial model raises another ethical question: What might such mechanisms do to workplace relationships and environments? One very real possibility is that they would undermine any sense of mutual trust and reciprocity in the workplace, which is unfortunate in its own right but which could also contribute to poor health.
Second, the authors’ criterion to protect from penalty a class of voluntary yet costly behaviors deemed fundamental to “personal freedom and identity” may prove more problematic than they recognize. The authors cite sexual activity, having children, and many recreational sports as examples of behavior that, while costly, many will want to protect as forms of personal expression and identity. They acknowledge the difficulty of making these determinations and propose a procedural solution likely to produce variation from one organization to the next.
But they do not acknowledge just how wide ranging views of health-related behaviors may be. To take two examples: bigger body types signal health and beauty among some subgroups and smoking cigarettes reinforces ideals of masculinity in some subcultures. Yet, these forms of personal expression will find themselves at odds with most employer-based programs whose primary targets are obesity and tobacco use.
Finally, these decisions are very likely to discriminate against socioeconomically disadvantaged groups. Low socioeconomic groups shoulder a disproportionate burden of injury, illness, and disease and these health disparities hold across all 14 major causes of death.
Socially disadvantaged groups also are more likely than their better off counterparts to engage in unhealthy behaviors. Smoking illustrates this fact well, with the habit now increasingly concentrated among lower socioeconomic classes.
The upshot is that penalty programs are likely to scrutinize and penalize those workers with the least power and voice in their organizations, a result that the authors’ proposed procedural protections may not prevent. As ethically essential as procedural justice is to health promotion activity, a fair process does not guarantee fair results.
None of this is to say that health promotion programs should not try to appeal to and mobilize individuals’ sense of agency. But programs that do this by offering rewards – not threatening penalties – are more ethically sound. Integrating and coordinating such programs with broader community and societal efforts to reduce barriers and facilitate opportunities promise even more ethical advantages and, possibly, better results.

Posted by Susan Gilbert at 06/29/2009 03:18:35 PM |

Read more: http://www.thehastingscenter.org ... =3632#ixzz0nXYjRnDQ

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older and younger workers

One of the advantages of being an insider is that employers often tell me things they would never mention publicly. There is an implied obligation on my part for complete confidentiality. There is no circumstance under which I will reveal the contributors to this article. So, please, don’t ask and don’t try to guess. I share this with you because I feel it is valuable information which will help many to make appropriate adjustments.
This post is written entirely from the point of view that if we know what the battlefield looks like, we are apt to win the war. I do not pretend that this is extensive research, only that some companies have issues. And you have to trust me when I say, this is just the tip of the iceberg. So, read on to learn what you need to know to fight the good fight.
Why some employers are reluctant to hire those over 50.
In the past ten years as a career coach, I have often worked with clients who believed they were overlooked for promotion, dismissed or not hired because of their age. Not one of these people looked to their performance or work place interactions for clues. And while each was subsequently successful in achieving their career goals, it wasn’t because we changed their age. Instead, we changed their behaviors, messaging, approach and expectations.
When someone tells me they were fired or overlooked because of their age, I can’t help but think, “That is the symptom, what is the disease?” What is it about age that causes folks to be overlooked or fired?
I look to those who hire and work with people over 50 for the answers. All those interviewed said they were apprehensive about hiring people over 50 in case the individual didn’t work out because they were reluctant to expose the company to potential litigation. Their observation was that older workers seem to be especially litigious.
Those companies, especially those in California where there are significant numbers of high tech employers, are at risk because the laws favor the candidate. Even with extensive documentation on performance issues, companies suffer from bad PR and expensive legal disputes. Not something a thinking executive willingly puts on their agenda. So the very laws in place to protect those over 50 are what makes some companies averse to hiring them. Ironic, that.
From individual contributor to VP, during a three-year heavy hiring period, one company experienced a significant performance issue with every over-50 hire compared to a 20% record for younger employees. Each was replaced at great expense to the company. The company is culturally and gender diverse and up till now, more than happy to hire older employees.
Executives with whom I spoke gave many examples of why they avoid hiring older workers. Each complained the candidates or employees often referred to their ‘30 years experience’ which provoked employers to respond, “Number of years is irrelevant. the only thing that is relevant is the last four or five years and what was achieved or learned.”
One executive mentioned, “When a resume or LinkedIn profile begins, ‘25 years experience’ I assume the person will rely on old expertise rather than up-to-the-minute and contemporary solutions. If they lead with number of years and not recent accomplishments, I run away.”
Work ethic: While you can argue the efficacy of doing so, high tech companies typically develop product plans based on a 50-60 hour work week projections which means employees consistently spend 60-70 hours working. One employer noted, in every case, older employees left work long before their younger colleagues. When a senior manager was asked why he thought leaving ‘early’ was acceptable, he said, “I have more experience than the others. I can get done in less time because I know how to do this.” He was wrong.

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The employer responds, “While experience is valued, the processes and techniques for creating products and doing business have changed significantly. Things take as long as they take regardless of how long you have been doing them. Arguments to the contrary, this system works and I don’t see it changing anytime soon.”
“Our younger employees are less encumbered and are more than happy to spend the time at work. They are eager to prove themselves and hungry. Whereas the older employees, especially the individual contributors, feel they paid their dues and don’t have to work as hard. Like it or not, we reward employees based on their contribution. Someone who works 65 hours contributes more than someone who works 45 hours.”
Adaptability: Employers require employees to adapt to new technologies (i.e. Agile), new processes and new business concepts. Older employees who constantly refer to what they did in the past alienate their peers and are not productive. “Here’s how we did it at xyz company…” is a poor substitute for a solution.
The employer responds: “We need innovative ideas, not a report on what worked in the past. When employees cling to their past experience, it is an impediment to moving forward.”
One of my clients had a manager that simply could not adapt to the Agile methodology for product development. He was a constant road block for release dates and the product quality suffered. He was invited to take classes, givin on-site mentoring and still could not adapt.
The ripple affect was he could not set proper expectations for his team and his old-school techniques were passed on. After nine months trying to solve this issue, the manager was moved to another position; one where he had no impact on the schedule. The company would have fired him for well documented lack of performance, but they were concerned about litigation. Based on this, no one over 35 was considered as his replacement.

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Takes longer to make decisions: The ‘fail-fast’ mentality of modern technology companies requires quick decision making. If it is the wrong decision, immediate course correction ensues. Older workers tend to take longer to evaluate and assess and over analyze thus taking more time to make decisions that impact schedules and the bottom line.
The employer responds: “Fail-fast is the key to our modern design, delivery and production technology process. Everything is affected when decisions are not made quickly. Older employees, especially those not accustomed to working that way, clog up the system. They are no longer hungry and eager to impress. They cease to be aggressive and appear to have stopped caring.”
Attitude: Employers need high energy, enthusiastic employees committed to the corporate mission. Older workers often behave as though this is their last job and they can do the minimum, relax and enjoy job security.
The employers responds: “Without the constant energy and creativity of each of our managers and executives, we will not succeed. If an older worker is not engaged and forward thinking, they damage the team morale and productivity. They have to keep up.”
“When an older worker reports to a much younger manager, the dynamic is often disruptive. We can’t afford all the personnel issues. If an older worker argues or won’t cooperate because they feel they know more, everyone loses and a lot of time is wasted.”
The bottom line is, often the track record of older employees and the ill-will generated by their behavior and lack of performance makes the company and hiring authorities gun-shy about hiring older workers.
These are just the facts as they relate to some companies. It is a substantive peek inside the rational for avoiding hiring older workers. All that having been said, there are many people over 50 who are not only gainfully employed, but revered by their employers. There are many prospective employers who consider people of any age as viable candidates. It is still important to learn to navigate these potentially career-killing waters.
If you are looking for a new job and are over 50, it behooves you to vet the employer carefully. If you see age diversity, you have found a good prospective employer who has likely not been negatively affected by your poor performing age mates.
I caution you not to kill the messenger. This insider’s information is shared in good faith and I certainly hope that those of you who recognize your own behavior or attitude can make the changes required so employers are more willing to hire your peers.

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SOLUTIONS:
Age discrimination is absolutely a fact of the over 50 candidate. It is a reality that you can manage and learn to minimize the affect on your career.
Listen to NPR broadcast on both the legal and job search aspects of ageism.

Listen to the podcast for information and insights on how to tailor your job search to avoid the hazards of age discrimination.  

Read Six steps to overcome ageism. Age getting in the way of landing a job,AND Overqualified? I just want a job
Links in one place to combat age discrimination
Rita Ashley is a career and job search coach for executives.  In the last two years 98% of my clients, many over 50 years old, achieved their goals within six months. Is it your turn? Contact me directly to discuss a customized solution.
Rita Ashley is the author of “Job Search Debugged” and “Networking Debugged.” Download both as PDFs for information on how to conduct a compelling job search




1.        Bernard says:
March 3, 2010 at 11:35 pm
That’s a good article, covering the very real reasons that employers are wary of employing 50+ people.
I can think of two things to add – one is that the idea of those in this category changing their behaviours rather than relying on “long experience” is right, but it’s much easier and more effective if you don’t fall into that pattern in the first place – I would recommend that all 30+ read this and take note – you need to start now making sure you don’t fall into the “experience is everything” behaviour, and keeping yourself active mentally and always challenging yourself and delivering new achievements – if you drop behind it will be much harder to catch up later!
Second is an additional consequence of the reluctance to employ 50+ people – this means that there are a lot who are in “middle” positions, who simply cannot move to a new job at the same employer or elsewhere, so they gradually get more and more “set in their ways” and relying on past glories, forming an entire stagnant layer in some organisations that can block everyone! Many companies will get rid of them eventually, but this will take time, and in many cases is difficult and expensive, and may be avoided due to the “loyalty” shown. It’s in the benefit of existing employers to help those heading towards such ages to understand the behaviours needed, and show a bit of “tough love”!

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2.        Tom Napier says:
March 4, 2010 at 12:05 am
The only thing that experience should show anyone is that the world of business and industry is ever changing. Those who don’t adapt are prone to termination and find it difficult to find new employment, just as Darwin predicted survival of the fittest (and luckiest).
I’m over 50 (just turned last November) and don’t put anything within my LinkedIn profile stating how long I have had to build my experience but I do let those who read my profile know that I have a diversity that is well suited for supply chain automation and may have insight through experience that others may not have.
The term thinking outside the box is over used but is applied so seldom. One thing that youth has as a strength over their seniors is their willingness to challenge the status quo. Nobody can go back in life but experience can help in formulating new ideas. Creativity is something that should never stop in one’s life. Each day should be recognized as a new opportunity to learn and do something new and hopefully exciting. Unfortunately, we mature and lose that spark and certain something. The serious folks who look like they will break their face if they smile have forgotten their youthful ability to be silly. Silliness is a form of creativity. Play is a form or creativity. Boring old farts have forgotten this and it manifests itself on their everyday work.
Rita, I think you hit the nail on the head, if we still use nails these days. Unfortunately, the paint brush that paints the bad picture for the over 50 grey power folk is wide. If there’s one piece of advice I can give to my elderly demographic, it is to read and write white papers, to keep up on what’s new and to create something new with putting your creativity into words.
That’s my rant… :?)
3.        Kristen says:
March 4, 2010 at 2:33 pm
Good insights, and very true. I wrote a blog on this last year after polling a diverse set of HR professionals, candidates, and hiring managers.
Here is a link to the direct post including the responses:
http://t.conquent.com/9A00
Some of note:
“Accept new ideas and processes, embrace change and you may find that you will outlast younger employees in tight times or if you have lost your job you will be considered as a great candidate as you have kept current , you don’t think old, and you have a great attitude. ”
“If you are over 40 and command more money to do a job that someone under 40 can do just as well and for less, what do you think might happen??? If your years of experience are not worth the extra money, they aren’t worth the extra money, and that’s just economics. “
4.        Bill Vick says:
March 4, 2010 at 2:55 pm
Ouch! True words in both the article and the comments that touch on points that need to be adressed in a broader forum. Age bias or discrimination is the elephant in the room that everybody knows about, but only whispers in hushed tones about, with all of the negative buzz words most of us have heard. I’m not sure there is quick and simple answer to such a complex problem. Ageism exists across all demographics and as a recruiter I can’t count the number of times a hiring manager would say a string of buzz words like aggressive, with new vision, up to date, and on and on. What was really interesting to me was the majority of my hiring managers were in that delicate stage called boomers, and had the same biases as did their younger peers and colleagues. I think Rita offered good advice on vetting the company and becoming a solution to a problem, not another cog in the wheel. In today’s market it’s really what can you do for me, the hiring manager, not what have you done It’s all about your ability to translate your experience into a solution can be the real reason for job search success. Life does not have to stop at 50 nor does success in career or life. The major problem I’m seeing is the job hunters’ own view of themselves as old and tired instead of the realities of the strength, wisdom and results they can bring to the table and who they really are. You truly are who you think you are, or can be, not as you think you were.
5.        Tom Bolt says:
March 5, 2010 at 6:43 pm
This is an excellent synopsis of age discrimination causes and a hint of cure! My knee jerk response to most articles involving ageism, since I am in the 50+ group myself, is the animal-defensive mechanism that creeps into my emotional thinking. But since I also am also an “insider” and have seen candidate discussions similar to those summarized by Rita, I know that just because something is labled a stereotype doesn’t mean that it isn’t true in some cases. “We have met the enemy and he is us,” as the philosopher Pogo once said. The more analytical side of my brain searches for answers to the “organizational fit” questions with a blade that cuts both ways. If an individual is measured by the organization based on the criteria for the job and not the stereotypical shadows cast over the process, an intelligent decison could involve hiring/promoting the best candidate regardless of age…or gender…or race. From the candidate perspective, if there is a biased decision based on age and an HONEST self-assessment (sometimes difficult to do without outside input) is that the decison was bogus, why would you want to work there anyway?

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6.        Deb says:
March 6, 2010 at 12:16 am
The good news is that the trend of younger workers working longer hours is no longer true. In the past 5 years, I worked with many 25 and under and all left promptly at 5, and rarely ever worked more than 40 hours. All took lunch, most took 1.5 hour lunches to “work-out” and eat. For some roles, though weekend work was encouraged, rarely did the 25 yr olds rise to the occassion. I have found this true and accurate in just about every industry, even healthcare, which brings scary thoughts that I will leave to another blog.
Though I am not quite 50, I had no problem working 50-60 hours a week, and made my co-workers productivity/performance look poor. I also did community work, which generally added another 20-30 hours a week.
I do agree that knowing this information is certainly helpful.
One issue that I wish was discussed in more detail was pay, which I believe (and have heard some feedback on) is at the bottom of the pyramid that was built for “reasons”, and then added to the top of the pyramid with “can an employee be happy with a 30-40% cut in pay?”
Proof is in performance. That’s all anyone can do to change this self-fulfilling prophecy and continued urban legend.
7.        Recruiting Animal says:
March 8, 2010 at 10:03 am
Re: senior workers applying for more junior jobs.
Most of the time, nobody wants to take a step backwards.
You’ll probably be working for less money. You might be doing work that is less challenging. And you might have to follow instead of lead.
The employer knows that.
I’m working on a plant manager’s role right now. The company hired someone who had been a VP Manufacturing.
I’m sure he told them that he would be very happy in a lesser job. But he wasn’t there a month before something better came around that he couldn’t refuse.
How can you beat the accusation that you’re not going to be happy and leave unless you offer to sign a contract which probably can’t be enforced.
8.        admin says:
March 8, 2010 at 3:37 pm
@animal Your point is valid. I don’t deny it is true in some cases.
My clients and ‘target market’ are technology executives. The issue about leaving a job for something better isn’t that common. There is no more chance someone a bit under employed will leave than for those who are level appropriate. One thing that tends to be true in tech companies is that people rarely change jobs just for money.
It is about recognition, respect, ability to succeed and a host of other things. The extend to which a company treats all employees well is the extent to which any employee is likely to stay or leave.
Another factor is sometimes, not often, a senior employee WANTS to step back. Many reason for that, but it happens more than one would think.
Rita Ashley, Career and Job Search Coach
9.        Recruiting Animal says:
March 8, 2010 at 3:47 pm
Common sense suggests that younger employees with young families wd need more time off than middle aged employees whose children are grown.
That’s the opposite of what was said here. Are the young people who work long hours single or without children? Or is that everybody?
10.        admin says:
March 8, 2010 at 4:00 pm
Common sense? The technology industry was founded on the 70 hour work week and anyone engaged in the industry knows it, accepts it. Few companies expect less than a 50 hour work week an most tend towards 60. The more senior the employee, the more hours are expected; sets the right example. Some of the work is home based, some on the road, but long hours are a fact of life, family notwithstanding.
How did that happen? The tech industry was catapulted to success on the backs of very young, very educated men, extremely dedicated men. Men who didn’t have families or if they did, they took a back seat to the raging success they anticipated with stock options, incredible tech advances and just plain camaraderie. Back in the day, it was not uncommon for companies to supply cots for those overnighters (what a message the mere presence sent). Many of those people are now millionaires and that hope continues. Some people, younger in their careers to be sure, keep a sleeping bag in the office to sleep under their desks.
Common sense tells us we cease to be productive after a certain number of hours, yet many senior execs work 65-80 hour days on a regular basis. It may not be common sense, right or even effective, but it is true.
A few years back a bloke asked me how he could find a 40 hour week job so he could attend to his ailing wife. There was nothing for it but to leave high tech.
Individual results may vary, but the standard is the standard, no matter how much we rail against the machine.
11.        Is age discrimination hampering your career? « Rita Ashley, Career Coach says:
March 9, 2010 at 5:40 pm
[...] Ageism is not a pretty thing to confront in a career. And while we can rail against it ad nauseam, the facts don’t change. Some people, some companies, discriminate against the older worker. [...]

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