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34 Academy of Management Perspectives February A R T I C L E S Building Sustainable Organizations: The Human Factor by Jeffrey Pfeffer Executive Overview Although most of the research and public pressure concerning sustainability has been focused on the effects of business and organizational activity on the physical environment, companies and their management practices profoundly affect the human and social environment as well.

This article briefly reviews the literature on the direct and indirect effects of organizations and their decisions about people on human health and mortality. It then considers some possible explanations for why social sustainability has received relatively short shrift in management writing, and outlines a research agenda for investigating the links between social sustainability and organizational effectiveness as well as the role of ideology in understanding the relative neglect of the human factor in sustainability research. T ere is growing public and business interest in building sustainable organizations and increasing research and educational interest in the topic of organizational sustainability. The Academy of Management has a division called Organizations and the Natural Environment, and there are numerous journals and research papers concerned with ecological sustainability. There are growing numbers of higher education programs focused on sustainability and an Association for the Advancement of Sustainability in Higher Education (Fountain, 2010).

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Marcus and Fremeth (2009) noted that this enthusiasm for what they called “green management” came from people’s expectations for how managers and the organizations they lead should conduct their business to protect the environment. As I gratefully acknowledge the advice, encouragement, and inspiration of Nuria Chinchilla from IESE, who encouraged me to think about the issue of human sustainability in both societies and companies. The helpful comments of the editor and the reviewers substantially clarified the arguments.

Ambec and Lanoie (2008, p. 46) noted, “Firms are facing growing pressure to become greener. ” As it is operationalized in the literature, sustainability is defined in part by an effort to conserve natural resources and avoid waste in operations. Conservation and the more efficient use of resources naturally lessen the burden of economic activity on the environment and help to ensure that the activity can be sustained over time because the resources required will not be exhausted.

Sustainability also appears to encompass activities that renew and recycle what is used, once again with the goal of ensuring that the ecosystem that supports life and lifestyle can and will be preserved. Other aspects of sustainability include preserving what is—as in preserving threatened plant and animal species and, in cultural sustainability, preserving the values, arts, culture, and food of “communities threatened by globalization and modernization” (Navarro, 2010, p. 20). In the physical sciences, much of the research on sustainability has focused on the amount of stress an

Jeffrey Pfeffer ([email protected] stanford. edu) is the Thomas D. Dee II Professor of Organizational Behavior at the Graduate School of Business, Stanford University. Copyright by the Academy of Management; all rights reserved. Contents may not be copied, e-mailed, posted to a listserv, or otherwise transmitted without the copyright holder’s express written permission. Users may print, download, or e-mail articles for individual use only. 2010 Pfeffer 35 ecosystem can tolerate as well as principles for restoring ecological balance.

In management, research attention has focused on the possible links between profitability and sustainability as well as the factors that cause organizations to pursue different sustainability strategies (e. g. , Ambec & Lanoie, 2008). Although sustainability clearly could encompass a focus on human as well as physical resources—in fact, the Academy of Management division on the natural environment has as one of its foci “managing human resources for sustainability”—there is a much greater emphasis on the physical rather than the social environment1 both in the research literature and in the actions and pronouncements of companies.

To illustrate this point, a search of Google Scholar finds 20,800 entries for the term “ecological sustainability,” 53,000 for “environmental sustainability,” but just 12,900 for “social sustainability” and a paltry 569 for “human sustainability. ” And even a cursory review of the management literature shows that virtually all of the articles focused on sustainability are primarily concerned with the effects of organizations on the physical as contrasted with the social environment (e. g. , Ambec & Lanoie, 2008; Bansal, 2002; Marcus & Fremeth, 2009).

Even when there is concern with the social effects of organizational activities, these concerns are mostly directed to the consequences of economic development and resource exploitation for the viability of indigenous cultures (Bansal, 2002) rather than the consequences of management practices for every individual’s health and well-being and the richness of social life as assessed by participation in civic activities (e. g. , Putnam, 2000). Environmental sustainability is important, and nothing in this paper should be taken to imply In this paper I use the term social environment to include organizational effects on people and small groups.

Just as physical sustainability considers the consequences of organizational activity for material, physical resources, social sustainability might consider how organizational activities affect people’s physical and mental health and well-being—the stress of work practices on the human system—as well as effects of management practices such as work hours and behaviors that produce workplace stress on groups and group cohesion and also the richness of social life, as exemplified by participation in civic, voluntary, and community organizations. 1 that this is not the case.

Nonetheless, this emphasis on the natural environment raises an interesting research question: Why are polar bears, for instance, or even milk jugs more important than people, not only in terms of research attention, but also as a focus of company initiatives? In 2008, Doug McMillon (Colvin, 2008), the CEO of Sam’s Club, a division of Wal-Mart, expounded on the innovation in milk jugs and the fact that his company had introduced a new jug that was able to increase the shelf life of milk, reduce the cost between 10 and 20 cents, and eliminate more than 10,000 delivery trips, thereby conserving energy.

In 2005, Lee Scott, Wal-Mart’s CEO, made the first speech in the company’s history broadcast to all of its associates. In that speech, also made available to Wal-Mart’s 60,000 suppliers, Scott committed the company to the goals of being 100% supplied by renewable energy, creating zero waste, and selling products that sustain resources and the environment (Plambeck & Denend, 2007). Meanwhile, Wal-Mart paid its employees almost 15% less than other large retailers, and because of the lower pay, its employees made greater use of public health and welfare programs (Dube et al. 2007). In 2005, 46% of Wal-Mart employees’ children were either uninsured or on Medicaid, a state program to provide medical care to low-income people (Rosenbloom & Barbaro, 2009). Compared to Costco, Wal-Mart offered fewer medical and other benefits, although these lower costs did not result in higher profits per employee (Cascio, 2006). Wal-Mart’s relative emphasis on the physical environment over its employees is far from unusual.

British Petroleum, a company that touts its environmental credentials in its advertising and other presentations, was one of the first major oil companies to devote significant investment to alternative energy, and at one point wanted BP to also stand for “beyond petroleum. ” Apparently less concerned about its people, the company paid a record fine of $87 million for an explosion in its Texas City, Texas, refinery that killed 15 workers (Greenhouse, 2009). The fine penalized the company not only for the explosion but also for numerous 6 Academy of Management Perspectives February safety violations found during a subsequent investigation and a failure to correct those deficiencies even after the fatal explosion. Even as businesses have appointed “eco-managers” (Hsu, 2010) to oversee company efforts to become more energy efficient and environmentally conscious, and even as companies track and publicly report carbon emissions from their activities (e. g. , Kaufman, 2009), one would be hardpressed to find similar efforts focused on employees.

Just as there is concern for protecting natural resources, there could be a similar level of concern for protecting human resources. For example, there has been no groundswell of reporting on employee physical and mental health and wellness, even though that might be an interesting and informative indicator of what companies are doing about the sustainability of their people. This lack of concern is puzzling given that health-care costs, which as noted below are related in part to what companies do in the workplace, are an enormous problem in the United States nd throughout the industrialized world. In this paper, I want to first make the case for broadening our dependent variables in management research from a focus on profitability and other indicators of firm performance, such as shareholder return and productivity on the one hand and environmental sustainability practices and social responsibility on the other, to also include organizational effects on employee health and mortality.

Being a socially responsible business ought to encompass the effect of management practices on employee physical and psychological well-being. Indeed, there is a large epidemiological and public health literature that suggests there may be important organizational effects on human health and life span. The available evidence suggests that there is a good likelihood of finding some interesting research results if we continue to expand our understanding of the connections between organizational practices and human wellbeing.

Then I want to open up the question as to why employee health has received relatively short shrift in discussions of organizational effects on the environment and the implications of such effects for sustainability. In so doing, I argue that an ideology of the primacy of markets (Davis, 2008) and shareholder interests and the associated idea that market outcomes are fair and just (Jost et al. , 2003), with sentient individuals making informed choices, may help explain the constrained focus of our research attention. The paper concludes with some implications for building a research focus on human sustainability.

Broadening Our Dependent Variables: Organizational Effects On Employee Mortality and Morbidity n assessing and evaluating countries and other political units, measures of population health (e. g. , infant mortality and life span) are frequently used as indicators of societal effectiveness and the level of country development. Cornia and Paniccia (2000) examined explanations for the dramatic increase in age-adjusted mortality, particularly for men, in Eastern and Central Europe during the 1980s and 1990s, taking these decreases in life span to be evidence of dysfunctional social conditions.

Marmot and Bobak (2000) explored the “missing men of Russia”—the enormous increase in mortality and consequent reduction in average life span for men following the collapse of the Soviet Union, once again implying that the health of a society’s people reflects at least to some degree the functioning of that society. Indeed, Marmot (2004, p. 247) explicitly argued that “health functions as a kind of social accountant. If health suffers, it tells us that human needs are not being met. ” Similarly, Gakidou, Murray, and Frenk (2000, p. 42) wrote that “health is an intrinsic component of well-being,” and the economist Deaton (2003, p. 15) also noted that “health is a component of well-being. ” What is true for countries or other political units is also true for organizations. The health status of the workforce is a particularly relevant indicator of human sustainability and well-being because there is evidence that many organizational decisions about how they reward and manage their employees have profound effects on human health and mortality. A few of the many ways company decisions affect the health and welfare of their people follow. I 2010 Pfeffer 37 The Provision of Health Insurance

In the United States, in contrast to every other advanced industrialized country, access to health insurance—and, as a consequence, access to health care for working-age people who are not so poor as to be covered by increasingly limited social welfare programs— depends on whether or not one’s employer voluntarily chooses to offer medical insurance as a benefit. Approximately half of the U. S. population today receives health insurance through an employer, and the evidence shows that the proportion of employers offering health insurance has declined while the amount employees pay for their coverage has increased.

The Kaiser Family Foundation reported that between 1999 and 2009, worker contributions to health insurance premiums increased by 128%, while the proportion of companies offering health benefits fell from 66% to 60%. These employer decisions about offering health insurance and the cost to employees, something that can also affect access, are consequential because there is a great deal of evidence showing that having health insurance affects health status.

Levy and Meltzer (2001), reviewing the large literature on the connection between health insurance and health status, noted that hundreds of studies showed that the uninsured had worse health outcomes than people with access to insurance. Wilper et al. (2009) recently replicated the results of an earlier panel study (Franks, Clancy, & Gold, 1993) showing significantly higher mortality for people without health insurance. This result held when age, gender, income, education, race, smoking, alcohol use, exercise, body mass index, and initial physician-rated health were all statistically controlled.

Based on their empirical results and population parameter estimates, Wilper and his colleagues estimated that there were more than 44,000 excess deaths per year in the United States because of lack of health insurance. Another study looking at the effects of health insurance on health used the fact that a random event, one’s birthday, affects access to health insurance. At age 65, U. S. residents become eligible for Medicare, federally provided health insurance. Using this fact and data on ealth status, Card, Dobkin, and Maestas (2009) found that access to Medicare resulted in a 20% reduction in deaths for a severely ill patient group compared to similarly ill people who did not have access to Medicare because they had not yet turned 65. Other studies show that people without health insurance are, not surprisingly, less likely to obtain various preventive screening tests for blood pressure and elevated cholesterol, Pap smears, and so forth (e. g. , Potosky et al. , 1998; Sudano & Baker, 2003). Such screening reduces mortality and morbidity through the early detection of harmful physical conditions (Sudano & Baker, 2003).

Moreover, the data show that even short periods of not having health insurance substantially reduce the utilization of preventive services (Schoen & DesRoches, 2000; Sudano & Baker, 2003). Having health insurance also affects people’s economic well-being, because medical bills are a large contributor to personal bankruptcy. Himmelstein et al. (2005) studied a sample of personal bankruptcy filers in five federal courts. About half of the people filing for bankruptcy cited medical causes: “Medical debtors were 42 percent more ikely than other debtors to experience lapses in coverage” (2005, p. W5-63). When employers decide to drop or curtail medical coverage, there are health and economic well-being consequences for their people. In addition to providing, or not providing, health insurance, some employers have recently begun implementing health and wellness programs for their employees, which can also have important effects on health. Because most large employers are self-insured, any savings from better employee health and reduced medical expenditures flow directly to company profits.

An evaluation of one such program at GlaxoSmithKline (Stave, Muchmore, & Gardner, 2003), covering more than 6,000 employees continuously employed from 1996 to 2000, reported an increased use of stress reduction techniques, more eating of fruits and vegetables, and an average cost savings of $613 per participant, largely because of reduced disability expenses. 38 Academy of Management Perspectives February The Effects of Layoffs Work Hours and Work-Family Con? ict Employers decide on whether or not to have layoffs, how many people they will lay off, and who will get laid off.

Budros (1997) has shown that layoffs are not just a consequence of economic conditions facing companies, a point made also by Cappelli (1999) in his discussion of the changing nature of the employment relationship. Budros found that layoffs are “contagious,” in the sense that they spread through similarly situated and socially connected firms, which appear to model others’ layoff behavior. Research has shown that layoffs are very harmful to the physical and mental health of those laid off. There is consistent evidence that job loss is a significant predictor of reported symptoms of psychological disorders (Catalano, 1991).

Being laid off increases the likelihood that an individual will engage in violent behavior by some 600% (Catalano, Novaco, & McConnell, 2002). One study reported that job displacement increased the death rate of those laid off by about 17% during the following 20 years, so that someone laid off at age 40 would be expected to live 1. 5 fewer years than someone not laid off (Sullivan & von Wachter, 2007). A study of plant closings conducted in Sweden, a country with a relatively generous social safety net, nonetheless found that mortality risk increased 44% in the four years following job loss (Eliason & Storrie, 2009).

A New Zealand study reported that unemployed 25to-64-year-olds had more than twice the odds of committing suicide (Blakely, Collings, & Atkinson, 2003), which helps explain the cause of the increased mortality following layoffs. Another New Zealand study, based on an eight-year follow-up of workers from a meat processing plant that closed compared to a neighboring plant that remained open, found an increased risk of selfinflicted harm that resulted in hospitalization or death and also an increased risk of being hospitalized with a mental health diagnosis (Keefe et al. 2002). And downsizing is associated with negative changes in work behavior, increased smoking, less spousal support, and twice the rate of absence from work because of sickness (Kivimaki, Vahtera, Pentti, & Ferrie, 2000). Employers determine the hours people work and when they work, subject to federal and state regulations and any union-bargained contracts. There has been an intensification of work, particularly in the United States (e. g. , Rousseau, 2006).

Americans work longer hours than workers in most European countries and now exceed the working hours of even Japanese (Yang et al. , 2006). A report by the National Institute for Occupational Safety and Health (2004) summarized the extensive evidence on the harmful effects of long working hours and shift work on people’s health-related behaviors as well as on on-the-job injuries and employees’ health status. There is a reasonably extensive body of evidence connecting work hours to poor health outcomes. Some of this research focuses on hypertension.

For instance, Yang et al. (2006), after summarizing studies showing the connection between hours worked and hypertension in Japan, reported their findings from analyzing the California Health Interview survey. They found that compared to people who worked less than 40 hours a week, those who worked more than 51 hours were 29% more likely to report having hypertension, even after statistically controlling for variables such as socioeconomic status, gender, age, diabetes, tobacco use, sedentary lifestyle, and body mass index.

Long work hours increase the likelihood that people will face a conflict between work and family responsibilities. Work-family conflict is a form of stress and has been found to influence health and health-related behaviors. Frone, Russell, and Barnes (1996), using two random samples of employed parents, found that work-family conflict was related to alcohol use, depression, and poor physical health. Moreover, work-family conflict is related to anxiety, substance abuse, and substance dependence (Frone, 2000).

Depending on the type and degree of work-family conflict and the particular disorder being investigated, employees were between 2 and 30 times more likely to experience a significant mental health problem if they experienced work-family conflict compared to people who did not. 2010 Pfeffer 39 Work Stress and the Consequences of Job Design Organizations design jobs, and job design has important psychological consequences—for instance, for motivation—as the large literature on job design attests (e. g. , Hackman & Oldham, 1980). Job design also has important effects on people’s physical well-being.

One important dimension of job design is the amount of control people have over their work. High job demands that people cannot control, because they have little or no discretion over the pace and content of their work, coupled with work that is socially isolating, produce job stress. Marmot and colleagues have done extensive studies on the effects of job stress, emanating from an absence of control over one’s work, on health outcomes ranging from metabolic syndrome (Chandola, Brunner, & Marmot, 2006) to cardiovascular disease and mortality (e. g. , Marmot, 2004).

Using both retrospective and prospective panel studies, Marmot reported large effects of job stress on mortality and morbidity. Much of this research was stimulated by studies of the British civil service. These studies, called the Whitehall studies, showed that, controlling for numerous individual characteristics such as family background, serum cholesterol levels, blood pressure, and so forth, it was nevertheless the case that the higher someone’s rank in the bureaucracy, the lower that person’s risk of cardiovascular disease and death from heart attack (e. g. , Marmot et al. , 1997). Inequality

The Whitehall studies are just part of a larger literature showing the connection between inequalities in health outcomes and inequality in individual attributes ranging from income to education. Wildman (2003, p. 295) reviewed papers reporting substantial “income-related inequalities in health in a number of developed countries,” noting that the United Kingdom and the United States were high-inequality countries. Marmot (2004) reported that virtually all diseases followed a status gradient and that gradients in both income and education were important in understanding differences in health.

It is not just the case that people with more income, higher education, and better jobs are more likely to enjoy better health and live longer lives—although that is clearly the case (see Marmot, 2004, for a review of this research). Some argue that there is an effect of inequality, particularly income inequality, on the average health status of a population. Lynch et al. (2001) argued that income inequality in the United States in the 1990s caused as much loss of life as the combined mortality resulting from lung cancer, diabetes, motor vehicle crashes, homicide, and AIDS combined.

Although the effect of inequality on average health outcomes remains a contested issue (e. g. , Deaton, 2003), there is growing concern about inequality in health outcomes within societies and increasing research attention to the causes and consequences of a number of forms of health-relevant inequality. The research and policy link to organization studies is clear: Many, although certainly not all, of the inequalities in social systems that result in inequalities in health are produced in and by organizations. Because most people work for organizations rather than being self-employed, income nequality is produced in part by decisions made by employers about how much wage dispersion to have, both within and across organizational levels, and who and what types of people will obtain higher and lower level positions and incomes (e. g. , Baron & Bielby, 1980; Pfeffer & Langton, 1988). The organization literature has a number of studies exploring the effects of wage dispersion on various outcomes ranging from satisfaction to indicators of organizational performance (e. g. , Bloom, 1999; Cowherd & Levine, 1992; Pfeffer & Langton, 1993; Siegel & Hambrick, 2005).

The importance of inequality for health suggests two important extensions to this line of research: first, including health outcomes as a dependent variable in studies of the consequences of wage dispersion, and second, renewing efforts to understand the factors that create greater or lesser inequalities in income, power, job responsibilities, time pressure, and other such dimensions inside organizations. If inequality is consequential for health, we need to better understand how that relationship operates inside organizations and what factors produce inequality in the first place. 0 Academy of Management Perspectives February The foregoing is only a partial review of a large epidemiological literature that potentially ties organizational decisions to health outcomes. There seems to be overwhelming evidence that organizational decisions about whether to offer health insurance and choices about layoffs, work hours, job design, and the degree of inequality created by wage structures have profound effects on employee physical and mental health and even people’s life spans.

There are other aspects of the work environment that are also likely to be important and might productively be studied, including whether or not people have paid sick days, the amount of vacation they receive and take, and the emotional climate of the workplace, including whether or not there is bullying and verbal abuse. If we want to understand employee psychological and physical well-being, and if we want to assess the effects f management decisions on people, health outcomes would seem to be one productive focus of research attention. That’s because organizational effects on psychological well-being frequently manifest themselves in people’s health status, as, for instance, in the effect of socioeconomic status on physical health as operating through its effect on negative emotions (Gallo & Matthews, 2003). Moreover, health-care costs are important both to companies and to society. Why Does Human Well-Being Receive Relatively Short Shrift? ven the profound effects of organizations and work arrangements on the psychological and physical well-being of the people who work in them and the growing interest in sustainability, it is interesting that the human dimension of sustainability remains largely in the background. In both social psychology and economics, there is increasing research attention to happiness as an important dependent variable in and of itself (e. g. , Diener, Suh, Lucas, & Smith, 1999; Frey & Stutzer, 2002; Oswald, 1997; Ryff, 1989).

And as already noted, health is considered an important indicator of well-being for both individuals and societies. However, in the management literature, the focus on a somewhat related topic, job satisfac- G tion, has evolved over time to largely although not exclusively consider the connection between job satisfaction and turnover—which is costly to the firm—and also the relationship between job satisfaction or its conceptual cousin, employee engagement, and customer service and other dimensions of organizational performance.

Although there is obviously a large and important literature on work-family conflict and its consequences, once again a focus of at least some significant fraction of this literature is on the consequences of such conflict for organizational well-being, as reflected in absenteeism, sickness, turnover, and job performance. This is not to say there is no interest in social responsibility and people for their own sake, but in the management literature, such concerns are often, although not invariably, coupled with their connection to profits, costs, or productivity.

This is scarcely the first time this point has been made. Walsh, Weber, and Margolis (2003, p. 859) have noted that while the Academy of Management was founded to deal with society’s objectives and the public interest along with organizational economic performance, over time the field “has pursued society’s economic objectives much more than it has its social ones. ” March and Sutton (1997, p. 698), in their critique of performance as a dependent variable, commented that organizational researchers live in two worlds, one of which “demands and rewards speculations about how to improve performance. Why some topics get attention and others don’t and how research questions are framed are themselves important topics for research and theoretical exploration. As Ferraro, Pfeffer, and Sutton (2005, 2009) have argued, theories matter, not just because theories influence the institutional arrangements, norms, and language of organizational management, but also because theories focus both research and public policy attention. Molotch and Boden (1985) described three faces of power.

The first face is the ability to prevail in explicit conflicts over decisions. The second face of power concerns the capacity to set agendas—whether or not there will be any decisions over which to fight and what such decisions will entail. They defined the third face of power as 2010 Pfeffer 41 “the struggle over the linguistic premises upon which the legitimacy of accounts will be judged” (Molotch & Boden, 1985, p. 273), and argued that this aspect of power was the least visible and accountable and possibly therefore the most potent.

In the present context, how we talk— or don’t—about sustainability and what is considered legitimately included and excluded from such discussions affects what we study, how we study it, and by extension, what becomes included in public policy debates as well. There are undoubtedly many reasons that the sustainability of the physical environment has received more emphasis than have people. One possibility is that the consequences of organizational actions on the physical environment are frequently much more visible and, therefore, salient.

You can see the icebergs melting, polar bears stranded, forests cut down, and mountaintops reshaped by mining, and experience firsthand the dirty air and water that can come from company economic activities that impose externalities. Reduced life expectancy and poorer physical and mental health status are more hidden from view. Even the occasional and well-publicized act of employee or ex-employee violence has multiple causes and is often seen as aberrant behavior outside of the control and responsibility of the employer.

Another explanation for the relative attention to physical versus human sustainability is the differential actions taken to make sustainability salient. Organizations and groups focused on improving the physical environment have taken steps to increase the visibility of what companies do—reporting on carbon emissions and measures of environmental compliance, for instance, and trying to ensure that these reports generate news coverage.

Partly as a result of this public attention, laws have been passed in numerous countries mandating environmental compliance to various standards and requiring assessments of environmental impact before certain forms of economic development can take place. These laws, at a minimum, ensure the availability of more data to assess physical environmental effects. And while between 1980 and 2006 there was a 62. 3% increase in the number of U. S. federal staff dealing with the environment, during that same period there was a decrease of 34. 5% in staff in agencies overseeing the workplace (Dudley & Warren, 2005).

These changes in federal staffing oversight also provide some indication of shifting social priorities and alterations in the focus of public policy attention. One lesson for those interested in human sustainability is that developing a consistent set of measures or indicators of the construct, gathering data on them, and publicizing such data might provide more impetus for focusing on the human sustainability implications of what organizations do. Another implication is that federal and state regulation and oversight matter— both for the substantive effect and as a signal of what society values.

Both environmental and social sustainability confront one issue: the belief that the sole goal of companies should be to maximize profits and the idea that “markets work well to reach optimal use of scarce resources” (Ambec & Lanoie, 2008, p. 45) so that markets should generally be left unimpeded. Davis (2008, 2009) has provided an account of the rise of shareholder (as contrasted with stakeholder) capitalism and the associated primacy of economic criteria in business and public decision making and has noted the growing importance of the market-like aspects of many domains of life, ranging from housing to employment.

Because all forms of sustainability contravene both the idea of economic performance above all else and the inviolability of markets, much more research is needed to understand the waxing and waning of managerial ideas and ideology. A model for such an investigation is Barley and Kunda’s (1992) exploration of the cycling of managerial discourse related to employee control between normative (cultural) and rational (economic) bases.

The point is that ideas and ideology are themselves important topics of study, and such an analysis is inextricably linked to variation in the interest in sustainability in any of its forms or manifestations. In many respects, sustainability represents a set of values and beliefs. As such, it is an ideology. Unfortunately, as nicely documented by Jost (2006, p. 651), “the end of ideology was declared 42 Academy of Management Perspectives February more than a generation ago by sociologists and political scientists. Jost, Nosek, and Gosling (2008) also detailed the resurgence of ideology as an explanatory construct in many branches of psychology and illustrated its explanatory usefulness. Ideology and belief may be even less frequent topics of study in management, with its emphasis on performance, efficiency, and rationality. However, as Tetlock (2000) demonstrated, political ideology can be empirically uncovered, dimensionalised, and, most important, used to explain how managers decide what course of action to take in realistic scenarios concerning topics ranging from correcting safety defects to corporate accountability.

If we are to understand why human sustainability receives relatively short shrift, ideology, how and why it develops, and how it affects decisions will need to be a part of the research agenda. Another factor that may explain the difference between environmental and human sustainability derives from the different actors in the two systems and the presumption of choice. Few would argue that trees “choose” to be cut down, that the air or water decides to be dirty, or that polar bears make decisions that result in the disappearance of food and habitat.

Therefore, there is an implicit assumption that people must act on behalf of the environment, threatened species of plants and animals, and possibly even indigenous populations because these entities can’t act on their own behalf. Employees, however, have choices, and exercise their choices in a labor market in which they compete for jobs and employers compete for talent. Presumably if they don’t like the conditions of their jobs, including the degree of inequality, the amount of stress, or the absence of health insurance, employees can decide to work elsewhere.

At the limit, if the conditions of work are really life-threatening, as the evidence shows, employees can choose unemployment over ill health and/or premature death. Ideas about market outcomes being fair— even if they sometimes aren’t (Blount, 2000)—the primacy of markets (Davis, 2008), and the fact that people are capable of making choices— even if such choices are constrained and socially influenced—lead naturally to a very different approach to human sustainability.

Threatened plants and animals and the natural world need protection, but sentient humans making free choices in competitive markets can, and should, fend for themselves. This line of argument, coupled with the finding that profitable companies are believed to be more ethical than unprofitable ones (Jost et al. , 2003)—as one way of justifying their profitability and as an example of the tendency to attribute good qualities to an entity that is successful—lead to greater reluctance to find human sustainability problematic and requiring intervention.

Although I have highlighted two factors—visibility of consequences and ideology—as helping to account for the relative emphasis on environmental as opposed to human sustainability, there are undoubtedly many other factors at work. The fundamental message is that we need to understand what subjects receive attention and why, as well as the beliefs and values that form the foundation for our theorizing—not just for the topic of sustainability but for many others, as well. The evidence suggests that these are important and underexplored issues. What If We Took Human Sustainability Seriously?

A Research Agenda hroughout this article I have highlighted questions that could productively receive research attention. In this concluding section, I offer some additional suggestions that logically follow from the literature reviewed in this article. As Ambec and Lanoie (2008) noted, one of the major issues addressed by research on environmental sustainability has been whether or not adopting sustainability practices imposes net costs on companies, thereby eroding their competitiveness, or whether the benefits of being “green” more than outweigh any costs incurred.

Completely parallel questions and issues confront a focus on human sustainability. First, just as in the case of environmental pollution, companies that do not provide health insurance, lay people off, pay inadequate wages, and have work arrangements that stress and overwork their employees also impose externalities that others pay for even as they save on their own costs. That’s because T 2010 Pfeffer 43 some portion of the extra costs of increased physical and psychological illness fall on the broader health system through, for instance, increased use of public health and emergency room facilities.

Second, just as green companies enjoy reputational benefits that help in brand building and product differentiation, so, too, we might expect that companies with better records of human sustainability could enjoy benefits in attracting and retaining employees and also in building a reputation that could attract additional consumer demand. Therefore, whether or not it pays to be a company that offers a system high in human sustainability, and how the various costs and benefits balance and under what conditions, would be an important focus for research. There are some data that suggest that human ustainability may pay off for companies. Each year the Great Place to Work Institute, in conjunction with Fortune, publishes a list of the best places to work. Most of the places are noted for their provision of good working conditions and benefits, including vacations, sick days, health insurance, training, and jobs that provide people autonomy and challenge. The Institute’s Web site shows data indicating that companies on the list consistently outperform benchmark indices over varying periods of time, indicating that, at least as measured by stock market performance, it is good to be a great place to work.

How and why these returns accrue remains to be explored in more detail. But it is quite likely that, just as in the case of environmental sustainability, human sustainability pays. Indeed, the literature on the positive effects of employee-centered management practices is extensive (e. g. , Becker & Huselid, 1998). If so, that raises a third question: If it does pay to be green, whether “green” is assessed in environmental or human terms, or both, then why is it so difficult to get companies to adopt practices consistent with sustainability?

Another implication of the research cited may help to explain one of the paradoxes of the U. S. health-care system—why it costs so much even as it does not deliver measurable health benefits, as assessed by indicators ranging from infant mortality to life expectancy to survival rates for various serious illnesses, that are no better than in many other industrialized countries. Once again, there are undoubtedly many answers to this important question.

But one possibility is this: If health status is affected by what happens to people on the job, the relatively poor health-care outcomes in the U. S. might result from a laissez faire labor market that leaves even the provision of paid sick days and paid vacation at the discretion of employers. In other words, differences in the distribution of working conditions across different countries (or, for that matter, other political units such as states or even industries) could possibly help account for differences in health outcomes.

Because of differences in unionization rates (by industry and sector) and differences across states in both formal regulation of working conditions and the vigor with which such regulations are enforced, there is a great deal of natural variation in working conditions that research has shown to be relevant to health and mortality. Exploring whether those variations also account for variations in health-care outcomes and costs would be fruitful. Wilper et al. (2009) estimated that there are more than 44,000 excess deaths in the United States annually because people lack health insurance.

Some, although not all, of the absence of health insurance results from employer decisions. If one added to the portion of these deaths resulting from employer actions the mortality coming from layoffs, company-generated inequalities in income and control over work, and all the other factors briefly reviewed in this article, the resulting number would be both interesting and important. It might spark some serious effort to prevent deaths from employer decisions. There is already a great deal of employer and public policy focus on individual choices such as diet and exercise.

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