As companies struggle to find the right balance of in-person versus remote work and workers fight for autonomy, the debate about returning to in-person work has largely focused on productivity. If employees are equally productive in remote settings, why ask them to return to the office? All things being equal, remote work is cheaper and more convenient than commuting.
Although productivity is important, we haven’t given sufficient consideration to the potential negative health effects of remote work for some people. Those who have the luxury of working from home might end up realizing that remote work is disadvantageous to their mental and physical well-being.
A recent compilation of evidenced-based studies investigating the mental and physical effects of remote work found mixed results. Some workers thrived in the remote environment, citing more time for healthy behaviors including exercising and bonding with family, while others became less active, gained weight and reported feelings of isolation and depression.
Much of this seems to relate to evolutionary biology. Despite the changes happening around us, our bodies remain the same.
Human bodies have been in their current form for roughly 300,000 years. Humans need to move. Strong evidence correlates increased movement with a reduced risk of developing cardiovascular conditions such as hypertension and high cholesterol, chronic diseases such as diabetes and certain types of cancer, and mental health conditions including depression and anxiety.
Questions about the pandemic
When will the pandemic end? We asked three experts — two immunologists and an epidemiologist — to weigh in on this and some of the hundreds of other questions we’ve gathered from readers recently, including how to make sense of booster and test timing, recommendations for children, whether getting covid is just inevitable and other pressing queries.
How concerning are things like long covid and reinfections? That’s a difficult question to answer definitely, writes the Opinion columnist Zeynep Tufekci, because of the lack of adequate research and support for sufferers, as well as confusion about what the condition even is. She has suggestions for how to approach the problem. Regarding another ongoing Covid danger, that of reinfections, a virologist sets the record straight: “There has yet to be a variant that negates the benefits of vaccines.”
How will the virus continue to change? As a group of scientists who study viruses explains, “There’s no reason, at least biologically, that the virus won’t continue to evolve.” From a different angle, the science writer David Quammen surveys some of the highly effective tools and techniques that are now available for studying Covid and other viruses, but notes that such knowledge alone won’t blunt the danger.
What could endemic Covid look like? David Wallace Wells writes that by one estimate, 100,000 Americans could die each year from the coronavirus. Stopping that will require a creative effort to increase and sustain high levels of vaccination. The immunobiologist Akiko Iwasaki writes that new vaccines, particular those delivered through the nose, may be part of the answer.
The more we move, the healthier we are. Moving every day doesn’t just make us feel better, it’s among the most far-reaching and effective forms of preventive medicine. Furthermore, sedentary activity is strongly linked to disease. More sitting time and less movement throughout the day can make a person less healthy. Both life expectancy (life span) and health profile (health span) are negatively affected by prolonged inactivity.
Despite incredible technological advances, the human body has basically required the same amount of movement for preventive health for more than 100,000 years. Unfortunately, technology and convenience often work against our health. With each technological victory, from the horse and buggy to the car, the airplane, the computer and now the smartphone, we move less. In today’s world, one can order meals, conduct relationships and even work while never taking a step. Studies of age-matched skeletons exhumed from before the industrial revolution — when people walked and moved more — show less knee arthritis than knees of today.
The past three years have rapidly accelerated this trend. Data on step counts during the pandemic have shown a decrease in NEAT behavior (non-exercise activity thermogenesis), daily steps from everyday living. These aren’t steps from exercise, they are steps from walking to lunch, taking the stairs at work and walking to the subway or through the parking lot. While much attention is paid to exercise as a way of staving off aging and disease, NEAT behaviors are also linked to disease prevention. Background steps add up over days, weeks and months. Although daily exercise is part of a healthy movement profile, the NEAT activities are the coals that keep the metabolic fire warm.
Right now, many of us aren’t getting enough. If you want to prove this to yourself, find a way to measure your steps such as the health app on your smartphone. If you work in a hybrid environment, check your steps on the days you commute. They’re likely much greater than the days you’re working from home while sitting next to your primary food source, the refrigerator.
Inactivity can translate into disease. In the United States, we spend $4.3 trillion, 18 percent of our G.D.P., on health care. Despite spending almost twice as much on average than other high-income countries, we are consistently ranked in the second tier of life expectancy among Western nations. As a nation, we aren’t especially healthy. Our most expensive two conditions, cardiovascular disease and diabetes, cost more than $500 billion per year (including both health care spending and lost productivity) and are largely preventable with a healthy diet and regular movement. We’re spending the most and moving the least. A recent survey found working from home in the United States still is the norm for roughly 50 percent of the work force but is less common in Europe and Asia, where 75 percent to 80 percent of workers are back in the office. As we move less, the associated health care costs will rise.
Another important consideration of remote work is mental health. Homo sapiens are social animals. Much like the biological imperative to move, we also need to interact. Despite advances in technology, our brains thrive with in-person relationships. When in person, we learn to read body language, understand unstated nuances in communication and work more effectively with others. Studies have shown increased rates of depression and anxiety during remote work. Even if it’s easier, there is a sense of isolation that develops when real, in-person communication is substituted with virtual interaction. EEG studies of the brain found that face-to-face interactions produced stronger and longer-lasting psychological connections than virtual ones.
This is not to say that everyone who works from home is facing a health crisis. There are many people who are thriving in the remote work world. Parents with children have more time to spend with their families, people have more time to walk their dogs and sometimes even go to exercise classes.
In my office, I’ve treated patients who are making the most of their increased time at home and living more active and healthier lifestyles. But I also see patients who have developed back and neck pain and become less healthy over the past few years. National trends back this up.
In some form, remote work is here to stay. Looking at the data from the past three years, there are both benefits and pitfalls to working from home. The best way forward might be a hybrid of in-person and remote work to ensure socialization and daily movement. If you’re working fully remote, set up specific meetings and times to exercise that will keep you accountable and plugged in. If your company calls for a return to in-person work, at least part-time, recognize this as favorable for your long-term health.
Jordan D. Metzl, M.D. (@drjordanmetzl), is a sports medicine physician at Hospital for Special Surgery in New York City and the author of five books on the intersection of movement and health, including “The Exercise Cure.”
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