The fragile worker: stigma, illness and disability in the contemporary workplace

Dr Jennifer Remnant looks at the concept of the 'fragile worker' and how the workplace copes with people who may need additional support due to managing a long term health condition.

Fragility is a not a concept we explore often in relation to the workplace. When we use the word fragile we are often talking about objects; when it’s used in relation to people, we often mean the very old, the very young, and/or the very ill. 

Recently, in response to an invitation to speak at the University College London, I have been trying to think about whether being fragile is exclusively a state of being, or whether it can also be used to in a situational context. Can someone be in a fragile position while not actually being fragile themselves, and could the fragility of their position be misinterpreted as personal fragility?

This can be a significant question for those of us who manage long-term health conditions or impairment in the workplace, especially when deciding whether to disclose that experience to colleagues in human resources (HR) or line managers. In part, disclosure depends on the model of disability drawn on by colleagues and managers.

The medical model of disability situates disability as an individual issue – a personal problem of defect that needs fixing. In the workplace this ‘fixing’ would be addressed via the individualised provision of workplace accommodations. However, the social model of disability argues that disablement is environmental, and by designing a social world that is only accessible to non-disabled people, we actively inhibit the inclusion of our disabled colleagues. To address this exclusion, adherents of the social model would seek for workplaces to be reimagined in collaboration between disabled and non-disabled people to create workspaces - and a labour market - that is inclusive in design.

There are no prizes for recognising which of these two models is manifest in most of our workspaces. The medical model is assumed in most organisational policies, as well as national legislation such as the Equality Act, 2010. This means that to access support, which will invariably be individual, and provided on an ad hoc basis, individuals must disclose their health condition, impairment or symptoms.

But what do we disclose? We are very likely to be symptomatic before we have a definitive diagnosis. The delays in diagnosis for people with endometriosis can take upward of a decade, and they are often not believed, told instead that they just have heavy periods. Similarly, neurodivergent people often learn to ‘mask’ or ‘pass’ as a neurotypical person, or do not have access to a diagnostic pathway. For these colleagues, amongst others, they are often left with the hidden additional workload of managing or hiding their symptoms/pain/neurodivergence as well as completing all the tasks associated with their role. This situation is further complicated when we reflect on health conditions that continue to be gendered, stigmatised or questioned in terms of their existence or cause – think chronic fatigue syndrome, varied mental health conditions, fibromyalgia or irritable bowel syndrome. Who wants to discuss their toileting habits with their line manager? What happens if your manager is someone who makes dismissive comments about periods, or questions the legitimacy of specific conditions? Even if they don’t hold these problem views, managers might assume that disability or ill-health would lead to reduced performance or increased absence. Such assumptions can create an atmosphere of fear and anxiety for disabled individuals who do want (or need) to disclose their conditions to their employers.

There are real risks that employers will not provide necessary support, or that disabled employees will be demoted or even dismissed because of their condition. Moreover, some disabled individuals may feel that their employers may not believe or accept their health or impairment status, which can lead to feelings of frustration and anxiety. The fear of being stigmatised can be a significant barrier to accessing the workplace support that many disabled individuals need to perform their job duties effectively. Ironically, impacting on employee performance.

In our current employment systems, disclosure is required to access workplace support, but we work in organisations that can actively penalise those that disclose, while making those that don’t disclose work harder to mask or conceal their symptoms, condition or impairment. This fragile positioning has nothing to do with an individual’s health status, and everything to do with a lack of appropriate support and accessibility. Within SBS we are well placed to develop new ideas about how to design the workplace and workplace processes – untying colleagues from unwarranted assumptions of fragility. My hope is that my own work, and the work of colleagues throughout SBS, will continue to support the development of improved policy and practice in our workplaces to enable the creativity that comes with supporting varied and diverse workforces.

About Jennifer Remnant

Dr Jennifer Remnant is a a Chancellor’s Fellow within the Department of Work, Employment and Organisation at Strathclyde Business School. Her research focus is on subjective experiences of health at work and employee perceptions; stakeholder perspectives and responses to ill-health and disability in the workplace; organisations and health; and historical, cultural and political perspectives, debates and depictions of health in relation to work.