The indiscriminate and enduring effects of long-COVID have illustrated how randomly illness can decimate the lives of previously healthy people.
We've heard stories from health professionals and journalists who have found themselves bed-bound and unable to work, forced to give up or re-orient the careers they have spent their lives building.
These stories of professional lives struck down by chronic illness are part of a wide-ranging conversation about the challenge of working and living with long-term health conditions.
A recently published report from the Work Futures Research Initiative found that 38 per cent of Australian workers identify as living with at least one chronic health condition.
Although the prevalence of chronic illness is higher within populations of higher economic and social disadvantage, our analysis of the latest Australian census data suggests the impact of long-term health conditions is being felt across the spectrum of the workforce.
People in the occupational categories 'manager' and 'professional' make up 38 per cent of the workforce who identify as living with at least one chronic condition.
That's more than 1.1 million Australians.
And with almost three quarters of workers indicating that their illness affected their capacity to work, employers are having to have some challenging conversations about how to accommodate the needs of employees with long-term health conditions.
Disclosing Illness in the Workplace
In our report, we looked more closely at the experiences of people in positions of leadership who are living and working with long-term health conditions.
Our team surveyed 326 leaders from Australia and New Zealand and asked them questions about how they experienced disclosing their illness in the workplace.
Telling your employer about a long-term health condition can be a fraught experience for any worker, but for people in positions of leadership the risks associated with disclosure may be heightened.
In part, this is because of the increased organisational visibility and accountability that is associated with higher status roles.
There are still pervasive social stigmas associated with chronic illness, particularly mental illness. These stigmas contribute to leaders' concerns that disclosing illness in the workplace may negatively impact reputation, perceptions of competency, and career prospects.
The concept of leadership is itself deeply embedded in traits like strength, invulnerability and vitality. Therefore, when a leader is faced with the prospect of disclosing an illness at work, they may feel their very identity as a leader risks being undermined.
With these factors in mind, it is perhaps not surprising we found over a quarter of leaders (28 per cent) did not disclose their illness in the workplace. The majority (54 per cent) made only a partial disclosure, which may have been to a trusted work colleague or to a manager.
Only 18 per cent of leaders indicated they were fully transparent about their illness at work.
Leader concerns about the impact on their career
People may not choose to reveal their long-term health condition for numerous reasons, including the desire to maintain privacy or due to the fear of not being believed.
"Sometimes it makes people feel sorry for me and that's not what I want." - Research participant.
Our findings suggest leaders were very selective about the kind of information they revealed. For instance, they were more likely to disclose general information about their illness rather than be transparent about the extent to which their work was being impacted by an impairment.
In part, this reluctance to disclose the extent of impairment can be attributed to the finding that many leaders held concerns that disclosing a chronic illness might invite questions about their competence and pose a risk to their career progression.
We found that 42 per cent of respondents agreed with the statement, my colleagues would think that I was incapable of doing my job. Thirty nine per cent were concerned to some extent that disclosing an illness would mean that they would be passed over for promotion, and 38 per cent of leaders agreed with the statement that, my career progression would be limited.
"I disclosed some of my medical history but kept a lot of it to myself. I am very wary of disclosing issues at work as I don't trust my employer not to hold that information against me." - Research participant.
We also found that a majority of leaders engaged in behaviours to actively conceal or minimise the visibility of their illness in the workplace.
Almost three quarters of respondents, 73 per cent, acknowledged that they hid their symptoms when in the workplace. Examples of hiding an illness might include not being transparent about the reason for a workplace absence or masking visible symptoms during a virtual meeting by turning off your camera.
"I have PTSD and it is something that isn't really accepted or understood as a real condition. I tend to hide a lot of what I'm feeling." - Research participant.
The importance of organisational culture
Our survey results indicate that a leader's tendency to disclose their illness was significantly correlated to feelings of psychological safety, that is, the more a leader trusted their organisation and their supervisor, the more likely they were to fully disclose their illness.
Similarly, the more a leader believed that the organisation cared about employees, the more likely they were to be transparent about their health condition.
Creating a culture that is conducive to disclosure is important because it can encourage leaders to seek help and request 'reasonable adjustments' that support them to continue to do their best work.
It also sends a strong signal to all employees that having a chronic health condition does not devalue their status as a valued member of the workplace, nor does it dampen their prospects for career advancement.
"I left the employment where I disclosed my illness due to lack of support and worsening condition… I would not disclose any illness in the future unless forced to do so." - Research participant.
At a time of severe skills and labour shortages, there's an extra incentive for Australian employers to ensure that they have the culture in place to retain the leaders and managers that comprise our skilled workforce.
