By Paul J. Rosch, M.D.
President, The American Institute of Stress
Clinical Professor of Medicine and Psychiatry
New York Medical College

Originally published in the Health and Stress, the newsletter (June 2005) of The American Institute of Stress

Since one of the topics that had attracted considerable interest in the initial institute report was the effect of vacations on the feeling of being overworked, this was explored in greater depth. This study found that 79 percent of employees had access to paid vacations but that:

• Although the average number of paid vacation days was 16.6, the average number of vacation days that employees had taken or expected to take in 2004 was 14.6 days.

• More than one third (36 percent) did not plan to use their full vacations.

• Very few (14 percent) take extended time for their longest vacations (2 or more weeks).

• 37 percent take less than a 7-day vacation including weekends, 12 percent take 1-3 days and 25% take 4-6 days.

• 49 percent take 7-13 day vacations and 14 percent take 14 days, both including weekends.

With respect to relieving stress, the amount of vacation time may not be as important as how that time is utilized. On average, employees who take paid vacation spend:

• 69 percent of their time relaxing and enjoying themselves with family or friends or alone.

• 19 percent of their time on family or personal responsibilities, including illness, funerals, caring for sick children or parents, tending to their personal illness or a medical problem.

• 13 percent of their time doing other things like going to school, working at another job, reserve military service, etc.

Most employees don't work during vacations.

• 58 percent never do work related to their jobs while on vacation.

• 21 percent rarely do any work during vacation.

• 21 percent work sometimes, often or very often.

• 9 percent work often or very often.

Those most likely to work while on vacation are employees with the greatest responsibilities and demands such as managers, professionals, high earners, Type As and those who regularly work the longest hours. At least one in five of those who regularly contact others or are contacted by others about work matters during non-work times frequently work while on vacation because the lines between work and family/personal time have become blurred.

There were significant gender differences too. Surprisingly, women spent less time (64 percent) than men (72 percent) relaxing and enjoying themselves while vacationing because of the need to attend to family responsibilities (24 percent versus 15 percent).

Vacation Requirements Vary by Country

As an aside, it is of interest to note that most countries require a vacation at full pay ranging from 10 days in Canada and Japan to 20 days in the Netherlands and the U.K., 24 days in Germany, 25 in Sweden and France, to 35 days for managers in Italy. In contrast, U.S. employers are not required to offer vacations. Most workers tend to get 10 days (two weeks) off after the first year and there may be periodic increases up to three weeks, depending on position and years of employment.

European countries tend to be much more liberal. French workers are legally entitled to two and a half days off for each month worked, which means they can take a full 25 days off after less than a year on the job. In addition, the French work week is now limited to 35 hours. With respect to paid holidays, totals range from eight days in the Netherlands and the U.K. to 14 in Japan. The U.S. has nine.

In many countries employers also provide a vacation allowance. In Mexico, if you are entitled to 20 days vacation, your employer must pay you for the 20 days plus another 25 percent, which would be the equivalent of 25 days pay. In actuality, Mexican employers often give much more (around 80 percent) than the statutory requirement.

In Belgium, the vacation premium is 85 percent of one month's pay and Australian workers typically receive 13 weeks paid leave after 15 years on the job. In many Muslim countries, paid leave is provided for one pilgrimage to Mecca and Indonesian workers get paid time off for prayer during the workday. In Italy, which has different priorities, you receive 15 days off with full pay if you get married.

Brazilian employees must be given one paid day off to donate blood and in some Asian countries women get one paid day off each month. In Japan, the law currently applies only to women with severe menstrual complaints. (Some say this benefits men as well.)

The Toll on Overworked Americans

Other surveys have also confirmed that Americans are overworked and need more time off. A study conducted in 2000 on behalf of Oxford Health Plans reported that one in six employees are so overworked they are unable to use up their annual vacation because of excessive job demands. The survey also revealed that:

• 34 percent report they have such pressing jobs that they have no down time at work.

• 32 percent work and eat lunch at the same time.

• 32 percent never leave the building once they arrive at work.

• 19 percent say their job makes them feel much older than they are.

• 17 percent say work causes them to lose sleep.

For example, a 42-year-old computer analyst in Poughkeepsie, N.Y., who had gone without a vacation in two of the last four years explained that, "If you take off a week, you've got three times as much work to do when you get back."

A 31-year-old Microsoft program manager in Seattle quit her job because she had not been able to take a vacation for five years. She remembered thinking "I can't go... I've got too many things to do." She subsequently took a less demanding position overseeing computers for the Seattle Opera in order to "have a life" and hopefully take a vacation the following summer.

The survey also showed that while most employers make it easy to keep medical appointments (70 percent) and return to work after illness (68 percent), other companies exude a corporate culture that places loyalty to the company as a prerequisite that often discourages healthy behaviors and lifestyles.

• 19 percent of survey respondents said workplace pressures make them feel they must attend work even when injured or sick.

• 17 percent said it is difficult to take time off or leave work in an emergency.

• 14 percent believe their employer makes it difficult to maintain a healthy diet.

• 14 percent feel that management only promotes people who habitually work late.

• 8 percent believe that if they were to become seriously ill they would be fired or demoted.

The study stated, "Americans are the most vacation-starved people in the industrialized world." This was based on statistics from the World Tourism Organization listing average annual vacation days for Italy (42), France (37), Germany (35), Brazil (34), Britain (28), Canada (26), South Korea (25) and Japan (25) with the U.S. being last at 13.

The Real Health Benefits of Taking Time Off

Oxford's chief medical officer said, "This survey is a wakeup call for Americans to realize that taking a vacation is not frivolous behavior. It's essential to staying healthy. Regular vacations are preventive medicine -- they cut down on stress-related illness and save health care dollars." He emphasized that while taking a vacation provide stress relief benefits, medical research shows that it can also lower risk of death. "Taking a vacation is a serious health issue that should not be ignored. It could save your life."

He was referring to data from the Framingham Heart Study data of women aged 45-64 showing that frequent vacations cut risk of death among all women by half. Another study from the State University of New York at Oswego published in 2000 found that regular vacations lowered risk of death by almost 20 percent in 35-57 year-old men.

A 2002 study commissioned by Expedia.com similarly found for the second year in a row that American workers do not take advantage of their vacation days because they are just too busy and can't afford to take time off. As a result of "Vacation Deprivation," workers continue to give back almost $19.5 billion in unused vacation time to their employers.

According to the president of Expedia, the nation's largest online travel agency, "Consumers seem conflicted regarding downtime. While many Americans feel too busy to take vacation, the desire to utilize it has become a top priority. Expedia.com wants to do everything possible to help Americans overcome 'Vacation Deprivation' by offering rich vacation planning solutions providing convenience, flexibility and savings in one place."

In commenting on this study, Dr. Dorothy Cantor, president of the American Psychological Foundation warned that, "Workplace stress can take its toll. In order to maintain a strong state of mental health, the human body needs a release and a source of replenishment. An ideal vacation should eliminate stress, encourage relaxation and provide opportunities for rejuvenation, making the benefits of the experience immeasurable."

Unfortunately, things seem to be getting worse rather than better. The Families and Work Institute of New York study also reported that both spouses in double-income households with kids put in over 15 hours a day on work, commuting, chores and child care. They believe, within 10 years, the projected average workweek will be up to 58 hours.

As a sign of the times, Hallmark recently marketed greeting cards for absent parents to tuck under cereal boxes in the morning -- Have a super day at school -- or to place on a child's pillow at night -- I wish I were there to tuck you in.

That's pretty sad.

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US Workers Too Stressed To Take Vacation

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