Why aren't you more well?
I want to share some alarming facts about working with breast cancer. The results of my recent doctoral research seems to be saying the same thing as researchers found several decades ago. Over 55,000 new breast cancer cases are diagnosed each year and the figures are rising. Although there are many studies on Breast cancer none explore the process of how women return/don't return to work after breast cancer. I conducted Interviews with sixteen breast cancer respondents and HR directors from five major employers based in the South West of England. My research found women’s return to work was limited due to employers’ lack of understanding of their working [dis]ability with few or no adjustments in place to accommodate their needs. Some disabilities are hidden, for example fatigue and emotional stress may follow surgery and chemotherapy/radiotherapy treatments and lead to loss of mental and physical work ability. Studies show a return to work allows breast cancer patients to move on from their cancer diagnosis but that they struggle to overcome the barriers in the process of returning. Few breast cancer patients are able to return to their original jobs, others are forced to change career paths or retire early due to ill-health continuing long after diagnosis.
Extensive literature reviewed and my own findings show that many women suffer discrimination at work after breast cancer. For instance, Macmillan found that employee discrimination has existed for many years and they have highlighted this in their reports since 2006. Macmillan say that employers are flouting the law regarding cancer patients. But what does this mean exactly? if there is no studies of managers' understanding and attitudes towards women working with breast cancer and their disabilities then how are we to understand how employers are flouting the law?
Maunsell (1999) found employers ignoring disability legislation and yet the same breast cancer issues are still occurring today. This is commonly seen in research findings across disciplines with a lack of understanding from employers directly (through personal dialogue) or indirectly (through workplace policy and practice) about returners’ work [dis]ability. Why are women with breast cancer still experiencing workplace discrimination? It seems from the abundance of empirical research on breast cancer there is a strong focus on return to work (RTW) using medical models of health or sickness absence intervention strategies for the purposes of Insurance management but these only serve employers needs, not the women with breast cancer.
Breast Cancer is a gendered health issue which has been missing from the study of women’s occupational health and workplace wellbeing for many decades. Messing (1998, p.70) questioned the difficulties in getting funding to focus on women’s occupational health and states, that sickness absence literature “exemplifies the field’s support for the employers’ perspectives” which my data supports. Because there are few studies that exist Messing suggests "It creates an image of women’s work as safe, which in turn militates against funding to study it” (p.71). I found no literature exploring how structural relations impact a RTW after breast cancer. By this I mean, how employers put in place policies and procedures to accommodate workers’ disabilities under section 20 of The Equality Act 2010 regarding reasonable adjustment. Additionally, across the scientific literature, absenteeism is more often than not classed as a behavior problem rather than a health and safety at work issue due to poor working relations.
By linking the sociology of health and illness together with the sociology of work my research has highlighted the need to move beyond the "interchanges of frontline settings" (deVault and McCoy, 2006, p 28-29) which demands exploring institutional language and practice to investigate what actually happens to women when they return to work with breast cancer. Focusing on gender, work, embodiment and health shows how each of these elements intersect the social body. When gender and class are intersected by health my data shows this reduces women’s chances of a successful return to work after breast cancer. Also age, disability and race can further increase the chances of women suffering discrimination. Women who have higher status jobs (managers and GP’s) are more likely to have private health insurance which enables them to have a longer recovery time off work and company intervention schemes for rehabilitation. Those on zero hours contracts on the other hand, are restricted in their decisions about returning by the resources available to them.
The research highlights the truth about working with cancer. Employers expect women with breast cancer to work as normal on their return to work. When they are back at their desks they are expected to work normally. Whilst some women struggle to cope others cannot cope well with busy work schedules due to fatigue from taxing treatment regimes. With little or no adjustments made to facilitate a safe return, it is not surprising that only one third of my breast cancer respondents returned to their original jobs. Why do employers expect women to be 'more well' living and working with cancer. We cannot just leave our sick bodies at the door of our workplace as we return back to our desks.
© Dr Dianne Dowling
The complete doctoral research thesis can be downloaded from: