Dying for a Paycheck: Why Work Is Literally Killing Us
Workplace stress is on the rise, and it’s killing employees—literally. Jeffrey Pfeffer explores how poor leadership, layoffs, and a lack of accountability are causing an unprecedented health crisis.
Welcome to another edition of the LinkedIn Presents: Redefining Work podcast, where we explore the changing dynamics of the modern workplace.
Today, I'm excited to share a thought-provoking conversation with a legend in the field of management: Jeffrey Pfeffer. He’s an author, professor at Stanford Graduate School of Business, and an authority on the business world, especially regarding power and leadership.
Our conversation touched on two key areas: the insights from his 2018 book Dying for a Paycheck, and the critical issue of power in the workplace. And believe me, both are more relevant now than ever.
Stress is Killing Us: Literally
Jeffrey didn’t hold back when discussing the grim realities of today’s workplace. His 2018 book Dying for a Paycheck highlighted the physical and mental toll that work is taking on employees—and the reality is, it’s only gotten worse since then.
"COVID and how we’ve treated workers post-COVID has made things substantially worse," Jeffrey told me, stating the stark reality that stress and depression are leading causes of death for many workers.
"The premise of Dying for a Paycheck is extraordinarily simple and backed up by decades of epidemiological research: Stress and depression kill people."
Let that sink in for a moment. It’s not just a metaphor that work is “killing” us—it’s a fact backed by data.
Chronic stress leads to bad habits (overworking, overeating, substance abuse) and has a direct impact on our central nervous system, hormonal balance, and overall health.
Yet, as Jeffrey noted, “nobody seems to care.”
The Workplace Health Crisis That No One Wants to Acknowledge
The connection between bad leadership and health isn't something we often talk about, but it’s a reality employees face daily.
Layoffs, inconsistent schedules, and employment insecurity have only escalated since the pandemic. Tech companies, flush with cash, continue to lay off thousands—because, well, everyone else is doing it.
“Layoffs have continued apace,” Pfeffer remarked, highlighting that stress from job insecurity has skyrocketed in the last few years. What's worse is that we still don't see employers taking responsibility for their workers' mental and physical well-being.
As Jeffrey said, “When you go to work, you have entrusted your mental and physical well-being to that employer.”
But how many employers actually live up to that responsibility? Not many.
Why Companies Won’t Fix It on Their Own
In a particularly sharp critique, Jeffrey parallels environmental and social damage in the workplace. Just as environmental cleanup is far costlier than prevention, so too is fixing the damage done by years of workplace stress.
But it’s also clear that companies aren’t going to take the lead in solving this issue unless they’re forced to.
“We didn’t get to a cleaner physical environment by relying on companies to be good corporate citizens,” Jeffrey reminded me. “Environmental progress came through litigation, regulation, and legislation. The same will be true for improving workplace health.”
And there’s a dark side to all of this: Companies often ignore their role in fostering employee well-being, and some even externalize these costs onto society.
When workers become physically or mentally unwell due to their job, it’s society that bears the brunt through healthcare costs, disability, and unemployment benefits.
The Reality of Power in the Workplace
The second half of our conversation shifted to a topic Jeffrey has spent decades researching: power. His book Seven Rules of Power gives a candid look at how power is wielded in the workplace.
Here’s the truth—if you want to succeed, you can’t just wait for the world to hand you what you deserve. And for HR leaders, this message couldn’t be more critical.
Jeffrey is blunt: “Do not depend upon some paternalistic organization to take care of you because they won’t. They’ve told you they won’t. Believe them.”
He emphasized the importance of building social networks, personal brands, and resilience. Essentially, you are responsible for your career, not your employer.
Jeffrey offered some tactical advice for those in HR, especially new CHROs.
In many organizations, the CHRO is in a staff role with little formal authority, which means understanding power dynamics is essential for survival and influence.
He pointed out that "we are in the sales business, every day selling our ideas, perspectives, and influence."
The Future of Work: Shifting Power Dynamics
We couldn’t wrap up the conversation without touching on the shift in power dynamics we've seen in the workforce, especially with younger generations.
Jeffrey noted that younger workers increasingly refuse to work for companies that treat them as disposable.
“They’ve seen their parents give their lives to companies that then laid them off,” Jeffrey explained. “They’re not going to fall for the same trap.”
And this generation’s approach could force companies to rethink how they attract and retain talent. "It’s going to become harder for employers to hold onto their talent without being more accountable for their well-being,” Jeffrey warned.
The fluidity of talent—especially as the gig economy grows—means that companies will need to invest more in creating environments where people want to stay.
✅ Key Takeaways
Workplace Stress is a Killer: Chronic stress and depression caused by poor leadership and job insecurity are literally killing people.
Prevention is Cheaper Than Remediation: Just like environmental damage, once employees’ health is broken, it’s expensive to fix.
Power Belongs to Those Who Claim It: Don’t wait for companies to fix the system. Build your own safety net and network, and don’t rely on paternalistic employers.
HR Leaders Must Master Power Dynamics: To succeed, CHROs need to understand power and influence, not just “human capital.”
Generational Shifts Are Changing the Game: Younger workers are less tolerant of poor treatment, and companies will need to adapt if they want to retain talent.
Poor company culture is often apparent not just within the organization but also from an external perspective, particularly for prospective employees. In today's environment, recruitment processes have become increasingly revealing of a company's true values—those that are demonstrated when no one is watching—and how much they genuinely care about their people. If a company treats prospective candidates poorly, it speaks volumes about how they likely treat their internal employees as well.