Is entrepreneurship good for your health?

When the head of a major corporation dies, the effect on the company is generally minor. The death of Apple founder Steve Jobs due to long-term illness, and the sudden death of Édouard Michelin, had virtually no impact on the company's share price. Christophe de Margerie, head of Total, was replaced 48 hours after his tragic accident. Too big to fail.

Olivier Torrès, University of MontpellierFlorence Guiliani, University of Sherbrooke and Roy Thurik, Montpellier Business School

However, this truth for a large company cannot be transposed to small and medium-sized enterprises (SMEs ), where the disappearance of the manager is likely to completely jeopardize the company's survival. That's why we believe that the health of the entrepreneur is the most important intangible capital of the SME.

Despite this obvious fact, entrepreneurship research has been slow to take an interest in health. Current results show that the health of entrepreneurs is mixed. The majority of studies show that the health of entrepreneurs appears to be good or even better than that of salaried employees or the general population. But at the same time, other studies, far fewer in number, seem to show the opposite (in terms of burnout and professional stress, relationship with sleep, etc.).

These contradictory results have led many researchers to conclude that there is no consensus. We don't believe this. On closer examination, these results are not so much contradictory as complementary. In our view, they reveal a single facet that characterizes the close relationship entrepreneurs form with their work, and above all with their company - a singular relationship that ultimately has a dual impact on health, in both its pathogenic and salutogenic dimensions.

This facet is existentialism, which considers that the individual is in charge of his or her own destiny and which we studied in a recent research article, is responsible for his or her actions and free to decide on the values and standards that guide him or her.

"No time to be sick

For the past fifteen years, we've been monitoring the health of entrepreneurs at the Amarok Observatory, a member of the Portail du Rebond. As our knowledge has accumulated (10 theses defended between 2014 and 2021), one thing has become clear. Entrepreneurs, and especially those with financial holdings, have a different relationship to work than the rest of us.

Because of their capital investment (ownership effect) and long working hours - (52 hours a week versus 36 hours for an employee in France, according to Eurostat) - the vast majority of managers consider their work, and above all their company, to be essential elements of their existence. The Germans make no mistake in describing the company founder as anexistenzgründer, literally a founder of existence.

This existential relationship has three consequences for health. The first is what we call the phenomenon of subordination. The term subordination has a double meaning. Firstly, it suggests the idea of an implicit hierarchy in which the company and the job take precedence over health and all other extra-professional considerations. But subordination also implies a relationship of power. In many situations, the company has a strong hold on the entrepreneur's existence. Like a magnet, the company exerts a power of attraction that constantly directs the entrepreneur's attention and behavior. The centrality of the company is such that it exerts an intellectual, emotional and moral domination over the entrepreneur's very existence.

Numerous results attest to this phenomenon of subordination. Most managers say they don't have time to be sick, and when they are, they still go to work (the phenomenon of over-attendance). They tend to sleep less, rest less at weekends, go on vacation less, play sport less. Female entrepreneurs tend to return to work sooner after childbirth than male employees, and it's not uncommon for some entrepreneurs to continue working from their hospital beds.

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They are constantly saying that there is "good stress" and "bad stress". To say that there is good stress is partly true for performance, but totally wrong for health. Taking our existentialist approach, when an entrepreneur experiences "good" stress, it means that the repercussions will be positive for the company, which is why he interprets it as stimulating; once again, it's work before health. Similarly, allowing time for recuperation and detachment - not thinking about work outside of work - is very difficult for them. At the end of the day, their business comes before their health.

Real suffering

The second consequence is the suffering that can result from this strong link between the company and the entrepreneur's life. Suffering is a subject little addressed by entrepreneurship researchers, who are more inclined to value the entrepreneur's success rather than failure.

Yet some forms of suffering are very real. The dismissal of an employee, or the transfer or liquidation of a business, are events that affect the foundations of ownership and call into question the entrepreneur's management, thereby also jeopardizing his or her mental health. These events can be experienced as a loss (loss of the employee relationship, loss of the business object, loss of control over events). Existential issues are so strong that entrepreneurship theorists draw on mourning theories, speak of trauma, and address existential risks such as suicide or burn-out.

The Amarok observatory has highlighted a higher risk of burn-out among entrepreneurs than among employees, and the need for preventive measures with the Amarok e-Santé system, which is now being used by many occupational health prevention services and in the agricultural sector.

In the most dramatic cases, such as suicidal risk, the prevalence of which increases significantly in situations of liquidation, it is important to continue promoting anti-suicide schemes in the employer community, such as Apesa or Agri-écoute.

But it would be simplistic, even counterproductive, to limit the question of entrepreneurial health to the pathogenic dimension alone. It is equally important to look at the resources and capacities that enable a person to be in good health. This salutogenesis stems from a state of well-being in which the person is in strong coherence with his or her condition of existence.

Existential hold

The third consequence is based on the existential interpretation of salutogenesis. Experts describe salutogenic functioning as an individual's ability to view environmental stimuli in a positive and constructive way, to use information to make effective decisions, to interpret stimuli as meaningful and challenging, and to direct energy towards coping, problem-solving and achieving results.

How can we fail to see the typical profile of the entrepreneur in this description of salutogenic behavior? Seeing positively and constructively, making effective decisions, intrinsic motivation, perceiving stimuli as challenges, solving problems, achieving results. Nothing resembles salutogenesis quite like entrepreneurship.

To check this concordance, we presented a list of 39 salutogenic factors (optimism, resilience, wisdom, self-efficacy, etc.) to 1,224 French entrepreneurs, asking them for each factor whether it had increased or decreased over the course of their career. The results showed that the salutogenic factors had almost all increased. The ability to adapt and to assume the consequences of one's own actions topped the list. Overall, being an entrepreneur has a beneficial effect on health.

Finally, although the entrepreneur tends to subordinate his personal health to the economic health of his business, the existential hold that binds him to his work has the effect of amplifying the intensity and frequency of states of existential mental health (entrepreneurial salutogenesis), but sometimes, alas, of engendering situations of acute suffering.

Olivier Torrès, Founder of Amarok, observatory of executive health, University Professor, University of MontpellierFlorence Guiliani, Assistant Professor, University of Sherbrooke and Roy Thurik, Emeritus Professor of Economics, Erasmus School of Economics, Rotterdam, Full Professor of Entrepreneurship, Montpellier Business School

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