Is entrepreneurship good for your health?
When a CEO of a major corporation dies, the impact on the company is generally minor. The death of Apple founder Steve Jobs following a long illness and the sudden passing of Édouard Michelin had virtually no impact on the companies’ stock prices. Christophe de Margerie, CEO of Total, was replaced 48 hours after his tragic accident. Too big to fail.
Olivier Torrès, University of Montpellier; Florence Guiliani, University of Sherbrooke and Roy Thurik, Montpellier Business School
However, while this may hold true for large corporations, it does not apply to small and medium-sized enterprises (SMEs), where the loss of a leader is highly likely to jeopardize the very survival of the business. This is why we maintain that the entrepreneur’s health is an SME’s most valuable intangible asset.
Despite this obvious fact, research on entrepreneurship has been slow to address the issue of health. Current findings reveal that entrepreneurs’ health is mixed. The majority of studies show that entrepreneurs’ health appears to be good or even better than that of employees or the general population. At the same time, however, other studies—though far fewer in number—seem to show the opposite (in terms of burnout and work-related stress, sleep patterns, etc.).
These conflicting results lead many researchers to conclude that there is no consensus. We do not agree with this assessment. Upon closer examination, these results are less contradictory than complementary. In our view, they reveal a single facet that characterizes the close relationship entrepreneurs form with their work, and especially with their business—a unique relationship that ultimately has a dual impact on health, affecting both its pathogenic and salutogenic dimensions.
This aspect is existentialism, which holds that the individual is in charge of their own destiny—a concept we explored in a recent research article—and is responsible for their actions and free to decide the values and norms that guide them.
“No time to be sick”
For the past fifteen years, we have been monitoring the well-being of entrepreneurs through the Amarok Observatory, a member of the Rebound Portal. As our knowledge has grown (with 10 dissertations defended between 2014 and 2021), one thing has become clear: entrepreneurs—particularly those from wealthy families—do not have the same relationship with work as everyone else.
Because of their financial investment (the sense of ownership) and their long working hours—(52 hours per week versus 36 hours for an employee in France, according to Eurostat)—the vast majority of business owners consider their work, and especially their business, to be essential parts of their lives. The Germans are spot on when they refer to entrepreneurs as“Existenzgründer,” literally “founders 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 dual meaning. First, it suggests the idea of an implicit hierarchy in which the company and work take precedence over health and all other non-work-related considerations. But subordination also implies a power dynamic. In many situations, the company exerts a strong hold over the entrepreneur’s life. Like a magnet, the company exerts a pull that constantly directs the entrepreneur’s attention and behavior. The centrality of the company is such that it exerts intellectual, emotional, and moral dominance over the very existence of the entrepreneur.
Numerous findings confirm this phenomenon of overwork. Most business leaders say they don’t have time to be sick, and when they are, they go to work anyway (a phenomenon known as “over-presenteeism”). They tend to sleep less, take fewer breaks on weekends, go on fewer vacations, and exercise less. Female entrepreneurs tend to return to work sooner after giving birth than female employees, and it is not uncommon for some entrepreneurs to continue working from their hospital beds.
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People are always saying that there is “good stress” and “bad stress.” While it’s partly true that stress can be beneficial for performance, this notion is completely wrong when it comes to health. Returning to our existentialist approach, when an entrepreneur experiences “good” stress, it means the outcomes will be positive for the business, which is why they interpret it as motivating; once again, work comes before health. Similarly, making time for recovery and detachment—the act of not thinking about work outside of work—is very difficult for them. Ultimately, their business comes before their health.
Real suffering
The second consequence is that it can lead to situations of distress resulting from this overly strong link between the business and the entrepreneur’s personal life. Distress is a topic rarely addressed by entrepreneurship researchers, who tend to focus more on highlighting the entrepreneur’s success than on their failure.
Yet certain forms of suffering are very real. An employee’s dismissal, or the transfer or liquidation of their business, are events that shake the very foundations of ownership, call into question the entrepreneur’s management, and thereby also jeopardize their mental health. These events can be experienced as a loss (loss of the employer-employee relationship, loss of the business itself, loss of control over events). The existential stakes are so high that entrepreneurship theorists draw on theories of grief, discuss trauma, and address existential risks such as suicide or burnout.
The Amarok Observatory has highlighted a higher risk of burnout among entrepreneurs than among employees, as well as the need to address this issue proactively through the Amarok e-Health program , which is now being adopted by many Occupational Health and Safety departments and in the agricultural sector.
In the most serious cases, such as the risk of suicide—the prevalence of which increases significantly during business closures—it is important to continue promoting suicide prevention programs within the business community, such as Apesa or Agri-écoute.
However, it would be simplistic, if not counterproductive, to limit the issue of entrepreneurs’ health solely to the pathogenic dimension. It is equally important to consider the resources and capabilities that enable a person to be healthy. This concept of salutogenesis stems from a state of well-being in which a person is in strong alignment with their life circumstances.
Existential grip
The third implication is based on the existential interpretation of salutogenesis. Experts describe the salutogenic process as an individual’s ability to view environmental stimuli in a positive and constructive manner, to use that information to make effective decisions, and to interpret those stimuli as meaningful and as challenges that channel their energy toward coping, problem-solving, and achieving results.
How can one fail to recognize the typical profile of an entrepreneur in this description of health-promoting behavior? Seeing things in a positive and constructive light, making effective decisions, having intrinsic motivation, viewing stimuli as challenges, solving problems, and achieving results. Nothing resembles health promotion quite like entrepreneurship.
To verify this correlation, 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 careers. The results showed that nearly all of the salutogenic factors had increased. The ability to adapt and the ability to accept the consequences of one’s own actions top this list. In general, being an entrepreneur has a beneficial effect on health.
Ultimately, although entrepreneurs tend to prioritize the financial well-being of their business over their own personal health, the existential bond that ties them to their work serves to amplify the intensity and frequency of states of good existential mental health (entrepreneurial salutogenesis) but, unfortunately, can sometimes lead to situations of acute distress.
Olivier Torrès, Founder of Amarok, an observatory on executive health, University Professor, University of Montpellier; Florence Guiliani, Assistant Professor, University of Sherbrooke and Roy Thurik, Professor Emeritus of Economics, Erasmus School of Economics, Rotterdam, Full Professor of Entrepreneurship, Montpellier Business School
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