Is entrepreneurship good for your health?
When the head of a large corporation dies, the effect on the company is generally minor. The death of Apple founder Steve Jobs after a long illness and the sudden passing of Édouard Michelin had virtually no impact on the companies' share 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, this truth for a large company cannot be applied to small and medium-sized enterprises (SMEs), where the disappearance of the manager is likely to completely jeopardize the survival of the company. This is why we assert that the health of the entrepreneur is the primary intangible asset of an SME.
Despite this obvious fact, entrepreneurship research has been slow to take an interest in health. Current findings show that entrepreneurs' health is mixed. Most studies show that entrepreneurs seem to be in good or even better health than employees or the general population. At the same time, however, a much smaller number of studies seem to show the opposite (in terms of burnout and work-related stress, sleep patterns, etc.).
These contradictory results lead many researchers to conclude that there is no consensus. We do not believe this to be the case. On closer inspection, these results are less contradictory than complementary. In our view, they reveal a single facet that characterizes the close relationship that entrepreneurs have with their work, and especially with their company, a unique relationship that ultimately has a dual impact on health, both in its pathogenic and salutogenic dimensions.
This facet is existentialism, which considers that individuals are responsible for their own destiny and, as we explored in a recent research article, are accountable for their actions and free to decide the values and norms that guide them.
"No time to be sick"
For fifteen years, we have been examining the health of entrepreneurs at the Amarok Observatory, a member of the Portail du Rebond. As our knowledge has grown (10 theses defended between 2014 and 2021), one thing has become clear. Entrepreneurs, especially those involved in wealth management, do not have the same relationship to work as everyone else.
Due to their capital investment (ownership effect) and long working hours (52 hours per week versus 36 hours for an employee in France, according to Eurostat), the vast majority of entrepreneurs consider their work and, above all, their business to be essential elements of their existence. The Germans are right to describe entrepreneurs asExistenzgründer, literally "founders of existence."
This existential relationship has three consequences in terms of health. The first is what we call the phenomenon of subordination. The term subordination has a double meaning. First, it suggests the idea of an implicit hierarchy where the company and work take precedence over health and all other non-work-related considerations. But subordination also implies a power relationship. In many situations, the business has a strong hold on the entrepreneur's existence. Like a magnet, the business exerts a power of attraction that constantly directs the entrepreneur's attention and behavior. The centrality of the business is such that it exerts intellectual, emotional, and moral domination over the very existence of the entrepreneur.
Numerous findings attest to this phenomenon of subordination. Most managers say they don't have time to be sick, and when they are, they go to work anyway (a phenomenon known as presenteeism). They tend to sleep less, rest less on weekends, take 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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They constantly say that there is "good stress" and "bad stress." Saying that there is good stress is partly true for performance, but completely wrong for health. Returning to our existentialist approach, when an entrepreneur experiences "good" stress, it means that the outcome will be positive for the business, which is why they interpret it as stimulating; once again, work comes before health. Similarly, they find it very difficult to allow time for recovery and detachment—not thinking about work outside of work. Ultimately, their business comes before their health.
Very real suffering
The second consequence is that it can cause suffering, which can result from this overly strong link between the business and the entrepreneur's life. Suffering is a topic that is rarely addressed by entrepreneurship researchers, who are more inclined to focus on the entrepreneur's success rather than their failure.
However, certain forms of suffering are very real. The dismissal of an employee, the transfer or liquidation of a company are events that affect the foundations of ownership and call into question the entrepreneur's management, thereby also jeopardizing their mental health. These events can be experienced as a loss (loss of the employee relationship, loss of the business, loss of control over events). The existential factors are so strong that entrepreneurship theorists draw on theories of grief, talk about 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 and the need to address this preventively with the Amarok e-Health system system, which is now being rolled out in many Occupational Health and Safety Departments and in the agricultural sector.
In the most dramatic cases, such as suicide risk, which increases significantly in liquidation situations, it is important to continue promoting anti-suicide measures in the business world, such as Apesa and Agri-écoute.
However, it would be simplistic, even counterproductive, to limit the issue of entrepreneurs' health to the pathogenic dimension alone. It is also important to consider the resources and capacities that enable a person to be healthy. This salutogenesis stems from a state of well-being in which the person is in strong harmony with their condition of existence.
Existential hold
The third consequence is based on the existential interpretation of salutogenesis. Specialists describe salutogenic functioning as an individual's ability to view environmental stimuli in a positive and constructive manner, to use information to make effective decisions, and to interpret stimuli as meaningful and as challenges that direct their energy toward coping, problem solving, and achieving results.
How can we not see the typical profile of an entrepreneur in this description of salutogenic behavior? Seeing things in a positive and constructive way, making effective decisions, intrinsic motivation, perceiving stimuli as challenges, solving problems, achieving results. Nothing resembles salutogenesis as much as 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 during their career. The results showed that almost all of the salutogenic factors had increased. The ability to adapt and the ability to take responsibility for the consequences of one's own actions appear at the top of this list. In general, being an entrepreneur has a beneficial effect on health.
Finally, although entrepreneurs tend to subordinate their personal health to the economic health of their business, the existential hold that binds them to their work has the effect of amplifying the intensity and frequency of states of good existential mental health (entrepreneurial salutogenesis) but sometimes, unfortunately, of causing acute suffering.
Olivier Torrès, Founder of Amarok, an observatory for 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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