Is entrepreneurship good for your health?

When a director of a large group dies, the effect on the company is generally minor. The death of Steve Jobs, founder of Apple, due to a long illness, and the sudden death of Édouard Michelin had almost no impact on the value of companies' shares on the stock market. Christophe de Margerie, head of Total, has been replaced 48 hours after his tragic accident. Too big to fail.

Olivier Torrès, University of Montpellier; Florence Guiliani, Université de Sherbrooke and Roy Thurik, Montpellier Business School

The attachment of entrepreneurs to their project contributes to their well-being. Snapwire/Pexels, CC BY-SA

However, this truth for a large company is not transposable to small and medium-sized enterprises (SMEs) where the disappearance of the manager is likely to totally jeopardize the survival of the company. This is why we affirm that the health of the entrepreneur is the first intangible capital of the SME.

Despite this evidence, entrepreneurship research has belatedly focused on health. The current results show that the health of entrepreneurs is mixed. The majority of studies show that the health of entrepreneurs seems to be good or even better than that of employees or the general population. But at the same time, other studies, much less numerous, seem to show the opposite (in terms of exhaustion and professional stress, the relationship to sleep, etc.)

These contradictory results lead many researchers to conclude that there is a lack of consensus. We do not believe in this observation. On closer inspection, these results are less contradictory than complementary. In our opinion, they reveal a single facet that characterizes the close relationship that entrepreneurs establish with their work, and especially with their company, a singular relationship that ultimately has a double impact on health both in its pathogenic and salutogenic dimensions.

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

"No time to be sick"

For fifteen years, we have been monitoring the health of entrepreneurs at the Amarok Observatory, a member of the Portail du Rebond. As knowledge has accumulated (10 theses defended between 2014 and 2021), one thing has become clear. Entrepreneurs, especially patrimonial entrepreneurs, do not have a relationship with work like everyone else.

Because of their investment in capital (property effect) and because of their long working hours – (52 hours per week compared to 36 hours for an employee in France, according to Eurostat) – the vast majority of managers consider that their work and especially their company are essential elements of their existence. The Germans are not mistaken in describing the entrepreneur as existenzgründer, literally a founder of existence.

This existential relationship will have 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 in which the company and work take precedence over health and all other extra-professional considerations. But subordination also induces a power relationship. 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 attention and behaviour of the entrepreneur. The centrality of the company is such that it exerts intellectual, emotional and moral domination over the very existence of the entrepreneur.

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 (phenomenon of overpresenteeism). They tend to sleep less, rest less on weekends, go on holiday less, practice sport less. Female entrepreneurs tend to return to work faster after giving birth than female employees and it is not uncommon for some entrepreneurs to continue working in their hospital beds.

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They are constantly saying that there is "good stress" and "bad stress". Saying that there is good stress is partly true for performance, but totally wrong for health. Going back to 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; Again, it's work before health. Similarly, it is very difficult for them to make time for recuperation and detachment – the fact that they no longer think about work outside of work. In the end, their business comes before their health.

Real suffering

The second consequence is to cause situations of suffering that can result from this too strong link between the company and the life of the entrepreneur. Suffering is a theme that is rarely addressed by entrepreneurship researchers who are more inclined to value the success of the entrepreneur rather than failure.

However, forms of suffering are very real. The dismissal of an employee, the transfer or liquidation of his or her business are events that affect the foundations of ownership and call into question the management of the entrepreneur and therefore also put his or her mental health at stake. These events can be experienced as a loss (loss of the employee relationship, loss of the business object, loss of control over events). The existential springs are so strong that entrepreneurship theorists mobilize theories of grief, talk about trauma, 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 remedy this preventively with the Amarok e-Health system that is now being distributed in many Occupational Health Prevention Services or in the agricultural world.

In the most dramatic cases, such as the risk of suicide, the prevalence of which increases significantly in liquidation situations, it is important to continue to promote anti-suicide measures in the employers' world, such as Apesa or Agri-écoute.

However, it would be reductive, even counterproductive, to limit the issue of entrepreneurs' health to the pathogenic dimension alone. It is also important to look at the resources and abilities that enable a person to be healthy. This salutogenesis stems from a state of well-being where the person is in strong coherence with his or her condition of existence.

Existential grip

The third consequence is based on the existential interpretation of salutogenesis. Specialists describe salutogenic functioning as an individual's ability to see stimuli from the environment in a positive and constructive way, to use information to make effective decisions, to interpret stimuli as meaningful, and as so many challenges that direct their energy to cope, solve problems, and achieve results.

How can we not see the typical profile of the entrepreneur in this description of salutogenic behavior? Seeing 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 concordance, we presented a list of 39 salutogenic factors (optimism, resilience, wisdom, self-efficacy, etc.) to 1224 French entrepreneurs by asking them for each factor whether they had increased or decreased during their career. The results showed that the salutogenic factors almost all increased. The ability to adapt and the ability to assume 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 the entrepreneur tends to subordinate his personal health to the economic health of his company, the existential hold that binds him to his work has the effect of amplifying the intensity and frequency of states of good existential mental health (entrepreneurial salutogenesis) but sometimes, alas, of generating situations of acute suffering.

Olivier Torrès, Founder of Amarok, Observatory of the Health of Leaders, University Professor, University of Montpellier; Florence Guiliani, Assistant Professor, Université de Sherbrooke and Roy Thurik, Professor Emeritus in Economics, Erasmus School of Economics, Rotterdam, Full Professor of Entrepreneurship, Montpellier Business School

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