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 be true for a large company, it does not apply to small and medium-sized enterprises (SMEs), where the loss of the business owner is highly likely to completely jeopardize the company’s survival. That is why we assert that the entrepreneur’s health is an SME’s most valuable intangible asset.
Despite this obvious fact, research on entrepreneurship has been slow to focus on 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 contradictory results lead many researchers to conclude that there is no consensus. We do not agree with this assessment. Upon closer inspection, these findings are less contradictory than they are complementary. In our view, they reveal a single aspect that characterizes the close relationship entrepreneurs form with their work—and especially with their businesses—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 his or her own destiny—a concept we explored in a recent research article—and is responsible for his or her actions and free to decide on the values and norms that guide him or her.
"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 Portail du Rebond. As our knowledge has grown (10 dissertations defended between 2014 and 2021), one thing has become clear: entrepreneurs—particularly those managing family wealth—do not have the same relationship with work as everyone else.
Because of their financial investment (the ownership effect) 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, above all, their business to be essential parts of their lives. The Germans are spot on when they refer to an entrepreneur asan “existenzgründer,” literally a “founder of one’s 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 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 subordination. Most female entrepreneurs 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, 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 even from their hospital beds.
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People are always saying that there’s “good stress” and “bad stress.” Saying that there’s such a thing as good stress is partly true when it comes to performance, but completely wrong when it comes to health. Returning to our existentialist approach, when an entrepreneur experiences “good” stress, it means the outcome 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 ability to stop thinking about work outside of work—is very difficult for them. Ultimately, their business takes precedence over their health.
Very Real Suffering
The second consequence is that it can lead to situations of suffering that may result from this overly strong connection between the business and the entrepreneur’s personal life. Suffering is a topic rarely addressed by entrepreneurship researchers, who tend to emphasize the entrepreneur’s success rather than failure.
Yet certain forms of suffering are very real. An employee’s termination, the transfer of ownership, or the liquidation of a business are events that shake the very foundations of ownership, call into question the entrepreneur’s management, and, as a result, also jeopardize the entrepreneur’s mental health. These events can be experienced as a loss (loss of the employment relationship, loss of the business itself, loss of control over events). The existential implications are so profound 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 company liquidations—it is important to continue promoting suicide prevention programs in the business community, such as Apesa and Agri-écoute.
However, it would be overly simplistic—and even counterproductive—to limit the issue of entrepreneurs’ health solely to the pathogenic dimension. It is equally important to examine 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 Grasp
The third consequence 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 way, to use that information to make effective decisions, and to interpret the stimuli as meaningful and as challenges that direct 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 salutogenic 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 salutogenesis 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 take responsibility for the consequences of one’s own actions topped the list. In general, being an entrepreneur has a beneficial effect on health.
Ultimately, although entrepreneurs tend to prioritize the economic well-being of their businesses 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, sometimes leads to situations of acute distress.
Olivier Torrès, Founder of Amarok, a health monitoring organization for executives, 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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