Evidence-Based Vacation Should Totally Be a Thing
I concede that there is a strong argument against developing an evidence base on vacations. What difference would it make?
Wringing out productivity increases can grievously outweigh concern for worker welfare. Shockingly high rates of people don’t even take all the paid time off to which they are entitled. How much impact could research have, when so much of this is about politics, competition, under-staffing, and culture? Research isn’t notorious for being good at effecting policy and culture change.
But that has to change, too, doesn’t it? And there are some countries (especially with strong worker unions), employers, and sub-cultures that would act on compelling evidence, if they had it. We have to get used to expanding our ideas about what needs evidence, and how to make that evidence count.
Then there is individual behavior. We are awash in a vast amount of news about utterly trivial potential risks and benefits of micronutrients, and lots of lifestyle issues. So much of it is notoriously useless or harmful. John Ioannidis has argued that nutritional science needs radical reform.
I think a lot of that effort would be better off going somewhere else. If our interest turned elsewhere, maybe research would be re-directed too. Sure, that’s some serious wishful thinking! But then, so is hoping for radical reform in a research sub-culture that’s thriving as it is.
The sparse experimental studies we already have around vacationing show how much important stuff there is for us to learn more about.
I couldn’t find a systematic review of randomized trials related to vacations. And I couldn’t find studies on the health and wellbeing effects of a lifetime of taking too little time off work. That seems critical to me. A single vacation may not have a big impact, and the wellbeing could wear off quite quickly. But short and few vacations, as a prolonged lifestyle, is associated with real health and life harm. With too little opportunity to recover from work-associated depletion of resources, goes one theory,
…“spirals” of resource loss may develop, culminating in burnout and other chronic health complaints.
Consider the Helsinki Businessmen Study. Back in the 1970s, this involved about 1,200 businessmen and executives who were healthy, but had at least 1 cardiovascular risk factor (like smoking, having high cholesterol, or being overweight). Half were randomized to 5-year intensive program of cardiovascular disease (CVD) prevention, and half were the control group.
And the intervention seemed to work. Until a 40-year follow-up of their patterns of dying delivered a shock: men in the intervention group had died at a higher rate than men in the control group for a big chunk of time. Timo Strandberg and colleagues isolated a subgroup that might account for this: men who had consistently less vacation. Something about them, they hypothesized, made them susceptible to harm from the intervention.
Working too much for too long does damage. But what changes can reduce it? That’s a critical area we need to know more about.
Let’s have a quick look at some of the questions where rare randomized trials have been done to try to get us closer to answers.
Does a short holiday reduce stress in the stressed-out? Here’s a small randomized trial comparing a 4-day long weekend in a partially paid-for Tyrolean wellness resort with 4 days at home that suggests it can.
How about a 3-week stay at a health resort with a program of activities to reduce stress, German style? Yes, that might work, too. Here’s a bigger randomized trial for people at risk of burnout.
And then there’s the trial from the Chopra Centre, comparing a vacation at a resort, with a meditation retreat on the resort.
What about hiking in the alps? There’s a cluster of trials in Austria and Italy testing whether hiking at moderate versus low altitudes helps people with metabolic syndrome [2004, 2006, 2010, 2014, 2015].
That’s not just about time off work and hiking, is it? So let’s take a detour to Lai Leong’s 2017 thesis on outdoor activities, connectedness with nature, and their impact on thinking and creativity. There are more than 30 trials addressing personal and social outcomes. And yes, this body of evidence shows benefits.
While we’re on that detour, what about incorporating getting outside for your lunch breaks? Does this kind of micro-recovery make a difference? Here’s a randomized trial comparing a walk in the park, with a relaxation intervention and a “lunch as usual” group [PDF]. (People in both intervention groups did better in the afternoon and felt better at the end of the work day in this short-term study.)
There’s a randomized trial of micro-breaks during the day, too. Even just a 1-minute break swapping tasks showed benefits, and a few minutes doing something you enjoy. Short breaks, those authors concluded, help people doing work that depletes cognitive resources, just as they’re needed for work that is demanding on you physically.
And finally, 2 trials in children – both related to keeping moving or preventing obesity. One found that overweight kids on fitness programs at school lost ground during the long summer vacation. And the other, in Belgium, found that closing off streets for children to play during school vacation increases their physical activity.
Those last trials raise a couple of important points. The first is the risk of weight gain during vacations. Jamie Cooper and Theresa Tokar write:
The most commonly studied time periods that are thought to contribute to yearly weight gain are the holiday season as well as summer vacations in children and adolescents.
In their prospective study, they recruited 122 adults (mostly women) via flyers on a campus. They found that weight gain was common on vacations from 1 to 3 weeks long, and that the weight gain persisted.
The second important point those trials in children raised for me was the issue of changing the environment, with benefits for individuals flowing organically from that. We could do with a lot more of that kind of change, especially in the work environments that channel people’s lives into so much work, that it’s to their personal detriment.
Maybe the worst offenders in workplaces are the least likely to change, though. As David Maume points out in his analysis of vacation time and gender,
Ethnographic studies clearly show that employers reward workers who display a willingness to subjugate their personal lives to the business imperatives of the firm.
Sounds like academia, doesn’t it?
Paul Flaxman and colleagues studied 77 academics prospectively around the Easter break in the UK – a 4-day weekend, surrounded by 2 weeks’ teaching break [PDF]. They classified the academics as either low or high in self-critical perfectionism. Those who were high perfectionist had less ongoing benefit from the time off: they were plagued by work-related worry and rumination quickly after returning to work.
Optimal cognitive function would be better for academics’ work, though, wouldn’t it? And less stressed bosses and co-workers, that’s for sure. It’s driven by an often resource-strapped and hypercompetitive research ecosystem, something that people in the US and the UK, for example, have grappled with. Those kinds of reports don’t seem to get into specific recommendations about the culture of overwork in academia, though, and maybe with a bit more research available to focus attention, they would.
Maume points out that unused vacation time could be an indicator for pressure to work longer hours, career pressure in general, job insecurity, or concern for loads on co-workers. Job characteristics, he points out, can shape individuals’ attitudes to working – being a workaholic is not necessarily innate to an individual.
Maybe among all the metrics for assessing academics’ productivity, unused vacation by leaders and the rate of unused vacation in their teams has a place?
Practices from country to country are just so dramatically different when it comes to time off work. There are certainly lots of options to consider, but we need to know which are worthwhile, and have effective implementation strategies.
People struggled enormously in the fight to get workers reasonable hours and paid vacations. They still are. Yet now in many areas that had long ago won these battles, people are working crazy hours again, partly driven by the recently-acquired ability to be tethered to our work electronically. And they’re not using all their vacation days on a quite massive scale in some countries. Maybe a strong evidence base on vacations wouldn’t make a difference. But facing these social forces without one surely doesn’t help.
The cartoons are my own (CC BY-NC-ND license). (More cartoons at Statistically Funny and on Tumblr.)
The “Oh, the Things We Could Know!” pays homage to the glorious Dr. Seuss’ book:
You have brains in your head.
You have feet in your shoes.
You can steer yourself
any direction you choose.
The photo in the Tirolean mountains is by Aufiaufnberg, via Wikimedia Commons.