The McKinsey Health Institute conducted a survey in four GCC countries in August and September 2022. This survey involved more than four thousand employees in the Kingdom of Saudi Arabia, Kuwait, the United Arab Emirates, and Qatar.
We assessed a range of health outcomes (mental, physical, social, and spiritual), business outcomes (with a focus on intent to leave), and workplace factors (with a strong focus on toxic workplace behaviors) in our survey.
Health outcomes assessed in our survey included:
Mental health: An employee’s cognitive, behavioral, and emotional state of being. Mental health is needed for an individual to understand and interact with the world through memory and language. Mental health allows us to experience joy, direct anger, limit harmful, impulsive behavior, and avoid serious depressive episodes. Mentally healthy individuals have the resilience to cope with normal stresses and adverse events while maintaining a positive and realistic sense of self.1Silvana Galderisi et al., “Toward a new definition of mental health,” World Psychiatry, June 2015, Volume 14, Number 2; Vikram Patel, “The Lancet commission on global mental health and sustainable development,” Lancet, October 2018, Volume 392, Number 10157; Adding years to life and life to years, March 29, 2022.
Within this survey, we looked at four subfacets:
- Burnout symptoms: An employee’s experience of extreme tiredness, reduced ability to regulate cognitive and emotional processes, and mental distancing (Burnout Assessment Tool).2Wilmar Schaufeli, Hans De Witte, and Steffie Desart, User Manual – Burnout Assessment Tool (BAT) – Version 2.0, KU Leuven, Belgium, 2019.
- Distress: An employee experiencing a negative stress response, often involving negative affect and physiological reactivity (4DSQ Distress Screener).3Johannes Anema et al., “Validation study of a distress screener,” Journal of Occupational Rehabilitation, April 2009, Volume 19, Issue 3.
- Depression symptoms: An employee having little interest or pleasure in doing things, and feeling down, depressed, or hopeless (PHQ-2 Screener).4Kurt Kroenke et al., “The patient health questionnaire-2: Validity of a two-item depression screener,” Medical Care, November 2003, Volume 41, Issue 11; Simon Gilbody et al., “Screening for depression in medical settings with the Patient Health Questionnaire (PHQ): A diagnostic meta-analysis,” Journal of General Internal Medicine, Volume 22, Issue 11.
- Anxiety symptoms: An employee’s feelings of nervousness, anxiousness, or being on edge, and not being able to stop or control worrying (GAD-2 Screener).5Amit Sapra et al., “Using generalized anxiety disorder-2 (GAD-2) and GAD-7 in a primary care setting,” Cureus, May 2020, Volume 12, Issue 5.
Physical health: The extent to which an employee can competently perform physical tasks and activities without substantial discomfort. It includes the capacity to move through the environment in which one lives with confidence and independence and to control one’s interactions with the physical world via fine-motor control. Employees with good physical health have sharp sensory capacities with keen senses of touch, vision, hearing, taste, and smell. Physically healthy employees are full of energy and vitality, free from the twin scourges of debilitating pain or fatigue, as per the World Health Organization (WHO).6The WHO quality of life (WHOQOL) - Brief, 2012 revision, WHO, 2012.
In this survey, we used a self-developed tool modifying questions from the WHO’s 2012 quality of life assessment, looking at:7The WHO quality of life (WHOQOL) - Brief, 2012 revision, WHO, 2012.
- if the stress from respondents’ jobs cause them to engage in unhealthy behaviors (for example, inadequate nutrition, lack of physical activity, lack of sleep)
- if respondents are self-reporting physical symptoms (experiencing physical pain that is preventing them from doing what they need to do at work)
Social health: Represents an employee’s ability to build healthy, nurturing, genuine, and supportive relationships. Employees in good social health have the capacity to form meaningful connections with others, to both receive and provide social support. Social health gives employees a strong sense of belonging to a community.8Linda J. Waite, “Social well-being and health in the older population: Moving beyond social relationships,” Future Directions for the Demography of Aging: Proceedings of a Workshop, Washington, DC: National Academies Press, 2018; Corey Lee M. Keyes, “Social well-being,” Social Psychology Quarterly, June 1998, Volume 61, Number 2.
In this survey, we used a self-developed tool modifying questions from the WHO’s 2012 quality of life assessment, looking at a range of social factors (including personal relationships, participating in group activities, time spent on nonwork activities and important people in their life).9The WHO quality of life (WHOQOL), 2012.
Spiritual health: Enables people to integrate meaning in their lives. Spiritually healthy people have a strong sense of purpose, belonging, or identity, which can correlate to better health.10Eric S. Kim et al., “Purpose in life and reduced stroke in older adults: The health and retirement study,” Journal of Psychosomatic Research, January 22, 2013, Volume 74, Issue 5; Patrick L. Hill, Grant W. Edmonds, and Sarah E. Hampson, “A purposeful lifestyle is a healthful lifestyle: Linking sense of purpose to self-rated health through multiple health behaviors,” Journal of Healthy Psychology, 2019, Volume 24, Issue 10.They feel a broad sense of connection to something larger than themselves, whether to a community, a calling, or a form of divinity. Spiritual health helps people feel rooted and mindful in the present moment.11John Fisher, “Development and application of a spiritual well-being questionnaire called ‘SHALOM,’” Religions, 2010.
In this survey, we used a self-developed tool modifying questions from Spiritual Health and Life Orientation Measure, 2010, and the Work and Meaning Inventory, 2012, looking at a range of spiritual factors (including sense of fulfilling a greater purpose, living in harmony, and feeling energized by work).12John Fisher, “Development and application of a spiritual well-being questionnaire called ‘SHALOM,’” Religions, 2010.
Work-related outcomes and factors assessed in our survey included:
Intent to leave: In this survey, we used a self-developed tool to assess an employee’s desire to leave the organization in which they are currently employed in the next three to six months.
Toxic workplace behavior: In this survey, we used a self-developed tool to assess an employees’ experience of interpersonal behavior that leads them to feel unvalued, belittled, or unsafe, such as unfair or demeaning treatment, noninclusive behavior, sabotaging, cutthroat competition, abusive management, and unethical behavior from leaders or coworkers.
The analysis of share of respondents reporting at least one mental-health challenge was determined by aggregating respondents reporting having a mental-health diagnosis, now or in the past; reporting to have sought or considered treatment for a mental-health condition; or having listed at least one of the following: symptoms of anxiety, burnout, depression, or distress.
Consideration of cross-country surveys
As cited in previous global pieces about health, such as “In sickness and in health: How health is perceived around the world,” a range of cultural and methodological factors can influence respondents’ answers to survey questions. These factors include, but are not limited to, language and word association, number ranges, comprehension issues, and attitudes toward taking surveys. It is important to note that comparisons between respondents in different countries are not only due to differences in attitudes and/or behaviors between respondents but also reflect response styles that are specific to cultural and geographic locations. Any insights drawn from cross-country comparisons should be interpreted with consideration of these multiple influences to survey responses.
