This month, New York City Councilman Rafael Espinal introduced a bill dubbed the “Right to Disconnect.” If passed, the law will protect employees in the city from being penalized by their jobs for not responding to emails and other digital messages outside of work hours. Smartphones make it possible for employees to remain connected to their work around the clock — and employers, Espinal argues, are taking advantage of that. The new legislation, he says, aims to give workers back some of their supposedly free time.

The movement to ban after-hours digital work didn’t come out of nowhere. Similar legislation has already passed in France and Germany, and was instituted in the latter country following the widely publicized suicide of Swisscom CEO, Carsten Schloter. Prior to his death in 2013, he spoke candidly about the effects of overwork on his mental health to the Swiss newspaper Handelszeitung. “The most dangerous thing is to fall into a mode of permanent activity and continuously consult one’s smartphone to see whether any new mails have come in,” Schloter told the newspaper. “Everyone should switch off their mobile phone from time to time.”

Jeffrey Pfeffer, a professor of organizational behavior at Stanford, is one of the academics sounding the alarm on this culture of overwork. His new book, Dying for a Paycheck: How Modern Management Harms Employee Health and Company Performance—and What We Can Do About It comes to a sobering, if not surprising, conclusion: our jobs are making us sick, to the tune of 120,000 excess deaths per year in the U.S. alone — making workplace-related illness the fifth highest cause of death.

Through dozens of interviews and a meta-analysis of hundreds of studies on workplace stress, Pfeffer identified some of the most harmful characteristics of modern labor, including unpredictable hours, employee productivity tracking software, rising health insurance costs, and unrealistic expectations. In his book, he shows how these factors amount to a perfect storm of anxiety and uncertainty, factors correlated with chronic and sometimes fatal ailments like heart disease, diabetes, and substance abuse. Stress, his research suggests, impacts workers in service, retail, and professional jobs just as much as it does those working in fields most often thought of as dangerous—like mining and construction—and makes it presence felt at all levels of the corporate hierarchy, from entry level employees to executives.

Dying for a Paycheck is a plea to the people who create employee policies and manage organizations to stop treating employees as merely numbers to manipulate for the greatest profit — a managerial mindset, he argues, that can hurt profits as much as it hurts people. Pfeffer wants companies to give more control to their workers over things like scheduling, provide them with better health care, and most importantly, acknowledge their humanity. But in a capitalist system where shareholders often focus on quarterly profit and growth above all else, even Pfeffer is skeptical of whether this is possible.

Do you believe that work-related stress and illness has increased over the last several decades?

Jeffrey Pfeffer: Probably. The things that cause work-related stress seem to have gotten worse. In the 1950s, people weren’t getting laid off right and left. We had none of this gig economy thing, where no one has any idea from one minute to the next how much they’re going to make, and we certainly didn’t have this scheduling software that is used in retail, where no one knows when they’re going to work. The provision of health insurance has gone down and the cost of health insurance has gone up. Work hours seem to have gotten worse, and the need to be always connected seems to have gotten worse. Most of the things we see as causing mortality and morbidity seem to be moving in the wrong direction.

Why do you think that is?

Number one, I think people haven’t really measured the effects of all of this on people’s health, and number two, I think [managers] frankly don’t care about people. There is this mantra [in business] that human assets are important, and they certainly should be, but I don’t see [many companies responding] that. At the first sign of economic distress, people get laid off. In the ’50s and ’60s, maybe, CEOs felt that they had a stewardship role and had a responsibility to balance the interests of shareholders, employees, customers, suppliers. That stakeholder model of capitalism has been replaced by shareholder capitalism. [CEOs] think they’re responsible only to shareholders — and everybody else, to hell with them.

Some of the biggest economic changes over the last 40 years stem directly from deregulation, deindustrialization, and the decline of labor unions. Why didn’t you deal with those issues in your book? How do you think those factors play into the larger concern about employee health?

What I was trying to do in this book was focus on the health effects of a set of workplace exposures, why people stay in unhealthy workplaces, and how we might remedy this. The book really does not go into the causes.

Certainly, the decline of unions has exacerbated the problems we talk about. It has given people less control; it has made their economic situations less secure. Union contracts have typically provided health benefits on decent terms, and that’s [been] eroded. But one could argue that the decline of unions and deregulation is not just a cause of this, but a symptom of the fact that we have turned our back on workers, and on people. We are [weakening] the organizations representing them. To me it’s all a co-occurrence, and it comes back to the little importance we place on the wellbeing of human beings. For the most part, the economy doesn’t value people very much.

What about the effects of technology like smartphones, or the kinds of employee surveillance and tracking software used in Amazon warehouses or for UPS drivers?

There has been an increase in technologies that permit people to work all the time and interfere with the separation between work and non-work life. There’s also been enormous progress — if that’s the right word — in technology that permits people’s work to be computer-monitored. And when your work is more tightly monitored and controlled, you lose job control, which research suggests is a very important issue around health and morbidity.

In your chapter on solutions, you mention that practices like child labor or slavery have become taboo, even though they can be profitable. But many companies still use these practices outside of the US, even though they’re not supposed to. Will the kinds of changes you’re advising only make life better for people in the developed world?

Eventually, they could hopefully work everywhere. My only point in making that comment was that when people say, “Well, it would cost more to do X, Y or Z,” there are decisions that we have made that weren’t necessarily “cost efficient” years ago, when we decided that certain things are just intolerable. As we have for the physical environment — it might be cheaper to let people throw all this crap into the air and the water, but we have decided it’s unacceptable. And we need to do something very similar with respect to people.

In the U.S., most people rely on their jobs for health care and other services. In your research, did you see a difference between the health impacts of work in the U.S. and countries with a stronger social safety net, such as in the EU?

We did compare the U.S. with Europe, and [tried] to get an estimate of how [many more deaths we have here]. We found that about half of them, of the 120,000 excess deaths, would be preventable if we were like Europe.

That seems like a lot.

I guess. Western Europe isn’t the Europe of 10 or 15 years ago. Union density has gone down in Europe, job protections have gone down, and there are people working in contract arrangements and facing economic insecurity. Many people — not the frontline people, [but] the senior executives — are facing severe workplace stress. We use examples of a couple of Swiss services executives who killed themselves.

Many free market economists believe that workers will motivate companies to create better working conditions, because they can leave a job if they aren’t happy. In the book, you argue against this idea. Why?

Employers don’t always tell employees the conditions that they’re getting into, and once you get there, it’s hard to leave. Labor markets only work when there’s efficient matching, but in many cases, people are struggling to find a job at all, or a job that pays. Prior to the passage of the Affordable Care Act, and probably after that, there’s a certain amount of job-lock in the sense that if I have health insurance at my present employer and I have some medical conditions being treated, [I don’t want to leave].

You mention that hierarchy is one of the major stressors that causes people to become ill. Have you considered non-hierarchical organizations or worker-run cooperatives as a possible solution for this?

I think workers cooperatives, which I wrote about in another book years ago, are wonderful. But there are so few of them. I’m trying to focus on solutions that are in the realm of the conceivable, feasible...that you could see happening. I don’t see a big movement towards workers coops taking off in the U.S.

Do you think companies will realize it’s in their own self-interest to institute changes like increased worker autonomy or better working hours, or is that something that is going to need to be regulated by legislation?

I would like to think that self-interest would work, but I don’t think so. To the extent that there’s a parallel to the environmental movement, at the end of the day, even though Walmart now touts its environmental bona fides and has found out that saving all this waste turns out to be profitable, the first impetus for all of these companies that are now green was in fact the government. If we’re ever going to make progress on this, it’s going to require one of two things: the government, or some enormous lawsuit.

Do you think it’s possible for workers to be treated well and with respect under capitalism?

Sure, of course. There’s a difference between working for Costco and Walmart. There’s a difference between Southwest and any other airline. The Men’s Warehouse, until recently, had fewer part timers, paid slightly better than average for retail. Patagonia, which is in a very competitive industry, treats workers better than competitors. I don’t think you have to move to Denmark, though that would be nice, and I don’t think you have to give up capitalism. I think there are companies within the U.S., within even the same industries, that do things better or worse.

But you do acknowledge that things are getting worse, and that we’re moving towards an economy where people have even less security.

In general, but that again doesn’t affect every company equally. Some companies have said we’re done with employees, some people love their employees. All these trends don’t cut across every organization equally.