Workplace stress may contribute up to $190 billion in health-care expenses and over 120,000 deaths each year, according to a study (PDF) by researchers at the Harvard Business School and Stanford’s Graduate School of Business. This means that anxiety about employment could be killing more Americans than diabetes, Alzheimer’s, or the flu every year. The study, to be published in the journal Management Science, estimates that a lack of health insurance, a heavy workload, and conflicts between work and family are the most financially costly workplace stressors. Not having insurance, which can also lead to poor treatment, had the largest impact on mortality, contributing to 49,000 deaths per year, followed by unemployment and low control over workplace demands, which together contributed to 65,000 deaths.

“Work is a very important part of people’s psychological and physical environment, so if we are concerned about health and health-care costs, we ought to worry about what goes on at work,” says Jeffrey Pfeffer, who coauthored the piece with GSB colleague Stefanos Zenios and lead author Joel Goh of HBS. It may seem as though people with lucrative but intense jobs in the financial sector would be most at risk of getting pummeled into sickness, but lower-income Americans are probably most at risk because, says Pfeffer, they “tend to get sorted into … shift jobs, long hours, economic insecurity.”

To predict the effect of job-related anxieties, the researchers scoured medical literature about 10 work-related triggers that lead to negative health outcomes–including unemployment, long hours, and feeling unfairly treated—and used survey data to determine their prevalence. Then they built a model that estimated the overall effect of those triggers in terms of cost and mortality. The researchers noted that worker neuroses tended to mirror the health of the overall economy: In 2006, when the markets were humming, there were fewer workplace-stress-related costs, according to their model; in 2010, when the country was climbing out of a crisis, the costs would have been higher. The fact that work angst can be cyclical doesn’t mean managers should be excused from making practical changes to make their employees feel better, Pfeffer says.

“People have discretion as to how they are going to deal with the general economic trends,” says Pfeffer. He points to such companies as Southwest Airlines or Costco, which have resisted industry-wide trends that create awful, high-pressure, low-security environments for workers. Refraining from layoffs during a downturn may seem costly, but Pfeffer says that type of policy could pay off in health-insurance savings.