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People and the world, Article

Working under blockade: what uncertainty and scarcity do to people

· Helfen statt Blockieren editorial team

Sanctions are usually measured in trade figures. Yet they also act at the workplace: on the bank analyst who decides on a transfer, on the exporter who does not know whether his delivery will remain permitted, and on the doctor who lacks a medicine. What occupational psychology shows about this, and where it is silent.

12 billionworking days are lost worldwide each year to depression and anxietyWHO and ILO, 28 Sep 2022
42 of 43studies on US sanctions found harm to health; 63 percent come from IranBMJ Open, review, 9 Oct 2026
40%of young Venezuelan doctors in a 2023 survey had emigratedTeaching and Learning in Medicine, 2025
872ksuspicious activity reports (exactly 872,048) reached the UK reporting office in 2023/24National Crime Agency, SARs report 2024

One model for both sides

For some twenty years occupational psychology has described strain with a simple picture: every job makes demands and every job offers resources. Demands are time pressure, responsibility, contradictory rules. Resources are room for decisions, support, fair pay, reliable information. When demands rise for a long time and resources dwindle, the risk of exhaustion grows; when resources suffice, they buffer a great deal. This is how Evangelia Demerouti and Arnold Bakker sum it up; their model has been tested in many studies since 2001.

The picture fits both sides of a blockade. In the countries that impose sanctions, it is mainly the demands that rise: lists change, mistakes are heavily punished, decisions have to be fast. In the countries under sanctions, it is mainly the resources that dwindle: materials, money, colleagues.

Where the strain arises

Following the job demands and resources model: demands rise, resources shrink. Assignment by the editorial team; how well it is supported is set out in the short study.

Where sanctions are imposedBanks and compliancescreen lists, clear hitsheavy fines for errorsExport departmentslicences, deadlines, new listsplanning by sightSmall firmsno legal departmentrefused paymentsWhere sanctions take effectHealth workersmissing medicinesdevices without spare partsTeachersreal wages fallcolleagues emigrateSelf-employedforeign currency, payment routesrules keep changingWhere sanctions are imposedBanks and compliancescreen lists, clear hitsheavy fines for errorsExport departmentslicences, deadlines, new listsplanning by sightSmall firmsno legal departmentrefused paymentsWhere sanctions take effectHealth workersmissing medicinesdevices without spare partsTeachersreal wages fallcolleagues emigrateSelf-employedforeign currency, payment routesrules keep changing

Model: Demerouti et al. 2001; Bakker and Demerouti 2017. Evidence by group: see sources and the short study “Work under blockade”.

What insecurity demonstrably does

There are solid meta-analyses on the effects of job insecurity. A review of 20 long-term studies found 29 percent higher odds of depressive symptoms for people who consider their job at risk; for actual unemployment the figure was 19 percent. A review of 17 studies with up to 174,438 employees in the BMJ found a 32 percent higher risk of coronary heart disease. The authors add an important point: after accounting for social circumstances and risk factors, the figure fell to 19 percent. Part of the association therefore lies in poverty and living conditions, not in insecurity alone.

What job insecurity demonstrably brings with it

By how many percent the odds (OR) or the risk (RR) are higher than without the strain. Meta-analyses of prospective studies; associations, not diagnoses.

Strain and outcomeHigher by
Perceived job insecurity: Depressive symptoms (OR 1.29; 95% CI 1.06 to 1.57)+29%
Unemployment: Depressive symptoms (OR 1.19; 95% CI 1.11 to 1.28)+19%
Perceived job insecurity: Coronary heart disease (age adjusted) (RR 1.32; 95% CI 1.09 to 1.59)+32%
Perceived job insecurity: Coronary heart disease (fully adjusted) (RR 1.19; 95% CI 1.00 to 1.42)+19%

Sources: Kim and von dem Knesebeck, International Archives of Occupational and Environmental Health 89(4), 2016, 20 cohorts; Virtanen et al., BMJ 347, 2013, f4746, 17 studies, up to 174,438 people. File daten/effekte_arbeit.csv.

None of these studies examines sanctions. Anyone who transfers the findings to an export department whose main customer is suddenly listed, or to a teacher whose pay is eaten up by inflation, draws a conclusion that is plausible but not measured. We state this limit explicitly.

In sanctioning countries: screening under threat of penalty

Anyone who screens payments in a bank works with an uneven calculation. A missed hit can cost a heavy fine and one’s own reputation; a refused permitted payment costs the bank almost nothing. In 2011 the economist Előd Takáts showed that high fines lead banks to report even weakly suspicious transactions, and that the flood of reports dilutes their value to investigators. He calls this “crying wolf”. The UK reporting office shows how large the volume is: 872,048 suspicious activity reports in one year.

Uncertainty acts similarly on decisions in public bodies and firms. A survey in public administration found that about one in four of the most important decisions of a year was made defensively: not the best option, but the one for which one is least likely to be blamed. The study does not concern sanctions; but it describes exactly the behaviour that appears in the debate on over-compliance as “de-risking”. For export departments it is shown that uncertainty about trade policy reduces investment. How much stress this means for the people who make these decisions every day has not been measured for sanctions by anyone using recognised questionnaires. Surveys of compliance professionals exist, but they mostly come from vendors in the industry.

In sanctioned countries: working with what is missing

A review in BMJ Open from October 2026 assessed 43 studies on the health effects of US sanctions; 42 found harm, for example in the supply of medicines. 63 percent of the studies come from Iran. Workers appear there mainly in interviews: health policy experts mention effects on motivation and emigration. A study from Iran with 31 interviews counts income, purchasing power and access to research funding among the main reasons for staying or leaving.

In Venezuela, 40 percent of 312 young doctors who took part in a survey in 2023 had left the country. 97 percent said that a lack of resources in hospitals had impaired their training. The authors recommend, among other things, programmes against moral distress, that is, the suffering of not being able to treat patients as one was taught. Whether sanctions or the government’s economic policy bear the larger share of this situation is disputed in Venezuela; the study does not separate the two.

Where money stops altogether, the issue is pay itself. After funding from development agencies and international financial institutions was halted in Afghanistan in 2021, the International Committee of the Red Cross says it paid the salaries of nearly 10,500 staff in 33 hospitals.

Cuba: two causes, one staff room

In October 2023, according to the Ministry of Education, Cuba’s schools were short of 17,278 teachers. The ministry itself named as reasons the move to better-paid work, emigration and too few applicants to teacher-training schools. According to the statistics office, the average state wage in 2024 was 5,839 pesos a month, in education 5,451 pesos. The UN Special Rapporteur Alena Douhan cites, reportedly, 30 to 50 percent vacant posts in the public service.

Both halves belong to the picture. The US embargo makes imports more expensive, deters banks and makes foreign currency scarce. At the same time wage levels, prices and the rules for private work are in the hands of the Cuban leadership, and those who criticise in public risk prison: Prisoners Defenders counted 1,351 political prisoners in September 2026; 496 of them are convicted but not in prison. The medical missions abroad are also disputed. In 2019 two UN Special Rapporteurs wrote of indications of forced labour, including withheld wages and pressure on doctors who abandon a mission. Cuba’s foreign minister counters that the cooperation “saves lives” and has taken more than 400,000 professionals to 164 countries.

Scarcity in the mind: a finding with a question mark

The thesis that scarcity itself burdens thinking has become well known: anyone who constantly has to make do with too little has less mental capacity for other things. A much-cited study in Science showed such effects in 2013 among people with little money. Later replications of 20 studies from this research field turned out mixed, with clear successes and clear failures; the original authors dispute the assessment. That is not enough for a robust statement about people under sanctions.

What demonstrably helps

Since 2022 WHO and the ILO have recommended above all measures at the level of the organisation, not only the individual: train managers, shape workload and room for decisions, make help easy to reach. Applied to sanctions this means: clear general licences, supervisory guidance and fixed contact points reduce the uncertainty borne by analysts and exporters. What companies, banks and individuals can do in practice is set out in the lead article “What companies, banks and every individual can do”; how banks decide, in the article “Banks worldwide”.

This piece is information, not legal, investment or health advice. It makes no diagnoses. It reflects the view of the editorial team, relies on the sources listed and names opposing positions. “Helfen statt Blockieren” is non-partisan.

Sources

All online sources accessed on 3 November 2026. Data files for checking: daten/ of this series.

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