Workplace health promotion

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Workplace health promotion is the combined efforts of employers, employees, and society to improve the mental and physical health and well-being of people at work. [1] The term workplace health promotion denotes a comprehensive analysis and design of human and organizational work levels with the strategic aim of developing and improving health resources in an enterprise. The World Health Organization has prioritized the workplace as a setting for health promotion because of the large potential audience and influence on all spheres of a person's life. [2] The Luxembourg Declaration provides that health and well-being of employees at work can be achieved through a combination of:

Contents

Workplace health promotion combines alleviation of health risk factors with enhancement of health strengthening factors and seeks to further develop protection factors and health potentials. [1] [3] Workplace health promotion is complementary to the discipline of occupational safety and health, which consists of protecting workers from hazards. Successful workplace health promotion strategies include the principles of participation, project management, integration, and comprehensiveness:

A report by the European Agency for Safety and Health at Work notes growing evidence that significant cost savings can be made by implementing workplace health promotion strategies, and over 90% of United States workplaces with greater than 50 employees have health promotion programs in place. [5] [6]

Strategies to promote health in the workplace

A National Institute for Occupational Safety and Health video on creating an organizational culture of health in the workplace

Strategies for workplace health promotion need to be inclusive to account for diversity in the workforce, and behavioral economics is a key tool for implementing workplace health programs. [7] The United States Department of Health and Human Services includes five strategic guidelines for workplace health promotion in its Healthy People 2010 initiative. These include:

More generally, workplace health promotion efforts are implemented at three functional levels, including:

In most instances physical activity interventions conform to Level II of this framework and may also include elements from Level III. Incentive-based Fitness Rewards Programs (FRPs) aim to influence employee behaviors and thereby conform to Level I.[ citation needed ]

Physical activity interventions

Approximately half of all current workplace health promotion programs are based on physical activity interventions given the relative ease by which employers can advocate such efforts to employees. [10] Employer-sponsored activity interventions in the form of team sports originated as early as the 17th century in the United Kingdom, however, most 21st century interventions rely on employer sponsorship of employee access to health and fitness facilities. [11] Employee convenience to sponsored fitness facilities strongly influences program participation, and facilities located near employee locations of residence hold lower time costs, receive increased use, and yield better program and health outcomes. [12] Women frequently demonstrate lower participation in workplace exercise programs than men, and young, single individuals are often more predisposed to pursue employer-sponsored physical activity initiatives. [13] In many cases, exercise-based workplace health promotion programs struggle to attract those who would benefit the most from such fitness efforts, including aging, sedentary, blue-collar, female, or less-educated employees. [14]

The sedentary nature of many modern workplaces increases negative metabolic risk factors such as high body mass index (BMI), waist circumference, and blood pressure and elevated fasting glucose and triglyceride levels. Breaking up long periods of sedentary time is shown to improve these risks. [15] [16] Specifically, utilization of portable pedal exercise machines in office environments has been shown to improve employee health, and use was demonstrated feasible during working hours. [15] Interventions using pedometers to influence employee behavior, decrease the duration of sedentary periods, and increase total movement during the work day have also proven successful. [17] Smartphone applications and workplace signs promoting stair use are known to improve employee health, and many employers are now investing in wearable technologies to encourage employees to monitor physical activity. [18] [19] Workplace Tai Chi programs have also proven effective as a health intervention and means of reducing absenteeism, particularly in older workers. [20] Despite these efforts, many health promotion programs struggle with poor participation, and the introduction of incentives is shown to improve employee involvement. [21]

Incentive-based programs

To encourage physical activity among the workforce, many employers offer financial incentives to employees through Fitness Rewards Programs (FRPs). [12] Seeing that exercise and dieting produce immediate discomfort, the benefits of weight loss are often not noticeable in the short-term, and many people seek long-term health but succumb to near-term temptations of unhealthy eating and inactivity (hyperbolic discounting), maintaining employee involvement in wellness programs is difficult. To solve these problems of immediacy, salience, and hyperbolic discounting FRPs offer financial incentives to employees for healthy behaviors. [22] Though lack of participation remains a problem even among well crafted FRPs, attrition is not random and greater weight loss success is associated with a reduction in later program dropout probability. [22]

Effects of workplace health promotion

The positive impact of workplace health promotion programs on productivity is widely discussed. The impact of workplace health promotion on absenteeism is substantial since productivity is impossible if an employee is absent. [23] However, the effects of presenteeism are also significant, and working while sick is estimated to cost the United States economy more than $150 billion per year. [24] Absenteeism is estimated to cost the average employer $660 annually per employee. [25] Based on productivity costs, employees experiencing negative health conditions or at risk of developing impaired health cost employers up to $1601 more than healthy employees per year. [26] Improvements in productivity and absenteeism following implementation of workplace health promotion programs can annually save employers $15.6 for every one dollar spent on health initiatives. [6] More generally, employee health care costs and absentee day costs decrease by $3.27 and $2.73, respectively, for every dollar spent on workplace health promotion. [21] In some cases, employer-based health programs have been shown to yield no reduction in health care spending or employer insurance outlay. [27] [28]

Relevant to health outcomes, workplace health promotion programs have demonstrated numerous short and long term benefits. Significantly, workplace physical activity interventions are shown to improve employee fitness, activity behavior, unhealthy lipid levels, work attendance, and job stress, and workplace exercise programs are known to reduce supervisor stress and abusive supervision of subordinates, increasing productivity. [29] [30] Additional improvements have been noted following workplace health programs in injury incidence, blood pressure, cholesterol levels, body mass index, cardiovascular disease risk, dynamic muscle performance, and maximal oxygen consumption. [12] [13] [31] [32] Some improvements vary by gender, with men often experiencing more consequential improvements in body mass index than women. [16] Workplace health promotion is also known to improve the "perceived health status" of employees, enhancing productivity and improving health program participation. [14]

Summarily, the expected outcomes of an ideal workplace health promotion program include:[ citation needed ]

Health promotion in low wage industries

Approximately half of employees in the United States are employed by small (less than 1000), low wage industries. [33] However, less than 10 percent offer wellness health promotion programs [34] due to lack of financial resource, time and hesitations rooting from investment return. [33] Work health promotion aims to provide better wellbeing to all workers, however, due to economic and social barriers a disproportionate amount of low wage workers are not included in studies regarding employee health promotion.[ citation needed ]

A 2015 study in Seattle/King County metropolitan area, low wage workers compared to high-earning workers have strong links regarding risky health behaviors. [33] Risky health behaviors are recognized as tobacco use, poor nutrition and sedentary lifestyle which then are factors contributing to chronic disease. [33] This then highlights disproportionate rates of chronic diseases within low-wage earning employees compared to higher socioeconomic earners. [33] It was also revealed in the Seattle/King County metropolitan area study how although the impact of chronic disease are prevalent in low-wage workers, high earners are the group who are more inclined in participating in work health promotion. Low wage industries were found to have barriers including awareness, working conditions, and management. [33]

The largest debate in the Seattle/King County study rooted from the issue of cost. The first cost revealed is the economic financial incentive. Whereby low wage industries examine the importance of investment return. Small companies debate the issue of whether the outcomes of worker health promotion are worthy of investment or labeled as 'organizational priority.' [33] In addition to the importance of profit, is the cost of employee privacy. Human resources managers in the study voiced their issue on privacy and the importance of keeping personal health matters separate from work and their workers. [33]

In addition to high rates of chronic diseases in low wage workers, there are also high rates of morbidity and mortality and hazardous environment exposure because of both socioeconomic and racial disparities. [35] Both gender and racial discrimination are linked to lower wage workers, where women and ethnic minorities contribute to low wage earner statistics. [36] Due to complexities of the environments and workspaces of individual workers with different gender and races, there is a decrease in participants within groups of low-wage workers in worker health promotion programs. Complexities vary to low wage earners contributing to largely part-time earners, wage and benefits distribution, and hazardous field of work. [35]

Suggestions to improve worker participation in low wage industries include convenience and better access. [36] To create worksite vaccinations and healthy diet options, increases the participation for preventive care in these industries. [36] An important factor to access on preventive or worker health promotion programs in low wage industries correlate to better health insurance coverage. The extension and improvement of the Affordable Care Act raises the incentive for both employees and employers to participate in preventive programs. [33] Extension to both full time and part time employees, increases coverage for hazardous work environments, and demographic equity. [35]

See also

Related Research Articles

<span class="mw-page-title-main">Sitting</span> Resting position of human body weight, primarily supported by buttocks in contact with objects

Sitting is a basic action and resting position in which the body weight is supported primarily by the bony ischial tuberosities with the buttocks in contact with the ground or a horizontal surface such as a chair seat, instead of by the lower limbs as in standing, squatting or kneeling. When sitting, the torso is more or less upright, although sometimes it can lean against other objects for a more relaxed posture.

<span class="mw-page-title-main">Exercise</span> Bodily activity intended to improve health

Exercise is intentional physical activity to enhance or maintain fitness and overall health.

<span class="mw-page-title-main">White-collar worker</span> Social class; person who performs intellectual labor

A white-collar worker is a person who performs professional service, desk, managerial, or administrative work. White-collar work may be performed in an office or other administrative setting. White-collar workers include job paths related to government, consulting, academia, accountancy, business and executive management, customer support, design, economics, engineering, market research, finance, human resources, operations research, marketing, public relations, information technology, networking, law, healthcare, architecture, and research and development. In contrast: blue-collar workers perform manual labor or work in skilled trades; pink-collar workers work in care, health care, social work, or teaching; and grey-collar jobs combine manual labor and skilled trades with non-manual or managerial duties.

Stress management consists of a wide spectrum of techniques and psychotherapies aimed at controlling a person's level of stress, especially chronic stress, usually for the purpose of improving everyday functioning. Stress produces numerous physical and mental symptoms which vary according to each individual's situational factors. These can include a decline in physical health, such as headaches, chest pain, fatigue, and sleep problems, as well as depression. The process of stress management is named as one of the keys to a happy and successful life in modern society. Life often delivers numerous demands that can be difficult to handle, but stress management provides a number of ways to manage anxiety and maintain overall well-being.

Absenteeism is a habitual pattern of absence from a duty or obligation without good reason. Generally, absenteeism refers to unplanned absences. Absenteeism has been viewed as an indicator of poor individual performance, as well as a breach of an implicit contract between employee and employer. It is seen as a management problem, and framed in economic or quasi-economic terms. More recent scholarship seeks to understand absenteeism as an indicator of psychological, medical, or social adjustment to work.

<span class="mw-page-title-main">Sedentary lifestyle</span> Type of lifestyle involving little or no physical activity

Sedentary lifestyle is a lifestyle type, in which one is physically inactive and does little or no physical movement and/or exercise. A person living a sedentary lifestyle is often sitting or lying down while engaged in an activity like socializing, watching TV, playing video games, reading or using a mobile phone or computer for much of the day. A sedentary lifestyle contributes to poor health quality, diseases as well as many preventable causes of death.

<span class="mw-page-title-main">Physical activity</span> Any voluntarily bodily motion produced by skeletal muscles and requires energy expenditure

Physical activity is defined as any voluntary bodily movement produced by skeletal muscles that requires energy expenditure. Physical activity encompasses all activities, at any intensity, performed during any time of day or night. It includes both exercise and incidental activity integrated into daily routine. This integrated activity may not be planned, structured, repetitive or purposeful for the improvement of fitness, and may include activities such as walking to the local shop, cleaning, working, active transport etc. Lack of physical activity is associated with a range of negative health outcomes, whereas increased physical activity can improve physical and mental health, as well as cognitive and cardiovascular health. There are at least eight investments that work to increase population-level physical activity, including whole-of-school programmes, active transport, active urban design, healthcare, public education and mass media, sport for all, workplaces and community-wide programmes. Physical activity increases energy expenditure and is a key regulator in controlling body weight.

Health promotion is, as stated in the 1986 World Health Organization (WHO) Ottawa Charter for Health Promotion, the "process of enabling people to increase control over, and to improve their health."

Workplace wellness, also known as corporate wellbeing outside the United States, is a broad term used to describe activities, programs, and/or organizational policies designed to support healthy behavior in the workplace. This often involves health education, medical screenings, weight management programs, and onsite fitness programs or facilities. It can also include flex-time for exercise, providing onsite kitchen and eating areas, offering healthy food options in vending machines, holding "walk and talk" meetings, and offering financial and other incentives for participation.

<i>Booster Breaks</i>

Booster Breaks: Improving Employee Health One Break at a Time is a 2010 book. Booster breaks are defined as: "organized, routine work breaks intended to improve physical and psychological health, enhance job satisfaction, and sustain or increase work productivity." Dr. Wendell C. Taylor is recognized as the architect of the Booster Break concept. The intent of Booster Breaks is to encourage health-enhancing breaks during the work day as a corrective to job stress and sedentary behavior. Examples of Booster Breaks are physical activity, meditation, or breath training. Even for brief sessions of 10 to 15 minutes, a routine practice of any of the preceding examples can produce physical, psychological, and/or mental benefits.

Occupational rehabilitation is the science and practices of returning injured workers to a level of daily work activities that is appropriate to their functional and cognitive capacity related to their position of which may be influenced by the severity of a worker's injuries.

A health risk assessment is a questionnaire about a person's medical history, demographic characteristics and lifestyle. It is one of the most widely used screening tools in the field of health promotion and is often the first step in multi-component health promotion programs.

<span class="mw-page-title-main">Occupational stress</span> Tensions related to work

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A lifestyle management programme is an intervention designed to promote positive lifestyle and behaviour change and is widely used in the field of health promotion.

<span class="mw-page-title-main">Zest (positive psychology)</span> Zest for living

In positive psychology, zest is among the discrete strengths people possess. Having zest means treating life as an adventure and feeling motivated in challenging situations. People with zest display enthusiasm, excitement, and energy as they tackle life's tasks. Zest is a component of the virtue of courage in some positive psychology paradigms.

Occupational health nursing is a specialty nursing practice that provides for and delivers health and safety programs and services to workers, worker populations, and community groups. The practice focuses on promotion, maintenance and restoration of health, prevention of illness and injury, and protection from work‐related and environmental hazards. Occupational health nurses (OHNs) aim to combine knowledge of health and business to balance safe and healthful work environments and a "healthy" bottom line.

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A psychosocial hazard or work stressor is any occupational hazard related to the way work is designed, organized and managed, as well as the economic and social contexts of work. Unlike the other three categories of occupational hazard, they do not arise from a physical substance, object, or hazardous energy.

The benefits of physical activity range widely. Most types of physical activity improve health and well-being.

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References

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