The End of Health Promotion at Work?

bh IN BRIEF

Information in the 2008 sanofi-aventis Healthcare Survey suggests workplace wellness programs are on the wane. Fewer employees report having access, and fewer said they use them. There are several reasons why programs fail, but there are still solid reasons why comprehensive workplace health promotion is needed. The Survey notes a trend towards more health education, up significantly (46%) in 5 years, perhaps at the expense of formal programs. Almost all (96%) of those polled said they thought it was appropriate for their employer to encourage disease and injury prevention, though confidential health information should be protected.

One of the interesting and a bit surprising findings from the 2008 sanofi-aventis Healthcare Survey was that fewer of the 1,500 respondents said they had access to workplace wellness (health promotion) programs. This year, 37% of plan members said their employer provided some kind of program, less than the high point in 2003 (43%) and about the same as the year the question was first asked (38% in 1999).

Worse, those who had access to those programs were using them less. Forty percent said they use these programs, versus 52% at the peak in 2004, and 44% in 1999 when the question was first asked. Only about 13% said they use them "definitely", while 37% said they use them "kind of". Six in 10 use them rarely or never. Does this mean that healthy workplaces are on their way out?

The Survey doesn't answer this question directly, but there are a number of possible explanations.

First, it may simply be that some employers no longer offer such programs. Assuming this is a deliberate decision, then why do health programs fail?

Programs need to be tied to business strategy – human resources, safety, quality – so they are not seen as a frill. Such programs tend to be under-resourced, and are the first to go when budgets are tightened.
Programs need to be specifically tied to employee needs, and focused on behaviour change as well as education. Surveys should be used to discover unmet needs, and HR data can be analysed to determine health issues that are major cost drivers.
Programs are sometimes seen as catering only to the healthy, and the least healthy employees often don't participate. Supported by many research studies, it's reasonable to lower the number of risks in order to reduce health costs. The healthiest among us are very low cost, but they also need encouragement to stay that way.
Organizations need to set explicit goals and invest in formal evaluation in order to know if existing programs work as intended. Programs also need steady promotion, and must be periodically refreshed.
Some organizational cultures are not conducive to health programming, and management needs to first hold the trust and confidence of employees.

Another possible reason is that many people do not want or cannot reasonably participate in wellness programming at work. They may be self-conscious, particularly at the beginning. Shift work also makes it difficult, as do widely dispersed locations with small numbers of employees.

Finally, just because certain employers terminate or curtail their health programming, that's not always right for others. Over the years, the Survey has reported positive correlations between benefits, health promotion programs, employer image, loyalty, and job satisfaction. The best advice is to offer as many options as possible to engage employees, and use their feedback to stay on target. Indeed, while there are fewer programs, more employers are providing health education: 57% this year, vs. 39% in 2003. Of interest is that even employers with less than 50 employees meet that standard.

The Survey helps gauge the state of mind of a nationally-representative sample of employees. But opinions are not necessarily facts. In this case, don't stop trying to improve the health and performance of your employees. Indeed, 71% of those without programs would be interested in participating, either definitely (35%) or "kind of" (36%).

And, an astounding 96% said it was appropriate for their employer to encourage disease and injury prevention, although most (61%) did not want their employer to have access to their personal health information. That's easy enough to accommodate.

In conclusion, employers invest in health promotion programs for several reasons, including:

Financial: To "save" money, or to improve productivity.
Cultural: "It's the right thing to do."
Human Resources: To attract and retain employees.
Public image: To be an "employer of choice".
'Line extension': They already have strong quality or safety programs.

Each employer needs to develop their own rationale for a healthy workplace strategy, and ask their advisors for help in assessing employee and organizational needs, setting goals, implementing, and evaluating. Since we're all ageing, there's no time like the present to get started.

¹Current and past editions of the Survey are available at www.sanofi-aventis.ca