Employer WellnessEmployer wellness programs and employer wellness consulting services

Technological and demographic transformations are changing the nature of work in our society. As these changes occur the broad-based model of Employee Health Promotion Programs described above will evolve and continue to develop. If current trends continue, the workers of tomorrow will be older, more racially and ethically diverse, increasingly female, and will frequently be located off-site. In the later case, technological advances are making it possible for more and more experts to conduct their work from their homes. Thus the very character of the worksite will change and so must our efforts to deliver Employee Health Promotion Programs. As an example, in the future it is likely that a great deal of health education programming will be delivered through personalized interactive multimedia formats, conveniently supplied to any number of workers through telecommunication systems.

As technological innovations increase in the workplace, Employer Wellness Program experts will face new health related challenges. In the past, some have assumed that technology would make workers more efficient, thereby allowing workers to work less, while being more productive. In reality, increases in technological innovation have simply allowed more of us to take our work with us where ever we go and feel guilty for not being increasingly productive.

This trend may absorb increasingly greater amounts of leisure time that is normally devoted to relaxation and recreation. Subsequent increases in fatigue and stress will ensure the continued need for effective Employee Health Promotion Programs.

When considering the scope of Employee Health Promotion Programs described in this article, many will think of substantial investments made by large businesses. The reality is that 60 percent of individuals working in the U.S. work for a employer of less than 100 workers (U. S. Bureau of Census, 1988). Due to economy of scale, it has been difficult and expensive for small employer owners to supply adequate healthcare insurance and prevention programming for workers.

Employer Wellness Program experts must understand this challenge and develop the way to overcome these obstacles. The evidence is clear that much more could be done to advance the health of our society through the workplace. As change agents, health educators must work to empower businesses and workers through education of the benefits of Employee Health Promotion Programs.

Businesses do not exist in a vacuum. They are part and parcel of the community in which they are located. Successful corporate administrators are cognizant of the need for positive community relations and should do what is necessary to promote good will. What better way to bridge relationships than by utilizing existing community Employer Wellness Program services and initiatives whenever possible (e.g., voluntary, private and public health agencies) and offering health related services back to the community. Since the community is also the home of the employee, an effective mode of health promotion is through programming directed at the larger community. Sponsorship of community related health fairs is one example more are listed below.

• Encourages employee/employer involvement in the community
Blood drives
Sponsorship of fund raising for community schools and social services
Community recycling initiatives
Youth league sports sponsorship
Job training initiatives
• Public relations and media initiatives advertising a healthy employer image
• employer newsletters and press releases on health issues to local media
• Environmentally sound use of waste disposal and community resources

At times Employee Health Promotion Programs have been instituted as public relations vehicles intended to enhance the organization image with little concern for improvements in employee health. Companies who are truly committed to enhancing employee health and wellness, are businesses who have worked to include Employee Health Promotion Programs into the employer’s mission statement. With this commitment, policies and procedures can be written to address short and long term goals of increased employee health, productivity, and morale. These policies and procedures are critical to the establishment of supportive organizational cultures conducive to employee health and wellness.

• Active employee involvement in Employer Wellness Program committees and employer decision making
• Availability of flextime work schedules
• No smoking policy
• Drug use policy and drug testing
• Motor vehicle seatbelts and the use of other protective/safety equipment
• Sexual harassment policy
• Family leave initiatives
• Consistent and frequent awards and recognition of employee work efforts

The environmental conditions of the worksite can be divided into both physical and psychosocial domains, both of which influence the climate and culture of a worksite. The cultural norms of a workplace have been identified as powerful determinants of worker health and behavior (Baum, 1995). Ultimately, workers benefit most from a healthy, supportive; eustressful workplace community was they feel valued and respected. Since adults spend approximately one third of their waking hours at work, one would hope that workers view work as less of a necessity and more of an enjoyable experience.

The climate of a workplace is also more conducive to enhancing health and human performance when the environment is safe, clean, aesthetically pleasing and ergonomically engineered. While some occupations maybe inherently dangerous (e.g., fire fighter, military personnel) all broad-based Employee Health Promotion Programs should control exposure to unhealthy conditions including: hazardous chemicals, noise, temperature, radiation and other risky conditions. Program examples include:

• Employee Health Promotion Programs grounded in supportive cultural change strategies
• Environmental and safety compliance measures
Lighting
Ventilation
Heating
Control of toxic substances
Noise
Universal precautions
• Ergonomically designed workstations
• Sanitary, clean, well maintained worksite
• Recycling promoted initiatives
• employee & management training in emergency procedures

An employee’s psychological health can never be neglected in a broad-based model of Employee Health Promotion Programs. Originating out of a need for alcohol abuse interventions in the workplace, today’s employee assistance programs (EAP) encompass assessment and counseling for substance abuse and dependency, stress related disorders, family conflicts and other personal issues.

Evidence of the need for such initiatives is wide spread. In a national survey conducted by the Northwestern Life Insurance Company (1992) 46% of workers reported that their job was very stressful, 34% thought about quitting their jobs because of workplace stress, and 14% did leave their job because of stress. Alcohol and substance abuse problems and issues of workplace violence and harassment are common areas of concern. For many the only viable treatment solution is the Employee Health Promotion Program.  Exemplary Employee Health Promotion Programs will include:

• Personalized assessment of employee concerns
• Treatment choice assistance
• Emphasis on prevention and treatment
• Personal and family counseling initiatives
• Treatment for addictions:
Drugs
Alcohol
Gambling
• Crisis intervention initiatives
• Stress management
• Ongoing support groups
• Management and employee training to identify individuals at risk.
• After treatment assistance

Small and large businesses carry a significant proportion of the provision of health care for families in this country by offering healthcare insurance for their workers. With the escalating increase in healthcare cost many businesses are attempting to slow the increase of healthcare insurance premiums by offering innovative cost control initiatives. Greater emphasis is being put on primary prevention to keep workers healthy and secondary prevention to identify and treat health conditions before they can become serious.

At some workplaces, workers are being encouraged to take greater responsibility for their health related behaviors through risk rated incentive packages. Linking wellness to employee benefits of gain sharing and co-payment cost reductions will provide new opportunities requiring efforts of collaboration between the human resource managers and the Employer Wellness Program specialists. These two sets of experts may also work together for the ongoing evaluation of cost effective Employee Health Promotion Programs.

In conjunction with the above initiatives most large businesses also have a nurse or physician on staff to dispense on-site medical and preventive care. Some initiatives have also found it cost effective to provide their own physical therapy programming to assist injured and infirm workers in regaining optimal functioning. A broad-based selection of health related employee services and benefits would include the following:

• Free or low cost health screenings provided on site by employer clinical personnel or through outside contractors:

Serum cholesterol
Colorectal cancer screening
Blood pressure screening
Mammography
Vision and hearing testing
Diabetes
• Referral procedures (e.g., Hypertension, Cholesterol, Cancer)
• First Aid and emergency care
• Disease control and prevention initiatives
• Onsite Child and adult care services
• Pre-retirement and financial planning
• Ongoing learning/educational opportunities
• Coordination of employer picnics and outings
• Parent-child work visitation initiatives
• Workers compensation/rehabilitation

physical fitness and nutrition initiatives have demonstrated effectiveness in delaying the onset of employee morbidity while enhancing self esteem, stress management and general feelings of well being. Although many physical fitness and nutrition initiatives are instructional in nature, they should go beyond educational initiatives by offering enabling supports for the adoption of healthy behaviors.

Quality Employee Health Promotion Programs promote and facilitate participation in daily physical activity for all workers, and when possible family members and retired workers. This is accomplished through access to fitness facilities, (preferably on site) and properly supervised physical fitness classes. In addition a broad-based program will provide opportunities for Personalized physical fitness and nutrition prescriptions from certified experts. Commitment to the model is demonstrated through occupational food services and sales consistent with healthy nutrition. Specific initiatives to include:

• Resistance training
• Flexibility conditioning initiatives
• Healthy cooking classes
• Aerobic conditioning initiatives
• Diet analysis and planning assistance
• Physical rehabilitative initiatives
• Weight/body fat control initiatives
• Team and individual recreational sports initiatives
• Physical fitness assessments and initiatives

Health education is easily integrated into all the areas of comprehensive Employee Health Promotion Programs and it is unlikely that any of the areas could survive without an educational component. It is a primary element of every primary, secondary, and tertiary prevention program and a way of promoting wellness and optimal health. A broad-based health education program must be based on theoretically and scientifically sound principles to ensure effectiveness.

Successful health education initiatives will incorporate adult learning theories and promote active participant involvement in all facets of program planning and implementation. Health education efforts should emphasize skill development and the adoption of health enhancing behaviors while being accessible to all workers, their families and retirees. Methods of delivery may include; one on one instruction, group presentations, seminars, workshops, educational media lending library and health literature distribution. Program examples may include:

• Health Risk Assessments
• Personalized health prescriptions and behavior change assistance
• CPR and first aid training
• Nutrition education initiatives
• Stress management
• smoking cessation  initiatives
• Heart disease and cancer education
• Blood borne pathogens education initiatives
• Sexual assault prevention initiatives

• Prenatal care
• Safety education initiatives
• Self care initiatives
• Healthy back initiatives
• Family centered initiatives
• Supplies of literature and educational media available for employee loan

As the science behind Employee Health Promotion Programs continues to evolve, the need to define and articulate the components of this broad-based approach increases. In 1987 Allensworth and Kolbe (1987) expanded the prevailing definition of broad-based school health to include the domains of Health Instruction, Healthy Environment, Health Services, Physical Education, Counseling and Psychological Services, School Food Service, Employee Health Promotion Programs for Faculty and Staff, and the Integration of School and Community Resources.

To promote the health of school children, prevention specialists have found that an integrated broad-based approach is the most effective strategy. Relying solely on health education or Physical Education initiatives to foster children’s health has demonstrated limited effectiveness. Consistent health messages delivered by numerous agents increases the possibility of attaining health goals and objectives. A similar model is essential if Employee Health Promotion Programs are to impact positively on the health and performance of all workers.

A broad-based model of Employee Health Promotion Programs includes the following components; Health Education Initiatives, employee Health Services and Benefits, physical fitness and nutrition Initiatives, Employer Wellness Program Policies and Procedures, Counseling and Employee Assistance Programs, a Safe and Healthy Work Environment, and the Integration of Company and Community Resources. This model can be used to evaluate and plan for Employee Health Promotion Programs that are truly broad-based in nature, focusing on primary, secondary, and tertiary prevention strategies for workers.

One value of a truly broad-based model is that it is possible to promote a holistic approach of employee health. A productive, healthy employee is one who is given the opportunity to develop emotionally, physically, intellectually, socially and spiritually. In addition, this model supports the ideals of wellness and optimal health by encouraging worksites to go beyond initiatives designed to only reduce healthcare costs, prevent disease, or maintain health.

A primary factor in the utility of this model is the integration and overlap of responsibilities. Design and implementation are dependent upon the cooperation and motivation of qualified – and ideally – credentialed experts throughout the administrative structure of a employer. Such a model requires consistent communication between health educators, medical staff, human resource managers, physical therapists, industrial hygienists, physical fitness physiologists, ergonomic engineers, dietitians, occupational therapists, psychologists and independent consultants. Planning must also incorporate active involvement of workers, administrators, family members, and employer retirees at all stages of the development, implementation and evaluation stages. All must be committed to the development of a healthy organization where workers are happy and proud to work.

Various organizations are working to advance the science of Employee Health Promotion Programs. Health educators have the expertise and training to be leaders in this area. On the basis of theoretical foundations of health behavior and the results of empirical research, we must start to articulate a clear vision of what optimal initiatives should consist of. The Components of this model are included below for reference and will be discussed individually in coming posts.

• Health Education
• physical fitness and nutrition Initiatives
• employee Health Services and employee Benefits
• Employee Assistance Programs and Counseling Programs
• Safe Work Environment
• Health Related employer Policies and Procedures
• Integration of employer and Community Resources

As the science behind Employee Health Promotion Programs continues to evolve, so will the need to define the dimensions of a broad-based model of Employee Health Promotion Programs. A representative model includes the following components; health education initiatives, employee health services and benefits, physical fitness and nutrition initiatives, Employer Wellness Program policies and procedures, counseling and employee assistance programs, a safe and healthy work environment, and the integration of company and community resources.

A broad-based approach to Employee Health Promotion Programs will maximize the impact of all interventions by increasing communication between administrators, workers, and employee families, while encouraging the adoption of a healthy worksite climate and culture. Philosophically, this model supports the ideals of employee wellness and optimal health by encouraging worksites to go beyond initiatives designed to only reduce healthcare costs, prevent disease, or maintain health.

A primary factor in the utility of this model is the integration and overlap of responsibilities for Employee Health Promotion Programs by various departments and individuals outside and inside the company. As the structure of the workplace continues to change, in the future this dynamic model can be used to evaluate and plan for Employee Health Promotion Programs that are truly broad-based in nature.

A Comprehensive Model For Employee Health Promotion Programs

According to the National Survey of Worksite Health Promotion Activities (1992) 81% of businesses in the U.S. with 50 or more workers have some form of Employee Health Promotion Programs activity. This result puts us in proximity of the Healthy People 2000 (1990) objective of 85 percent by the year 2000. Why are businesses getting into the employer of Employee Health Promotion Programs? The three most common reasons cited for employer interest in Employee Health Promotion Programs are the desire to control spiraling healthcare costs, to encourage a healthy productive work force, and as a way of boosting the morale of workers and the image of the company (O’Donnell, 1994).

As the motivations behind Employee Health Promotion Programs differ, so do the extent of a Employee Health Promotion Programs efforts. A program may consist of distributing the occasional health pamphlet on the warning signs of cancer to workers, or it may comprise an elaborate and strategically planned Employer Wellness Program targeted to the specific needs of a company and its workers. Research indicates (O’Donnel & Harris, 1994) that some Employee Health Promotion Programs have been more effective than others in improving health status, but what would a truly broad-based model of Employee Health Promotion Programs consist of?

Imagine yourself working for the healthiest employer possible. What characteristics or Employer Wellness Program strategies would make that organization so healthy? Examine it from a holistic perspective. What does that employer do to enhance the physical, social, emotional, spiritual, and intellectual aspects of employee health? How does that employer develop effective health policies and relevant programs that impact all workers? Finally, how does that employer demonstrate its belief that workers are the employer’s most valued asset?

It is unlikely that any one single of a Employer Wellness Program will be accountable for the positive health outcomes of all workers. Employer Wellness Program have evolved from the occasional fitness facility for the exclusive use of employer executives, or the sporadic employee safety program, to a wide range of health enhancing services and initiatives. Employer Wellness Program experts frequently speak of the importance of cultural change and the need to institutionalize Employee Health Promotion Programs in today’s workplace. This goal can only occur through a broad-based and integrated approach that impacts on workers through numerous channels.