Worksite Health Promotion

V. Key Issues: Population Health >> E. Health Promotion >> General Health Promotion >> Worksite Health Promotion (last updated 12.4.14)

Policy Problem

Poor health among workers and their families results in lower productivity on the job and/or sick days, along with higher expenses for health benefits, workers compensation, sick leave or other health-related benefits/expenses.  The worksite role in maintaining indoor air quality,  occupational safety and health and prevention (e.g., clinical preventive services, high blood pressure control) are covered elsewhere.  This section focuses on comprehensive programs that encourage healthier lifestyles.

Policy Options

There is a wide range of practices that can improve employee health by controlling tobacco use, encouraging physical activity and healthy eating.

Policy Considerations

• Partnership for Prevention. Leading by Example. CEOs on the business case for worksite health promotion.
• Partnership for Prevention. Communication series featuring business leaders, public health experts, and policy makers speaking on the benefits of creating healthy worksites and promoting employee wellness. Click here for podcasts.

Policy Recommendations

• Centers for Disease Control and Prevention. Healthy People 2010 includes two major worksite-specific objectives related to health promotion. The first is for 75% of employers (regardless of size) to offer a comprehensive employee health promotion program. The second, and related, objective is to have 75% of employees participating in employer-sponsored health promotion activities.  There also are more specific worksite objectives related to offering:
  • Nutrition/weight management classes
  • Physical activity and fitness programs
  • Programs to prevent or reduce employee stress
  • Reducing deaths from work-related homicides
  • Reducing the proportion of nonsmokers exposed to environmental tobacco smoke
  • Increasing the proportion of worksites that prohibit smoking or limit it to separately ventilated areas.
  • Other recommendations regarding environmental health (improving indoor air quality), health protection (reducing deaths and injuries related to work-related accidents, reducing injuries from work due to overexertion or repetitive motion, reducing occupational eye injury and increasing the use of appropriate ear protection devices, equipment, and practices), may also improve employee health, but are not addressed in this section.

• Partnership for Prevention. Investing in Health: Evidence-Based Health Promotion Practices for the Workplace. Provides employers with guidance for establishing health promotion practices in the workplace. These practices improve employee health by controlling tobacco use, promoting cancer screening and early detection, and encouraging physical activity and healthy eating.
• Partnership for Prevention. Healthy Workforce 2010: An Essential Health Promotion Sourcebook for Employers, Large and Small. Strategies and rationale for investing in worksite health promotion.

Implementation

• Healthy People 2010. As of 1999, roughly one third of employers under 250 workers and half with 750 or more workers had comprehensive employer-sponsored health promotion programs. As of 1994, 61 percent of employees aged 18 years and older participated in employer-sponsored health promotion activities.

Analysis

• Baxter S, Sanderson K, Venn AJ, Blizzard CL, Palmer AJ. The relationship between return on investment and quality of study methodology in workplace health promotion programs. Am J Health Promot. 2014;28:347–363. This systematic review of the literature featured, 61 studies; 47 of those studies were of traditional workplace wellness programs while 14 were of dental and clinical medical programs that happened to be offered in work settings. Of the 47 traditional workplace wellness programs, 46 saved money and 41 saved more than they cost, i.e., 41 had a positive ROI (ROI = Benefits/Costs). Among the 9 randomized controlled trials of traditional workplace wellness programs, the mean ROI was 1.79 to 1.00, even when the single study that showed a negative ROI was included. That study (2) had an ROI of -3.3. Without that study, the mean ROI of the randomized controlled trials would have been 2.28 to 1.00.
• Goetzel, Ron Z., Enid Chung Roemer, Karen Butcher Kent, and Kristyn J. Smith. Comprehensive Worksite Health Promotion Programs (April 2013)
  • Read the full report
  • Read the cost savings analysis supplement
  • American Institutes for Research report (1012.60KB PDF)
  • Institute for Health and Productivity Studies report (1.39MB PDF)
  • Institute for Health and Productivity Studies analysis supplement (924.50KB PDF)
• Goetzel, R.Z., Pei, X., Tabrizi, M.J. et al. Ten modifiable health risk factors are linked to more than one-fifth of employer-employee health care spending. Health Aff (Millwood). 2012; 31: 2474–2484.

Resources

• U.S. Occupational Safety and Health Administration
• American College of Occupational and Environmental Medicine
• North Carolina Occupational Safety and Health Education and Research Center. This listserv provides free, electronic, international forum for  Occupational & Environmental Medicine (OEM), including news and discussion about OEM (media, scientific publications, regulations, legal cases), resources such as (grants, jobs, websites, conferences) and peer-review and consensus opportunities. An archive provides searchable access to all broadcast content from 1993.
• North Carolina Occupational Safety and Health Education and Research Center. Links to OEM resources.