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The key questions about health promotion
are: What keeps people healthy? What aspects of the
material and social working and living environment serve
as resources? What experiences and learning processes
enable and motivate people to make an effort to stay
healthy? Health promotion at work is intended to help
healthier practices and behaviour at work to become
easier and more rewarding for all. Under a corporate
policy geared to promoting health, there should be
working conditions which are conducive to health and
which encourage the workforce to adopt healthy working
practices and lifestyles.
The need for better health promotion in the workplace is
highlighted by certain findings from Germany where the
days lost through illness and accidents in 1994 were
about 574 million working days; early invalidity: only
one-third of all employees in Germany work right up to
pensionable age. This major reduction in earning capacity
is dominated by diseases of the circulatory system and of
bones and muscles, psychiatric disorders, and cancer;
diseases of bones, joints and muscles, especially
rheumatic diseases; accidents: in 1989 there were 1775132
notifiable accidents in the Federal Republic of Germany,
leading to economic losses of resources amounting to DM
43200 million (about US$2900 million).Measuring the benefits
Like any other activity, health promotion must
be examined in terms of its cost-benefit and
cost-effectiveness, with regard to the company’s
health as well as its operating objectives. At the
planning stage, goal-oriented indicators should be
selected which over the course of time can determine to
what extend desired changes have taken place. So in the
case of health promotion at work there are always two
factors to be assessed: the health benefits and the
economic benefits. The main indicators which can be
recorded in order to determine the benefits of health
promotion will include: sick leave or periods of
incapacity for work: absenteeism: staff turnover;
occupational accidents; increased productivity; quality
of output; company image and sense of belonging to the
enterprise; and staff participation in improvements.
The following may be indicators of better working
conditions and individual; health benefits; improved
working atmosphere and communications; the number of jobs
with improved ergonomics (chairs, machines, software
etc.) and environmental strain reduced to a minimum; the
number of workers or groups attending health courses to
obtain additional qualifications; changes in individual
attitudes to health and modes of behaviour (such as
eating habits in the canteen); a decline in individual
risk factors.
The benefit and effectiveness indicators should then be
compared with the investment in personnel and material
resources devoted to health.
Approaches
The key characteristics can be summarized as
follows.
- Health promotion is a
process through which healthy and health-inducing
practices and types of behaviour are made more
rewarding for everyone in the enterprise.
- Health promotion
combines strategies for work-oriented and
behavioural change conducive to personal
development, healthy job design and reinforcement
of personal responsibility for health.
- Health promotion is
intended to reduce and eliminate disadvantages
for individuals and specified groups of workers
on a permanent basis.
- Humanitarian company
aims and a participatory management style create
a positive atmosphere for promoting health.
- The aims of health
promotion should be set out in terms which are
practical, which target-specific groups and which
are informed by an overall concept of health.
- The aims of health
promotion in an enterprise become more focused
and are more readily accepted when workers are
actively involved in all phases.
- Constant monitoring
and regular assessment of the costs and benefits
of health promotion provide arguments in favour
of a permanent in-house health policy.
It is an established fact
that improved employees’ participation and promotion
of a healthy lifestyle pay off both in economic and in
health terms. The more sophisticated such arrangements
are in an enterprise, the higher the quality of health
promotion will be in practice.
Dr. Karl Kuhn is Director and Professor at the
Federal Institute for Occupational Safety and Health,
Dortmund, Germany.
Excerpted from ‘World Health’
May-June 1997.
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