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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