Workplace health promotion and employee health in Swedish municipal social care organizations

Aim

The aim of this explorative study was to investigate the employers’ management characteristics, their provision of workplace health promotion (WHP) measures, and employee satisfaction with WHP in relation to employee health in Swedish municipal social care organizations.

Subjects and methods

A cross-sectional design was used, and questionnaires were sent to top managers (representing the employer) and employees in a nationwide random sample of 60 of the 290 municipal organizations for the social care of elderly and disabled people in Sweden. The questionnaire data from the 60 managers were linked to aggregated employee data concerning self-rated health and satisfaction with WHP from a representative sample of 8,082 employees in the same organizations. All analyses were performed at the organizational level using independent t-test, Spearman’s rank correlation and multiple linear regression analysis.

Results

In the multivariate analysis, the organizational WHP index (i.e. local WHP projects and WHP coordinators), individual WHP index (i.e. health profile assessment, fitness activities and medical check-up), and the level of employees’ satisfied with WHP were associated with employee health (F?=?9.64, p?<?0.001, adjusted R ²?=?0.48). General organizational and management characteristics were, however, not statistically related to employee health.

Conclusion

The results suggest that the provision of individual-directed and organizational-directed health-specific measures were related to employee health in Swedish municipal social care organizations and, therefore, can be part of a comprehensive approach to address WHP.     

Employers' Perspectives on the Provision of Suitable Duties in Occupational Rehabilitation

The workplace based approach to occupational rehabilitation depends on the availability of, and employer willingness to provide suitable duties to workers with injuries who are either temporarily or permanently unable to perform their pre-injury work duties. Given the importance of suitable duties to the outcome of occupational rehabilitation, it is surprising that there has been no research that examines the feasibility of providing suitable duties from an employer perspective. Accordingly, this paper presents the results of a representative statewide survey of employers in New South Wales, Australia. Findings indicate that most employers experienced difficulty in providing suitable duties to their workers with injuries, and that small employers (<20 employees) experienced more difficulty than large employers. Workers' compensation bodies need to develop strategies to assist employers in this central task of occupational rehabilitation.     

Epidemiological surveillance: a management tool for occupational health

Epidemiological surveillance represents a practical and intuitive approach to preventing occupational disease and injury, yet it is underutilized in health care management. Through the systematic analysis of employee occupational health data, the epidemiological surveillance approach allows prompt identification of potential workplace hazards, identifies high-risk groups for targeting preventive efforts and provides a mechanism for evaluating interventions. Often, epidemiological surveillance can utilize existing data resources, making it a cost-effective tool. Epidemiological surveillance should be valuable in supporting management decisions relating to health promotion and disease prevention programs, as well as basic clinical needs of employees.     

Conflicting rationales for promoting health in the workplace

In the UK, state-sponsored health organizations argue that one of the main rationales for workplace health promotion is that of economic benefit to the employer. However, fundamental changes in the structure of the economy in the 1980s have created particular conditions whereby workplace health promotion can also be considered as a management control strategy. Here, the employer takes an interest in the health of its workforce primarily to deflect employee attention away from particular working patterns that are not conducive to sustaining employee health and well-being. The focus on employee health is negative, with labour being treated as a commodity to be exploited. In these circumstances, emphasis is placed on the responsibility of the individual employee for his/her health. It is only when an organization adopts a holistic approach to workplace health, manifesting itself in what has come to be known as human resource management, that labour's innate quality of having a potential that can be harnessed and developed is acknowledged. It is this innate quality that sets it apart from the other factors of production land and capital.     

Dutch monitor on stress and physical load: risk factors, consequences, and preventive action

OBJECTIVES: Due to recent changes in legislation on occupational health and safety, a national monitor on stress and physical load was developed in The Netherlands to monitor (a) risks and consequences of stress and physical load at work, (b) preventive actions in companies to reduce these risks, and (c) organisational and environmental variables that facilitate preventive actions. METHODS: Information was gathered from employers, employees, and employees' representatives. The monitor was used with a nationally representative sample of companies in industry, wholesale trade, and banking and finance, 782 companies in total. RESULTS AND CONCLUSIONS: The information from the employees, aggregated at the company level, was not found to be correlated with that from the employer from the same companies. Although many employers do recognise risk factors for both physical load and stress as a problem they often seem to underestimate the problem when compared with employees or their representatives. This is particularly the case for psychosocial risk factors. Also, the perception of outcome measures, especially employers who consider emotional exhaustion to be work related, were fewer than the employees' representatives of the same organisation. Preventive measures on physical load are much more popular than measures against stress. It is the responsibility of the employer to take more preventive action of all kinds. They need to recognise risk factors as problems and health outcomes to be related to work. Employees of larger companies should participate with employers to consider effective measures, and more use should be made of support at branch level. For specific preventive measures, specific predictors emerged. Except for measures to prevent work stress, information from employees did not sufficiently contribute to the initiation of preventive measures in the workplace.

 

     

Impact of Bipolar Disorder on Employers

Among the typical employer’s workforce, there are employees with various physical and psychological conditions that may affect their healthcare costs and productivity. One such condition, bipolar disorder, is especially costly. Despite many available treatments, a large portion of bipolar disorder-related costs are not related to direct healthcare expenditures, but rather are indirect expenditures related to lost productivity. Thus, ensuring that employees who exhibit symptoms of bipolar disorder receive a timely and correct diagnosis followed by appropriate treatment may prove cost effective. To accomplish this, employer-sponsored health plans should have adequate resources to provide treatment to employees and dependents with bipolar disorder and use evidence-based guidelines to treat the disorder. Increasing awareness of bipolar disorder through education and training in the workplace or the establishment of employee assistance programs may help link those with the disorder to treatment. The provision of reasonable workplace accommodations to employees with bipolar disorder may increase productivity, resulting in additional savings. The coordination of all health plan programs and related services provided to employees is an important consideration. By becoming knowledgeable about bipolar disorder and its treatments, employers can better work with insurers, health management vendors, and intermediary organizations to provide worksite and health plan programs to assist their affected employees.     

Smoking cessation in the workplace: results of an intervention programme using nicotine patches.

In the workplace, employees need to be protected from the health threats of exposure to environmental tobacco smoke. There is a significant cost to employers associated with employee smoking at work, yet the uptake and development of a well-defined policy on smoking are not widespread, and few policies tackle the issue through promotion of smoking cessation. Such an approach could not only reduce costs associated with smoking at work, but also have a direct impact on public health. GlaxoSmithKline has implemented a voluntary programme of smoking cessation support for its employees in the UK. The 10 week programme offers a series of one-to-one support sessions with a trained occupational health adviser, as well as access to nicotine replacement therapy patches. At 12 months (n = 123), 25 participants (20%) were non-smokers, of whom 19 (15%) stated that they had not smoked at all for the 12 month period. The other six (5%) had relapsed, but had since tried again and quit successfully. An additional three (2%) classed themselves as non-smokers but still smoked occasionally. Fifty-two per cent of participants stated that regular face-to-face contact and monitoring of progress were particularly useful in helping them to stop smoking. This provides compelling support for the active promotion and support of smoking cessation among employees.     

Heart check: the development and evolution of an organizational heart health assessment

PURPOSE: The purpose of this article is to document the development, testing, and application of an organizational assessment tool used to measure employer support for heart health. Additional information is presented on its future research and applications plan. DESIGN: This article represents the pooling of results from multiple studies using a variety of designs, including pilot tests, cross-sectional analyses, and quasi-experiments. SETTING: Worksites covering the spectrum of employers across industry types and size, and throughout all of New York State. SUBJECTS: Over 10,000 New York employees and 1000 New York employers are represented in the multiple phases of this research. MEASURES: Heart Check is a 226-item inventory designed to measure such features in the worksite as organizational foundations, administrative supports, tobacco control, nutrition support, physical activity support, stress management, screening services, and company demographics. Additional side studies used professional judgments and behavioral surveys. RESULTS: As an assessment tool Heart Check shows evidence for reliability and validity. Applications of the instrument show characteristics that define high-scoring companies, quasi standards for New York employers, and, when applied during interventions, positive changes in organizational support levels. CONCLUSIONS: A relatively inexpensive, easy-to-use, and metrically tested instrument exists for measuring the construct of organizational support for employee heart health. The instrument shows promise as part of a system to enhance heart health through public health-based interventions in the workplace.     

Quality assessment in worksite health promotion.

The rapid expansion of worksite health promotion programs and the proliferation of service providers have resulted in increased concern about the quality of such programs. And while employers may view health promotion programs as a service to be purchased, in general, quality standards, price, and outcomes are less well established for primary prevention programs than for other medical services. This trend creates substantial potential for inappropriate expenditures, undermining the general credibility of such programs. Recognizing the limits of epidemiologic data and the potential for misuse of health promotion activities in the workplace, the California Department of Health Services (CDHS) undertook the development of guidelines for employers' use in assessing the quality of the numerous employee health promotion or chronic disease risk reduction programs available to them. To make the use of such programs as productive as possible, the CDHS developed recommendations in two main areas: (1) general recommendations for six fundamental program planning and development activities that underlie sound health promotion programs, and (2) specific criteria for seven types of health promotion programs commonly implemented in work settings. Optimally, worksite-based health promotion programs should be part of a comprehensive effort that provides for appropriate medical oversight, referral, and follow-up procedures. These programs should be complemented by appropriate changes in the work environment and in organizational policies. Programs should also include strategies to assist employees in initiating healthier behaviors and maintaining the new behaviors once they are established. Preventive medicine and occupational medicine practitioners and medical directors should be familiar with the issues addressed by these recommendations.     

Premium growth and its effect on employer-sponsored insurance

We use variation in premium inflation and general inflation across geographic areas to identify the effects of downward nominal wage rigidity on employers’ health insurance decisions. Using employer level data from the 2000 to 2005 Medical Expenditure Panel Survey-Insurance Component, we examine the effect of premium growth on the likelihood that an employer offers insurance, eligibility rates among employees, continuous measures of employee premium contributions for both single and family coverage, and deductibles. We find that small, low-wage employers are less likely to offer health insurance in response to increased premium inflation, and if they do offer coverage they increase employee contributions and deductible levels. In contrast, larger, low-wage employers maintain their offers of coverage, but reduce eligibility for such coverage. They also increase employee contributions for single and family coverage, but not deductibles. Among high-wage employers, all but the largest increase deductibles in response to cost pressures.     

Disability at Work: A Look Back and Forward

Purpose This article presents new evidence on employment barriers and workplace disparities facing employees with disabilities, linking the disparities to employee attitudes. Methods Analyses use the 2006 General Social Survey to connect disability to workplace disparities and attitudes in a structural equation model. Results Compared to employees without disabilities, those with disabilities report: lower pay levels, job security, and flexibility; more negative treatment by management; and, lower job satisfaction but similar organizational commitment and turnover intention. The lower satisfaction is mediated by lower job security, less job flexibility, and more negative views of management and co-worker relations. Conclusion Prior research and the present findings show that people with disabilities experience employment disparities that limit their income, security, and overall quality of work life. Technology plays an increasingly important role in decreasing employment disparities. However, there also should be increased targeted efforts by government, employers, insurers, occupational rehabilitation providers, and disability groups to address workplace barriers faced by employees with disabilities, and by those with disabilities seeking to return to work.     

Workplace health promotion and labour market performance of employees

This paper investigates the average effects of firm-provided workplace health promotion measures on labour market outcomes of the firms’ employees. Exploiting linked employer–employee panel data that consist of rich survey-based and administrative information on firms, workers and regions, we apply a flexible propensity score matching approach that controls for selection on observables and time-constant unobserved factors. While the effects of analysing sickness absenteeism appear to be rather limited, our results suggest that health circles/courses increase tenure and job stability across various age groups. A key finding is that health circles/courses strengthen the labour force attachment of elderly employees (51–60), implying potential cost savings for public transfer schemes such as unemployment insurance or early retirement schemes.     

Return to Work Following Breast Cancer Treatment: The Employers’ Side

Purpose Research on employers’ experiences with return to work (RTW) of employees with breast cancer is lacking. Employers seem to be the key people to create good working conditions. Our aim is to explore how Belgian employers experience their role and responsibility in RTW of employees with breast cancer. Methods Using a qualitative design (Grounded Theory) 17 employers from the public (7), private (5) and non-profit (5) sector, directly involved in the RTW process, were interviewed. The analysis was based on the Qualitative Analysis Guide of Leuven (QUAGOL) with constant data comparison and interactive team dialogue as important guiding characteristics. Results RTW of employees with breast cancer is experienced by employers as an intangible process that is difficult to manage. This was expressed in (1) concern, referring to the employer’s personal and emotional involvement, (2) uncertainty about the course of illness and the guidance needed by the employee and (3) specific dilemmas in the RTW process (when does one infringe on employee privacy; employee vs. organization interest; employers’ personal vs. professional role). The degree to which this was experienced related to variety in organizational, employer, and employee factors. Conclusions The findings of this study confirm the importance of the employer’s involvement in RTW of employees with breast cancer and contribute to a better understanding of its complexity. The employers did their best to grasp the intangibility of the RTW process. Further research is needed to refine these findings and to discover the specific needs of employers regarding supporting RTW of breast cancer patients.     

Privacy in occupational health practice: promoting and impeding factors

AIM: This article describes the views of occupational health professionals, employees, and employers on factors that are thought to promote and impede privacy in occupational health practice. METHODS: The data were collected through theme interviews with 44 subjects and were analysed by content analysis. RESULTS: Both promoting and impeding factors organized around two content areas: "caregiving" (patient-caregiver relationship) and "tripartite cooperation" (cooperation between occupational health professionals, employees, and employer). The content areas illustrated the two different roles Finnish occupational health professionals have toward their two groups of clients: employees and employers. "Adequate behaviour" (respect, good communication, presence) and "Adequate knowledge base" (instinct, work experience, ethical thinking, knowledge of legislation) promoted privacy in caring relationship, whereas "Inadequate behaviour" (untrustworthy, busy, distant, "friend") impeded its realization. In tripartite cooperation, the promoting factors had to do with "Common good" (impartiality, regular contacts, community spirit, fair play) and "Individual good" (informed consent, advocacy). The main category, "Confusions in loyalties", emerged from three subcategories (confusions in confidentiality, confusions in duties, and confusions in roles) illustrating the impeding factors in tripartite cooperation. CONCLUSIONS: Questions of privacy are crystallized in occupational health professionals' diverse duties and roles towards employees and employers. In occupational health practice, privacy cannot be seen only as a privilege of employees, but must also be viewed as an instrumental value serving the interests of employers and whole work community. Confusions in loyalties need more discussion and research before privacy can be optimally realized. Lapses in confidentiality should never happen.     

Peer Reviewed: Workplace Health Promotion in Washington State

The workplace is a powerful setting to reach large numbers of at-risk adults with effective chronic disease prevention programs. Missed preventive care is a particular problem for workers with low income and no health insurance. The costs of chronic diseases among workers — including health care costs, productivity losses, and employee turnover — have prompted employers to seek health promotion interventions that are both effective and cost-effective. The workplace offers 4 avenues for delivering preventive interventions: health insurance, workplace policies, health promotion programs, and communications. For each of the avenues, the evidence base describes a number of preventive interventions that are applicable to the workplace. On the basis of the evidence and of our work in Washington State, we present a public health approach to preventing chronic diseases via the workplace. In addition to relying on the evidence, this approach makes a compelling business case for preventive interventions to employers.     

Lebensqualit?t und k?rperliche Aktivit?t im betrieblichen Kontext

Background

An efficient and hard working employee is one of many requirements an employer depends on to remain competitive in today??s economy. Yet growing mechanisation facilitates the daily routine continuously. Increased sedentary work and media consumption pander to today??s inactivity and the many risk factors it is connected to. It is essential to respect the protection and promotion of each employee??s health and well-being. Hence, occupational health management, i.e. workplace health promotion, occupational rehabilitation and occupational safety, may come into play as it controls and integrates all processes at work.

Method

Employees of a medium-sized company (n = 221) were examined to determine their individual physical and psychological condition. The relation between physical demands on the job, health-related quality of life and level of physical activity is the focus of this study. The quality of life questionnaire, a questionnaire regarding sports activity, a questionnaire concerning physical demands on the job and the IPN test were used for gathering the data.

Results

Overall, physically active persons show significantly better data in the physical, social, psychological and contextual test range. Further, physically active employees are more satisfied with their state of health and contribute to the business success to a greater extent.

Conclusion

It appears fundamental that companies should also be instrumental in raising employees?? awareness of physical activity as a balance to everyday life and its effects on health and well-being. A commitment to more physical activity and exercise offers an opportunity to influence the quality of life strongly.     

Employee perceptions of workplace health and safety issues. Can a questionnaire contribute to health needs assessment?

A questionnaire survey was conducted to determine attitudesand perceptions of employees of a Scottish local authority ofthe role of occupational health services. Questions were includedcovering the following areas: influences on health, the effectof the workplace on health, satisfaction with work and workingconditions, the role of occupational health services, and personalhealth experience. Most of the survey respondents believed thatthe prime function of an occupational health service is to ensurea safe working environment. However, it was indicated that managementhas responsibility for employee welfare at work and that anapprorpiate management structure to address safety issues shouldbe accessible. In addition, employees would like the occupationalhealth service to provide some health promotional activities,particularly stress management courses and the opportunity forexercise.     

Employers’ Perspectives on Accommodating and Retaining Employees with Newly Acquired Disabilities: An Exploratory Study

Introduction Timely and appropriate accommodations can help employees who experience disabilities stay at work instead of exiting the labor force. Employers can play a critical role in connecting such workers with the accommodations they need. This qualitative study seeks to inform policy makers who want to improve workforce retention outcomes by uncovering factors that affect whether employers provide accommodations to, and ultimately retain, employees with disabilities. Methods We conducted semistructured interviews with a convenience sample of human resources professionals in 14 Arkansas-based employers, yielding detailed information on 50 cases in which an employee developed or disclosed a disability. We analyzed the interviews using a grounded theory approach and compared cases to identify key themes emerging across subgroups of cases. Results Two organization-level factors and four employee-level factors influenced employers’ efforts to accommodate and retain employees with disabilities: employer resources; employers’ communication with the employee and other stakeholders; employee tenure; employee work performance; active/sedentary nature of employee role; and the severity and type of employees’ health conditions. Conclusions Consistent with prior literature, employers with greater access to resources and better ability to communicate generally made greater effort to accommodate and retain employees with disabilities. However, employers in the study did not deploy these resources and processes consistently when making decisions about whether and how to provide accommodations to workers with disabilities; employee-level characteristics affected their actions. Policy makers should consider intervention approaches that reach workers who may be overlooked by employers with scarce resources.     

Promoting mental health through employment and developing healthy workplaces: the potential of natural supports at work

In England, policy developments in the field of mental health are stimulating interest in employment for mental health service users as a means of mental health promotion. To date, research that might assist in increasing employment rates amongst this group has focused largely on the question of which service users are most likely to benefit from vocational interventions and, more recently, on models of vocational support. Less is known about how employers can assist people in their transition or return to work. In this article we draw on the accounts of 17 employment project clients to identify workplace factors that were associated with job retention. Specific adjustments such as flexibility about working hours, work schedules and job tasks emerged as crucial in enabling clients to deal with the effects of medication, and to regain stamina and confidence. Over and above these, however, 'natural supports' of a kind from which any employee would arguably benefit were equally important. In this respect the main themes revolved around training and support to learn the job, supportive interpersonal relationships at work, workplace culture, and approaches to staff management. These themes might equally provide a productive focus for workplace health promotion more generally, using organization development approaches.     

The impact of a prospective survey-based workplace intervention program on employee health, biologic stress markers, and organizational productivity

OBJECTIVE: To study whether knowledge about psychosocial work indicators and a structured method to implement changes based on such knowledge comprise an effective management tool for enhancing organizational as well as employee health and well-being. METHODS: White- collar employees representing 22 different work units were assessed before and after a 1-year intervention program. Subjective ratings on health and work environment, biologic markers, absenteeism, and productivity were measured. RESULTS: Significant improvements in performance feedback, participatory management, employeeship, skills development, efficiency, leadership, employee well-being, and work-related exhaustion were identified. The restorative hormone testosterone increased during the intervention and changes correlated with increased overall organizational well-being. Absenteeism decreased and productivity improved. CONCLUSIONS: Fact-based psychosocial workplace interventions are suggested to be an important process for enhancing employee well-being as well as organizational performance.