HEALTH PROMOTION IN THE WORKPLACE: FRAMING THE CONCEPT; REVIEWING THE EVIDENCE

The term “health promotion in the workplace” is a multidimensional concept that embraces at least two major philosophies about what health is and how it is influenced. The first philosophy sees health as largely the product of individual behaviour and as an individual responsibility. It may acknowledge the role of genetics and environment to some degree, but the type of health promotion arising from this set of beliefs focuses on individual behaviour. Consequently, the workplace is seen primarily as a venue through which various programmes can be delivered. Examples of programme areas are: fitness, stress management, smoking cessation, back care, weight reduction/nutrition, medication. The second philosophy sees health as being influenced by a number of forces, a significant number of which are outside the individual’s control. While acknowledging the individual’s responsibility for his or her own health, this set of beliefs focuses on the role of the environment. Consequently, the workplace is seen as an influence on health in its own right. The attention here tends to be on the organisation and design of work in both its physical and psychosocial dimensions. Any workplace claiming to “do” health promotion can be characterised by the subscription of its senior managers to one or other of these philosophies or, more commonly, to some blend of the two. The 1997 Luxembourg Declaration on Workplace Health Promotion in the European Union1 is an interesting document in this regard because it presents a “blended” philosophy as the ideal. Yet studies using the Luxembourg Declaration as a framework for research have revealed that by far the more common philosophy followed by organisations claiming to practice health promotion is that of focusing on the individual as opposed to the environmental.2 Be this as it may, it needs to be acknowledged that health, as we experience …