Barriers in Workplace Health Programs Remain, Study Says

Although worksite programs designed to change modifiable health risk factors such as obesity and smoking have lead to better health for employees and decreased health care costs for employers, barriers to participation in health promotion/disease prevention (HP/DP) programs remain, according to an article in the June issue of the Journal of Occupational and Environmental Medicine.

"To be most effective, HP/DP programs should be integrated into the traditional health protection mission of occupational health and safety professionals," said Tamara M.K. Schult, MPH, of the University of Minnesota.

Schult was one of three authors who reviewed the role of key stakeholders such as employers, employees and health plans in relation to the barriers and incentives found in providing HD/DP programs.

Participation Rates Are Low

In 1999, some type of health promotion activity was reported by 95 percent of companies with more than 50 employees. Participation rates today in HD/DP programs, though, are low, as the article's authors note that programs are not always targeted to the employees who need them most and smaller companies are unable offer them due to limited purchasing power and resource restraints.

According to the article, other barriers to investing in employee health are that the benefits might be intangible or might not be realized for years. Federal insurance regulations can pose barriers as well for example, employers are restricted from rewarding employees who make positive health changes.

The authors of the article suggest that partnering with health plans might avoid some of the confidentiality and other barriers to worksite HP/DP programs.

Barriers Exist, But the Incentives Are There

There are incentives for employers to invest in HP/DP programs.

The need for company owners and managers to control continually rising health costs is a powerful incentive to participate in HP/DP programs, said Schult. In addition, many companies are shifting to a "human capital approach," recognizing that improvements in worker health can lead to gains in corporate performance.

The success of health promotion programs ultimately depends on employee participation, the article notes.

It has been debated that shifting health costs from employers to employees will give workers incentives to decrease their costs, but this has yet to be proven. Despite the obvious benefits of improved health, many people do not want to change their behavior, even if they're aware of the health risks.

Several studies have found that other incentives are needed to increase employee participation in HP/DP programs.

Historically, the federal government has provided only modest support for prevention, including HP/DP programs. Signs that this might be changing include the National Institute for Occupational Safety and Health's "Steps to a Healthier U.S. Workforce Initiative," designed to integrate healthy lifestyle promotion into workplace safety initiatives.

"The Time is Right" for OH Professionals to Get Involved

For professionals in the occupational health fields, HP/DP programs offer an opportunity to expand their role. By broadening their traditional emphasis on environmental health and safety, occupational health professionals can incorporate risk-reduction strategies into a spectrum of services supporting a healthy work environment and managing employee health.

"The time is right for occupational and environmental physicians to vigorously collaborate with all the key stakeholders in HP/DP to create the integrated health protection and promotion programs of the 21st century," the authors conclude.

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