Symposium: If Health Promotion Is So Smart, Why Isn't Everyone Doing It?

But even as momentum builds to address worker health both on and off the job, the conference spent the most time addressing the barriers -- particularly from the employee perspective -- that must be overcome for the integration effort to succeed.

While corporate representatives who spoke at the May 13 symposium lamented the management "silos" blocking health promotion, Laura Welch, M.D., from the Center to Protect Workers' Rights, identified three concerns often raised by employees about health promotion programs:

• Too much focus on health costs rather than employee benefit;
• Corporate paternalism;
• Privacy.

The latter point sparked a lively discussion during the question-and-answer period of the conference. "I think the privacy concerns raised by Dr. Welch are really important," commented Devra Golbe, an economist at Hunter College. "I don't want my employer to know I'm depressed, diabetic and eat a lot of junk food and so next week I'm going to have a heart attack." Golbe argued that if employers reach the conclusion that illnesses raise health care costs and hurt productivity, workers could be punished for being sick.

"But what if there were factors at work that contributed to your depression?" asked Greg Welch of the National Institute for Occupational Safety and Health, who moderated the discussion. "Your relationship with your supervisor, an inflexible work schedule -- would you like to have those issues dealt with at work?"

From a cost standpoint, the issue of depression is critical, because individuals with high risk for depression have 70.2 percent higher costs than those at lower risk, according to another symposium speaker, Peter Hayes, director of health strategy for Hannaford Bros. Co. Yet because of the stigma surrounding mental illness, depression is precisely the sort of disease that raises privacy concerns.

Hayes and Michael Gondek, corporate medical director at the Dow Co., stressed that a key element in their companies' successful integration effort is that employees recognized the goal was better health -- not lower costs.

"If employees believe this is just a way for the company to save money, you're going nowhere," said Gondek.