At the broadest level, workplace health interventions can be categorized under occupational health and safety (OHS), or voluntary health practices, which are also referred to as individual lifestyle practices or personal health practices, and organizational culture (OC).
Broadly, the category of OHS refers to efforts to protect workers against health and safety hazards on the job.
It involves the establishment of programs, policies and standards that outline how an organization will recognize, assess and control hazards. The scope of OHS is broad, including things such as musculoskeletal disorders, housekeeping, machine guarding, fall protection, first aid, early and safe return to work and the roles of the joint health and safety committee.
As a health promoter, it is not expected that you will become an OHS expert. It's important however, to ensure the organization's overall health promotion strategy links with its OHS efforts. As well, for times when relevant OHS issues are identified, it's important you have an adequate referral network, internal partners or external partners who can help address the OHS side of the triangle.
If we refer back to the definition of CWHP, we see clearly that the efforts of employees to care for their own well-being are one of two critical components. The voluntary health practices side of the triangle represents the interventions, such as programs and policies that aim to positively influence lifestyle behaviours.
As you learn more about the CWHP approach you will see that a critical component is the implementation of a situational assessment. It's through this assessment that the priority issues and needs of both the organization and its employees should be identified. In a true CWHP approach, lifestyle interventions should only be implemented in response to such identified needs.
Lifestyle issues can include a wide variety of behavioural issues, including tobacco use, alcohol and drug use, nutrition, immunization, stress management and physical activity. There is some evidence of short-term changes in individual behaviour and even improvements in productivity as a result of this type of intervention.4 However, it is important to note that even if individual lifestyles can be successfully changed, health outcomes may not necessarily be improved, as health status is powerfully influenced by factors other than lifestyle.
We mentioned stress management as an example of a voluntary health practice. Stress management is important for each individual worker. However, with CWHP, it is the cause of stress we want to change, not just the way people respond to it. For example, in a conflict between employees and a supervisor, it's more effective to address the behaviours, systems or communication methods that are causing the conflict rather than teach the whole team stress management techniques. This idea of looking at the root cause of issues, such as stress, typically means looking at organizational culture.
There are many definitions of organization culture. What is common, however, is the notion of a set of shared values and norms that establish a standard for the way people interact with each other within the organization and with stakeholders outside the organization'.5 As such, when we are trying to make changes to culture we are trying to fundamentally change the common values, work practices and the way of interacting that are typically described as "the way things are done around here."
It is on this side of the triangle that you are seeking to change the working environment. Often, you are looking at specific interventions for things such as leadership style, management practices, work organization, employee autonomy and control and social supports. These factors have been shown to have a dramatic impact on employee health outcomes.
Organizational change projects have historically been undertaken to increase corporate productivity. More recently, the concept of cultural change has been moving into the realm of workplace health promotion because recent research has shown that many factors contributing to productivity are closely related to health.
Before moving on to the next module, take some time to review Dr. Graham Lowe's presentation, 'The Cultural Foundations of Health and Performance' at www.thcu.ca/Workplace/video/flash/presentation.cfm. In it, you will find more information and facts regarding organizational culture and its impact on the organization.
For more on organizational culture and change, see the THCU Info-packs:
Though most often separated in theory and practice, in reality these categories overlap. For example, cancer prevention is frequently discussed under the heading of voluntary health practices but is also an OHS issue since many workplace chemicals and other hazards may contribute to cancer. Stress, one of the most common workplace issues, crosses all three categories. Some lifestyle changes, or voluntary health practices, such as increased physical activity, may help reduce stress. But unless the cause of workplace stress, such as a hazardous work environment or an unwieldy workload due to organizational change, is removed, stress may not decrease significantly.
This cross over between categories leads to the depiction of the categories as overlapping circles instead of the sides of a triangle.
Whichever visual model you choose to apply, it's important to understand how the categories are unique in themselves and how they interrelate.