Health Status Improvement
Many employers today are launching worksite wellness programs. But are these efforts truly wellness programs? Read on to see why they may not be.
Within worksite wellness, I too often think we view issues as being either/or, rather than being inclusive. Most worksite wellness programs today are not about wellness at all, but rather improving the health status of individual employees. While our attention is focused on employee health status, this does not mean we can’t also start to deliver wellness type programming and interventions as well.
So what is the difference?
While there are a number of wellness definitions available to consider, I will use the definition and model put forth by the National Wellness Institute (NWI). NWI defines wellness as “an active process through which people become aware of and make choices toward a more successful existence.” The NWI model of wellness consists of six, interconnected dimensions:
• Physical
• Social
• Intellectual
• Spiritual
• Emotional
• Occupational
Like wellness, health is often described as being a multi-dimensional concept. Health is generally measured in terms of:
• Physical conditions such as pain, disability or condition likely to cause death
• Emotional conditions
• Social functioning
Health status is a snapshot of health at any one particular point-in-time. Health status can be measured at both the individual and population levels. Individual health status can be measured objectively through:
• The presence or absence of illness
• The presence or absence of risk factors
• The severity of any diseases present
• Overall perception of health
In the workplace, employee health status is generally measured through the use of health risk assessments and biometric screenings.
As best as I can determine, there is no absolute measure of health status. And because the measure of health status also includes overall perception of health, health status is also somewhat subjective.
By comparing the above definitions with the way worksite wellness is being practiced today, we can clearly see that what is being called wellness today is not really wellness, but really employee health status improvement (EHSI). So from my perspective, let’s stop calling what we do today worksite wellness and call it employee health status improvement or employee health improvement instead. Instead of creating phony worksite wellness programs, let’s instead focus on creating solid, effective EHSI programs instead.
Given today’s worksite wellness program focus almost exclusively on physical health, many of the concepts and practices already in place can be readily applied in the EHSI program model. Since health status is a function of disease states, risk factors and overall health perception, let’s focus the attention of EHSI programs on risk reduction, chronic disease management, medical self-care and helping employees to better perceive and act on their health status.
Since we are not faced with an either/or situation here, let’s also start to do wellness programs at the same time we are doing EHSI programs. EHSI programs will never equate to wellness because they are not designed to. At their best, EHSI programs are designed to avoid health problems. Prevention or avoidance alone will never yield wellness. Creating wellness requires the taking of deliberate actions to move beyond the point of prevention or no health risks. Prevention and avoidance are based on the pathogenesis model which will not, by itself, ever create wellness.
Recall the definition of wellness. Wellness is about creating opportunities for “a more successful existence.” Wellness is a process where employee health status is a static snapshot at one specific point-in-time. Wellness is closely aligned with the concept of salutogenesis, or the creation of opportunities for health.
Given that wellness is multi-dimensional, here are my present thoughts about what constitute wellness type programming in the workplace for each of the wellness dimensions:
• Physical – This domain will be covered by the EHSI program
• Social – Creating positive, supportive, employee first or employee centric organizational cultures and workplace climates; random acts of kindness; employee volunteer programs
• Intellectual – Brain health and fitness
• Spiritual – Helping employees find meaning and purpose in both work and life
• Emotional – Workplace mental health promotion; stress management; building resilience
• Occupational – Integration with employee safety; integration with employee training and development
I believe pathogenesis and salutogenesis represent different segments of the health – wellness continuum and can successfully co-exist by building off each other’s core principles. Employers can and should deliver both EHSI and worksite wellness programs.