Health Promotion in the Workplace – The Merging of the Paradigms

Summary

Purpose: To synthesize the lessons from both occupational health and health promotion, to improve workplace health.

Approach: This article briefly outlines the evolution in defining and understanding health promotion as well as current thinking in occupational health and safety.

It also discusses an approach taken in the healthcare sector in British Columbia, Canada, where evidence-based practices and collaboration became the cornerstones to bringing about change and achieve impressive cost-beneficial results in healthcare workforce health.

Conclusion: Traditionally, workplace health promotion and occupational health and safety have been two solitudes. Workplace health promotion is rooted in ‘wellness’ and healthy lifestyle choices, while occupational health is heavily dictated by workplace health and safety requirements and legislation. Recently however, there has been increasing recognition of the need for a more holistic approach that focusses on workplace culture, addressing both primary and secondary prevention [1], as well as interventions aimed both at the individual as well as the organisation [2].

Keywords

Health promotion - occupational health - environmental health - health care

• References

• 1 Yassi A, Ostry A, Spiegel J. Injury prevention and return to work: Breaking down the two solitudes. In. Sullivan T, Frank JW. editors New Views on Preventing Work-Related Disability: Taylor & Francis Books Ltd. 2003: 75-86.
• 2 Poland B, Green L, Rootman I. Settings for health promotion: Linking theory and practice. 1st ed. Thousand Oaks: Sage; 2000
• 3 World Health Organization. Chronicle of the World Health Organization: Development and constitution of the W.H.O.: Volume 1. Geneva: WHO; 1948
• 4 LaLonde M. A new perspective on the health of Canadians: A working document. Ottawa: Ministry of Health and Welfare; 1974
• 5 Marmor TR, Mashaw J. Strategy for survival: change and stability in the management of healthcare institutions. Health Management Quarterly 1994; 16 (04) 5-8.
• 6 World Health Organization. Ottawa charter for health promotion. In: First International Conference on Health Promotion; 1986 November 21. Ottawa: 1986
• 7 Nutbeam D. Health promotion glossary (original health promotion glossary). Health Promotion 1986; 1 (01) 113-27.
• 8 Hancock T. Health, human development and the community ecosystem: three ecological models. Health Promotion International 1993; 8: 41-7.
• 9 Starfield B, Shi L. Determinants of health: Testing a conceptual model. In. Adler NE, Marmot M, McEwen BS. et al. editors. Socioeconomic Status and Health in Industrial Nations: Social, Psychological and Biological Pathways. New York: NY: New York Academy of Sciences; 1999: 344-6.
• 10 Hamilton N, Bhatti T. Population health promotion: An integrated model of population health and health promotion. Health Canada, Health Promotion Department Division; 1996
• 11 Spiegel J, Labonte R, Hatcher-Roberts J. et al. Tackling the 10–90 gap: A report from Canada. Lancet 2003; 362 9387 917-8.
• 12 Labonte R, Spiegel J. Setting global health research priorities. British Medical Journal 2003; 326: 722-3.
• 13 Yassi A, Mas P, Bonet M. et al. Applying an ecosystem approach to the determinants of health in Centro Habana. Ecosystem Health 1999; 5 (01) 3-19.
• 14 Forget G, Lebel J. An ecosystem approach to human health. International Journal of Occupational and Environmental Health 2001; 7 (02) Supplement S33-38.
• 15 Green LW, Kreuter MW. Health promotion planning: An educational and ecological approach. 3rd ed. Mountain View, CA: Mayfield; 1999
• 16 Amick III BC, Habeck RV, Hunt A. Measuring the impact of organizational behaviours on work disability prevention and management. Journal of Occupational Rehabilitation 2000; 10 (01) 21-38.
• 17 Yassi A, Ostry AS, Spiegel J. et al. A collaborative evidence-based approach to making healthcare a healthier place to work. Hospital Quarterly 2002; 5 (03) 70-8.
• 18 Koehoorn M, Lowe GS, Kent VR. et al. Creating high quality healthcare workplaces. Vancouver: Canadian Policy Research Networks discussion paper. 2002
• 19 Norman R, Wells R. Ergonomic interventions for reducing musculoskeletal disorders. In. Sullivan T. editor. Injury and the New World of Work. Vancouver: BC: UBC Press; 2000: 115-39.
• 20 Sullivan T, Kerr M, Ibrahim S. Job stress in healthcare workers: Highlights from the national population health survey. Hospital Quarterly. 1999. (summer) 34-40.
• 21 O'Brien-Pallas L, Thomson D, Alksnis C. et al. The economic impact of nurse staffing decisions: Time to turn down another road?. Hospital Quarterly 2001; 4 (03) 42-50.
• 22 Siegrist J. Adverse health effects of high effort – low reward conditions at work. Journal of Occupational Health Psychology 1996; 1: 27-43.
• 23 de Jong J, Bosma H, Peter R. et al. Job strain, effort- reward imbalance and employee well-being: a large scale cross-sectional study. Social Science & Medicine 2000; 50: 1317-27.
• 24 Lowe GS. High-quality healthcare workplaces: A vision and action plan. Hospital Quarterly 2002; 5 (04) 49-56.
• 25 Gleason SJ, Sochalski J, Aiken L. Review of magnet hospital research: Findings and implications for professional nursing practice. Journal of Nursing Administration 1999; 29: 32-42.
• 26 Yassi A, Ostry A. The impact of healthcare organizational factors on nurse health, well-being, recruitment and retention in the South Fraser health region of British Columbia. Vancouver, BC: British Columbia Nurses Union; 2003
• 27 Shannon HS, Robson LS, Guastello SJ. Methodological criteria for evaluating occupational safety intervention research. Safety Science 1999; 31: 161-79.
• 28 WCB. Focus Report on Occupational Injury and Disease. Vancouver: Workers Compensation Board of British Columbia. 2002
• 29 Hsu L-L, Lee C-C. Green JA. et al. Severe acute respiratory syndrome (SARS) in Singapore: Clinical features of index patient and initial contacts. Emerging Infectious Diseases 2003; 9: 06.
• 30 Centers for Disease Control and Prevention. Outbreak of severe acute respiratory syndrome – worldwide 2003. Morbidity and Mortality Weekly Report 2003; 52: 226-8.
• 31 Booth CM, Matukas LM, Tomlinson GA. et al. Clinical features and short-term outcomes of 144 patients with SARS in the greater Toronto area. Journal of the American Medical Association. 2003: 289.
• 32 Lee N, Hui D, Wu A. et al. A major outbreak of severe acute respiratory syndrome in Hong Kong. New England Journal of Medicine 2003; 348: 1986-94.
• 33 Menzies D, Fanning A, Yuan L. et al. Hospital ventilation and risk for tuberculous infection in Canadian health care workers. Annals of Internal Medicine 2003; 133 (010) 779-89.
• 34 Jagger J, De Carli G, Perry J. et al. Occupational exposure to bloodborne pathogens: Epidemiology and prevention. In. Wenzel R. editor. Prevention and Control of Nosocomial Infections. 4th ed. Baltimore: Lippincott, Williams and Wilkins; 2003
• 35 Yassi A, McGill ML, Khokhar JB. Efficacy and cost-effectiveness of a needleless intravenous access system. American Journal of Infection Control 1995; 23 (02) 57-64.
• 36 Yassi A. Managing chemical hazards in hospitals. In chapter: Health Care Facilities and service. In. Stellman JM. editor. The Encyclopaedia of Occupational Health and Safety. Geneva: International Labour Office; 1998: 97-9.
• 37 Weaver V. Chemical hazards in health care workers. Occupational Medicine 1997; 12 (04) 655-77.
• 38 Canadian Institute for Health Information. Canada’s healthcare Providers. CIHI: Toronto; 2001
• 39 Workers’ Compensation Board of British Columbia. Statistics 2002. Vancouver: WCB of BC. 2002
• 40 Lomas J. Connecting research and policy ISUMA. Spring; 2000: 140.
• 41 Yassi A, Cohen M, Pollak N. et al. The relationship of work environment and injuries to resident care staff in intermediate care. Accepted to Nursing Research. 2003
• 42 Ronald LA, Yassi A, Spiegel J. et al. Effectiveness of installing overhead ceiling lifts. Reducing musculoskeletal injuries in an extended care hospital unit. American Association of Occupational Health Nurses Journal 2002; 50 (03) 120-7.
• 43 Spiegel J, Yassi A, Ronald LA. et al. Implementing a resident lifting system in an extended care hospital. Demonstrating cost-benefit. American Association of Occupational Health Nurses Journal 2002; 50 (03) 128-34.
• 44 OHSAH. OHSAH value report. Vancouver: Occupational Health and Safety Agency; 2003 September. 2003
• 45 Engst C, Chokar R. et al. Effectiveness of overhead lifting devices in reducing the risk of injury to care staff in extended care facilities. Ergonomics 2005; 48 (02) 187-99.
• 46 Holliday PJ, Fernie GR, Plowman S. The impact of new lifting technology in long-term care. American Association of Occupational Health Nurses Journal 1994; 42: 582-9.
• 47 Villeneuve J. The ceiling lift: An efficient way to prevent injuries to nursing staff. Journal of Healthcare Safety, Compliance and Infection Control. 1998: 19-24.
• 48 OHSAH. Meeting the challenge: Funding for lifts is on its way. Vancouver: Occupational Health and Safety Agency for Healthcare; 2001 August.
• 49 Yassi A, Noble MA, Daly P. et al. Severe acute respiratory syndrome. Guidelines were drawn up collaboratively to protect healthcare workers in British Columbia. British Medical Journal 2003; 326: 1394-5.
• 50 Office of the Auditor General of BCInformation Use by the Ministry of Health in Resource Allocation Decisions for the Regional Health Care System. Victoria: Government of British Columbia; 2001: 02..
• 51 Shannon HS, Robson LS, Sale JEM. Creating safer and healthier workplaces: Role of organizational factors and job characteristics. American Journal of Industrial Medicine 2001; 40: 319-34.
• 52 Parker M, Gadbois S. Building community in the healthcare workplace, Part 4: Partnering with union members to create community. Journal of Nursing Administration 2000; 30 (11) 524-9.
• 53 Johansson M, Partanen T. Role of trade unions in workplace health promotion. International Journal of Health Services 2002; 32 (01) 179-93.
• 54 Baril R, Clarke J, Friesen M. et al. Management of return-to-work programs for workers with musculoskeletal disorders: a qualitative study in three Canadian provinces. Social Science & Medicine 2003; 57: 2101-14.
• 55 Yassi A, Tomlin K, Sidebottom C. et al. Politics and partnerships: Challenges and rewards of partnerships in workplace health research in the healthcare sector of British Columbia, Canada. International Journal of Occupational and Environmental Health 2004; 10 (04) 360-7.