Saturday, January 18, 2014

Worksite Health Promotion: A Global Perspective

When Dr. Robert Karch first developed what is now the American University's Master's of Science Program in Health Promotion Management in the late 1970s, the curriculum was built almost exclusively on how worksite health promotion and community initiatives were practiced in the US. But some very progressive initiatives were taking place outside our borders, while other countries were struggling with issues someone else had already solved.

A Global Health Promotion Network

In 1996, with the help of about 30 people from 18 countries, the International Institute for Health Promotion (IIHP) was formed. It has grown to about 80 institutions with a network of hundreds of people around the world. Their goal is to foster information sharing and collaboration among international academics, industry, governments, foundations, and other professional thought leaders in health promotion.

When asked which countries took the lead, Dr. Karch says, "Canada was extremely progressive in the mid-'70s through the early-'80s. Some of their early work was way ahead of the US and served as a model for other countries. But they approached it more from a public health perspective and less as a worksite health promotion initiative."

Countries like Japan and Brazil have required annual physicals as part of their employee health programs for many years. As a result, they gathered valuable information about the health status of their workforce and developed strong workplace wellness programs. While other countries -- such as Germany, the UK, France, and Singapore -- also have strong programs, most are primarily driven by the private sector.

An increasingly globalized economy explains the growing international interest in wellness. The US is clearly the leader when it comes to worksite health promotion. Though credit goes to the private sector, the government may become more involved in the near future. Subsidiaries of many US-based corporations now operate in other countries, and management wants to implement initiatives they've seen in America. As these companies move people to other countries, employee wellness concepts go with them. Academics visit the US to attend conferences and take ideas back to organizations in their countries.

Undeniable ROI

The international community is becoming increasingly aware that healthy workers represent a real return on investment. Government officials and corporate decision makers hear about successful workplace wellness programs through the international activities of organizations like the IIHP. They read about the growing body of evidence through the Internet and the broader distribution of professional employee health periodicals. Average citizens hear about these benefits on TV and radio and want such services for themselves and their families.

As US companies establish overseas operations, host governments respond to demands for enhanced services. Even emerging countries may offer programs and service opportunities; American companies need to learn where to look and how to ask.

This exposure to employee wellness concepts hasn't been a one-way street, as other countries had lessons to teach American companies. In the early days of the automobile industry, corporate wellness programs were primarily an executive perk. Unions began demanding similar services. Japan has provided their manufacturers with corporate health promotion services for years. When a large Japanese auto maker set up a plant in Lexington KY, it built a community wellness center, not just for management and their employees, but for the families and community. This model and similar experiences led other progressive companies to follow suit.

Features of Top-Notch Programs

Because they have deeper pockets to fund more comprehensive programs, international companies with the best worksite wellness practices are often larger corporations.

They seem to share certain common features:

    Clear commitment starting at the very top
    Adherence to internationally recognized quality management principles
    Progressive Internet digital and video communication systems
    Technologies that convert wellness messages into other languages
    Quality professional staff placed in major international locations
    Incentives built into management practices to meet corporate wellness goals
    A strategic plan to deliver culturally appropriate programs in foreign settings.

According to Dr. Karch, one characteristic of overseas corporations sets them apart from the US. Many international professionals Dr. Karch meets are highly trained physicians who refuse to be satisfied with old wellness programming models. "While it's easy to get set in our ways and resist change, these decision makers want only the very best and latest models. They spend time in the States and see the best practices. When they go back home, they take what they've learned here and make it fresher... better. They create new wellness campaigns, develop innovative policies, and build healthier environments from scratch. Overseas companies constantly push the envelope."

Challenges Ahead

Dr. Karch admits there are still challenges. "Just as no company can be competitive without a strong, healthy workforce, neither can a country. The worker is the economic engine that drives any country. Chronic disease states are universal. Every country faces this problem. Part of the solution is lifestyle. What better place to deliver healthy messages to the greatest numbers than in the workplace?"

For many years, companies in countries with a more socialized medical delivery system failed to recognize the benefits employee health promotion brought to their bottom line. From an insurance perspective, they had little to gain. The increasing use of tax breaks and tax incentives are getting employers' attention. Growing emphasis on productivity, presenteeism, and workplace safety are motivating corporations to provide environments that promote a healthy workforce.

Corporations operating overseas should seek out employee health resources available in their host countries. This is especially true for smaller companies with limited internal resources. And it's not just a question of providing employee health services for American workers. There is also the challenge of designing programs compatible with the culture and traditions of their foreign workers. The IIHP has established Regional Centers to bring the collective resources of their membership to regions worldwide including Europe, China, and South America. Others are being developed.

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