Health is certainly the focus of worksite wellness programs today. And you do want your program to have clarity of focus, right?
A look at the definitions of health doesn't really help us to establish what health really is. Beyond the definitions, there are two ways to view health:
• The reductionist/mechanistic view
• The health creation or production view
The difference in these views can be seen in both the different definitions of health and how health as a concept is implemented or executed. These two different views see health as being either a personal choice, or as a social responsibility.
Health, when viewed through the reductionist/mechanistic lens, is considered to be either personal or individually determined. This view is about a link between health and the body. The reductionist/mechanistic view is a medical view of health. Health is seen as being a medical problem with medical solutions delivered by medical care.
In this view, health is medicalized. Medicalization is a process whereby non-medical problems and issues become defined and treated as medical problems, usually in terms of illnesses and disorders.
The conceptualization of health in this view is having a healthy body. Health as a goal is achieved by deliberate and intentional action. Health maintenance involves will-power, self-control, self-discipline and self-denial. Health is achieved through body maintenance in accordance with physical standards.
Worksite wellness programs today, with their focus on employee health status management, typically view health through the reductionist/mechanistic lens based on the medical model which focuses on organ related pathology within the individual. Health is viewed in medical and technical terms. This view fits right in with the individualistic and hard work core values of the American culture.
The creating or producing view of health looks at health as being more than just about illness. This view considers the role of social, environmental, economics and behavior as determinants and moderators of health. In this view, health is more than about the individual and is seen in human social and cultural terms.
When it comes to the creating or producing view of health, all the following matter:
• How we are treated in society
• How equitable society is
• How clean the environment is
• Living and working conditions
• How much control individuals have over their work and personal lives
In this view, health is a social responsibility and the belief is that socioeconomic circumstances are more powerful in creating or producing health than medical care. As seen through this view, the main determinants of health are:
• Factors unique to the individual
• Individual behavior/lifestyle factors
• Social and community networks
• Material living and working conditions
• General socioeconomic, cultural and environmental conditions
How many of these determinants is your current program addressing?
From a worksite wellness perspective, it is important to understand what causes ill-health and what is needed to create or produce good health. This understanding will help you determine a purpose for your program, along with making sure the programming and interventions are aligned with both the purpose and the organization's culture.
The workplace is the ideal venue to unite these two disparate views of health. Worksite wellness should address both individual responsibility, as well as the socioeconomic and cultural viewpoints through the creation and support of healthy organizations with their positive, supportive workplace environments, climates and culture.
While recognizing and acknowledging conceptual differences, effectiveness and success in worksite wellness comes down to implementation, execution, programming, interventions and how the concepts of health are practiced in the workplace setting.