Workplace wellness has a long way to go

A giant spiral staircase dominates the airy atrium of GlaxoSmithKline's Navy Yard office in Philadelphia, coaxing people who enter the building to walk up to its upper three floors. The lifts are tucked out of sight to reduce the temptation of using them.

The company's move to the carefully designed low-rise space two years ago is one of several initiatives by the pharmaceutical group to encourage healthier working practices. The building is dominated by unassigned "standing" desks, with communal spaces to encourage movement and sociability. More than 85 per cent of staff use the stairs.

Ron Joines, medical director in GSK's environmental health and safety group, says: "When we began to examine our flagship programmes, we found they offered good outcomes for health and organisation culture, leadership, engagement and productivity. It became a catalyst for even greater investment."

GSK is among a growing number of employers in the private, public and non-profit sectors that are exploring ways to help attract and retain staff and make them more productive. They view the activities as both socially responsible and economically sound.

Derek Yach, head of the Vitality Institute, says: "There is a long-term shift and a huge opportunity for further growth in attention to the 'fourth bottom line' of health." The Institute is part of Discovery, a South Africa-based health insurer that champions prevention and wellness programmes.

Yet Discovery's research warns that despite the promotion of workplace health programmes, notably in the US, there is limited leadership and advocacy, poor alignment of financial incentives, regulation that does not support evidence-based practice and a dearth of partnerships that extend programmes beyond staff to their families, let alone the wider community.

Dr Yach says few employers and consultants rigorously measure and analyse initiatives and their benefits. Existing attempts to measure internally and benchmark external progress are voluntary and hard to compare. As a result, he wants greater disclosure.

In South Africa, there is much discussion about mandatory employee health-related reporting for companies quoted on the Johannesburg stock exchange. Elsewhere, research is under way to categorise and guide disclosure more effectively and to create incentives that reward good practice.

"For so many years, employers have recognised the value of reporting on environmental consequences, but have failed to address the core drivers of workplace morale, productivity and the health of their own employees," Dr Yach says. He adds that, once companies start reporting, the discrepancy between the high level of spending on treatment and the modest investments needed for prevention should become obvious.

The canteen at the UK office of BP, the energy company, offers healthy eating options and rewards those who take them with discounts. Over the past two years, consumption of healthy food has increased by 7 percentage points. "We've taken the opportunity to build elements into our tender with vendors that are health focused," says Richard Heron, chief medical officer at BP.

Dr Heron, who is also president of the Faculty of Occupational Medicine, a UK charity, points out that, as people of working age spend most of their time at work, "there is the potential to touch the health of a significant proportion of the population".

He thinks more doctors should train in the specialism of occupational health and that it should be integrated more closely into healthcare systems, such as the UK's National Health Service. He also envisages the need for more rigorous evidence reviews and a rebalancing in the focus of programmes to the areas of greatest need, such as mental health and musculoskeletal conditions.

Dr Joines says GSK's programmes are a logical response in a business that spends £1.4bn a year on healthcare for its workforce and reports 1.6m workdays lost or impaired through illness - 12 per cent of total potential workdays.

The benefits of the programmes in the US include lower sickness absence and stabilisation of overall medical costs.

The experience has pushed the company to implement initiatives such as flu vaccination, smoking cessation and infection screening, and an "energy for performance" scheme that trains sedentary staff to take breaks to stretch, rehydrate, walk or listen to music.

Dr Joines concedes that in countries where there is less of a culture of preventive care the programmes can be more difficult to implement. The cost-benefit trade-off for employers is also different in locations with stronger mutualised or state healthcare, such as the UK.

In Philadelphia, some staff moan that, while the Navy Yard office has ample free parking, it is remote from public transport and the city centre, where amenities are within walking distance. Workplace health still has a long way to go, especially where the car is king.

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