The World Health Organization defines health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. This definition gives a broad perspective to the concept of health as comprising several factors that define well-being. Therefore, when talking about an individual’s health, one speaks about these core components of well-being.
This definition puts a clearer perspective on the issue of workplace health and well-being. Creating health or well-being solutions for employees, therefore, requires a clear understanding of these components and that health is not a single, abstract index, but a composition of one’s physical, mental, and social well-being. Essentially, these components of health underpin several unique factors that drive an individual, described in public health parlance as the determinants of health.
Attaining full health potential, therefore, requires different routes for each individual based on these determinants or drivers. According to the WHO, the determinants of health include:
- the social and economic environment,
- the physical environment, and
- the person’s individual characteristics and behaviors.
These factors are key influences on every individual’s health and must be factored into providing the best health solutions for each person. Similarly, in the workplace, well-being and health solutions would be ineffective at moving the needle in driving positive health outcomes if these unique drivers or determinants are not integrated into the design.
Social and economic determinants
An individual’s socioeconomic context has a big influence on their healthcare outcomes. Studies have linked higher income and social status with better health outcomes and have demonstrated that the wider the gap between the rich and the poor, the wider the margin of health outcomes between them. The same thing applies to education, access to healthcare services, the presence of social support, workplace culture, and community, which are other core social determinants of health.
For context, if your wellness program sets a goal of lowering the prevalence of chronic disease within the workforce, understanding the social context of each employee is essential to finding the right and most effective solutions.
For example, employees with lower income may find it more expensive to go on a diabetic diet, which includes more fruits, vegetables, fish, and fewer carbohydrates and sugar, which are often cheaper and readily available. Recommending healthy diet plans to curb the prevalence of diabetes in an organization, therefore, may be a viable plan for those on a higher income but may be far-fetched for people on a lower income scale.
In the same way, a lack of strong social support may preclude addiction treatment and recovery in certain situations. And this social support also includes support from work. Employees who lack robust social support or communal influence are often likely to relapse when dealing with addiction issues and even mental health problems.
Work culture also has a strong influence on health and well-being as a social driver. Workplaces with discrimination against religious beliefs, sexual orientation, or race are likely to report poorer health outcomes regardless of the designed wellness initiatives or programs. These are strong determinants of well-being and hinder wellness engagement as well as promote stress, which is a risk factor for many chronic diseases.
Physical determinants
The physical determinants of health include the physical environmental conditions of places people spend most of their time. Physical requirements are often downplayed in workplaces with wellness solutions focused on external causes or risk factors of disease.
Your workplace physical environment may be significantly driving your employee’s ill health. Do your employees’ workstations meet ergonomic conditions? Does the design of your workplace promote stress, isolation, and physical inactivity? What are the conditions of their transportation systems to work? Are your employees burnt out from work overload and stress? Are your employees breathing quality air at work or are they left to inhale debris and molds from poorly maintained HVAC systems?
While your wellness program may emphasize yoga and meditation as tools to alleviate burnout or work-related musculoskeletal disorders, not addressing these physical drivers means these solutions would be ineffective.
In addition to workplace physical conditions, people’s home conditions also influence their health outcomes. Do they have access to clean air and safe water at home, do they reside in healthy communities? Understanding these contexts help managers and wellness officers design holistic wellness solutions that address these environmental factors.
For instance, paid sick leaves may benefit employers with frequent asthma attacks, but it does not solve the problem. Ultimately, it leads to a lose-lose situation as this both increases healthcare spending and administrative costs for the employer and lower healthcare outcomes for the employee. Identifying and solving problems relating to air quality may be a more relevant and appropriate wellness step in helping the employee.
Individual characteristics and behaviors
Your employees’ unique biology as well as health behaviors pose a strong influence on their health outcomes. While individuals can prevent diseases and improve their health by making healthy decisions, there are some biological factors that also modulate their risk of disease.
Studies have revealed that early childhood development (ECD) may be a pointer to health outcomes later in life. Early childhood refers to the first eight years of life, and experiences within this period set a crucial foundation for the entire course of one’s life. Childhood experiences are a strong indicator of one’s emotional, mental, and social health and well-being later in life.
Emotional health problems, such as anxiety, depression, and poor self-esteem, as well as social issues including poor work performance and anti-social behaviors in certain employees may be linked to childhood development experiences, and these need to be included in holistic wellness solutions to achieve meaningful results.
In addition to ECDs, Genetics also plays a role in the risk of ill health conditions and in treatment outcomes. Precision medicine is expanding the frontier in the area, with research revealing that genes play a crucial role in our risk of certain diseases and how effective medications are. For instance, breast cancer treatment may yield varying results for different people despite using equal therapeutic doses and adjunct medications.
Precision medicine has revealed that these discordant treatment results are often tied to the presence or absence of certain genes in different people. Further, the presence of a genetic variant may increase one’s risk of lung cancer or dementia while another individual exposed to the same risk factors but without the gene variant may have a lower risk of the disease. Understanding these genetic nuances would help is the first step in providing the right wellness solution in dealing with these illnesses.
Finally, personal characteristics, including cultural and religious beliefs may also affect health outcomes. Employees may be unwilling to participate in certain wellness initiatives because it goes against their cultural or religious beliefs. In these situations, it helps to first help these employees deconstruct these beliefs if they pose a barrier to positive health outcomes.
Health and its determinants
Health is not a single entity or destination but a complex of interconnected factors. A one-size-fits-all approach to well-being, therefore, will be ineffective at driving the needed results in the workplace. To build viable wellness solutions, managers and employers need to take a holistic approach that integrates an individual’s social, physical, and personal contexts into providing a unique wellness solution that fits their health and wellness journey.
