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Pay More Attention to Psychological and Social Aspects
of the Workplace Says Expert

While a great deal of our waking hours are spent at the workplace, there is relatively attention paid to the psychological and social aspects of work and its impact on workers. Terrence Dalton of Health Canada’s Workplace Health Bureau spoke with CPRN Researcher Adam Seddon about the importance and benefits of promoting workplace well-being, and the various challenges in getting these workplace issues on the agenda of policy-makers, business and labour leaders. 

AS: From a Health Canada Perspective, What Are The Major Determinants Of Workplace Well-Being?

TD: The Workplace Health Bureau of Health Canada has approached the issue of health in the workplace in a comprehensive and integrated fashion by looking at the key factors that affect employee and organizational health and productivity, the physical and psycho-social work environment, personal resources, and health practices. The physical environment includes factors such as air quality and noise in the workplace, the quality of lighting, safety, space, ergonomics, etc.; while the psycho-social environment includes such factors as relations with supervisors and co-workers, workload, recognition, fairness, training, job design, etc. Personal resources refers to the sense of control over work and health employees feel they have and their access to support in times of need. Health practices refers to one’s behaviour in terms of physical activity, sleeping and eating habits, smoking, alcohol use, etc. All these issues are directly or indirectly related, and impact on the health and productivity of employees and the organization. It is from this perspective that a comprehensive and integrated approach to workplace health is promoted and encouraged.

For example, in workplaces you’ll often have a wellness committee in one corner of an organization, an occupational health and safety committee in another corner, and an employee assistance program in yet another corner, all separately doing their own thing. What we’re trying to promote is that a comprehensive and integrated approach is a more effective way to address the varied issues, needs and concerns of employees and the organization.

AS: How Have Health Canada’s Approaches To Workplace Well-Being Changed Over The Years?

TD: When we first started looking at workplace well-being we saw a lot of activities and research that focused on traditional issues such as workplace health and safety and lifestyle. This was a reflection of the legislative requirements around safety issues in Canadian workplaces and health promotion efforts to encourage Canadians to become physically active, quit smoking, eat better, etc. What seemed to be missing was a focus on the organization, it’s culture, the design of jobs, issues of demand / control, and of recognizing employee effort. These types of issues were often left out of the traditional workplace health perspective. So we started off with a comprehensive and integrated approach to workplace health and have enhanced our focus on what you might call the ‘psycho-social’ factors of the work environment to encourage more action in this area. We have also increased our emphasis on the impact of, or business case for, workplace health initiatives in terms of health, productivity and competitiveness. Of equal importance are the factors that will help ensure the success and sustainability of the workplace health initiatives, namely the commitment and leadership, planning, people focus, process management and monitoring, tracking and evaluation.

AS: When Did This Shift In Approaching Workplace Health Take Place?

TD: Over the past five years there has been an increased focus on how organizational factors affect health and productivity, as well as the factors and processes that need to be considered to successfully implement and sustain workplace health. This was in response to the lack of recognition of the impact that organizational factors have on the health and productivity of workers, and the ever present quest for non-existent quick and easy fixes for these issues. A greater focus had also been paid to individual lifestyle issues and encouraging employees to exercise more, eat better, drink less, quit smoking, manage stress, etc., rather than looking at what organizations could do to reduce the causes of stress, illness and injury.

The other main focus was on health and safety issues because of legislative requirements. In other words, comprehensive and integrated workplace health wasn’t receiving the attention that it deserved considering its impact on health, productivity, business and health care costs, etc. The issues surrounding it were often being addressed in a piece-meal approach, and key implementation and sustainability factors like leadership, planning, people focus, process management and outcomes were not being adequately dealt with. We’ve been trying to put more of a spotlight on these issues through various initiatives, as has CPRN through its research on job quality indicators.

AS: What Are Some Of Health Canada’s Major Initiatives In Promoting Workplace Well-Being?

TD: Well over the last five years we’ve initiated a Healthy Workplace Criteria award in partnership with the National Quality Institute; a survey of key stakeholders in workplace health promotion; a national round-table discussion and report called “More Than Just Hard Hats And Safety Boots - Creating Healthier Work Environments,” written in partnership with the Conference Board of Canada. We have also conducted and supported research on organizational factors that affect health and productivity such as “Best Advice on Stress Risk Management;” with the National Quality Institute we’ve helped develop a business case for workplace health in “Investing in Comprehensive Workplace Health Promotion;” and in partnership with the Canadian Labour and Business Centre, produced case studies of best practices in workplace health. Of course, we have the Workplace Health System, a comprehensive and integrated approach to workplace health and supporting resources such as guides, employee questionnaires, profile reports, evaluation tools, etc. We’ve also recently updated our employee workplace health questionnaire and profile report by placing more emphasis on workplace environment issues. For instance we’ve incorporated questions that deal with work demand and control, effort and recognition and we present the data in terms of a stress satisfaction offset score, a business health culture index as well as a multiple health risk score for the organization. By identifying how certain work environments produce stress or satisfaction, and linking this with absenteeism and other health and productivity related outcomes, we help the organization make a ‘business case’ for the need to deal with these issues. We have also facilitated meetings regarding workplace health research and a Healthy Workplace Week. Currently, we are working on a project with the Mental Health Unit of Health Canada to identify and promote the change processes that lead to creating a healthy workplace, the changes that are most likely to contribute to improving worker health outcomes and the extent to which these changes have been linked to positive organizational results.

AS: What Sort Of Criteria Do You Use When Determining Who Might Qualify For Something Like The Healthy Workplace Award That You Mentioned?

TD: The Healthy Workplace Award is managed by the National Quality Institute (NQI). Organizations make a submission to the Institute showing how they meet the Healthy Workplace Criteria. They must demonstrate how they’ve met the Criteria in terms of taking a comprehensive approach, taking into account the physical environment, psychosocial environment, personal resources, health practices, and address the quality drivers of leadership, planning, people resources, process management and outcomes. The assessment process includes a review of the application and supporting documentation, a work site visit, and an assessment against various criteria to determine if the organization will receive the Canada Award for Excellence. The NQI has recently developed the Progressive Excellence Program. This Program is an implementation roadmap which takes the full Canada Awards for Excellence criteria and breaks it down into logical sequential steps that build one upon the other to develop and sustain organizational excellence. The Progressive Excellence Program helps organizations to build workplace improvement plans and to measure how they are doing at each step of the way.

AS: HRDC Recently Noted That About 3,000 Canadian Workers Are Injured Each Day On The Job. Given What Appears To Be A High Level Of Workplace Injury, Is It Not Premature To Focus On These So-Called ‘Softer’ Psycho-Social Workplace Issues?

TD: Well the evidence that there are strong links between both illness and injury and the so-called psychosocial aspects of work is getting stronger. So, it’s not a case of one versus the other. If for instance you had both a chemical hazard and an electrical hazard in the same workplace are you only going to deal with one? That’s clearly not the case. If you have enough evidence to indicate that some of these psycho-social factors are also hazards, they need to be dealt with as well. We should recognize that these are factors that contribute to or inhibit workplace health and productivity and we should therefore take appropriate steps to deal with them.

I understand the fear expressed by some that expanding the notion of workplace health to include the psycho-social domain may divert attention and resources away from issues like physical safety, which some feel are inadequately addressed even today. Occupational health and safety are a very important piece of the equation, but that does not mean other factors are not important. Again, it’s not a case of one thing versus the other – they are all important and interrelated - one affecting the other. The big challenge is how to deal with issues comprehensively without diverting resources away from other workplace health concerns. In the psycho-social area, there may already be significant resources allocated in workplaces to such things as training, human resources development, recognition, etc. In those cases, it may be a case of diverting, and making better use of, already existing resources to reduce the causes of stress and illness. It may not necessarily mean new dollars, but rather a reallocation, or perhaps a better use of existing dollars.

AS: What Have Been Some Of Health Canada’s Biggest Successes Thus Far In This Endeavour?

TD: We’re certainly making headway in terms of awareness and understanding of the issues around workplace health. We’ve made progress on that front. We’ve developed resources, linked with partners, done training, conducted research, and engaged in promotion and awareness.

Even though we have made progress, we still have a long way to go. In terms of awareness, understanding and action, I think one can say we’re where tobacco issues were 10 or 15 years ago. There are still many barriers to overcome before we get these issues on the agenda. Many people continue to look at workplace health as a ‘soft’ issue, a point you made a bit earlier.

When we talk about human resource management or organizational culture, it’s often from the perspective of productivity. Linking it to health outcomes remains the exception. While we are making progress on that front, it is slow and there are many difficulties in getting the message out to employers. You know, it’s not on the radar screen of many organizations yet. If you look at how managers, be they in the public or private sector, are generally recognized, compensated and rewarded, you will probably find very few of them being rewarded for ensuring that the work environment for which they are responsible is safe, healthy and supportive for employees. The challenge is to show the link between organizational factors and health, and how this affects productivity, creativity and ultimately the bottom line. I suppose if most senior managers actually believed that such a relationship existed, they’d be banging down our doors. Unfortunately, employers and employees are not banging down our doors, so we obviously have not gotten that message out as much as we’d like.

AS: You Just Noted That Many Of These Issues Have Not Yet Gained Mainstream Acceptance Among Employers As A Problem. What Are Some Of The Other Challenges?

TD: Well, you get another sense of the lack of public awareness and commitment by simply looking at the absence of national or provincial non-government organizations that address comprehensive workplace health. Health Canada’s Workplace Health Bureau, which focuses on comprehensive workplace health, does not have any similar provincial counterparts. Provincial Workers Compensation Boards are probably the closest in mandate, however, their focus is predominantly on occupational health and safety. Also workplace health has not yet been accepted, identified and researched as a “key” determinant of population health that deserves more focus.

At the workplace level there is also difficulty in getting information from workplaces about their efforts in implementing our approach to comprehensive workplace health. They have little interest in telling us how successful they have been in implementing their programs.

It’s also been a challenge to encourage organizations to do more evaluations so that they will know whether they’ve been successful and where they’ve fallen short. Many organizations find it to be a big challenge and a major commitment to address workplace well-being in a comprehensive manner. Trying to evaluate how well they are doing is perceived as yet another difficult step in the process. As a result, organizations generally do a poor job of monitoring, tracking and evaluating their progress. So, there is more work to be done on that front.

We have developed some resources to help facilitate and encourage organizations to monitor, track, and evaluate. We however need more Canadian research in terms of long term tracking, monitoring and evaluation of comprehensive workplace health programs processes and outcomes.

AS: What Would Mark A Major Step Forward In Your Mind?

TD: Although the research seems to consistently show the link between work environments and health, we have not really seen any significant policy shift in how we deal with population health. I have not seen any major new funding initiatives in Canada going towards workplace health per se. We seem to still be struggling to get out of the old mold of focusing on individual change and putting a greater emphasis on the impact of the environments like workplaces and schools where we live, learn, work and play. There are over 15 million people in the Canadian workforce who spend two thirds of their waking hours at the workplace and too often that work environment has a negative effect on people as opposed to a positive one. I can’t see significant progress in population health until we start taking a better look at the role workplaces play in our daily lives, our health and our prosperity. We need to make sure that the work environment has a positive influence as opposed to a negative one, both from a physical and psycho-social perspective.

AS: What’s On The Horizon?

TD: We need to continue making the business case in favour of better workplace health. We need to get the message out that workplace health is associated with competitive advantages and ultimately Canada’s ability to be productive and competitive in a global economy. Hopefully we can get the issue of workplace well-being on the agenda of other organizations, be it other levels of government, other departments, business sectors, etc. We need more partnerships with key business players and other key stakeholders to try and drive this agenda forward at the provincial and local level and within the public and private sector. Government cannot do it on it’s own. We also need to make linkages between what happens in workplaces and how this spills over into communities in terms of health and social costs. If we continue to develop linkages and partnerships, break down the “silos,” and develop a better understanding of what other groups are doing, we should be able to move the agenda forward in a more effective and efficient manner.

We also need to ensure that the concept of workplace health is adequately addressed in university and college curricula, be it in MBA programs or business management programs.

We also need to get a better understanding of the issues, needs and concerns of small business in the area of workplace health. Small businesses account for a huge part of our economy and employ much of the workforce. Unfortunately, many small businesses perceive workplace health to be too costly and outside of their capabilities and be seen as a “soft” issue.

AS: Thanks for taking the time to talk to us about these issues.

Health Canada website - www.hc-sc.ca