Worksite health promotion and low wage workers: Promoting health or promoting health disparities?

Low wage and immigrant workers tend to have low rates of participation in worksite health programs. This study investigated the rates of participation and the barriers to participation in a well-resourced comprehensive employee health program at a major university in the US. A random sample of 5000 benefits-eligible employees were invited to participate in a web-based survey. A paper and pencil version of the survey was distributed in English and Spanish to departments where employees might not be computer literate. Results indicate that the low wage workers reported poorer overall health than did other employees. However, they were more likely to view lifestyle change as an important strategy for improving their health than were other employees. Despite their expressed need and interest (as well as a financial incentive offered to all employees), only 21% of the low wage workers reported completing the first step of the program (filling out a health and lifestyle assessment), as compared to 60% of other employees. Only 3% of the low wage workers reported participating in classes intended to improve fitness, as compared to 16% of other employees. Focus groups of low wage workers and their managers identified (1) various barriers to increasing participation rates in the program as it is currently construed and (2) strategies for modifying the program to make it more accessible and relevant. The low wage workers were less likely than other workers to report that the university was committed to improving the health of all employees.