Health at work: The growth, development, and status of worksite health promotion

Worksites have long been considered as important settings for reaching large number of people with health promotion messages and programs. American business organizations have been generally receptive to these efforts, due in part to the fact that employers provide health insurance for most American workers, and health care expenditures represent a steadily expanding cost of doing business. Beginning in 1985, there have been four national surveys examining the nature and extent of worksite health promotion (WHP) activities in the United States conducted at roughly seven year intervals (1985, 1992, 1999, and 2004). These surveys were designed to provide an overall picture of workplace programming and to track progress toward achieving national public health objectives. In this presentation, we draw the surveys together as a historical archive and trace the growth and development of WHP in the United States. The surveys represent a valuable resource for identifying trends, priorities, gaps, and future directions in WHP programming. We begin with an overview of how the samples were drawn and how the surveys were structured, including limitations. Following this, survey findings are organized into three categories: the good news (i.e., progress and positive trends), the bad news (i.e., where progress has lagged), and the no news (i.e., what we need to know but don't). While WHP has grown and matured in many respects, progress has not been universal. In addition, significant knowledge gaps exist pertaining to program quality, program reach, and participant satisfaction. On the basis of this analysis, future directions are discussed.