A Primer On The History of Worksite Wellness Programs

Just as the history of man can be categorized into phases (commonly referred to as ages), so too can the history of worksite wellness. This article examines four phases in the history of worksite wellness programs.The history presented here only applies if, like me, you believe that wellness consists of integrated multiple dimensions. If however, you believe that worksite wellness is only about physical health, then you will see the historical timeline presented here as being much shorter.Phase 1: The Recreation PhaseThe earliest reported incidence of wellness being practiced in the workplace dates back to 1897 at the Pullman Company near Chicago, Illinois. In an effort to accommodate their labor needs and the needs of rural individuals coming to the city in search of work, many companies during this period created company towns, or communities/neighborhoods within larger municipalities. As part of their company town, The Pullman Company created an employee athletic association to complement their company provided housing, stores and schools. Other companies at the time, including National Cash Register, Sears, Roebuck & Company, and Hershey Foods also created employee recreational initiatives. This phase culminated with the 1941 creation of the National Employee Services and Recreation Association (NERSA). NERSA spearheaded efforts to create employee recreation programs from that point on. Texas Instruments launched its employee recreation program in 1953.Phase 2: The Fitness PhaseIn the late 1950′s, the focus of the worksite wellness began to shift from recreation to fitness. PepsiCo began their renowned employee fitness program in the late 1950′s. PepsiCo was followed in the 1960′s by Sentry Insurance, Rockwell International, Xerox Corporation, American Can and NASA launching employee fitness programs.The 1970′s saw a continued emphasis on fitness related programs with the creation of employee fitness programs by Kimberly-Clark and Mesa Petroleum. Also impacting the field was the passage, by Congress, in 1970 of the Occupational Safety and Health Act and the continued expansion of Employee Assistance Programs beyond its original focus on alcoholism into a more broad brush approach. The term wellness was also introduced into the lexicon and mainstream. Building on the work of Dr. Halbert Dunn in the 1960′s, an informal network of physicians and psychologists in the 1970′s began creating comprehensive, multi-dimensional models of wellness, wellness assessment tools, and actively wrote and spoke about their concept of wellness.The 1970′s also saw increased attention being paid to cardiovascular health and the prevention of cardiovascular disease. Increasing attention was also being paid to other chronic diseases and the potential for their prevention. This led to the next phase of worksite wellness evolution.Phase 3: The Medical PhaseWith the emphasis on cardiovascular disease, executive health emerged as a program focus. The combination of increased attention to cardiovascular disease and other chronic diseases, along with escalating employer related healthcare costs resulted in the 1980″s worksite wellness programs becoming more focused on and aligned with the pathogenesis model of medicine. This resulted in increased attention being given to employee health promotion, along with an emphasis on health risk reduction and individual responsibility for health. As a result, health education, health risk assessments, biometric screenings and individual behavior change initiatives became the core programming found within worksite wellness programs. In order to substantiate their impact on employer healthcare costs, ROI (return-on-investment) measurement became the most common way of evaluating worksite wellness program success.The late 1990′s saw an expanded role for the workplace health clinic at large employers. What has traditionally been an occupational role began to expand into acute care services, pharmacy services, preventive care, chronic disease management, case management, specialty services, as well as wellness. Worksite based health centers are seen as having the ability to both reduce costs and improve the quality of care employees receive, thereby offering value to both the employer and the employees.Phase 4: The Fusion PhaseAs the 21st century loomed on the horizon, population health management entered the workplace and available monies became increasingly tighter. Researchers have also been able to establish that individual health is the result of a combination of determinants and not just individual lifestyle. This has resulted in an increasing recognition that there needs to be better integration across the various silos of employee benefits delivery and with core business strategies and practices as well.Early in the 21st century, the National Institute of Occupational Safety and Health launched an initiative integrating employee wellness and safety which is now known as Total Worker Health. Increasing attention is also being paid today to the role an organization’s environment, climate and culture play when it comes to employee health. Organization health is seen as being just as important as individual employee health. Some are beginning to see the future as being a fusion of employee health with organization development.In today’s healthy organization, workers are seen as being a vital asset for the organization and not just employees doing a job. Healthy organizations create the conditions that allow employees and the organization to thrive.