As the line between 'work' and 'life' becomes hazier with each passing year, a comment recently made to Human Capital by a contact in the legal profession bears repeating. The legal profession is notoriously high pressured; employees work long hours and client expectations are extremely high. This HC contact mentioned that in his firm, he could cite two recent examples where initiatives by the employer had potentially saved lives.

In the first instance, as part of standard executive health checks, a senior partner was undergoing standard checks, including blood pressure monitoring. Asked whether he had any history of blood pressure problems, the employee said no. Upon checking, the blood pressure result was so high that medics - despite protests from the employee - strongly recommended he go straight to hospital.

In the second instance, also as part of standard health check, a woman was found to have an abnormality on her breast; investigation revealed the early stages of breast cancer.

While in both cases it would be hoped the individuals concerned would have detected a problem and sought assistance, there is no way to tell. It's just possible that the actions of the employer saved lives.

It raises an important question: at what point should employers intervene when it comes to the health of their employees? Clearly it is not viable for all employees in all workplaces to undergo the rigorous health checks outlined above. Are there other proactive steps employers can take?

Lead a horse to water...

Firstly, the question of whether employers have any right to intervene at all. Brad McDougall, managing director of Springboard Health & Performance, says it is "a tricky one". "On face value many would argue that health is the responsibility of the individual. However, with research demonstrating that those in poor health are up to 42% less effective in their roles, 3.1 times more absent and eight times less satisfied at work, there is a clear incentive for employers to support employees to improve - and/or manage - their health."

This is supported by recruitment firm Peoplebank, which conducted its own internal research into how and to what extent its 200+ employees wanted company involvement in areas previously deemed 'private'. One of the key findings suggested that even while looking for more work-life balance, employees weren't looking to distance themselves from the company. Rather, they were interested in Peoplebank becoming more engaged in their life and leisure activities.

"We've got a large Gen Y component in our workforce and clearly they want work to be part of their lifestyle," says Michelle Cooper, national people and performance manager at Peoplebank. "They don't want to come to work to just work. They want it to be part of what they do - it's not clock in, clock out and then live my life; it's realising that life is part of the time at work."

Although initially conceived as a way to provide greater insight into the work-life demands for its employees, Peoplebank has used its employee research as a launch pad for a range of initiatives covering off both the physical and psychological health of employees, as Cooper explains:

"When we look at the health and wellbeing of our people we try to understand firstly what the actual needs of our employees are; we seek to find that out via employee surveys around how we can better support them, both in terms of flexibility and in terms of benefits.

"A lot of what we find is flexibility-wise people want to stay healthy by going to the gym and would like flexibility to do that. What we do is let people know that firstly we want them to go to the gym, throughout work hours, and we make it ok for that to happen. They might step out at 3pm and then come back to work, because that works better for them."

High risk employees

Engaging employees around their health, particularly those at high risk, is a sensitive issue and one which employers should consider very carefully. 'High risk' or chronic health risks refer to any disease or health concern that lasts for an extended period of time. These include diabetes, high blood pressure, heart disease and the like. However, a poorly considered (direct) approach may lead to the employee feeling alienated or threatened, not to mention the risk of discrimination.

McDougall says that best practice suggests all employees should be engaged in issues surrounding their health equally, with clear communication provided around the availability of further support for employees at high risk.

"Access to this support can be facilitated via an 'opt-in' model, where employees take personal responsibility to initiate access themselves. Alternatively, a highly successful 'opt-out' model can be applied whereby the employee is contacted by a third party and informed of their automatic enrolment into a support program with the ability to decline at their discretion," he explains.

Cooper echoes this 'open to all' approach. Peoplebank sends out information about health, and top tips for staying fit. Information and support is also provided around serious illness through partnering with the Cancer Council and similar organisations.

"I think education comes first because we want to help employees. We can offer the corporate plans and the free week deals, and we've had Fitness First come out on site. But it's all about education; once we offer these programs we want employees to actually use it. It's two-prong: education and providing benefits they will actually use," Cooper says.

Just as important, Cooper adds, is how comfortable an employee feels about talking to managers or colleagues about sensitive information. "A lot of it is about creating the environment to talk about it. How comfortable are employees about talking to their managers? We do the Hewitt Best Employer survey and one of the questions is how much do people trust their managers - we came back at around 79%."

Health coaching

Employee Assistance Programs (EAPs) have been offered by employers for several years - Peoplebank has had one for 10 years - so what's new in third party employer offerings to employees in need? Coaching has crept into just about all areas of corporate life - from executive coaching to cross-cultural coaching. It's no surprise that the coaching concept is now being carried into the corporate health and wellness space. McDougall says health coaching is being used worldwide as an evidence-based intervention to positively modify health behaviours and manage chronic disease.

Unlike traditional approaches, health coaching avoids the prescriptive approach of 'telling' the individual what they need to do to improve their health. Instead health coaching centres around empowering the individual to take control for them self. Ultimately it is the individual who is the subject matter expert - not the coach, as they know the most about their own health, their goals, work pressures, and obstacles.

"They control the knowledge, but as is often the case, may not control the process. Consequently the coach plays an active support role as a facilitator and change agent, guiding the individual to develop their own personalised action plans," McDougall says.

Healthcare specialist Medtronic has used this health coaching approach for its 38,000 global employees, using Springboard for its 400 local employees. Jane Wagstaff, OHS manager, Medtronic, says that globally the company wanted a program whereby it could assess the health and wellness of employees and implement strategies that could address any issues that arose as a result of those risk assessments.

During the first phase of the program, Medtronic launched an online health risk assessment program to employees, which tied all the company's health benefits together on one website. "We implemented it here about three months ago as part of our Total Health Program. When users click on the Total Health Website they are directed to a vielife [Springboard] sponsored Medtronic website and that's where the risk assessment is," Wagstaff explains.

Employees are invited to complete an online lifestyle risk questionnaire focusing on weight, medical health, nutrition, stress, sleep, activity, lifestyle and job satisfaction. Using the questionnaire results, employees are stratified according to their level of health risk.

Employees were then offered the opportunity to participate in The Medtronic Health Coaching Program - an evidence based coaching program that focuses on delivering positive health change outcomes. The program is delivered via telephonic health coaching sessions from professionally trained health coaches who work directly with the employees.

Employees with high health risks were invited to participate in a 12-week personal telephonic health coaching program. The program focuses on supporting the employee 'where they are at' in terms of their health concerns, goals and readiness to change. Employees scheduled sessions at times convenient to them and that focused on creating sustainable changes for positive health in the future.

"A number of employees have been contacted and 46 at the moment are in the health coaching program," says Wagstaff. "The one-on-one coaching identifies unhealthy behaviours and the coach and the employee work together to develop an action plan and set appropriate goals. I've received anecdotal evidence indicating that employees are really excited about the strategy. It's very proactive. We've got a lot of employees who travel regularly for work and it's tough to maintain a healthy lifestyle when you're jetlagged."

Wagstaff notes that the process is completely anonymous, with Medtronic only receiving general information such as how many people are using the program. She concedes that broaching the topic of health with employees is "tricky" and is instead keen on targeting people through general awareness programs.

"What's good about Medtronic is we've made the investment and once you start you can build on that, and there are so many other strategies you can put in place to build on what you've already done. Once they've done the health risk assessment and you've gotten their attention, they are more engaged than they were before."

As an added enticement to focus on health, Medtronic now offers employees $400 to spend on anything health related: ballroom dancing lessons, tennis rackets, Zumba classes. "We had a benefit in place where we offered subsidised gym memberships, and you get a percentage of people that take that up. But the feedback was that a lot of people don't want to go to the gym. When we expanded it to $400 to spend however people wanted - the uptake has been remarkable."

The key, she adds, is to engage employees with the process. "One of the key benefits we've found from this is it's helped to engage our employees. You're busy; resources are at a premium - so a strategy that engages your employees has so many benefits, not just for the individual but for the organisation as well. And because not everybody does it, it can actually differentiate you as an employer and you can then build on the momentum," she says.

While Wagstaff concedes that it's "just a small thing" to offer employees, she believes this kind of support is becoming increasingly common in Australia. "Employers in the US and other countries must pay for medical costs as part of employment, so clearly they are further ahead than we are. However, I believe organisations that take an interest in employee health really see the benefits of doing so," she concludes.

Lasting change

What's the key to making sustainable change in the way an individual handles their health & wellness habits?

According to Brad McDougall, it's a threefold process:

  1. Ensure they have a clear picture of where they want to be, and to set meaningful and achievable goals
  2. Assess from time to time: a) Their readiness to change b) The importance they place on making the change c) Their confidence in embarking on change. If any of these elements are low then attention must be given to improving these prior to attempting change, whether it be upfront initially or downstream, as these can significantly sabotage success and consequently act as de-motivators. For example, if a smoker is not ready to change or if quitting is not of high importance to them then they are unlikely to succeed in a Quit Smoking program.
  3. When faced with temptation it is helpful to reflect on the reason they want to change, and focus on the emotional reason why change has been initiated.