Three main factors were identified as influencing employers’ views on the promotion of health and wellbeing in the workplace and these are summarised in Fig. 1. These included (1) employers’ conceptualisation of workplace health and wellbeing, (2) employers’ descriptions of (un)healthy workers and perceptions surrounding importance of healthy workers, and (3) employers’ beliefs around the role the workplace should play in influencing employee’s health and wellbeing.
Employers’ conceptualisation of workplace health and wellbeing
Previous research has shown that there is often confusion regarding what workplace health and wellbeing entails [12]. Therefore, to place conversations on the topic of workplace health and wellbeing in context, it was necessary to understand participants’ perceptions of what it means. By carrying out the word association activity in the focus groups, it enabled participants to think broadly on the topic, which resulted in a wide range of responses. Workplace health and wellbeing was perceived to encapsulate one or all of the following areas: occupational health and safety, mental health, nutrition, physical activity, and general health issues. Responses varied from group to group and within groups.
The rural groups viewed health and wellbeing in the workplace as mostly relating to occupational health and safety. This was particularly the case in the two focus groups that were set in a large mining town where safety was a prominent issue. Because of the narrow focus on occupational health and safety in these two groups, many conversations pertaining to other aspects of workplace health and wellbeing (e.g., how lifestyle health behaviour risk factors can be reduced) were somewhat diminished compared to the other groups. These participants were focused on safety issues relating to the avoidance of accidents and injuries. The metropolitan groups, especially those comprised of white collar workers, were more likely to view health and wellbeing in the workplace as encompassing a broader range of issues touching upon all themes identified. Women, more so than men, focused on health in a more holistic manner. Across all groups, a particular emphasis was placed on mental health issues, mostly in relation to work-related and personal stress.
“Work/life balance, mental health, and then stress…I’m dealing with a lot of people with mental health and stress issues at the moment.” (FG9, metropolitan, white collar, women)
Employers’ descriptions of (un)healthy workers and perceptions surrounding importance of healthy workers
To effectively investigate the factors influencing employers’ views on health and wellbeing in the workplace, it was important to understand their perceptions surrounding what defines a healthy worker and, conversely, what defines an unhealthy worker. Several terms were used to describe both the healthy worker and the unhealthy worker and these were subsequently grouped into themes. No weighting was given to any one aspect over another when depicting the workers; however the frequency of comments provided indicated that the state of workers’ mental health was the most salient defining feature.
The healthy worker was described in terms of positive mental attributes. Examples of these attributes included being alert, cheerful, focused, confident, and calm. Healthy workers could also be recognised by their high productivity, their collegiality, their use of safe work practices, their healthy physical appearance, their ability to maintain a work-life balance, and their health consciousness (e.g., maintaining a healthy diet and sleeping enough). In contrast, unhealthy workers were described as having negative mental attributes (e.g., being stressed, having a negative attitude, lacking self-respect, and visibly unhappy), experiencing significantly reduced productivity, lacking vitality and fitness, being unpleasant company, not having a supportive network, regularly making poor food choices, and being reliant on stimulants (e.g., caffeine or cigarettes) and other drugs.
Most participants reported that healthy workers were of utmost importance in the workplace. Reasons provided for this perception included the increased productivity, more positive attitudes, and greater levels of safety perceived to be associated with healthier workers. A link, however, between the importance of healthy workers and a need to introduce health and wellbeing initiatives at work was not often made by participants, hence the dashed line instead of continuous arrow presented in Fig. 1.
Productivity was the most frequently mentioned outcome of importance in relation to having healthy workers. Greater productivity was believed to translate into higher business profitability. Unhealthy workers were perceived to be more likely to take sick days or carry out their duties in a slow manner due to fatigue, thus costing the business. It was also noted that there were difficulties associated with the need to fulfil duties when workers with unique roles were absent.
“It’s very important because it affects the running of the business. If you’ve got numerous people with sick days and that sort of thing, it has a financial impact on the business.” (FG10, metropolitan, white collar, men)
“I think it’s important because our employees are actually friends and they’re people we care about and we want them to be well and healthy for their own sake. When somebody is not well their production is down and that costs you as a small business, but the money side is less important than the moral side of their wellbeing.” (FG1, rural, blue collar, men and women)
Employee attitude and demeanour were also highlighted as typical traits of a healthy worker that were highly desirable in the workplace setting. For example, interactions between fellow employees and customers or clients could be positively or negatively influenced depending on the mood of staff members. The morale of the team was listed as particularly important.
“If someone is happy and cheerful, well they’re healthy, they give better customer service, they work better with their colleagues, and you’ve got a happier team. If they’re cheerful they will joke amongst each other. Having been in a position of being an unwell boss, I’ve known how grumpy and glum and cranky and irritable I can be.” (FG2, rural, white collar, women)
“They want to be there, I mean obviously they boost your morale, I mean the morale is going to be up. When morale’s down everyone’s whinging, no one wants to be there, it’s toxic.” (FG4, rural, white collar, men and women)
Healthy workers were viewed as necessary due to their role in maintaining workplace safety. This was most commonly reported in the blue collar and rural groups. Mental alertness was reported to be an integral aspect of the healthy worker; this trait was singled out as a vital feature of workers.
“You have to have a healthy (workforce), well from where I come from, it’s the risk you know, if you’re not healthy and fit you’re a danger. You know the size of the stuff that I’m involved in someone can be killed, you can be killed or, you know it can be massive. Plus it’s a risk to everybody else. So you must be healthy and happy.” (FG5, metropolitan, blue collar, men and women)
In contrast to the beliefs reported above, it was reported by a handful of participants that there was little or no relationship between the health of employees and productivity and other desirable traits (e.g., cheerful demeanour and team player). A manager of a hotel mentioned:
“Down where I work, some of the staff may be unhealthy, but whether or not I look at them as an unhealthy staff member, well that doesn’t really make much sense. Some of the healthiest staff there are the laziest staff there. And some of the people that are slow, oh not slow, but they don’t look healthy, they smash out work. They know what they’re doing and they get it done.” (FG7, metropolitan, blue collar, men)
A few participants believed that workers could engage in high risk behaviours including regular illicit drug use, while still maintaining high levels of competence and success in their roles. This contradicts earlier descriptions of healthy workers.
“Well I’d dispute that…I think the proof would be go to (the city), there would be many drug users, many lawyers on cocaine and are doing an exceptional job. So it depends what you’re talking about.” (FG10, metropolitan, white collar, men)
Employers’ beliefs around the role the workplace should play in influencing employees’ health and wellbeing
Generally, participants identified a need for healthy workers; however views varied between and within groups. Employers’ conceptualisation of workplace health and wellbeing also influenced their beliefs. Occupational health and safety was unanimously viewed as essentially the role of the workplace, however on the broad topic of health and wellbeing, views differed depending on industry and location and whether or not workplaces already prioritised health and wellbeing initiatives. Such comments were more pronounced in the rural areas and from participants working in blue collar industries.
“During work hours I think yes. Because nowadays the liabilities are generally on the employer to push for safe work practice – was that a safe area that he was working in when he hurt himself? That would be more looked at than the actual person’s fatigue level or something like that.” (FG1, rural, blue collar, men and women)
“Obviously the health and safety of the workers is paramount at work.” (FG3, rural, blue collar, men and women)
Safety aside, it was felt that employers were responsible for the health and wellbeing of employees, but that the level of responsibility and context varied. It was first and foremost up to the individual to maintain an acceptable level of personal health, while the workplace was often viewed as playing a more minor role that should support employee health. There was reluctance to enforce particular behaviours outside the scope of occupational health and safety as this was sometimes perceived to interfere with personal choice.
Respondent 1: “Well certainly the employee is (responsible). The management can have a view and provide support, but I’ve been in organisations where they have a gym and people choose not to use it – it’s their choice. Or they have facilities for mental health which they don’t choose to use, so it’s really a case of providing the backup, but individuals are individuals and they do what they wish.”
Respondent 2: “Themselves first, and then management should be the people that are overlooking it and seeing what he’s doing wrong or if he’s eating bad or this and that, so it’s up to me it’s up to management to say, “Hang on mate, come here”. Talk to them on the side and say, “Try this. Try that. Have a problem come back to me”. That is what it is.” (FG8, metropolitan, white collar, men)
As mentioned earlier, the responsibility of the workplace in terms of the mental health of their workers was a strong theme throughout the focus groups. This was also related to friendships in the workplace and the sense of responsibility, which was again, more salient in those from smaller businesses. There emerged a hierarchy of responsibility with safety at the top, followed by mental health, and then lifestyle factors at the bottom (e.g., nutrition and physical activity).
“That is part of your job as a boss so as to keep an eye on the mental health of your workers to see where they’re actually travelling. You obviously don’t want to step into their personal lives but you’ve still got to be on the edge of it, see if there are problems with the family and that type of thing because that combined with fatigue is absolutely critical to your people.” (FG1, rural, blue collar, men and women)
“If we notice someone stressed we’ll pull them aside and have a chat to them, if we notice any, I don’t know, something unusual happening we’ll identify it if we can and have a chat to the staff to make sure there’s something not underlying that we can help with. And we have workplace counselling available where you can go and speak to somebody.” (FG6, metropolitan, blue collar, women)
Around half of all participants reported having some sort of policy or program relating to mental health, cigarette use, alcohol consumption, healthy eating, or physical activity indicating some level of perceived responsibility beyond occupational health and safety issues. These included employee assistance programs, healthy staff menus, smoke free zones, provision of low and non-alcohol alternatives at work functions, and active transport policies. Such programs were rarely reported in small business settings.
In contrast to the findings reported above, some participants felt that the workplace did not play a role in influencing workers’ health and wellbeing. Such sentiments were often associated with two beliefs: (1) workplaces only exist to make money, and (2) the workplace should not attempt to control personal lifestyle behaviours. The latter belief was often articulated as the ‘nanny state’. The nanny state was discussed with anger and frustration by several participants especially those in the rural groups; one participant threw their paperwork into the middle of the table in a display of angry dismissal regarding the concept of creating health and wellbeing programs at work; thus highlighting the controversy of this topic for some participants.
“If someone has got an unhealthy lifestyle, is the workplace the place to try and sort that out? I don’t think so. I think companies exist to make money they don’t exist to improve people’s lives. They come to work, work hard and you go home and if you’ve got issues you sort it out at home. I don’t think the workplace is a place to sort somebody’s issues out.” (FG3, rural, blue collar, men and women)
“And this is the grey area, if you’re talking about the organisation doing something for the individuals about their health, because normally that’s an individual’s choice, and most organisations wouldn’t see it as their responsibility. It’s a bit like a ‘nanny state’.” (FG8, metropolitan, white collar, men and women)
“I have a problem with the whole concept…our whole society is moving where individuals don’t take responsibility for themselves, and I’m not saying it’s wrong for a workplace to adopt this, I think it’s quite a healthy thing, but how much money do we spend on it?” (FG4, rural, white collar, men and women)
To further explore the nanny state issues being raised, participants were asked to imagine that they could apply for funding to implement healthy workplace changes. Perhaps counterintuitively, all expressed a desire to implement changes if funding was provided. Their responses seemed to imply that many of their concerns regarding a nanny state were somewhat alleviated and indicated some sense of duty in relation to their employees’ health. Many of these responses were reported in an enthusiastic manner, with excitement expressed about the prospect of being able to help their colleagues to achieve healthier lifestyles. Such a finding highlights that many influences may be at play when employers are making decisions relating to the implementation of health promoting initiatives at work.
Interviewer: “So what about if you could apply for a grant for up to $10,000 to improve the health and wellbeing of your workplace in line with the smoking, nutrition, alcohol, and physical activity areas. Would that be appealing?”
Respondent 1: “Yes. It would relieve our funding because we’re so tight on what we spend our money on. To know that you actually had that money to spend to promote wellbeing, hopefully that they will take on themselves at the end of the day – it would be great.”
Respondent 2: “Definitely. I think if it was any form of grant, I would turn around to my staff and buy a gym membership for everyone and say, “Look, you’re designated for two hours this week. You let me know what hours suit you to go the gym or whatever”, or some sort of a program.”
Respondent 1: “The benefit coming out of it that they would continue that physical activity or that healthy program and things like that. You can’t keep pouring it into it. You hope that from the initial push then people will try and keep that.” (FG4, rural, white collar, men and women)