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ResearchWellbeing and health promotionWellbeingOccupational Health

Wellbeing Tree: European tool for workplace health bears fruit

by Jennifer Lunt, Professor David Fishwick and Professor Andrew Curran 26 Sep 2014
by Jennifer Lunt, Professor David Fishwick and Professor Andrew Curran 26 Sep 2014

Wellbeing at work is increasingly important for maximising a workforce’s potential, and a new tool can help get this important message out to both employers and workers. Dr Jennifer Lunt, Professor David Fishwick and Professor Andrew Curran explain how.

Together with colleagues from across Europe, the Health and Safety Laboratory (HSL) has “grown a new type of tree”. The tree concept is one way of explaining what wellbeing at work should be about, its scope and its importance to workplace health and business interests. It can also be used to support the occupational health (OH) community, given the move away from a focus on workplace risk and worker protection, towards the modification of a broader range of health risks and influences on worker performance (Heron, 2013).

Why wellbeing at work remains important

The publication of Dame Carol Black’s review of the health of Britain’s working-age population raised the prominence of wellbeing at work (Black, 2008). Furthermore, it provided a focal point for wellbeing on the Government’s agenda. It also led to the launch of a set of national wellbeing initiatives such as the “fit note”, OH advice services for small businesses and GPs, and the Workplace Wellbeing Tool (Department for Work and Pensions, 2014).

These initiatives were launched with a view to helping reduce the substantial costs of poor wellbeing to society and the workplace. At the time of publication, the annual estimated cost to the UK tax payer was more than £60 billion. Since then, a recession has added further considerations: as a potential by-product of austere times, presenteeism (the tendency to be at work and unproductive when unwell, potentially driven by a fear of job loss) has apparently become more commonplace. Presenteeism is thought to cost UK employers more than £15 billion per annum (Newcombe, 2013). For sustainable performance, wellbeing at work still matters in tough economic times.

More concrete evidence is now emerging on the business gains that can be achieved by managing wellbeing at work more effectively. For example, a recent analysis of “wellness” initiatives (focusing on health promotion) found a return on investment of $1: $3.36 (Rouse et al, 2012), saving 1.7 absence days per employee. According to Heron (2013), employers adopting a positive stance towards wellbeing are more likely to have “engaged employees aligned with business goals.” More evidence that managing wellbeing at work is worth the investment.

An optimal approach

Definitions of wellbeing are still debated. Common to the more widely cited definitions (Foresight, 2008 and Waddell and Burton, 2006) is recognition that wellbeing is a dynamic “state” and based on the interaction between the social, physical and psychological resources of the individual, and their context. Experiencing wellbeing means that the individual feels good, is functioning at an optimal level psychologically, socially and physically, can develop their potential and flourish, work productively and generally have a positive impact on their surroundings. This is whether they are at work, at home or in the community.

As wellbeing at work arises from the interaction between the worker and their workplace, employers need to provide the context in which their workforce can flourish and be productive. How an organisation is run, and how its culture and values dictate the priority that workforce wellbeing has relative to productivity, quality and customer satisfaction, matters as much as workers taking physical exercise or having a healthy diet. To keep an ageing workforce productive, managing wellbeing also requires an approach that spans prevention, retention and earlier return to work of staff, dealing with the health challenges that the ageing process inevitably brings (Kendall et al, 2012).

Recent years have also seen positive approaches to health and wellbeing becoming increasingly popular (eg Seligman, 2008). Thinking about health matters has advanced from a preoccupation with preventing harm, as embodied by conventional risk management and stress-prevention research, towards harnessing physical and psychological health “assets” or resources that, if utilised, create the ideal environment for workers to excel and innovate. Examples of such assets might be positive working relationships, meaningful work, mastery and morale (Lunt et al, 2007). Lack of morale is not necessarily harmful, but having morale is considered good for wellbeing (Lunt et al, 2007).

In short, effectively managing wellbeing at work necessitates a holistic approach. This does not mean crystals, aromatherapy or head massages. It requires an approach that tackles systems, culture/leadership and individuals, spans prevention, retention and return to work and engineers positive outcomes that go beyond the prevention of harm.

Current approaches

In practice, when you take a look at most case study collections of wellbeing at work programmes, you might be forgiven for thinking that it predominantly concerns health promotion. Healthy food options, gym vouchers or support to give up smoking are examples of schemes typically badged as wellbeing initiatives. Other more reactive examples falling under the wellbeing umbrella include having private medical insurance and access to counselling (Business in the Community, 2009).

These examples can have a legitimate role in either protecting or permitting recovery of individual worker wellbeing. Yet they do not truly tackle the underlying influences on wellbeing at work, such as leadership styles, attitudes to health and management systems. What can be done to prevent this apparent default to solutions that target just the worker, and not the workplace environment?

Demystifying wellbeing at work

One solution may be to find more innovative ways of communicating to employers what wellbeing at work really encompasses, where they should target their efforts, and why it should matter to them. With this in mind, the Wellbeing Group from within the Partnership for European Research into Occupational Safety and Health (PEROSH) developed the Wellbeing Tree.

PEROSH wellbeing tree

A static version of the Wellbeing Tree

PEROSH is a network of 12 occupational safety and health institutes from across Europe. Its aims include coordinating European health and safety research, and using the resources and knowledge from different countries to improve research efficiency. One of the PEROSH research groups is the PEROSH Wellbeing Group, led by the UK HSL. The group comprises wellbeing experts working in health and safety institutions from across Europe with a track record of translating science into useable resources for the workplace. Part of the purpose of the group is to improve understanding of how to manage wellbeing among European employers. You can read more about PEROSH here.

The PEROSH Wellbeing Group felt that the tree, in particular a fruit tree, provided an easily grasped metaphor for communicating the constituents of a holistic approach to wellbeing at work (a “static” version of the tree is provided below).

First, the notion of “growth” implied by the use of a tree allows the relationship between investing in workforce wellbeing, and the benefits of doing so to be readily expressed. Consequently, the contributors or inputs into wellbeing correspond to the roots of the tree. Similar contributors are grouped by larger roots into individual, job environment, organisational and societal influences. A fruit tree also allows the beneficial consequences of worker wellbeing to the workplace to be captured as fruit; with similar consequences being grouped by branches, using similar groupings. These shared groupings ensure that the tree is a balanced model of wellbeing.

A second advantage of using such a tree is that it lends itself to explaining the interdependence between the worker and their work context when shaping wellbeing. In other words, the transactional nature of wellbeing can be expressed via feedback loops. For example, the benefits of reinvesting in wellbeing on continued growth can be expressed as fruit falling from the tree and providing further sustenance. Struggling through austerity can be portrayed as poorer environmental conditions and less investment in staff, giving rise to an impoverished yield. Third, by embracing interactions that extend from the individual to society, the tree is undeniably integrated.

Two versions of the tree were developed, one targeting employers, and one targeting experts using more technical terms. Developing an expert version was considered to lend scientific credibility to the employer-focused version. Both versions are separated into two levels. The first level explains the purpose of the tree and how it can be used, the second labels its components. Labels are revealed by dragging the mouse over the tree to open “pop-up” text boxes. Labels are intentionally non-directional or neutral to allow for both the positive and negative “knock-on effects” that change can bring for worker wellbeing.

Developing the tree

The tree’s development was based on a consensus decision-making process between experts. PEROSH members were initially surveyed using a Delphi methodology (a structured communication model) to obtain consensus on wellbeing definitions, drivers and potential solutions among members of PEROSH. The results provided the foundations for the tree. Its concept, content and labels were then arrived at iteratively through facilitated face-to-face team discussions and email between group members. The current evidence base for wellbeing at work is represented by the group members that developed the tree.

PEROSH’s wellbeing tree does not pretend to be an empirical testable model of wellbeing due to the great variety of factors that the PEROSH group wanted to integrate as possible constituents of wellbeing. Its nature means that it incorporates other related concepts, such as quality of life at work. Its intended purpose is to provide a simple and clear tool for increasing employers’ and employees’ understanding of a widely misconstrued topic, and as a tool for guiding improvements.

If current trends towards an increased intensification of work, demands for more flexible working and a blurring of boundaries between work and home continue, then getting these messages across will become significantly more important.

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Intrigued? Then please take a look at the tree on the PEROSH website. If you are an employer, a health and safety or OH expert, and you want to do more to protect and harness the wellbeing of workers, then the Wellbeing Tree could help.

References

  • Business in the Community (2009). Healthy People = Healthy Profits
  • British Safety Council (2013). “The business benefits of health and safety: A literature review”.
  • Black, C (2008). Working for a healthier tomorrow.
  • Department of Work and Pensions (2014). Helping people to find and stay in work.
  • Foresight Mental Capital and Wellbeing Project (2008). Final project report. The Government Office for Science. London.
  • Heron, RJL (2013). Editorial, Occupational Medicine, pp.314-319.
  • Kendall N, Burton K, Lunt J, Daniels K and Mellor N (2012). Common Health Problems: The Chasm of Lost Opportunity. Symposium at the Second International Wellbeing at Work Conference.
  • Lazarus R, Folkman S (1984). “Stress, appraisal, and coping”. New York: Springer.
  • Lunt J, Fox D, Bowen J et al (2007). Applying the biopsychosocial approach to managing the risks of contemporary occupational health conditions; scoping review. HSL report HSL/2007/24.
  • Rouse M, Hurst C, Sarma S, Zaric G (2012). Meta-analysis. Workplace Wellness Programmes.
  • Newcombe T (2013). Stress and presenteeism ‘sapping UK productivity’ says research.
  • Seligman MEP (2008). “Positive health”. Applied Psychology: An International Review, 57, pp.3-18.
  • Waddell G, Burton AK (2006). “Is work good for your health and wellbeing?” London: The Stationery Office.
Jennifer Lunt, Professor David Fishwick and Professor Andrew Curran

Dr Jennifer Lunt is principle psychologist, Professor David Fishwick is chief medical officer and co-director of the Centre for Workplace Health and Professor Andrew Curran is director of science and delivery at the Health and Safety Laboratory.

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