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1188 CVJ / VOL 57 / NOVEMBER 2016
Veterinary Wellness Bien-être vétérinaire
Wellness at work: Building healthy workplaces
Debbie L. Stoewen
Wellness is “the active process of becoming aware of and
making choices toward a successful existence, both as
individuals within society and within the work environment”
(1). Wellness enhances physical, mental, and social well-being,
and in one word, “health.” In recent years, wellness has moved
into the workplace as enterprises — meaning both for-profit
and not-for-profit companies, businesses, firms, institutions and
organizations designed to provide goods and/or services — have
recognized the role that the workplace can play in supporting
worker health. While enterprises have the responsibility to
provide safe and hazard-free work environments, they also have
the opportunity to promote worker health and foster healthy
workplaces (2). The average person spends more time working
than any other daily activity of life (3), and, over a lifetime, an
average of 90 000 hours on the job (4). The workplace, there-
fore, is an important setting, not only for health protection — to
prevent occupational injury — but also health promotion
to improve overall health and well-being (2,5).
The concept of the healthy workplace is not new, but it
has indeed changed, evolving from a nearly exclusive focus on
occupational health and safety (managing the physical, chemical,
biological, and ergonomic hazards of the workplace) to include
work organization, workplace culture, lifestyle, and the com-
munity, all of which can profoundly influence worker health (6).
Today’s healthy workplace includes both health protection and
promotion (6). In short, it includes wellness.
The World Health Organization (WHO) has captured these
elements in its definition of the healthy workplace. Based on
a systematic literature and expert review, WHO proposes the
following definition (5,6):
A healthy workplace is one in which workers and managers
collaborate to use a continual improvement process to protect
and promote the health, safety and well-being of all workers
and the sustainability of the workplace by considering the
following, based on identified needs:
Health and safety concerns in the physical work environment;
Health, safety and well-being concerns in the psychosocial
work environment, including organization of work and
workplace culture;
Personal health resources in the workplace; and
Ways of participating in the community to improve the
health of workers, their families and other members of
the community.
Based on this definition, healthy workplace initiatives can be
cultivated in four spheres of influence (6, Figure 1).
Physical work environment
Psychosocial work environment
Personal health resources
Enterprise community involvement
Physical work environment
Many kinds of physical hazards can threaten the health and
safety of workers. Examples of such hazards include electrical
dangers; ergonomic-related risks (e.g., repetitive motion, awk-
ward posture, or excessive force); radiation exposure, machine-
related injuries; and the risk of a work-related motor vehicle
crash. These hazards need to be recognized, assessed, minimized,
eliminated, or controlled (6,7).
Psychosocial work environment
“Psychosocial hazards” can also threaten the health and safety of
workers. These are better known as work stressors and are related
to the psychological and social conditions of the workplace,
including the organizational culture and the attitudes, values,
beliefs and daily practices, as opposed to the physical conditions
of the workplace (6). They can be harmful to the mental and
physical health of workers, with evidence of 2 to 3 times greater
risk of mental illness, injuries, back pain, and workplace conflict
and violence (6).
As derived directly from the WHO Healthy Workplace
Framework and Model (6):
Examples of psychosocial hazards include but are not
limited to:
Poor work organization (problems with work demands,
time pressure, decision latitude, reward and recognition,
support from supervisors, job clarity, job design, poor
communication)
Organizational culture (lack of policies and practice
related to dignity or respect for all workers, harassment
and bullying, gender discrimination, intolerance for
Dr. Debbie Stoewen is the Care & Empathy Officer and
Director of Veterinary Services for Pets Plus Us, Oakville,
Ontario. She is a licensed veterinarian and registered social
worker with a special interest in “the social side” of veterinary
medicine.
Use of this article is limited to a single copy for personal study.
Anyone interested in obtaining reprints should contact the
CVMA office (hbroughton@cvma-acmv.org) for additional
copies or permission to use this material elsewhere.
FOR PERSONAL USE ONLY
CVJ / VOL 57 / NOVEMB ER 2016 1189
VETERI NARY WELLNESS
ethnic or religious diversity, lack of support for healthy
lifestyles)
Command and control management style (lack of
consultation, negotiation, two-way communication,
constructive feedback, and respectful performance
management)
Lack of support for work/life balance
Examples of ways to influence the psychosocial work
environment:
Eliminate or modify at the source:
– Reallocate work to reduce workload, remove supervi-
sors or retrain them in communication and leadership
skills, enforce zero tolerance for workplace harass-
ment and discrimination
Lessen impact on workers:
– Allow flexibility to deal with work/life conflict situ-
ations; provide supervisory and co-worker support
(resources and emotional support); allow flexibility in
the location and timing of work; and provide timely,
open, and honest communication
Protect workers by raising awareness and providing
training to workers, for example regarding conflict
prevention or harassment situations
Personal health resources
The provision of personal health resources in the workplace
can support or motivate worker efforts to improve or maintain
their personal health practices or lifestyle, as well as monitor and
support their physical and mental health (6,7). Such resources
include health services, information, opportunities, and flex-
ibility. Although work can get in the way of making healthy
lifestyle choices, motivated and innovative employers do what
they can to remove the barriers and support the personal health
goals of their employees.
As derived directly from the WHO Healthy Workplace
Framework and Model (6):
Examples of personal health resource issues in the workplace:
Employment conditions or lack of knowledge may make it
difficult for workers to adopt healthy lifestyles or remain
healthy. For example:
Physical inactivity may result from long work hours,
cost of fitness facilities or equipment, and lack of flex-
ibility in when and how long breaks can be taken
Poor diet may result from lack of access to healthy
snacks or meals at work, lack of time to take breaks for
meals, lack of refrigeration to store healthy foods, or
lack of knowledge
Examples of ways to enhance workplace personal health
resources:
These may include medical services, information, train-
ing, financial support, facilities, policy support, flexibil-
ity, and promotional programs to enable and encourage
workers to develop healthy lifestyle practices. Some
examples are:
Provide fitness facilities for workers or a financial
subsidy for fitness classes or equipment
Encourage walking and cycling in the course of work
functions by adapting workload and processes
Provide and subsidize healthy food choices in cafete-
rias and vending machines
Allow flexibility in timing and length of work breaks
to allow for exercise
Enterprise involvement in the community
Community involvement refers to the ways in which a work-
place goes above and beyond to involve itself within the com-
munity in which it operates, offering expertise and resources
(beyond its day-to-day offerings) to support the social and
physical wellbeing of the community (6). Activities that posi-
tively influence the physical and mental health, safety, and
well-being of workers and their families offer the greatest advan-
tage. Examples include spearheading a community project and
volunteering in community initiatives to benefit those in need.
Ultimately, as stated in the WHO Healthy Workplace
Framework and Model (Burton, 2010):
A healthy workplace aims to:
Create a healthy, supportive, and safe work environment
Ensure that health protection and health promotion
become an integral part of management practices
Foster work styles and lifestyles conducive to health
Ensure total organizational participation
• Extend positive impacts to the local and surrounding
community and environment
Those in veterinary medicine might ask, “But how does all of
this apply to me in the veterinary workplace? Why would I want to
Figure 1. Spheres of infl uence for a healthy workplace.
Psychosocial
work environment
Personal health
resources
Physical work
environment
Enterprise
community
involvement
FOR PERSONAL USE ONLY
1190 CVJ / VOL 57 / NOVEMBER 2016
BIE N-ÊTRE VÉTÉRI NAIRE
think beyond the necessities of occupational health and safety when
there’s already more than enough to think about — and do — with
running a practice?” These are valid questions, and the answers
are just as important as the questions.
First, it is the right thing to do. Ensuring employee health and
safety follows one of the most basic of universally accepted ethi-
cal principles, “do no harm” (6). There is a moral imperative to
create healthy veterinary workplaces that do not harm the men-
tal or physical health, safety, or well-being of its employees (6).
Second, it is the smart thing to do. Worker health, safety and
well-being not only benefit workers and their families but also
have substantial implications for the productivity, competitive-
ness and sustainability of enterprises (5). There is a wealth of
data demonstrating that in the long term, businesses that protect
and promote employee health tend to be the most successful (6).
They have the most physically and mentally healthy and satis-
fied employees; less sick leave, disability, and turnover; and
higher productivity and quality of products and services (6,7).
As recognized by the WHO, “The wealth of business depends on
the health of workers” (6). Accordingly, to support workers is
to support the enterprise. The two are inextricably entwined.
Businesses that do not protect and promote employee health
incur significant costs on multiple levels.
And third, it is the legal thing to do (sort of!). A safe and
healthy work environment is considered a fundamental human
right (8). The legislation varies tremendously across geographies,
but at minimum, there is always legislation requiring employers
to protect workers from hazards in the workplace that could
cause injury or illness.
Accreditation Canada, an independent, not-for-profit organi-
zation that accredits health care and social services organizations
across Canada, addresses the need for health care organizations
to create a culture that supports a safe and healthy work envi-
ronment (9). A safe and healthy work environment is classified
as “a strategic and high priority.” The situation is the same in
the United States. The Joint Commission on Accreditation of
Healthcare Organizations, an independent, not-for-profit orga-
nization that accredits and certifies nearly 21 000 health care
organizations and programs in the US (10), mandates that hos-
pitals have processes to promote physician wellness (11). To this
author’s knowledge, the veterinary accreditation bodies of North
America do not refer to the necessity of including processes to
promote veterinary wellness or create organizational cultures
that support a safe and healthy work environment. This does not
mean, however, that we can be complacent. On the contrary, we
have the opportunity to follow the lead in medicine — and even
take the lead with the ability to customize, from the ground up,
the most personal, creative, meaningful, and sustainable well-
ness initiatives that best meet employees’ needs and interests.
To clarify, it’s not that work is generally regarded as bad for
physical and mental health and well-being. On the contrary,
when compared to worklessness or unemployment, work is
good for physical and mental health and well-being (12). Work
is usually the main source of income to make a living and fully
participate in society, and it is strongly connected to individual
identity and social status (12). However, it can have harmful as
well as beneficial effects on health and well-being depending on
the workplace. There are costs in all directions — for workers,
the workplace, the community, and beyond — if worker health
and wellness and the imperative to create healthy workplaces
are disregarded.
Increasingly, enterprises large and small and from all sectors
are bringing wellness into the workplace (13). It’s time we take
a critical view of what we, in the veterinary profession, are doing
to promote health and well-being in the workplace, and ask
ourselves what else we can be doing. Along with the responsi-
bility to provide safe and hazard-free workplaces, we have the
opportunity to promote health and well-being and foster healthy
workplaces. We can encompass the opportunities if we expand
our circles of responsibility. In so doing, we meet the moral
imperative to create workplaces that do not harm the mental
or physical health, safety, or well-being of our employees; we
gainfully increase the productivity, competitiveness, and sustain-
ability of our practices; and we take the lead in our profession.
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... In companies, security provided by a healthy work environment implies a reduction in risks at work and suffering professional injuries or illnesses, so, can generate the perception of job satisfaction, physical and mental well-being in employees [5]. Although currently, the Secretary of Labour and Social Prevention in Mexico contemplates regulations and norms in this regard [6], in practice, work environments must ensure safety using different methods and techniques that allow evaluating prevailing conditions at present [7]. Awareness-building strategies are required for some textile companies' owners or managers in Hidalgo-México about importance of employee's safety & health and job satisfaction related to their work position in the company. ...
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In the Mexican textile industries, State of Hidalgo’s especially, conditions as high temperatures, the handling of chemical substances, high noise and vibration levels, humidity, dust and others, continuously exposes workers to associated risks. Diagnosing and proposing improvements by working conditions assessments are not easy to perform, especially if this is not an essential item in the culture of those responsible for carrying them out neither have honest opinions of employees about problems or risks during work hours, without posing a threat to their current labour status. This study aims to assess 420 worker’s job post, using an occupational satisfaction instrument finding the lowest rankings in ironing area.
... Employment is considered to play a major role in a person's health and wellbeing. It leads to integration in society, ensures a sense of autonomy, and enhances physical, mental, and social wellbeing (Stoewen, 2016). Therefore, the workplace represents an important setting that improves overall health and welfare, as well as all socioeconomic domains (Luciano & Meara, 2014). ...
... Employment is considered to play a major role in a person's health and wellbeing. It leads to integration in society, ensures a sense of autonomy, and enhances physical, mental, and social wellbeing (Stoewen, 2016). Therefore, the workplace represents an important setting that improves overall health and welfare, as well as all socioeconomic domains (Luciano & Meara, 2014). ...
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WHO Healthy Workplace Framework and Model: Background and Supporting Literature and Practices Available from: http://www.who.int/occupational_health/healthy_workplace_ framework.pdf Last
  • J Burton
Burton J. WHO Healthy Workplace Framework and Model: Background and Supporting Literature and Practices. 2010. Available from: http://www.who.int/occupational_health/healthy_workplace_ framework.pdf Last accessed September 20, 2016.
Is work good for your health and wellbeing? Department of Work and Pensions Available from: https://www.gov.uk/government/uploads/system/uploads/attach ment_data/file/214326/hwwb-is-work-good-for-you.pdf Last
  • G Waddell
  • Ak Burton
Waddell G, Burton AK. Is work good for your health and wellbeing? Department of Work and Pensions, UK. 2006. Available from: https://www.gov.uk/government/uploads/system/uploads/attach ment_data/file/214326/hwwb-is-work-good-for-you.pdf Last accessed September 20, 2016.
WHO Healthy Workplace Framework and Model: Background and Supporting Literature and Practices
  • J Burton
Burton J. WHO Healthy Workplace Framework and Model: Background and Supporting Literature and Practices. 2010. Available from: http://www.who.int/occupational_health/healthy_workplace_ framework.pdf Last accessed September 20, 2016.
Is work good for your health and wellbeing? Department of Work and Pensions
  • G Waddell
  • A K Burton
Waddell G, Burton AK. Is work good for your health and wellbeing? Department of Work and Pensions, UK. 2006. Available from: https://www.gov.uk/government/uploads/system/uploads/attach ment_data/file/214326/hwwb-is-work-good-for-you.pdf Last accessed September 20, 2016.