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Taking Workplace Health Promotion Global:
The Art of Cultural Integration
Anne Marie Kirby, CIS
1
and
Rodrigo Rodriguez-Fernandez, MD, MsIH, MSc, DTM&H, FRSA
2
Although migration has been occurring since the origins of the
human race, the recent era of expanding globalization has led
to the increased movement of the global workforce across and within
national boundaries. The social, political, and economic aspects of
worker mobility have been the focus of numerous studies
1,2
and have
led employers to pay closer attention to the impact that worker mobi-
lity may have on business continuity. As more multinational corpora-
tions (MNC) are starting to place workers in low- and middle-income
countries (LMIC; eg, high-tech companies based in the US relocating
assets to LMIC such as Bangalore, India), the health status of employ-
ees may be negatively affected by the new environment. Conversely,
some countries might confer a protective effect as well. Better under-
standing of how subpopulations relocating to different countries might
experience different health outcomes after deployment may provide
further insight in the complexities that lead to health outcomes within
migrant populations.
According to a recent report, international assignee levels have
increased by 25%over the past decade, and a further growth of 50%
is predicted in mobile employees by 2020.
3
A further study ranked the
United Kingdom as having the highest rate of professionals leaving in
2016.
4
Those interviewed stated that their reason was the pursuit of a
better quality of life (29.9%) and improved career progression
(17.3%). The United States ranked fourth in terms of countries where
national (US) employees are leaving (26%). According to the US
Department of Commerce, investment and employment by MNCs
have a 0.1%increase in hiring for jobs in the United States, while
increasing their hiring abroad by 4.4%.
5
The Problem: Disparate Programs and Data
From Multiple Systems
Years ago, Anne Marie Kirby, chief executive officer (CEO) of Cor-
eHealth Technologies, was speaking with a very clever leader in a
consulting organization and she shared her panacea for her ‘‘Jumbo’’
customers. These Jumbos, as she called them, are large global orga-
nizations with thousands of employees. She said that if the leaders
could have visibility through a single unified view of health programs
for all of their employees, it would be the Jumbos’ organizational Holy
Grail. Unfortunately, not much has changed since then. Organizations
are still struggling to synthesize and understand data from multiple
systems, multiple vendors, and across multiple locales. The data def-
initions do not match. The benchmarks are different. And in fact, the
programs and offerings are so diverse, there is no ‘‘apples to apples’’
comparison, even if the data are compatible. This lack of cohesive
information is costing organizations money and lost opportunity.
Role of Private Sector in Global Health
Promotion
Noncommunicable diseases (NCDs) kill 41 million people each year,
accounting for 71%of all deaths globally.
6
Each year, 15 million
people between the ages of 30 and 69 die from an NCD and over
85%of these ‘‘premature’’ deaths occur in LMIC. The World Health
Organization has recognized the need to assemble a wide range of
employer/workplace stakeholders in order to mitigate this growing
NCD burden. Given the amount of time individuals spend at work,
workplaces have been identified as an effective location to tackle the
mounting NCD epidemic. Large multinational companies within the
commodity, banking, retail, manufacturing, technology, and automo-
tive industries, to name a few, have proven that when it comes to rapid
mobilization and efficiency, their resources of human capital, intel-
lectual capital, financial, and geographical footprint can contribute
significantly to improving health outcomes in local and global popu-
lations. Whether it is providing free HIV antiretroviral medication or
lending a hand in infectious disease outbreaks such as Ebola, a large
number of case studies have shown the important role the private
sector can play in global health promotion.
7,8
As CEO of a wellness technology company that works with global
well-being service providers, Kirby has overseen the deployment of
the CoreHealth platform in a number of countries around the world.
CoreHealth has dealt with the same issues that all North American
companies do when delivering programs to employees around the
world. Kirby and her colleagues have experienced the first-hand tech-
nical issues of multiple languages and translations, cultural differ-
ences, and access to technology (computers, mobile, WIFI, etc).
Most importantly, there are the unique regulatory rules for data pri-
vacy and security in every region or country. And in some cases,
because they sell to foreign wellness providers, they have also dealt
with business challenges such as taxation, company registration, and
the local market.
Kirby also notes that the ideal scenario is when they work with
organizations that have ‘‘boots on the ground’’ in every country where
participants live. However, there are very few organizations in the
world where:
1. health is their primary focus;
2. they understand the value of prevention; and
3. they have health professionals in every locale.
1
CoreHealth Technologies, Kelowna, British Columbia, Canada
2
International SOS, London, United Kingdom
Editor’s Desk: The Global Health Issue 629