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- Herausgeber: John Wiley & Sons
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- Sprache: Englisch
Make your workforce happier, healthier--and more productive--with strategies from a world-leader in company culture and health In A Cure for the Common Company: A Well-Being Prescription for a Happier, Healthier, and More Resilient Organization, health and well-being expert, Richard Safeer, M.D. delivers a step-by-step roadmap to creating a culture of health on your team and in your company that keeps your people happier and more engaged. In the book, you'll discover the importance of shaping your well-being culture, challenging yourself, your team, and your workforce to live better lives by offering them new tools and methods to do just that. This book discusses: * Bulletproof strategies to help leaders build a sound cultural foundation that supports their efforts at change * A path forward that allows organizational leaders to step up and help their employees be the best versions of themselves * Techniques to build a supportive culture that overcomes common obstacles to change, including positive social climates, norms, and peer supports A can't-miss resource for business and human resource leaders at medium- to large-sized organizations, A Cure for the Common Company also belongs on the bookshelves of every professional interested in supporting employee health and well-being.
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Veröffentlichungsjahr: 2023
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Table of Contents
COVER
TITLE PAGE
COPYRIGHT
DEDICATION
A NOTE TO THE READER
ACKNOWLEDGMENTS
Introduction
WHY CULTURE IS THE SOLUTION
NOTES
1 Inspiration from a Fire Truck
WILLPOWER IS A FAILED STRATEGY (FOR MOST OF US)
A WELL‐BEING CULTURE IS A COMPETITIVE ADVANTAGE
THE FOUNDATION OF EMPLOYEE HEALTH AND WELL‐BEING
THE PATH TO A WELL‐BEING CULTURE
IS IT WELLNESS OR WELL‐BEING?
THE EMBERS ARE HOT
WHO IS ON THE WELL‐BEING CULTURE TEAM?
THE WELL‐BEING CULTURE BUILDING BLOCKS
HOW I HELP HOPKINS GET HEALTHY
THAT'S A WRAP—LET'S GET STARTED
NOTES
2 Getting Personal
INFLUENCE OF SUBCULTURES ON LIFESTYLE HABITS
THE REMOTE WORKER SUBCULTURE
HOW TO SUPPORT HEALTHY SUBCULTURES
CULTURAL HEALTH AWARENESS
HOW I HELP HOPKINS GET HEALTHY
THAT'S A WRAP
NOTES
3 Best Companies Value Well‐Being
THE VALUE OF SHARED VALUES
CHOOSING THE SHARED VALUES
MAKE WELL‐BEING A SHARED VISION
CHARACTERISTICS OF A SHARED VISION
SHARING THE WELL‐BEING VALUES AND VISION
MAYBE NOT EVERYONE AGREES
MAKING THE SHARED VALUES COME TO LIFE
INCLUDE EMPLOYEE HEALTH AND WELL‐BEING IN THE ANNUAL PERFORMANCE EVALUATION
THAT'S A WRAP
NOTES
4 Oh, the Weather Outside Is Frightful
GETTING TO KNOW YOUR COMMUNITY OF METEOROLOGISTS
SINGIN' IN THE RAIN
PACKING FOR THE SAME VACATION
THERE'S NO PLACE LIKE HOME
LET'S NOT SELL HAPPINESS SHORT!
DYING FOR A PAYCHECK
HOW I HELP HOPKINS GET HEALTHY
THAT'S A WRAP
NOTES
5 All the Cool Kids Are Doing It (or Thinking It)
HOW NORMS WORK ON US AND OUR ORGANIZATIONS
SPOTTING THE HEALTH NORMS IN YOUR CULTURE
NORMS CAN BE INTENTIONALLY CHANGED OR CREATED
CHOOSING NORMS TO CHANGE
THERE'S NO PLACE LIKE HOME
AVOID GOING TO EXTREMES
A CASE STUDY IN A LOW‐STRESS START TO THE DAY
THAT'S A WRAP
NOTES
6 More Than My Love Handles
RECRUITMENT AND SELECTION
FIRST IMPRESSIONS
INFORMATION AND COMMUNICATION
BENEFITS AND PROGRAMS
STORIES AND NARRATIVES
REWARDS AND RECOGNITION
LEARNING AND TRAINING
SYMBOLS AND TRADITIONS
DEATH BY SITTING: CUES FROM OUR WORK ENVIRONMENT
POLICIES
HOW I HELP HOPKINS GET HEALTHY
THAT'S A WRAP
NOTES
7 The Friends and Family Plan
WILLPOWER IS A BAD STRATEGY
BE YOUR BEST WITH A BUDDY
ALL ABOARD: PEER SUPPORT DRIVES SAFETY AT UNION PACIFIC
IF ONLY IT WERE A NORM OR PART OF THE SUBCULTURE
EXTEND YOUR REACH WITH CHAMPIONS
CREATING PEERS THROUGH GROUP PROGRAMS
I'M NOT SURE HOW TO LEND PEER SUPPORT
SOCIAL CONNECTEDNESS
THERE'S NO PLACE LIKE HOME
HOW I HELP HOPKINS GET HEALTHY
THAT'S A WRAP!
NOTES
8 How to Be the Best Boss
MAKING WELL‐BEING A PRIORITY
BE A WELL‐BEING ROLE MODEL
MANAGE WITH WELL‐BEING SKILLS
BE A FORCE OF CHANGE
COMMUNICATE OFTEN AND VARY THE MESSENGER
HOW I HELP HOPKINS GET HEALTHY
THAT'S A WRAP
NOTES
9 Culture Killers
CULTURE KILLER #1—ALL TALK, NO ACTION
CULTURE KILLER #2—LACK OF ACCOUNTABILITY
CULTURE KILLER #3—THE ANTAGONIST
CULTURE KILLER #4—THE ARROGANT
CULTURE KILLER #5—LOSING FOCUS (OR NEVER HAVING IT TO START WITH)
CULTURE KILLER #6—FASTER IS NOT BETTER
CULTURE KILLER #7—IGNORING THE ACTUAL WORK
CULTURE KILLER #8—PASSION WITHOUT A FOUNDATION
CULTURE KILLER #9—WHEN YOUR GOAL IS RETURN ON INVESTMENT (ROI)
THE SPEED OF CHANGE
THAT'S A WRAP!
NOTES
10 Counting Culture
YOUR OPINION MATTERS
HOW IS THE SUBCULTURE OF MY TEAM?
A BIGGER PICTURE
MEASURING THE EFFECT OF WELL‐BEING PROGRAMS
A WELL‐BEING CULTURE IS AN INVESTMENT, NOT A COST
YOUR MEASUREMENT PARTNERS
HOW I HELP HOPKINS GET HEALTHY
THAT'S A WRAP
NOTES
11 Dinner Is Served
THE BEST COMPANY TO WORK FOR … TWICE
THE COST OF BEING FRUGAL
A JOB IS MORE THAN A PAYCHECK
IS YOUR ORGANIZATION READY FOR THE NEXT CHALLENGE?
MAKING LIFESTYLE MEDICINE A NORM
HOW I HELP HOPKINS GET HEALTHY
THAT'S A WRAP (FOR REAL THIS TIME)
NOTES
ABOUT THE AUTHOR
INDEX
END USER LICENSE AGREEMENT
List of Illustrations
Chapter 1
Figure 1.1 The Well‐Being Culture Building Blocks
Guide
COVER
TABLE OF CONTENTS
TITLE PAGE
COPYRIGHT
DEDICATION
A NOTE TO THE READER
ACKNOWLEDGMENTS
Introduction
Begin Reading
ABOUT THE AUTHOR
INDEX
END USER LICENSE AGREEMENT
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Richard Safeer, MD
A Cure for the Common Company
A Well‐Being Prescription for a Happier, Healthier, and More Resilient Workforce
Copyright © 2023 by John Wiley & Sons. All rights reserved.
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To my wife, who was patient with me for years when my work–life balance wasn’t balanced. For helping me lower my stress with her beautiful smile and joyful laughter.
To my parents, for creating a loving culture in our family (and driving us to Brooklyn).
To my children, for giving me pause to think about how their well‐being impacts mine and how my well‐being supports theirs.
To my siblings, cousins, nieces, and nephews, as well as the relatives who’ve since passed. Thanks for all the great Thanksgiving memories.
A NOTE TO THE READER
THIS BOOK IS NOT INTENDED as a substitute for the medical advice of your own physician. The reader should regularly consult a physician in matters relating to their health.
This book is for educational purposes only and is not intended as specific professional advice for any organization.
Although the author has made every effort to ensure that the information in this book was correct at press time, the author does not assume and hereby disclaims any liability to any part for any loss, damage, or disruption caused by errors or omissions, whether such errors or omissions result from negligence, accident, or any other cause.
The author disclaims any liability whatsoever with respect to any loss, injury, or damage arising, directly or indirectly, from the use of this book.
The ideas expressed in this book are those of the author alone, and not those of Johns Hopkins Health System or Johns Hopkins Medicine.
ACKNOWLEDGMENTS
MY JOURNEY TO ARRIVING AT this book has been shaped by hundreds (possibly thousands) of peers, mentors, co‐workers, authors, friends, researchers, speakers, leaders, and, of course, my family. Although I can't list everyone, I'd like to extend my appreciation to the following:
Meg Lucik, who has shared many years of my professional journey, and made many of the well‐being culture building blocks come to life. My other colleagues in the Office of Well‐Being at Johns Hopkins Medicine: Nicolette Amato, Tara Butler, Debi Celnik, Jennifer Salaverri, Carolyn Fowler, Lee Biddison, Suzanne Brockman, Julie Lavoie, and Daria McClamb. Former team members Wendy Bowen and Debbie Dang.
My manager, Inez Stewart, for advocating for the well‐being of the Johns Hopkins Medicine workforce. My human resource colleagues who have worked alongside us for years: Jennifer Alexander, John Bowe, Lee‐Ann Brazelton, Paul Brewer, Jennifer Clarke, Robyn Crowder, Mario Delgado, Theresa Forget, Jamestina Diop, Allisson Fritz, Laura Fricker, Mara Garcia, Sherita Golden, Jeff Goldman, Beth Gotjen, Kelly Greene, Nicki Hancock, Brentina Horshaw, Yariella Kerr‐Donovan, Nancy Kinker, Elizabeth Edsall Kromm, Susan Kulik, Darlene Kurek, Denise Lannon, Stella Lee, Sharon Leitner, Destiny Lowery, Kris Lukish, Maryalice Meister, Irish McClung, Yvonne Mitchell, Tim Moore, Tehani Mundy, Frederick Owusu, Essence Pierce, Dione Powell, Joe Ramacca, Leslie Rohde, Monica Sandoval, Michele Sedney, Jennifer Smith, David Strapelli, Beth Thierer, Julie Thomas, Misty Turner, Gaelle Valburn, Maura Walden, Beth Wilson, Michael Wittstadt, Carol Woodward, Aliyah Young, and those who have retired during my tenure.
The hundreds of Healthy at Hopkins champions supporting their peers.
My friends in finance: Jack Brossart, Keith Hall, Mike Larson, and Suzy Gerlak. Thanks for making sure we have a budget!
My colleagues in the legal department: Annette Fries and Neil Duke.
My colleagues in marketing and communications: Janet Anderson, Hope Byers, Mariann Calloway, Carla Chase, Kate Morrison, and Mia Scharper.
My faculty colleagues for your collaboration to bring world‐class information to our well‐being strategies and for serving as guests on our Ask the Expert program.
Cheryl Connors, Albert Wu, and members of the RISE teams. Matt Norvell, Paula Teague, and the rest of our chaplains. Karen Swartz and the department of psychiatry. Meghan Davis for leading our Total Worker Health effort. Beth Thierer, Kimberly Claiborne, and the EAP team.
My occupational health colleagues who contributed to work represented in this book: Amy Alfriend, Ed Bernacki, and Nimisha Kalia. The entire occupational health team for their challenging work with COVID‐19 and contribution to navigating us through turbulent waters.
My colleague Angelo Mojica and his food service team, including the numerous dieticians who make it easier to choose healthy foods at Johns Hopkins Medicine every day.
The facilities, security, and environmental services teams for keeping our workplace safe and clean.
Every Hopkins leader who does their part to foster a well‐being culture and every employee of Johns Hopkins Medicine. You make world‐class healthcare possible.
Thank you, Judd Allen, for enhancing my understanding of workplace culture and its impact on employee health. I appreciate your peer support and encouragement of doing more celebrating!
My professional colleagues in the American College of Lifestyle Medicine: Susan Benigas, Noel Boyland, Cate Collings, Beth Frates, George Guthrie, Tyler Hemmingon, Julie Holtgrave, David Katz, Kristen Collins, Padmaja Patel, Kaitlyn Pauly, Tom Rifai, Dexter Shurney, Ron Stout, Jean Tips, and Martin Tull.
My colleagues from other professional fields: Susan Brady, Bonnie Davis, Kerry Evers, Ron Goetzel, Susan Johnson, Al Lewis, Johns Harris, Michael O'Donnell, Janice and Jim Prochaska, Stacey Snelling, and Paul Terry. There are many more not listed here. You know who you are. Your collegiality and wisdom have helped me grow.
My colleagues from CareFirst BlueCross BlueShield: Dann Winn, Carrie Greene, Nancy Lesch, Jody Young, and Glenn Leary.
Fiona Shields and Emily Roberts, for joining Hopkins early on our journey to a well‐being culture. Wellness Corporate Solutions made it possible for us to get off to a good start. Our Labcorp Employer Services team members: Shavise Glascoe, Lindsey Laborwit, Ann Namabiro, Emmaline Olson, Celeste Rose, and Laura Tringali.
Books aren't shaped alone, either. My book agent, Doug Hardy, for recognizing the importance of this work and finding a partner in Wiley. Lari Bishop for articulating the case for the book so that it made it an easy choice for Doug to snatch. Thanks for your patience, Zachary Schisgal and Jozette Moses, while I learned to navigate publishing my first book. Thanks to Russ Hall for guiding me through the writing process, researching examples, and shaping the book. My cousin Debbie Feit for her creative mind and giving the book some sparkle so that you don't fall asleep while reading (no money‐back guarantee). Adaobi Obi Tulton for providing developmental editing services. Michelle Hacker for pulling it all together. Tim Moore and Gary June for helping me find people to read the book. Becky Robinson, Kelly Edmiston, Elizabeth Mars and the Weaving Influence team for helping me “Reach” a bigger audience.
Bonnie Maschinsky, for supporting our family while I continued my job and wrote at night and on weekends. My ninth‐grade English teacher who said my writing wasn't good enough to be in the advanced group. I appreciate the lifetime of motivation to be a better writer.
Introduction
PAUL'S BEEN WORKING AT A large professional services company for more than 25 years. As technology accelerated to warp speed, the challenge of keeping a sane work practice became more difficult. Balancing his busy work schedule with his other commitments became increasingly challenging and finally caused him to focus on his well‐being. Not only did he improve his diet and start running, but he also developed a meditation practice. The new habits improved his physical health, and being out in nature allowed him to decompress.
Kerry works at the same company. She recognizes that her well‐being affects her performance and admits striving for balance in her personal and professional life is challenging. Like Paul, she is conscious of eating healthy foods, exercising, and the need for getting time away from work.
What makes Paul and Kerry different from many other employees at Accenture is that they are also managers. What makes Paul and Kerry different from most managers at all companies is that they are not only trying to keep themselves healthy and well, they are also making physical and mental health part of the normal conversation with their teams.1 They even discuss mindfulness, a skill only recently, but quickly, starting to seep into the vernacular of leadership. Paul goes as far as developing a team wellness plan and designating a team member for keeping well‐being on the team agenda. Kerry's a trained mental health ally, there to help her colleagues when they are going through a tough time.
“A great place to work starts with a culture that enables all people to have the opportunity to reach their potential,” says Ellyn Shook, Accenture's chief leadership and human resources officer. “Our cultural building blocks have served as our foundation for years—our behaviors, our beliefs, how we develop people and how we do business.”
It's this philosophy that has contributed to Accenture's recognition as one of Fortune's 100 Best Companies to Work For. And it's leaders like Paul and Kerry who have helped the company achieve 14 consecutive years as a great place to work.
Shook is one of many executives who recognize the impact of workplace culture on employee well‐being. But how do we build a well‐being culture and what are culture building blocks? When you type “workplace culture” into the Google search bar, you'll find more than 9 million results. However, when you enter “workplace‐culture building blocks,” you get one: an article on how to recruit physical therapists more effectively.2 But have no fear—there's a prescription for a happier, healthier, and more resilient team and organization through building a well‐being culture, and you can find it in these pages.
Contrast Accenture with a company across the street (figuratively speaking). Sam pulled himself out of bed after another restless night of sleep; count him among the majority of employees complaining of work‐related insomnia.3 Despite being tired and not feeling well, he drags himself to Toxic, Inc. Sam is not alone. Six out of 10 employees say they've gone to work sick (thank goodness this survey was before COVID‐19),4 many out of concern their employment status would otherwise be in jeopardy. Sam will eventually quit his job to escape the stress, joining many other Americans who've done the same to save their health and well‐being.
How can you achieve the same success as Paul, Kerry, and Accenture and avoid being on the path of Toxic, Inc.? Every day, leaders in organizations small, large, private, and public are struggling to reconcile their own well‐being with their work and figuring out how to support the health of their teams. Leaders and employees alike are struggling to overcome the pervasive and sometimes invisible workplace influences on their behaviors and mood. Many companies offer programs, a wellness portal and health‐promoting policies, but the environment, the people, and the business priorities aren't always aligned. Employees need more—a lot more—for their well‐being.
When the global pandemic hit in 2020, employee health and well‐being became an urgent issue. Everyone faced new stressors, inside and outside of work. Isolation compounded the problem. Many families, communities, and organizations lost people they cared about. Some employees learned to work remotely, while others lost their jobs as employers struggled to get their footing.
Yet there were other companies like Accenture that stood out in this time of crisis. Organizations in which employees worked together, helped each other, and were recognized as places where people were glad they worked. Their cultures are a large part of why their employees are happy and resilient.
For some employers, it took a pandemic to realize the value of their employees' health and well‐being. However, the fracturing of the workforce along the fault lines of well‐being started long before. In the United States, employer‐sponsored health insurance costs almost $8,000 for single coverage and more than $22,000 for family coverage and there is no end to the increases in sight.5 That's a lot of donuts.
Employers have the real challenge of recruiting and retaining employees. In unhealthy workplace cultures, there is higher turnover. In addition to recruitment costs, vacancies take a toll on well‐being. There are often overt or subtle messages that the work still needs to get done, albeit with fewer people.
Americans, as a group, aren't getting younger or healthier. The opposite is true. We have a nationwide culture of poor health and well‐being. Chronic conditions are on the rise and we're one of the most stressed‐out countries in the world.6 And that was before the global pandemic. The leading causes of premature death in America are generally preventable. Now, pair that information with an aging workforce, a falling birth rate, a tighter labor market, and people needing to work longer than expected because they aren't financially prepared for retirement. We've been waiting for the tide to turn, for community leaders and politicians to make real change happen, but we're approaching the edge of the cliff. If companies and organizations want to be successful, which means having a viable and dependable workforce, they have no choice but to act now.
For decades, employers have recognized the role they could play and the importance of acting. A lot of companies have been trying. Consider the title of a recent Forbes column: “The Rise of the Chief Wellbeing Officer.”7 Count the number of articles on culture of health issues published in one week by the Society for Human Resource Management. Look at the growing number of universities offering degrees in health and wellness promotion to feed the demand from public and private organizations.
Leaders know the outcomes they would like to see and they're willing to make them a priority, but the wellness programs they offer—lunch and learns, biggest‐loser contests, health‐risk assessments, and the like—just aren't delivering. The real issue is that changing human behavior is too complicated to be shifted by transactional wellness tactics alone. If you are trying to live a healthy and well life, it's much easier to swim with the current of a workplace well‐being culture.
In 2018, the majority of leaders from organizations representing more than 5.2 million employees around the globe conceded that they had not yet achieved a culture of well‐being.8 However, more than 80 percent of these employers without a culture of well‐being aspired to create one. One challenge is that culture is a loose concept. They often don't know where to start and how to build a workplace well‐being culture. Consequently, they throw money at it and are disappointed when not much changes.
What you'll discover in this book is that creating a culture of well‐being doesn't take much money. It may only take you (well, maybe invite a few friends to help). Leaders who take a systematic approach by using the six building blocks of a well‐being culture described in this book can impact their team's well‐being and even the whole company, depending on your role in the organization. By building a more positive well‐being culture, you'll be able to unlock employee engagement, morale, and productivity while improving the health and resiliency of your team.9 When you act, you'll be able to compete for top talent. Frankly, a well workplace can make every leader's job more satisfying and enjoyable.
WHY CULTURE IS THE SOLUTION
We know, and research proves, that a key factor in anybody's ability to achieve their health goals is whether those goals are supported by the people they're closest to—at home and at work. We've all had the experience of working toward a goal with a buddy or family member, but we don't always recognize the more subtle influences of the other people around us and our work environment. But can organizations leverage these forces to support employees?
Compared to pervasive and often subtle cultural influences, employer‐driven health and wellness tactics can feel transactional—or worse, hypocritical or manipulative. In one survey, 75 percent of respondents said their companies offered “wellness programs” strictly out of self‐interest.10 That means that three out of four employees on your team potentially feel coerced rather than supported in achieving their personal health goals. And just because resources are available doesn't mean people can or will take advantage of them, especially the people who need them most. The biggest reason these programs are only partially successful, though, is that they expect the individuals to bear the full responsibility of changing their behavior despite the influence of their environment, rather than in conjunction with a supportive environment.
Most people want to be challenged at work, but not to the point of causing excess stress. Unfortunately, work is a primary stressor in most people's lives, regardless of age or life stage. A culture that supports a well workforce can have a profound effect on avoiding anxiety, burnout, disengagement, and poor mental health. Companies that have a genuine caring culture have happier and healthier employees who experience a higher sense of well‐being.11
I've been in this line of work for over 25 years. I have built strategies, executed plans, trained leaders, and measured results. I've explored research on individual and organizational change and the influence of companies on employee well‐being. I've been a change agent. I've succeeded and I've fallen short. What I hear repeatedly is that most leaders genuinely care about the people on their teams: they want them to have lower stress levels, they want them to feel healthy and happy, and they want them to be excited to come to work! But they don't know how to make that happen. Culture is complicated and cultural change is not something you necessarily learn in college or when you're promoted to a leadership position … or ever! It's especially hard when it comes to health. It's a challenging and potentially uncomfortable topic, and leaders may project their own experiences onto others, which may get these leaders and organizations into trouble.
Leaders need guidance in their efforts to help employees, and that is the practical promise of this book. The missing piece for most leaders and companies is a method and framework for influencing and shaping a culture of health. A Cure for the Common Company offers practical steps for putting each well‐being culture building block in place, avoiding the things that can derail your effort, and then providing specific ways to measure whether your plan is working.
That is my big goal, my big passion. I want more people to be happy, healthy, and resilient. I want more leaders to feel joy in their work with their teams, and I want more organizations to be successful and feel proud of their support for employee health and well‐being.
NOTES
1.
“Why Wellbeing Is the Unspoken Key to Future of Work.” (2019). Accenture, November 15.
https://www.salesforce.com/blog/df-sponsor-accenture/
.
2.
Thorburn, E. (2021). “4 Ways to Attract New PT Staff When the Workforce Is Dropping Like Flies.” WebPT, October 28.
https://www.webpt.com/blog/4-ways-to-attract-new-pt-staff-when-the-workforce-is-dropping-like-flies/
.
3.
Dill, K. (2014). “Survey: 42% of Employees Have Changed Jobs Due to Stress.”
Forbes
, April 18.
https://www.forbes.com/sites/kathryndill/2014/04/18/survey-42-of-employees-have-changed-jobs-due-to-stress/?sh=667bc9c23380
. Last accessed August 2, 2022.
4.
“Survey Shows Workers Often Go to Work Sick.” (2016).
Cision PR Newswire
, January 12. 2016,
www.prnewswire.com/news-releases/survey-shows-workers-often-go-to-work-sick-300202979.html
.
5.
“2021 Employer Health Benefits Survey.” (2021). Kaiser Family Foundation.
https://www.kff.org/report-section/ehbs-2021-summary-of-findings/
.
6.
Ray, J. (2019). “Americans Stress, Worry and Anger Intensified in 2018.”
Gallup.com
, April 25.
https://news.gallup.com/poll/249098/americans-stress-worry-anger-intensified-2018.aspx
.
7.
Reilly, C. (2020). “The Rise of the Chief Wellbeing Officer,”
Forbes
, July 7.
www.forbes.com/sites/colleenreilly/2020/07/07/the-rise-of-the-chief-wellbeing-officer/
.
8.
“Working Well: A Global Survey of Workforce Wellbeing Strategies.” (2018). Buck, December.
https://content.buck.com/hubfs/Downloads/Surveys/Buck%202018%20GWS%20Executive%20Summary_final.pdf
.
9.
“Unlocking the Power of Company Caring: Workplace Wellness Study 2016.” (2018). Everyday Health and the Global Wellness Institute.
https://globalwellnessinstitute.org/wp-content/uploads/2018/06/EverydayHealth_GWI_Company_Caring_Workplace:Wellness_Study_Final.pdf
.
10.
Ibid.
11.
Ibid.
1Inspiration from a Fire Truck: The Case for Building a Workplace Well‐Being Culture
ONE DAY, JUST A FEW months after starting my job at Johns Hopkins, I was walking on the hospital campus when I saw a big red truck parked in front of one of our buildings. I was deep in thought, and my brain registered it as a fire truck. As I passed by, though, something prompted me to take a second look. Turned out it wasn't a fire truck at all. It was a soda truck.
This sugar dispensary was parked under an old sign—a capital “E” on a round board—telling anyone needing help that this was the entrance to the emergency room of the hospital, or it had been at one time. Inside that building, some of the brightest minds and best caregivers in the world were treating people with diabetes, heart disease, and other increasingly common chronic illnesses that are partly caused by sugar or made worse by it. Outside the building … well, there was no escaping the irony.
For me, the irony was especially meaningful, because supporting the health and well‐being of the employees in that hospital was my responsibility. I was certain some of the soda going through the delivery dock was going into the mouths of my colleagues shortly thereafter. When I arrived at Johns Hopkins, the dedication and commitment of the workforce toward taking care of our patients became quite apparent—even if it came at the cost of our own health. The same painstaking steps implemented to optimize the care of our patients were not being taken for our own workforce.
My story, of course, began much earlier than my employment at Hopkins. I grew up in a time when riding my bike and playing hide‐and‐seek in the neighborhood was a regular part of the day, sometimes well into sunset. Physical activity was a part of my fabric, my social circles, and my neighborhood culture. Finding time to play in the neighborhood got a little more difficult for me when I entered the workforce. However, at the outset of my career as a physician, movement at work was part of the job. I don't know how many steps I walked in the halls of the hospital during residency or between patient rooms during my first three jobs after finishing training. Moving from patient to patient is part of my professional culture.
My career trajectory had changed by the time I was 40. I became the Medical Director for Prevention at a large and prominent regional health insurance company. I found myself sitting in front of a computer more often and in meetings. When my wife identified “love handles,” I realized that I spent most of my waking hours sitting in a workplace that wasn't supporting my health. I had been more than happy to partake in whatever snacks and treats my co‐workers brought to share. To make matters worse, insomnia had started to creep into my nights. There it was, folks. I was married, with three kids and a house in suburbia. I had hit middle age and my health and well‐being were deteriorating. I should have known better—and done better. I studied nutrition in college, and I had strayed from the fundamentals.
Along my career and health journey, I discovered that we don't need to choose one or the other. It started while working at George Washington University. While pursuing some academic work related to cholesterol, I stumbled upon an article about an employer helping its employees lower their cholesterol, then another company successfully supporting employee well‐being, and so on.
Happiness, health, and work may exist together. In fact, when they do, it makes for a more resilient organization. Of course, our home and our community play a big role in our happiness and health as well. Yet because we spend most of our waking hours working, our thoughts and behaviors during these hours strongly influence our well‐being. As a leader, manager, health promotion specialist, human resource professional, lifestyle medicine clinician, or any other professional influencing employees, you have a unique opportunity to create a happier, healthier, and more resilient team and workforce. You might even like the way it feels yourself!
WILLPOWER IS A FAILED STRATEGY (FOR MOST OF US)
Albert Einstein famously stated that insanity is “doing the same thing over and over again and expecting different results.” Yet, every New Year's Eve, millions of people make one or more New Year's resolutions or goals. It may only be weeks or perhaps a month or two before our best intentions start to lie in the corner like a heap of dirty laundry. A year later we do it again; rinse and repeat.
Fewer than 10 percent of Americans feel they are successful keeping their New Year's resolutions, and yet we keep trying, year after year.1 I don't know how many times I've stopped eating chocolate. While choosing a date to start a healthy habit or quit an unhealthy one can be an important part of achieving a healthier lifestyle, we've all come to understand there must be a better, more successful approach.2
There are plenty of reasons to have health and well‐being goals. Foremost, in the wake of a global pandemic, there is an epidemic of mental health challenges. Our stress levels and feelings of happiness (or sadness) impact many, if not most of our other health choices. Who hasn't sat down in front of the TV with a bowl of ice cream or a bag of potato chips after a stressful day at work? When I am stressed, I forage the kitchen for a hidden piece of chocolate. The same health challenges that plagued us before the arrival of COVID‐19, such as two‐thirds of us being overweight or obese, millions still smoking, and fewer than 25 percent getting the recommended amount of exercise, still exist—possibly worse than before.3
All too often, our society praises individual achievement, while underappreciating collective efforts. This starts early with elementary school report cards, art projects, and athletic performance. Don't forget those 100 percent attendance awards! Yes, sometimes teams are recognized, but this is America, the land of “rugged individualism,” and by and large, the expectation is that we make advances on our own, including with our well‐being. Even workplaces have traditionally focused on the individual's role in his or her own happiness and health rather than the collective well‐being of the organization.4 Hats off to those who can improve their health and well‐being without anyone's help.
However, for most of us, we continue to learn and understand that it is communities that have the bigger and more lasting influence on our behaviors, beliefs, and thoughts. Dan Buettner traveled the world to better understand how pockets of centenarians reached their ripe ages. His work, articulated in The Blue Zones, highlighted shared aspects of these communities that contribute to their longevity, including the strength of their relationships and the like‐mindedness of their health practices.
In the same context, through their book Connected, Nicholas Christakis and James Fowler decoded the science behind our strong propensity for sharing the same behaviors and emotions as those with whom we keep company. Not only do our family members, friends, and co‐workers influence our choices and thoughts, but so do more distant relatives and friends of friends—for example, when my wife's hair salon keeps the bowl of chocolate on the front desk full so she can grab a piece before heading home. I sniff it out on days of distress. Without having ever met my wife's hairdresser, she influences my behavior every six weeks.
So why aren't organizations taking advantage of what we know to be true? We are more likely to be healthy and well when we are in a supportive group, team, and community that has aligned behaviors, beliefs, and attitudes around well‐being (aka, well‐being culture). Perhaps it's because we haven't previously clearly articulated the importance of organizational well‐being culture and how to shape it. Our co‐workers shouldn't approach a New Year's resolution alone when we know they are much more likely to be successful in a workplace well‐being culture. This is not such an insane idea.
A WELL‐BEING CULTURE IS A COMPETITIVE ADVANTAGE
Most people want to work in an environment in which they feel valued and supported. People generally know what is healthy, but they face challenges adopting healthy behaviors and getting rid of unhealthy ones. Consequently, many people in the workforce seek employers that support health and happiness, and those who already work for these employers tend to stay longer at their jobs.5 It's often said that people don't leave their jobs—they leave their managers.6 Being a manager who creates a well‐being culture supportive of happiness and health guarantees a more satisfied, appreciative, and engaged employee as well as a more resilient team.
In addition to improving recruitment and retention, a well‐being culture also results in improved team performance and decreased absenteeism.7 These benefits alone lead to a positive financial picture. Yes, creating a well‐being culture at work can even make it easier to create healthy habits. 8 These healthier lifestyle choices lead to lower medication needs and fewer physician visits and hospitalizations. Better health makes it easier to be happy.
Granted, there is skepticism that workplace wellness creates savings.9 However, as you'll come to learn by reading this book, creating a well‐being culture is a much more comprehensive approach and addresses concerns about a lot more than money itself. A well‐being culture is nothing short of an essential element of a successful organization.
THE FOUNDATION OF EMPLOYEE HEALTH AND WELL‐BEING
The culture‐based approach is markedly different from most tools available in the workplace wellness industry. The “culture” piece is almost always missing. Historically, employers have focused on individual motivation and effort. Typically, the employee is encouraged to complete a health survey, seek coaching where needed, and read a health newsletter. Annual events such as health fairs and contests are sometimes thrown into the mix. They have a feel‐good quality that fits with a culture preoccupied with self‐determination and can be helpful to a small number of people. While inexpensive and easy to deliver, such efforts rarely address the underlying conditions that lead people toward unhealthy practices. Fortunately, some employers have progressed beyond this one‐dimensional approach, but only to a limited degree. The elements of workplace culture that work against happiness, health, and resiliency are typically ignored.
The wellness industry's playbook offers excellent self‐help tools that would be much more beneficial if delivered in a well‐being culture. It's helpful and often necessary to partner with a wellness vendor to bring many aspects of culture building to the table. However, culture building has many more ingredients, and many key elements can only be pursued effectively internally. To make matters more complicated, “culture of health” is becoming a buzz phrase driven by clever workplace wellness marketing departments seeking to make their products more appealing. I hope you will not be distracted by shiny new packaging and instead, create the well‐being culture you want and need.
Defining a Culture of Health
Excerpts within this box are from R. Safeer and J. Allen, “Defining a Culture of Health in the Workplace,” JOEM 61, no. 11 (2019): 863–867.
Webster's defines “culture” as the “behaviors and beliefs characteristic of a particular social, ethnic, or age group.” While well‐intentioned, the same organizations, researchers and thought leaders that promoted wellness as a product, have rebranded under the buzz phrase, “culture of health.” Unfortunately, the meaning behind “culture of health” has been hijacked from the social sciences, and what is being promoted in the commercial space often lacks any reference to key culture frameworks and concepts that are shared in this book. Your organization will be better served to appreciate that a culture of health is a web of social influences that manifests itself in shared healthy beliefs and behaviors.
The analogy to a web is fitting for several reasons. Webs are complicated and intricate works that connect a common structure in multiple ways. When pulling a web in one direction, it distorts the shape of the web both near and far. Similarly, the words and behaviors of an individual certainly affect those next to us, but also reverberate to those connected to our immediate circle and so on (like a ripple in the water after a stone makes its initial splash).
Furthermore, webs can get messy when tugged suddenly and forcefully. Webs are fragile and need to be handled with care. Sudden movements can have irreparable consequences, so thoughtful approaches on how to shape your well‐being culture are warranted.
One goal of building a well‐being culture is to align workplace influences with healthy beliefs and behaviors. The individual and cultural approaches to building a well workplace and work team are complimentary. In my experience, a supportive culture provides the needed foundation for individual efforts to succeed. The more progress individuals make with their own well‐being, the more they can contribute back to the well‐being culture. Some of the advantages of creating and sustaining a healthy culture that are not inherent in traditional workplace well‐being programs include:
Healthy cultures touch everyone—not just those who are already interested in improving their well‐being. You don't need to “sign up” or “show up” to reap the benefits of a healthy workplace culture. In a workplace well‐being culture, you are immersed in an environment supportive of your well‐being journey.
It is easier to make progress in employee health if people continue their healthy behaviors. Supportive cultures keep people on their healthy path, while unsupportive cultures thwart New Year's resolutions.
Building new positive practices is easier in a supportive culture. A supportive culture increases the likelihood of developing new healthy habits, attitudes, and beliefs.
A well‐being culture improves employee morale. Most people want to feel cared for and benefit from caring for others. An organization with a well‐being culture inherently has created a sense of community where everyone is rowing together, in the same direction, toward a healthier destination. This collective effort undoubtedly improves the sense of community and makes for a more resilient organization.
THE PATH TO A WELL‐BEING CULTURE
For most of you, well‐being culture is a new phrase, but wellness is not. However, my guess is that the meaning of “wellness” remains elusive given that it is used in so many ways. Understanding the history of wellness can make it easier to appreciate its contribution to individual well‐being, as well as its shortcomings.
The history of “wellness” starts with “health.” Just a few years after World War II ended, the World Health Organization offered this definition of “health”: “Not merely the absence of disease or infirmity but a state of complete physical, mental and social wellbeing.”10 In 1959, Halbert L. Dunn, in his seminal article “High‐Level Wellness for Man and Society,” called for more research and greater effort for a “positive orientation toward life and society.”11
Meanwhile, employers started taking an interest in the health of their employees. Blue Cross was founded in 1929 to help patients in Dallas, many of whom were public school teachers, pay for their healthcare.12 Employee Assistance Programs (EAPs) can be traced back to the 1930s, when some companies began to offer interventions over concerns about alcoholism and the resource expanded in the 1950s to support mental health issues.13,14
The postwar cultural shift that promoted fitness spanned decades. Depending on when you were born, you might remember Jack LaLanne from the 1960s, Rocky Balboa from the 1970s, or Jane Fonda from the 1980s. EAPs expanded their offerings in the 1970s as companies took interest in workplace wellness as a cost containment strategy.15
Big corporate wellness programs, such as Johnson & Johnson's Live for Life program, began leading the way in 1978, and were mostly concerned with exercise and weight control. Around the same time, the National Wellness Institute (NWI) was formed. Dr. Hettler (one of the founders of NWI) released the “Six Dimensions of Wellness Model,”16 one of the earliest of many other wellness models to follow suit. The 1980s brought rise to other wellness‐oriented organizations, such as the Wellness Councils of America.
Evidence of the advantages of worksite wellness grew gradually, until in the 1990s the federal government launched the Healthy People 2000 initiative encouraging 75 percent of employers with 50 or more employees to offer health promotion services as a benefit.17
As the science of medicine started to accelerate and new drugs, surgical techniques, and diagnostic tests became available, healthcare continued to move away from the foundation of health—nutrition, exercise, sleep, and the rest of what we inherently know to be good for us. Healthcare was leaving a void. As more advances were deployed, healthcare costs started to rise. Good relationships, movement, sleeping well, and basking in nature are free (or at least a lot less expensive)! Conditions were ripe for a new industry to emerge that improves health at a much lower cost than remedial or diagnostic measures. Employers were sure to be interested since most were starting to cover the cost of health insurance as a benefit to attract and retain employees. As health insurance costs started to rise, a less costly option grew more attractive.
For decades, workplace‐wellness companies popped up to offer simple solutions to complex problems. While these companies had the best intentions, they mostly failed to produce the results they promised because they didn't address the root causes of why individuals weren't reaching their optimal state of being. When “wellness” business started to suffer, the adoption of “well‐being” was eagerly promoted. It was a chance to give their company a makeover. However, like previous attempts, and although programs and outcomes vary from one organization to another, collectively, their effectiveness is questionable.18
Current well‐being strategies don't address the essential elements of building a healthy culture that are shared in this book. To make matters more complicated, now “culture of health” is becoming a buzz phrase. Again, many of the same people driving a for‐profit industry looking to genuinely help, but not completely understanding the science, are just rebranding the same old stuff.19
The current wellness market includes supplements, anti‐aging products, and a dizzying array of self‐help apps. This wellness economy is a colossal global industry, estimated to be $4.5 trillion in “value”!20 In this book, I am offering you a path to achieve a well‐being culture for your team and organization that doesn't require you to put a mud pack on your face each night (although I am not opposed to smooth skin). You can create a well‐being culture that supports the continuum of well‐being. That means happiness, health, and resilience are included!
IS IT WELLNESS OR WELL‐BEING?
If you're looking for a conversation that might not have an end, ask a friend to explain the difference between wellness and well‐being. The World Health Organization defines wellness as “a state of complete physical, mental, and social well‐being, and not merely the absence of disease or infirmity.” I think of well‐being as a state of mind and body that fluctuates on a continuum, based on countless variables. To me, well‐being is not a constant state, but rather an ongoing journey with a destination of wellness. For the purposes of this book, I will use well‐being to describe a journey to wellness.
Frankly, I think you can embrace either term. Given that everyone is on their own well‐being journey (we're all different), it makes sense that I'm encouraging you to embrace your own definition of well‐being, which might be the same as your definition of wellness. If someone tries correcting you, pay no attention to this minutia. What's important is that you learn what you need to feel well and then come to understand how to attain the state of well‐being that you desire.
Different segments of the healthcare industry use related phrases. In the occupational medicine field, employee health and productivity management is quite similar to employee health and well‐being. Even the trending population health can be used to refer to employee health and well‐being when working with employee populations. A well‐being culture in the workplace though, is a separate concept from each of these terms. If I'm doing my job right, you'll come to embrace the full meaning of this phrase by the end of this book.
Johnson & Johnson: Early Adopters of the Well‐Being Culture
Johnson & Johnson (J&J) is one of the largest companies at the forefront in addressing employee health and well‐being. More than 75 years ago, J&J created a credo that squarely focused on health and well‐being; not only for its customers, but also for its employees.
A central portion of the Johnson & Johnson Credo is:
We are responsible to our employees who work with us throughout the world. We must provide an inclusive work environment where each person must be considered as an individual. We must respect their diversity and dignity and recognize their merit. They must have a sense of security, fulfillment, and purpose in their jobs. Compensation must be fair and adequate and working conditions clean, orderly, and safe. We must support the health and well‐being of our employees and help them fulfill their family and other personal responsibilities. Employees must feel free to make suggestions and complaints. There must be equal opportunity for employment, development, and advancement for those qualified. We must provide highly capable leaders and their actions must be just and ethical.
While only one sentence of the excerpt is highlighted to make a point, every sentence of the paragraph reflects and impacts employee health and well‐being. In the context of the full credo, health and well‐being are raised well before the financial obligations to shareholders. The way J&J conducts business serves as an exemplary model.
THE EMBERS ARE HOT
Whether you get the news from an actual newspaper or the internet, you are likely aware that chronic diseases (such as heart disease, cancer, and type II diabetes) have not been cured. If anything, more people are getting diagnosed with these conditions each year. Unhealthy behaviors are primary factors in the seven leading causes of death—heart disease, cancer, stroke, respiratory diseases, accidents, Alzheimer's, and diabetes. Together they account for more than 70 percent of all deaths in the United States. The COVID‐19 pandemic illustrates the benefit of healthy lifestyles. Those with healthy behaviors have stronger immune systems, which are more likely to protect us from the devastating possibilities of this infection.
Behaviors, such as walking outside, eating nutritious food, and getting good sleep not only help our physical health but also our mental health; which, by the way, for many people, is also in shambles. More than 1 in 10 adult Americans are depressed,21 and more than half report an unhealthy amount of stress in their lives from a number of different sources—including work.22 The economic and social costs are a tremendous additional burden to individuals, businesses, and communities.
COVID‐19 also challenged our resilience as individuals, and collectively as teams and organizations. Why is it some people, some teams, and some companies were able to withstand the uncertainty and the new challenges of the swiftly changing public health and social dynamics? They were equipped with healthy behaviors and constructive attitudes, combined with supportive and competent leadership and peers as well as necessary tools and resources.
We must respect the many cultures within which our employees live. Our employees are part of their family culture, community, ethnic, and possibly religious cultures, as well as sports, hobbies, and a variety of other subcultures (to be explored in Chapter 2). All these cultures add up to the individual's collective experiences, which play a role in how one impacts, and is impacted by, the culture in the workplace. By understanding the complexity of the human experience, employers stand a better chance of being more supportive so that employees can have a healthy workday, which will carry over outside of the workplace. You can't do this alone, however. You need a team.
