In an Australian first, the Victorian government has stumped up $218 million over five years to fund a workplace health initiative, dubbed WorkHealth, aimed at identifying and reducing risk factors for chronic disease. By June 2010, 200 000 Victorian workers (approximately 10% of Victoria’s workforce) had participated, and this number continues to climb.

The checks have been conducted on constructions sites, in shearing sheds, office buildings, and rural showgrounds. Next February, punters at the Western Bulldogs Family Day in February can play spot the Prime Minister while waiting in the queue for their government-funded health assessment.

While not as much fun as hitting the jumping castle, at 15 minutes the checks are a relatively easy way to get an objective assessment of your own health—a pertinent point given that, to date, almost half the participating workers who are at high risk of cardiovascular disease and type two diabetes have considered themselves to be in good health. Ironically, the higher the level of risk, the healthier they consider themselves to be.

The checks require workers to fill in a short, self-reporting questionnaire about their health, including questions about alcohol consumption, smoking, food intake and exercise. Next up blood pressure, non-fasting cholesterol, blood glucose, and waist circumference are measured by a trained professional, and finally all this information is assessed and the worker is given immediate feedback and advice based on the results.

Of the Victorian workers who had participated at June 2010:

• 95.8% of males and 90.6% of females had low fruit and veg intake;
• 20.3% of males and 15.8% of females were smokers;
• 40.1% of women and 26.0% of men reported risky alcohol consumption (N.B. different risk levels were used for the two genders);
• 32.1% of males and 15.7% of females had high blood pressure;
• 32.5% of males and 9.0% of females had low levels of good cholesterol;
• 29.8% of males and 15.9% of females were at risk of type 2 diabetes; and
• 7.7% of males and 1.3% of females were at risk of cardiovascular disease.

Most risk factors increased with increasing age; however, lifestyle factors such as risky alcohol consumption and poor nutrition tended to reduce with age. Overall, 67% of those surveyed were identified as “at risk”. 25% were at high risk of heart disease and diabetes, and 1% were at extreme high risk.

Depending on the severity of risk, at-risk workers are advised to take the results of the WorkHealth check to their doctor within 12 months, three months, one month or 24 hours—however, there is no data on whether workers are following through on this advice. Individuals at risk of Type Two diabetes are also eligible to take part in a free lifestyle intervention program, but very few have taken WorkSafe up on this offer.

The results of WorkHealth checks are confidential, but workplaces with more than 50 participants are sent a report profiling the health and health risks of their workforce, in general terms. (For example, 23% of the workforce are smokers, etc.) Due to strongly expressed concerns on the part of unions, alcohol consumption is not included in this report, although WorkSafe is hoping to revisit this issue.

The intent of the report is to allow employers to implement targeted, low-cost interventions, however there’s no indication of how frequently they do so. We do know that very few employers have applied for the one-off government funding on offer to assist with the development and implementation of health and wellbeing initiatives in the workplace. WorkSafe Victoria has itself described the original grant application process as extremely rigorous, and a simpler system which will “pre-approve” employers who met certain criteria is slated for 2011. The grants will provide between $5000 and $10 000 as “seed funding” for work health initiatives.

We also know that only 1500 of the free Healthy Workplace Kits have been ordered so far, despite nearly 20 000 workplaces taking part in the WorkHealth Checks.

In interviews with 75 000 workers and nearly 1000 employers conducted 1-2 months after participation in the WorkHealth program:

• 59% of employers said that they had, or planned to make changes;
• 63% of workers intended to increase their levels of physical activity;
• 70% intended to change their diet;
• 28% intended to reduce their consumption of alcohol; and
• 30% intended to see their GP.

However, there is no data about whether these good intentions have translated into action. This is one of the key challenges highlighted by the WorkHealth checks: how to translate health assessment into changed health behaviour, and improved health outcomes. Unless workplaces and individuals respond to the information uncovered in the checks, they will be useful only insofar as providing researchers with a picture of workforce health.

WorkSafe is aware of this risk, and in addition to the streamlined grant process for employers, in January 2011 the WorkHealth Coaching service will be launched. With the consent of at-risk workers, WorkHealth checks will be followed up with a phone call, seeking to enrol workers in an appropriate health program over the phone. There will also be six months free access to a telephonic coaching service on offer, in which time there will be approximately ten calls, aimed at setting individual health goals and monitoring progress.

Another teething problem the WorkHealth checks face is in relation to the one size fits all approach WorkHealth opted for, in terms of program design and marketing.  Blue collar workers have been much slower to participate in WorkHealth checks than white collar workers. 29.6% of professionals have participated, 19.7% of clerical employees, and 17.0% of managers, but only 5.9% of labourers, 4.6% community workers and 4.3% of machinery workers.

Participation rates have also varied according to the size of the organisation. Large employers sign up in droves, but the rate of worker participation is often low. Small employers are much more reticent about signing on, but when they do, there are high levels of participation. This is probably due to positive peer pressure in smaller workplace, since WorkSafe has also found that employees at large workplaces tend to be supportive of health and wellbeing activities in the workplace, while employees in small workplaces are less likely to think that such activities belong at work.

With these disparities in mind, WorkSafe Victoria is looking at how they can begin tailoring their communications about WorkHealth to specific industries, rather than using an across the board marketing approach.

“Boosting the profile of health and wellbeing in the minds of employers as a key business issue is a priority,” says WorkHealth Director Pam Anders. “Healthy happy workers are a key element to business success, and we’re driving home that message.”

It is not only employers whose attitudes are likely to shift as a result of participation in the program. Post-participation interviews show that workers who participate in the WorkHealth programs expected to see an improvement in health and safety practices over the next 12 months. This complements existing research, which has shown that blue collar workers are more responsive to workplace health promotion when it occurs in conjunction with OHS initiatives. Moreover, 6/10 workers surveyed said that they would make workplace health and wellbeing a priority when next looking for employment.

With other jurisdictions interested in replicating the checks, and some funding from the federal government available through the Healthy Workers program, is WorkSafe Victoria leading a WorkHealth revolution?

Much of the information above is drawn from a Health Leaders Forum hosted by WorkSafe Victoria, which RTWMatters was lucky enough to attend. Learn more about the WorkHealth checks here.