More than 80 percent of large employers (those with 200 or more employees) report that they offer at least one health promotion activity.  It might be posters about eating more fruits and vegetables, or a smoking cessation program, or incentives to be more physically fit.  How well do these activities support the health needs of low income employees?

That question was the subject of a recently published paper by researchers with the University of Washington School of Public Health and the American Cancer Society.  The researchers conducted focus groups with 77 workers who met the researchers’ definition of low-socioeconomic status:  ≤ high school education and/or an annual household income of $25,000 or less.

Throughout the many hours of conversations with the workers, the authors report the most frequently expressed recommendation was to provide healthier foods in the office break room and at meetings.

‘‘Stop bringing all the sweets and treats,” was a comment from one participant.

The authors write:

“Employees believed their employers used indulgent foods (such as doughnuts or pizza) as incentives to boost meeting attendance or reward work achievements. Most said that although they would eat unhealthy foods when provided, they would prefer to be spared temptation and to receive rewards in a different form (financial, public recognition).”

Their study involved focus groups with 77 individuals who worked at several Seattle-area companies with 1,000 or more employees. They were employed in 11 different industries, with the majority in retail, healthcare, and education.

The workers discussed how job stress affected their health. The authors share quotes from the workers, such as:

“‘Most of the companies these days. . .they’re having you. . .commit to improving your health. What’s interesting is that they’re the ones that are killing you softly with. . . stress. . .It’s like ‘you all care about my health, but you’re the ones helping in killing me?’’’

The authors also report:

“Among low-SES employees who use tobacco, stress was the reason cited most often for not being able to quit, or starting up again after quitting. ‘. . .I had quit smoking for like three years, and then I started up again because of the stress.’

“Many low-SES employees said they felt overworked and not cared for by their companies, which led to increased stress. To reduce stress, employees recommended that companies provide them with consistent and reasonable work hours, clear and respectful communications, and more assistance with workload.”

Like many of us, the workers said they know what they need to do to be healthy:

“‘It’s not that I don’t enjoy. . .eating healthy. If I had someone at home to push me to exercise, I probably would. But just at the end of the day, that’s the last thing that I’m thinking about.’’

‘‘Of course, I know that I need to have a better exercise regimen. . . We have our job which goes probably 10 hours a day, maybe 12 hours. And then you go home and you’ve got to tend to family and children. . .’’

The authors observe:

“Focus group participants noted that inactive job roles combined with short, timed lunch breaks can make it difficult to exercise at work. Many also mentioned that long work hours and frequent overtime results in little time for recreational physical activity before or after work hours.

The responses from these workers in Seattle sound familiar to what I read in a 2012 report from MassCOSH and the Boston Workers’ Alliance. I wrote about it here.

The researchers also conducted interviews with 12 representatives of Seattle-area companies that employ more than 1,000 workers. (Not necessarily the same companies where the 77 worker-participants were employed.)  I found this part of the paper also quite interesting.  Some of the company reps, for example, seem to bemoan workers’ disinterest in their company’s wellness program.  The authors also write:

“Most were very reluctant to discuss anything related to employee socioeconomic status, income, or education.”

Hmmm….unwilling to acknowledge the connection income and health?

The Henry J. Kaiser Family Foundation’s 2017 Employer Health Benefits Survey reports that the vast majority of large firms offer some health promotion activities.  Just as they would with their customers, firms should be asking themselves how well these activities align with the interests and needs of their employees.

Instead of donuts on Mondays and pizza on Fridays, they should be asking their employees how to spend that money.  It may not have anything to do with “wellness.” It might be something to improve their job, and that would be better for their health.