Occupational health promotion may reduce premature aging and disability.
Many diseases that cause disability and premature death are lifestyle-based. On the other hand, our lifestyle can serve to reduce the risk of many diseases we once thought we were helpless to prevent, even some genetically based diseases.
Within the last five years, there has emerged a “new” movement called “wellness.” The movement gained popularity within the personal health promotion industry and is now gaining traction in occupational settings as “workplace wellness” programs are emerging. This is an exciting time for health promotion with great potential for not only preventing disease, but also for altering the course of aging, prolonging careers, and even reaching higher levels of physical and mental health than we ever imagined possible.
Perhaps the two greatest challenges in this movement will be avoiding the “quackery” that often accompanies new health-related initiatives and failing to truly innovate by merely rediscovering the past. As George Santayana famously noted in his magnum opus The Life of Reason, “Those who cannot remember the past are condemned to repeat it” (Santayana,1905, NY: Dover).
To conquer the first challenge, we must adhere as best we can to evidence-informed and evidence-based recommendations and practices. To conquer the second challenge, we must take the advice of Santayana and “read history.” The famed Johns Hopkins physician Sir William Osler similarly commented to the effect that to study medicine without reading history is like sailing an uncharted sea.
Originally wellness was defined as a state of well-being characterized by the absence of disease. This radically changed in the 1970s. More recently, wellness has been defined as a relative state of optimum health. The absence of disease is considered merely a neutral point of sorts.
Wellness is deemed to be optimum health wherein mental health, physical health, intellectual functioning, resilience, as well as energy and motivation are at optimum levels (Everly & Feldman, 1985). The endeavor of health promotion may be seen as any and all activities that move one to the absence of disease and beyond to the achievement of optimum health.
History of the Wellness Movement
The modern era of wellness and health promotion can be traced to Jonas Salk’s 1973 groundbreaking treatise, Survival of the Wisest. In that book, Salk defined the pursuit of health in two epochs. Epoch A was the pursuit of the absence of disease. Epoch B he defined as the pursuit of optimum health, a condition far beyond the mere absence of illness.
Epoch B is the epoch within which optimal mental and physical health are fostered and sustained by individuals, families, businesses, communities, and governments. The Federal Office of Health Promotion was created by President Carter in 1979. Lawrence Green was its first Director.
The first health and wellness promotion textbook was later authored by Dr. Green and colleagues entitled Health Promotion Planning (1980). To our knowledge, the first practitioners’ guide to workplace wellness was Michael O’Donnell’s Health Promotion in the Workplace (1984). Following the creation of the field of Health Psychology in 1977, the first college textbook on occupational wellness and health promotion was written and entitled Occupational Health Promotion (Everly & Feldman, 1980, NY: John Wiley).
The book provided specific guidelines for the design and implementation of comprehensive occupational wellness and health promotion programs. The University of California system, the University of Wisconsin, and the University of Maryland system led the way in the academic approach to wellness and health promotion.
Virtually prototypic occupational wellness programs were initially fielded by IBM, Control Data, Kimberly-Clark, and Johnson and Johnson. The first peer-reviewed journal dedicated to health promotion was the American Journal of Health Promotion first published in 1986. So we see a rich history in this field now enjoying a renaissance within occupational venues, but more steady growth when applied to personal health.
A Health Care Crisis?
Health care costs in the United States are enormous with the provision of adequate, high-quality health care being vigorously debated in political as well as economic circles. Despite having the most expensive health care system, the United States ranks last overall among 11 industrialized countries on measures of health system quality, access to care, equity, and healthy lives (Commonwealth Fund report. Jun 16, 2014).
Disability and premature deaths in the United States are 31 percent higher than in comparable countries (Peterson-Kaiser Health Tracker, 2017). Drug prices in the United States are roughly 50 percent higher than in other comparable nations for commonly prescribed drugs. The health care system in the U.S. ranks 50th of 55 countries in terms of overall efficiency (Bloomberg Healthcare Efficiency Index, Sept. 2016).
Yes, the health care system in the United States is broken. No, we do not have an efficient health care system compared to other countries. Is it time for a different approach?
Many authorities assert the health care crisis stems from the increasing demand for services fueled by unhealthy lifestyles, poor diet, a lack of exercise, and ultimately a failure to foster health and wellness promotion early in the lifespan (Epoch B).
Occupational Health Promotion
Most people spend one-third of their lives at work. There is a powerful rationale to promote, not only organizational health, but personal health using the workplace as a platform.
This is especially true in careers that place people at high risk for physical or psychological injury such as law enforcement, fire suppression, emergency medicine, air traffic control, health care, the military, disaster response, etc. Careers in these and related professions might actually be prolonged, if desired.
A prototypic occupational health promotion program should consist of at least the following core educational and skill-building components, the “keys” to effective wellness and health promotion:
3. Using exercise to promote mental and physical health
4. Diet as a tool to promote mental and physical health
5. Repairing the body and mind through rest, relaxation, and sleep
While these aforementioned five components can be effective in promoting Epoch B from a workplace platform, these same components can be implemented as a personal wellness and health promotion program which anyone at any time can choose to design and implement, given proper professional guidance.
Even if one has a gene for a disease or disorder, epigenetic expression is not a fait accompli. Evidence suggests that one can act to reduce the risk of ever experiencing the disease itself. Promoting personal wellness and optimum health may be an effective way to take control of your time and your life so as to alter the normal course of aging, prolong your career, avoid premature disability, and avoid personal disaster!
(c) George S. Everly, Jr., PhD