Workplace health promotion

Principles and framework

The Luxembourg Declaration establishes the principles that distinguish high-quality workplace health promotion: it must be based on the participation of all employees, integrated into all important decisions and all areas of the organization, oriented towards problem-solving following a cycle of needs analysis, prioritization, planning, implementation, continuous monitoring and evaluation, and combine measures focused on the individual with measures focused on the work environment. The European network has supplemented the declaration with quality criteria and subsequent documents, such as the Edinburgh Declaration on the Promotion of Mental Health at Work.

The World Health Organization proposes a model for healthy work environments with four areas of action: the physical work environment, the psychosocial environment, personal health resources (information, services, and opportunities to adopt healthy habits), and the company’s participation in the community, all based on management commitment, employee participation, and a process of continuous improvement. This model positions health promotion as part of a system integrated with prevention.

In Spain, the Spanish Network of Healthy Companies (Network of Healthy Companies) of the INSST (National Institute for Safety and Health at Work) recognizes organizations that adhere to the Luxembourg Declaration and demonstrate good practices, and offers a framework with quality criteria, a self-assessment questionnaire, and program examples. Health promotion is voluntary for both companies and individuals, but it must comply with legislation on prevention, equality, and data protection, and its health-related activities are carried out with guarantees of confidentiality.

Areas of intervention

• Working conditions and organization. Ergonomic design, workload, autonomy, support, leadership, work-life balance and disconnection, which are the basis on which the other programs are built.
• Physical activity. Encouraging movement during the day, active breaks, access to sports facilities or programs and promoting active transportation.
• Food. Healthy options in cafeterias and vending machines, nutritional information and food education programs.
• Tobacco, alcohol, and other substances. Detoxification programs, smoke-free policies, and protocols for addressing consumption with a health, not disciplinary, approach.
• Mental health and emotional well-being. Management of psychosocial risks, voluntary and confidential psychological support, stress management training and stigma prevention.
• Prevention of chronic diseases. Early detection of cardiovascular risk factors, vaccination campaigns and voluntary screenings within the framework of health surveillance.
• Sleep and rest. Education in sleep hygiene and organization of work time compatible with rest.
• Active aging. Programs to maintain work capacity throughout working life.

Quality requirements of a program

• Management commitment. Written policy, allocated resources, and visible involvement of managers.
• Needs assessment. Based on risk assessment, aggregated health surveillance and absenteeism data, and consultation with staff.
• Participation. Involvement of workers and their representatives in the design, implementation and evaluation.
• Integration. Coordination with the prevention service, health surveillance, human resources and equality plans.
• Voluntariness and confidentiality. Voluntary participation, without employment consequences, and confidential treatment of health data.
• Equity. Coverage for all staff, including shifts, contracts, remote work and vulnerable groups.
• Evaluation. Process and outcome indicators, periodic review and continuous improvement.

Organizational application: how to develop a health promotion program

1. Obtain management commitment and approve a health promotion policy integrated into the prevention policy.
2. Conduct a needs assessment using risk evaluation, aggregated health surveillance and absenteeism data, and staff consultation.
3. Establish a working group with representation from management, the prevention service, human resources and the workers.
4. Define priorities and plan actions on working conditions and health habits, with objectives, responsible parties, resources and indicators.
5. Ensure voluntariness, confidentiality and coverage for all staff, and coordinate health activities with health surveillance.
6. Communicate the program, carry out the actions and facilitate participation at accessible times and conditions.
7. Evaluate with indicators, review the program periodically and, where appropriate, join the Spanish Network of Healthy Companies.

Preventive management software allows the integration of the health promotion program with risk assessment, health surveillance and training, planning and monitoring actions with responsible parties and indicators, and analyzing aggregated results with traceability and separation of health data.

Limits and common mistakes

1. Presenting health promotion as a substitute for occupational risk prevention or using it to divert attention from poor working conditions.
2. Focusing the program on individual habits without addressing the organization and working conditions.
3. Designing actions without diagnosis or staff participation.
4. Violating voluntariness or confidentiality, or using health data for employment purposes.
5. Excluding groups (shifts, contracts, remote work) or scheduling activities outside of working hours without compensation.
6. Do not evaluate the results or review the program.

The quality criteria and tools are set out in the INSST health promotion portal and in the documents of the European network; this sheet is for informational purposes.

Regulatory and reference framework

• Luxembourg Declaration on Health Promotion at Work . Definition, principles and quality criteria of the European Network for Health Promotion at Work.
• INSST. Promoting health at work . Thematic portal with criteria, tools and the Spanish Network of Healthy Companies.
• Healthy workplaces: a model for action (WHO, 2010) . Model of healthy work environments.
• Law 31/1995, of November 8. Law on the Prevention of Occupational Risks; a preventive framework that is complemented by health promotion.
• Spanish Strategy for Safety and Health at Work 2023-2027 . Lines of action on the promotion of health, well-being and mental health.
• WHO Guidelines on Mental Health at Work (2022) . Recommendations on organizational and individual interventions.

Organic Law 3/2018 and the General Data Protection Regulation govern the processing of health data in the programs, and Royal Decree 39/1997 regulates health surveillance with which health activities are coordinated.