Work place health promotion - a double-edged sword

"I think promoting health in the work place is a good thing, but I still want to sound a warning and make people look closer at all the consequences. There is a risk that workers will be grouped as more or less desirable as a result," says Erika Björklund at Umeå University, who earlier this year defended her doctorate "Constituting the Healthy Employee? Governing gendered subjects in workplace health promotion".

The individual becomes responsible

Erika Björklund interviewed and observed participants and pedagogues at four different work places of varying size - one municipal, one in the public sector and two in the private sector. She concluded that health promotion programmes are based on a shared view of what constitutes good health, and that everybody can and want to make lifestyle changes to better their health. Lifestyle-related illnesses are generally viewed as a result of bad choices made by the individual. The trend both in society as a whole and in the work place is that people are being made responsible for their own health.

"Alternative views seem strange. And I do accept it is unavoidable that some of the responsibility rests with the individual, but not all of it. Not all health promotion is about lifestyle. In a work place there are factors like organisation and support which also play a role. As an individual you also live in a context which will determine your chance to take responsibility for your own health - like personal finance and family life," says Erika Björklund.

A new kind of control

Health activities in the work place will impact on what we do outside of work as well.

"It is a new kind of control over the employees' bodies. That's OK for those who enjoy it. The question is whether it is OK to choose not to participate?" she says.

All the interviewees in Erika Björklund's study are generally happy with the fact that they've managed to start regular physical exercise and other health promoting activities with help from their employer. There is no criticism, but that's exactly why it might be important that those who remain outside the system initiate a debate about integrity and the right to refuse to participate. There must be a level of acceptance for those who want to stay out of work place health activities, she feels.

Taking part might look like a free choice, but that choice is influenced by the norms surrounding what level of responsibility we should take in order to live a healthy life. There is rarely a clear definition of what is healthy either. The term is being used to describe "good" behaviour and attitudes. Being healthy is also associated with having a strong body and the ability to be rational - attributes often associated with men. This could lead to the man becoming the norm, while women are viewed as more problematic when it comes to health.

"What is viewed as healthy also becomes part of how a "good" individual and employee is expected to behave. You could imagine us reaching a point where people's lifestyle will determine whether they get a job or not," says Erika Björklund.