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Health Promotion International Advance Access originally published online on March 5, 2007
Health Promotion International 2007 22(2):102-111; doi:10.1093/heapro/dam002
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© The Author (2007). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Why do managers allocate resources to workplace health promotion programmes in countries with national health coverage?

Angela M. Downey1,* and David J. Sharp2

1 Faculty of Management, The University of Lethbridge, Lethbridge, Alberta, Canada T1K 3M4 2 Richard Ivey School of Business, The University of Western Ontario, London, Ontario, Canada N6A 3K7

* Corresponding author. E-mail: angela.downey{at}uleth.ca


   Abstract

There is extensive evidence that worksite health promotion (WHP) programmes reduce healthcare costs and improve employee productivity. In many countries, a large proportion of healthcare costs are borne by the state. While the full benefits of WHP are still created, they are shared between employers and the state, even though the employer bears the full (after-tax) cost. Employers therefore have a lower incentive to implement WHP activity. We know little about the beliefs of managers with decision responsibility for the approval and implementation of WHP programmes in this context. This article reports the results of a study of the attitudes of Canadian senior general managers (GMs) and human resource managers (HRMs) in the auto parts industry in Ontario, Canada towards the consequences of increasing discretionary spending on WHP, using Structural Equation Modelling and the Theory of Planned Behaviour. We identified factors that explain managers' intentions to increase discretionary spending on wellness programmes. While both senior GMs and HRMs are motivated primarily by their beliefs that WHP reduces indirect costs of health failure, GMs were also motivated by their moral responsibility towards employees (but surprisingly HRMs were not). Importantly, HRMs, who usually have responsibility for WHP, felt constrained by a lack of power to commit resources. Most importantly, we found no social expectation that organizations should provide WHP programmes. This has important implications in an environment where the adoption of WHP is very limited and cost containment within the healthcare system is paramount.

Key words: worksite health promotion; structural equation modelling; Theory of Planned Behaviour


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