Technical Paper 1:
Obesity in Australia: a need for urgent action
As a setting of particular importance in obesity prevention, the workplace represents an arena for social leadership and peer support in tackling behavioural change, while work and employment policies and practices can enable or inhibit positive change.
A recent review of the effectiveness of workplace weight loss programs concluded that outcomes show modest short-term improvements in body weight, but that there is a paucity of long-term health and economic data. Common factors of worksite health promotion programs with successful outcomes (such as small decreases in BMI) include regular participation, intervention intensity, the inclusion of dietary advice, supervised physical activity, support for physical activity outside the workplace, counselling and plant reorganisation.
A review of workplace-based interventions targeting dietary behaviours through various education and environmental initiatives that were focused around the work canteen found positive but modest changes in diet and food purchases or no impact.
Reviews of workplace initiatives promoting physical activity (interventions included health checks, motivational prompts and physical activity programs) have found inconsistent or inconclusive evidence,[111, 112] with some strong evidence for increased physical activity behaviour but inconsistent or no evidence for improvements in cardiovascular outcomes, body weight or general health. More comprehensive interventions, incorporating individual approaches and changes in workplace culture and organisational structure, were more successful.
‘WorkHealth’ is an initiative of the Victorian Government which began in July 2008.10 It is a five-year, $218 million program aimed at improving the health and wellbeing of Victorian workers through workplace-based health checks and providing access to advice and education programs to help workers reduce their risk of chronic disease. The aims are to reduce absenteeism, improve productivity, reduce injuries and reduce the burden of chronic disease on the Victorian health system. The voluntary initiative uses the workplace as an opportunity for health promotion and disease prevention; partnerships between government, employers and workers to develop effective health solutions; and links to existing health initiatives and services. Through the initiative, every Victorian workplace (involving up to 2.6 million workers across the state) will be given the opportunity to participate in staff health programs. All workers will be provided with information on how to improve their health and will initially be offered two types of free on-site screening tests. These include a self-assessment chronic disease test to identify physiological and lifestyle issues contributing to their level of risk of developing a chronic disease; and the collection of physical and biomedical measurements, such as height, weight, cholesterol, blood pressure and blood sugar. The health provider will assess the information collected, provide the worker with individualised information and advice, and, where appropriate, provide the worker with recommendations for a general practitioner (GP) follow-up. The initiative also involves co-contribution grants for larger workplaces for screening, and for the expansion of existing or new health and wellbeing programs.
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These programs will provide information and advice, and facilitate free on-site screening services for chronic disease. A chronic diseases prevention program will also be developed through the initiative; those workers identified as most at risk and those newly diagnosed with chronic diseases such as type 2 diabetes will be provided with access to services such as a free lifestyle change program to help them adopt healthier eating and physical activity behaviours, and information and education programs.
These kinds of programs and opportunities could be provided to Australian employees more broadly as a standard condition of employment. For example, workplaces could offer risk assessment and risk modification programs, nutritional education for workers and families, and physical activity embedded in or in association with regular daily work practice. In addition, incentives could be provided to employers to reduce the chronic disease risk profile of their employees.