Workplace health promotion: a commentary on the evolution of a paradigm

Reports of workplace health promotion programs are reviewed in light of Kuhn's views on paradigmatic advances in science. Such reports fall into two categories: those which describe single health-habit interventions (e.g., smoking cessation, weight control, or stress management) and those which describe comprehensive efforts to incorporate many single health-habit interventions into integrated programs. Common to virtually all of these programs in their focus on the modification of the health behavior of individuals. Consideration of such organizational-level factors as work design or climate which are beyond the control of the individual, yet may contribute heavily to illness and absenteeism of employees, is typically omitted. It is concluded that workplace health promotion in the United States has achieved the status of a paradigm and that this paradigm is associated with several limitations and ethical problems in light of the programs' objectives: to reduce organizations' medical-care costs and improve productivity.