Workplace Culture of Health and Health Equity: Disconnect in Perceptions Among Leaders and Low-Wage Employees

PurposeTo compare employee and leadership perceptions of workplace culture of health (CoH) and health equity in a healthcare system.ApproachA qualitative approach was utilized to collect insights through interviews with leaders and focus group discussions with low-wage employees.SettingA mid-Atlantic healthcare system.ParticipantsThis study includes interview participation from 19 leaders ranging from mid-level managers to executive leadership, and focus group participation by 61 low-wage employees from departments including environmental services, security, clinical services, and administrative support.MethodData were collected through semi-structured interviews and focus group discussions. Thematic analysis was used to identify themes regarding perceptions of Culture of Health (CoH), health equity, and barriers to health and well-being (HWB).ResultsLeaders emphasized a holistic approach to HWB and generally focused on health equity in patient services vs employee HWB. Low-wage employees were largely unaware of the terms CoH and health equity, and described "not feeling valued" and a lack of connection with organizational values. Leadership noted barriers to operationalizing equitable HWB, including siloed organizational structures and limited data. Communication challenges between leaders and employees were a significant contributor to the apparent disconnect.ConclusionHealth equity should be a foundational consideration for organizational CoH activities. Organizational efforts to address communication barriers can help to ensure that organizational vision and goals are effectively conveyed and demonstrated to low-wage employees.