A Holistic View of Workplace Physical Activity for Saint Louis County, Missouri

A Holistic View of Physical Activity in the Workplace for Saint Louis County, Missouri

Physical activity is a priority health issue affecting American employers and workers, including businesses located in Saint Louis County, Missouri. A healthy workforce is vital as American companies seek to thrive in a global economy, and physical activity is one dimension of health that employers may affect through supportive health promotion practices. Health is no longer defined as strictly an absence of illness, but rather it encompasses a more holistic approach as defined by the World Health Organization of "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" (World Health Organization, 2003, para. 1). Increasingly, employers understand the interrelatedness of the broader dimensions of health as they affect employee well-being.

Physical activity is a foundational health indicator with holistic implications that influence the quality of life of employees, who often spend over half their waking hours in the workplace (Healthy People, 2013). The U. S. Department of Human and Health Services (HHS) created a framework known as Healthy People 2020, for organizations and individuals to identifying important health issues for Americans. The comprehensive program identifies key objectives to address primary health issues, with a goal of streamlining program development, implementation, and evaluation. Physical activity is broadly defined as aerobic conditioning, muscle strengthening, bone strengthening, balance and flexibility. Saint Louis County employers seeking to attract and retain healthy workers must address physical inactivity as part of a holistic approach to wellness in the workforce. The Healthy People 2020 goal for physical activity is to "improve health, fitness, and quality of life through daily activity" (Healthy People, 2013, para.1). More specifically for the business community, a workplace objective to "increase the proportion of employed adults who have access to and participate in employer-based exercise facilities and exercise programs " (para. 12) is being developed to address physical inactivity (Healthy People, 2013). A holistic approach to workplace wellness offers employees an opportunity to maintain physical, mental, and spiritual balance, creating a synergistic environment for success.

Physical Activity Statistics

United States Statistics National and local statistics indicate a significant portion of the adult population is at risk for health related conditions associated with physical inactivity. Implications for employers include increased absenteeism, increased healthcare costs, decreased productivity, reduced employee morale, and a diminished corporate image (American Cancer Society, 2013). According to the Department of Health and Human Services, more than 80% of Americans do not meet the physical activity standards as set by the 2008 Physical Activities Guidelines for Americans (U. S. Department of Health and Human Services, 2013), which include 150 minutes of moderate intensity physical activity such as brisk walking. In a recent study on sedentary behavior and physical activity in office employees, researchers found 65% of time at work was spent in sedentary behavior. During lunchtime on a workday, 60% of time was spent in sedentary behavior (Brown, Ride, Gilson, Burton, Brown, 2013). American employers will increasingly find it difficult to meet productivity demands in the absence of an active, healthy workforce, reducing the ability to compete locally or globally.

Missouri Statistics

Statewide, 31% of Missouri adults are identified as obese, a chronic disease behavioral risk factor associated with physical inactivity. More than 30% have cardiovascular medical conditions including high cholesterol and high blood pressure (Saint Louis County, 2013). In a 2010 prevalence and trend survey, 27% of Missouri adults stated they had participated in no physical activity during the past month, surpassing the previous year's findings (CDC, 2013).

Sedentary adults are at higher risk for chronic diseases, with absenteeism and increased healthcare costs reducing organizational health (Healthy People, 2013).

Saint Louis County Statistics

Locally, Saint Louis County health data associated with physical inactivity includes similar results according to the 2011 Community Health Needs Assessment (Saint Louis County, 2013). The adult obesity rate is approximately 27%, with more than 30% of adults having cardiovascular medical conditions, including high cholesterol and high blood pressure.

Surveys of county residents indicate 22% of the adult population leads a sedentary lifestyle, with nearly 20% having been diagnosed with depression. Additionally, health department occupational and industrial health data indicates a significant portion of the county workforce is employed in management, professional, and related fields with 41.5% working in an office environment, in primarily sedentary settings (Saint Louis County, 2013). Changes in workplace health practices are necessary to reduce the effects of physical inactivity.

Saint Louis County Health Department Resources

The Saint Louis County Health Department serves over one million people who live, work, or visit the county, offering a variety of health services at no cost to county employers. The commitment to whole health is acknowledged in the vision statement. "We will be a progressive health department providing a full array of services which includes assessment, policy development, and assurances for health information, disease and injury prevention, and environmental health” (p. 1). Employee health education components within the department include presentations, workshops, health fairs, and educational materials, with the goal of promoting healthy behavior. Many programs aim to reduce health risk factors, such as obesity and diabetes, that often impede physical activity in employees. Another key health education component for businesses seeking a whole health approach to physical activity is the on-site workplace smoking cessation program, taught by trained smoking cessation facilitators. This eight week comprehensive smoking cessation program is offered at no cost to smokers at worksites within Saint Louis County. The county's staff of health education specialists are available to educate employees and facilitate corporate wellness, underscoring their mission and vision, while improving quality of life for St. Louis County employees and businesses (Saint Louis County, 2013).

Benefits of Health Promotion Through the Dimensions of Health

A holistic approach to health and wellness considers the interrelatedness of physical, mental, and spiritual elements that affect an individual's quality of life. A true sense of well-being involves more than the absence of illness (World Health Organization, 2013). It includes a foundational balance of physical health, emotional stability, and a sense of purpose. Employers seeking to attract and retain a healthier workforce will promote a synergistic approach to wellness, with a greater understanding of the dimensions of health that lead to self-management and optimal well-being. Therefore, physical inactivity in the workplace setting is not a stand alone health issue, as multiple dimensions of health must be considered for effective wellness promotion development.

Physical Health

The most obvious benefits of addressing workplace sedentarism are the physical outcomes including weight management, increased energy, better sleep, stress reduction, disease and illness control (Healthy People, 2013). Multiple studies have been conducted on physical activity intervention strategies, with varying outcome results. Behavioral theory constructs are commonly applied in physical activity studies, as researchers seek to identify personal and environmental factors that influence an individual's behavior. Employers may focus on external factors to increase motivation and the resulting behavior outcome. Determining key reinforcers and creating an environment that is conducive to a physically active workforce may lead to increased levels of activity in employees. Theory-based health promotion studies provide employers a framework for development, implementation, and evaluation of current health promotion practices that reduce the affects of physical inactivity. For example, employees can be encouraged to increase physical activity during the work day with the addition of lunch time walking sessions, stretching breaks, and the use of active workstations. Giving the opportunity to make healthy choices allows employees to practice self-managed health behaviors, fostering increased energy and self-efficacy. The use of incentives further reinforces the level of commitment to health by employers and key leadership within the company (Taitel, Haufle, Heck, Loeppke, & Fetterolf, 2008). Understanding the benefits of physical activity is important for employers because optimal physical functionality allows greater productivity. With a baseline of physical health through functional fitness, people are freer to grow intellectually, emotionally and spiritually.

Social Health

Introducing physical activity to the workplace for the purpose of creating a healthier workforce can produce positive social outcomes for employers, increased productivity, decreased absenteeism, and a more positive environment (Mattke, Liu, Caloueras, Huang, Van Busum, Khodyakov, Shier, 2013). Social health, the ability to make friends and socialize, is an important element in creating an effective physical activity program that is supported by positive influence from coworkers. Employees having positive relationships with coworkers will likely offer encouragement to others and be a source of accountability for those seeking to engage in physical activities as part of a workplace wellness program. This affords each employee the opportunity to explore physical activity in a comfortable, supportive environment, reducing the likelihood of negative behaviors. For example, if a lunch walking program is implemented, socially healthy relationships will provide motivation to engage in programming to improve health, furthering an individual’s self-efficacy and self-esteem.

Other positive outcomes of healthy personal relationships in the workplace include the creation of a dynamic and engaging atmosphere where employees feel comfortable challenging themselves. In some cases where sound relationships are developed, coworkers may challenge one another to achieve success in incentive-based physical activity programs. Assessing social health before beginning a physical activity program will provide qualitative data on levels of respect, support, accountability, and communication amongst coworkers. Strategies for developing an optimal wellness plan with increased physical activity as a primary health goal may be based on the social health level of the individuals within the work environment. Introducing results-oriented physical activity programming that is sensitive to the data will increase the likelihood of successful implementation (WELCOA, 2013).

Emotional Health

Emotional health is a mental health indicator of perceived life satisfaction, happiness, cheerfulness, peacefulness (CDC, 2013). Exploring physical activity through the lens of emotional health will assist employees in the correlation between an active lifestyle and feelings of accomplishment, resulting in higher self esteem. High levels of self-esteem in turn will increase resilience to stress (Mann, Hosman, Schaalma, & de Vries, 2004; Rutter, 1987), thus creating a more positive work environment. Employers seeking to develop a healthier workforce may find emotional health factors play a significant role in successful physical activity program development, implementation, and evaluation.

Developing a sustainable physical activity plan that addresses individual needs with an emphasis on autonomy allows an employee to grow in confidence, increasing physical activity levels for intrinsic purposes, thus reinforcing the commitment to personal health and wellbeing. Increases in self-discipline as a result of emotional balance lead to self-efficacy, with the goal of sustained physical activity, as employees develop confidence in their ability to perform.

Employers seeking innovative ways to increase productivity and morale, may find physical activity education and on-site program offerings increase health protective behaviors. As more employees participate in activities, social norms may shift, positively affecting feelings towards others, creating a socially healthier environment. Additionally, the organization benefits from emotionally secure employees with a greater desire to increase physical activity.

Intellectual Health

Another dimension of health that relates to physical activity in the work environment is intellectual health. This aspect looks beyond the physical nature of an individual to the critical thinking skills and personal belief clarifications that are necessary to understand the impact of health behaviors. This includes processing new information as it relates to healthy decision making and the actions that follow. Understanding physical activity motivators and barriers will assist employer health promotion efforts when a basic understanding of the intellectual nature of the workforce is acknowledged.

As employees are encouraged to reduce their sedentary hours, offering an understanding of the intrinsic value of increased physical activity will create a greater level of self-efficacy. The belief that physical activity is important and attainable can be fostered through on-site educational programs, identifying key motivational messages that encourage action. For example, a study determining the value of health promotion via emails found that employees increased their physical activity levels with just one physical activity and one nutrition email per week (Plotnikoff, McCargar, Wilson, & Loucaides, 2005). Developing a conducive environment for receiving positive health information based on the assumption that employees are able to apply critical thinking skills allows them to make positive changes in health behaviors.

An intellectual health focus can serve as a base for health information dissemination as employees learn the importance of self-care. Individuals are more likely to establish new attitudes and behaviors that support self-care decision making with tailored health promotion messages (DiClemente, Crosby, & Kegler, 2009). Employers who encourage an active lifestyle through on-site programming will benefit from the increased health of their workforce.

Spiritual Health

A dimension of health often overlooked in the workplace is spiritual health. While spiritual health encompasses traditional beliefs in God, it also includes a broader understanding of the desire to live a fulfilled life, with aspirations, ambitions, and a sense of purpose. When individuals have hope and vitality, they are more equipped to face challenges that might otherwise impair well-being. Spiritual health may not be measured in traditional church attendance or religiousness in many cases, but rather, on an expanded view of spiritual maturity and quality of life (Dhar, Chaturvedi, & Nandan, 2011).

Employers may choose to frame physical activity as part of a whole-health centered approach to well-being, including the encouragement to explore spiritual health on an interpersonal level. As employees seek to gain purpose and vitality, educating them on the importance of physical, mental, and spiritual balance will direct them to establish a physical activity plan as a foundational element. This may be developed and implemented through workplace programming, providing a positive environment for physical activity and personal spiritual growth.

Empirical evidence supports the benefits of including spirituality in addressing physical health issues. For example, a study following participants in a bereavement program found those with strong spiritual beliefs resolved their grief within the study timeframe, while those with low levels of beliefs showed little change in the first nine month period following their loss (Walsh, King, Jones, Tookman & Blizard, 2002). Spirituality is an integral part of many employee's health belief systems and should be recognized by employers when developing a physical activity program with a holistic approach.

Environmental Health

Environmental health is interwoven into the fabric of all dimensions of health as an external influencing factor. According to the World Health Organization (2013), environmental health "addresses all the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviors" (para.1). In the workplace, this includes the physical campus characteristics such as layout of buildings, campus aesthetics, equipment, accessibility, furnishings, lighting, sound, and temperature. It also includes chemical and biological factors such as air quality, toxic substances, mold, water quality, and UV radiation. As employers strive to increase physical activity opportunities for their workforce, it is important to assess the affect of these environmental elements. For example, improper lighting in a workstation may cause eye strain, back pain, and fatigue, reducing the likelihood of lunchtime physical activity despite employer incentives.

Individuals and their environment exert mutual influence over one another according to Sundstrom and Sundstrom (1986). The affects of undesirable environmental influences create barriers for employees and in a reciprocal manner, the employees affect the workplace by reducing the desired health-supportive environment. Encouraging on-site physical activity requires a commitment from employers to provide a conducive atmosphere. For example, an outdoor walking path that is safe, uncluttered, and aesthetically inviting may influence employees to engage in lunchtime physical activity, particularly if the individuals are intrinsically motivated to improve their health. Engaging in assessments and monitoring environmental health factors as they influence individual health behaviors will result in improved quality of life for employers and employees.

Global Health

Understanding the importance of global health and the improved quality of life it creates, is necessary as the current American working age population is declining. Emerging market economies such as Brazil, Mexico, and Indonesia may provide a greater portion of workers in the near future (EY, 2013). Employers seeking to attract and retain healthy employees will embrace practices and policies that reinforce a commitment to global health. Improving the health of the present workforce through increased worksite physical active will benefit employers as they find new sources of workers.

From a reputation management standpoint, American employers that offer innovative onsite physical activity solutions will potentially attract a greater number of health conscious employees over those that discourage positive on-site health behaviors through traditional business practices. As global staffing becomes the norm, a consistent model of health conscious employees will stimulate interest in American employment opportunities from global sources.

From an advocacy perspective, American businesses have the opportunity to promote physical activity and health in the workplace (National Physical Activity Plan, 2013), with a goal of reducing high risk behaviors among employees. Creating an optimal model of work-life balance will demonstrate a commitment to health for the global population to emulate. Presently, over 50% of American working mothers and fathers feel it is difficult to balance work and family (Pew Research Center, 2013). Offering on-site physical activity opportunities is one example of an employer's commitment to improving quality of life, supporting a healthy workforce locally and globally.


Physical inactivity is a leading health indicator for American businesses, affecting Saint Louis County employers and workers. A healthy workforce remains a top priority for businesses as they strive to attract and retain productive employees, through sound development, implementation, and evaluation of health promotions. Employers focused on developing strategies and programs that include a holistic view of wellness, particularly as the dimensions of health relate to physical activity, will create a more positive workplace environment, with increased quality of life as a health outcome.


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DoctoralLisa Hautly