Creating a Culture of Wellness – UCSF

Summary

Some of the most impressive wellness programs do more than simply offer benefits or incentives; they create an environment that encourages, and even nudges, people in the direction of healthy behaviors. These employers create a work environment in which employee wellness is the culture, not just a program.

Of course, there are many ways of doing this, and no single technique can function as a “magic bullet” for making health behaviors the norm in a workplace. In fact, as the very concept of a “culture of wellness” suggests, an emphasis on health and wellbeing pervades most, if not all, aspects of an organization. Those who create a such a culture don’t just create single programs, but rather foster an environment where wellness is accessible, valued, and even expected. While there is no step-by-step path to creating a culture of wellness, the leaders in this area have several important things in common:

First, they involve all members of their community. This may, in itself, seem practical, but it involves more than making wellness programs and incentives a benefit for all employees. For example, Stanford University opens many of its health and wellness offerings to both students and employees, making healthy behavior and a strong community mutually reinforcing. In addition, wellness programs are not restricted to only people at high risk. For example, weight loss and nutrition programs are available to all, rather than requiring a minimum BMI to qualify as a covered benefit.

In addition, these workplaces reinforce health messages. Consider, for example, the distinction between offering nutrition or weight loss classes alone, or offering them in a workplace with a cafeteria that serves healthy foods. The education alone may help to promote health, but the availability of food choices that align with this education powerfully reinforces the messaging, turning awareness into behavior without requiring extra effort on the part of employees.

Beyond simply creating a healthy environment, however, those who create a culture of wellness do so in ways that increase and ease healthy choices, rather than simply restricting unhealthy options. This encourages buy-in, sustains satisfaction with the program, and perhaps even has the potential to reinforce healthy behaviors outside the workplace.

Additionally, organizations and companies with a strong culture of wellness have leaders who support those programs. Beyond simply allocating resources for wellness, these leaders “walk the talk,” actively engaging in healthy behaviors of their own, expressing support for employees who do the same, and clearly communicating that wellness is a central value of the company. And, most important, this comes not only from a single leader or department but extends throughout an organization’s leadership.

Finally, employers that achieve a true culture of wellness successfully communicate that this effort is for the employees’ sake, not for that of the company. Their message is, “We care about and want to support your health,” not, “We want to reduce our costs.”

Analysis

These employers go well beyond simply implementing programs to promote health – they make wellness a central tenet of their workplaces and establish healthy behaviors as the norm. There are two central advantages to establishing a culture of wellness. The first is that it supports and reinforces the messages of more targeted health promotion programs, giving employees the opportunity to actually put the health messaging they hear into practice. Cultures of health make it easier to turn knowledge into habit. Second, cultures of wellness help to make healthy behaviors the more natural choice, perhaps even the default. Often, health messaging and education will come into conflict with settings that make it much easier to act in unhealthy ways. By contrast, in settings where health is central to the culture, there is the potential to boost the wellbeing of all employees, even those who don’t actively engage in more concrete wellness offerings. Rather than simply trying to build increased motivation for health, these employers make good health a function of environment and not just willpower.

UCSF- Smart Choice and Healthy Beverage Initiatives

UCSF has demonstrated a concerted effort to make the food options on its three campuses healthier through two programs. In 2009, UCSF implemented Smart Choice, which created a standard system for designating healthy food options sold at UCSF.^[1] Nutritional information for all food was printed on customer receipts. A recognizable “S” symbol was used to mark Smart Choices—healthy options.

In 2015, UCSF also introduced the Healthy Beverage initiative, ending the sale of all sugar-sweetened beverages on its campuses.^[2] The idea was to further reinforce efforts to create a healthier food environment for all faculty, staff, students, patients, and community members. People could still bring their own sweetened beverages (i.e., it wasn’t a ban), but the initiative was publicized with the express goal of encouraging healthy decisions even off-campus.

UCSF’s efforts set an example for two reasons. First, they show the influence of a community-wide environmental change. Rather than implement a specific “healthy options” cafeteria, etc., UCSF made the choice to implement its programs throughout its entire system, meaning that it became an integrated part of the UCSF environment. In addition, UCSF didn’t make moves to ban employees’ consumption of unhealthy foods and beverages while on site but rather focused its attention on how changing aspects of the environment could make healthy choices easier. As such, UCSF presents a strong example of a deliberate environmental change to “make the healthy choice the easy choice.”