Uneven distribution of workplace health projects

A 2008 report by the Central Federal Association of Health Insurance Funds shows that projects on workplace health promotion are unevenly distributed across sectors and enterprises. Workers in the services industry, women and migrant workers are much less likely to benefit from health promotion projects than workers in the manufacturing sector. The report illustrates that workplace health promotion is most widespread where works councils and trade unions are strongest.

Background

In 2007, a change to paragraph 20 of the Social Security Code V (Sozialgesetzbuch) sought to improve workplace health promotion by strengthening the role of the health insurance funds and by regulating close cooperation between the various actors. The insurers now have to engage in workplace health promotion; more specifically, they have to cooperate with employers and employees, as well as with employers’ liability insurance associations, in detecting health and safety hazards and in conceptualising and applying prevention measures at the workplace. In practice, the role of health insurers can be restricted to the provision of information, but it may also extend to counselling, project leadership or the evaluation of projects. Ultimately, their role depends on the management’s decision.

As of 1 July 2008, the seven existing federal health insurer associations are represented by the Central Federal Association of Health Insurance Funds (Spitzenverband Bund der Krankenkassen, GKV-Spitzenverband Bund). In December 2008, the Medical Review Board of the Central Federal Association (Medizinischer Dienst des Spitzenverbandes Bund der Krankenkassen, MDS) published a report (in German, 3.2Mb PDF) (Präventionsbericht 2008) on the health promotion projects either realised or supported by German health insurers in 2007. One chapter focuses on workplace health promotion. The results present the findings in relation to 3,014 documented cases, based on the health insurers’ responses to a questionnaire issued by the MDS.

Although the report does not give detailed information on the role of the health insurers nor on the actual projects, it does highlight certain trends.

Study findings

Distribution of projects

The 3,014 documented case studies were carried out at 6,888 sites or enterprises. The report notes that in 88% of all cases, the promotion measure was merely implemented at one site of a company. Only in one case – namely, at a restaurant chain – did the project include a larger number of company sites. The majority of the enterprises or sites (59%) usually employed a workforce of 100 or more people in 2007 (Table 1).