In 1995, the World Health Assembly of the World Health Organization (WHO) endorsed the Global Strategy on Occupational Health for All, which emphasized the importance of primary prevention of occupational diseases and encouraged countries to establish national policies and programs for occupational health (1). However, 10 years later, a national survey revealed that improvements in healthy workplace approaches were minimal and that further improvement was required (2). In 2007, the 60th World Health Assembly endorsed the Global Plan of Action on Workers’ Health (GPA), 2008–2017 and set clear objectives and priority areas for action, one of which was to protect and promote health at the workplace (3). The Stresa Declaration on Workers’ Health (2006), the ILO Promotional Framework for Occupational Health and Safety Convention (ILO Convention 187) (2006), and the Bangkok Charter for Health Promotion in a Globalized World (2005) also provided important points of orientation for linking occupational health with public health to achieve a basic level of health for all workers (2).
In this context, the WHO provided a flexible framework Healthy Workplaces: A Model for Action (2010), which was adaptable to diverse countries, workplaces, and culture (4). At the core of the model is the need to secure the engagement of the workforce via effective leadership and the promotion of workplace culture values that underpin health and wellbeing by considering 4 action areas including the following: 1) the physical work environment; 2) the psychosocial work environment; 3) personal health resources; and 4) enterprise involvement in the community. Since then, numerous groups and networks addressing workplace health have been developed in different regions and countries. The European Network for Workplace Health Promotion provided the definition of “Workplace Health Promotion (WHP)” as “the combined efforts of employees, employers, and society to improve the health and wellbeing of people at work” (5). The “Healthy Enterprise” Standard (BNQ9700-800) in Canada specified a series of WHP action plans and recognized the efforts of companies by certifying them to maintain and sustainably improve the health of people in the workplace (6). The Total Worker Health approach in the United States was defined as policies, programs, and practices that integrated protection from work-related safety and health hazards with promotion of injury and illness-prevention efforts to advance the wellbeing of the United States workforce (7). The Total Health Promotion in Japan was a groundbreaking approach to health promotion theory and practice and aimed to enhance the human experience free from restrictive classifications and false images (8).
Since 1993, pilot projects for workplace health practice in different industries and companies have been developed with the support of the WHO. The project has explored and summarized overall intervention strategies of WHP that were verified effectively and suitable in China (9). A series of WHP practical tools, including the compilation of regulations, archives, evaluation tools, typical cases, analyses, and health education resources, etc., have been developed for the implementation, assessment, and evaluation of healthy enterprises. Although enormous practices and achievements have been made, numerous problems, including lack of recognition of the importance of occupational disease prevention, inadequate capacity of occupational health services and little funding, have constrained further development of WHP in China. In October 2019, “Healthy Enterprise” Action Plan (HEAP) was issued nationwide with the aim of providing new impetus to move from strategy to action and to shift the pilot exploration to a practical and indispensable part of “Healthy China” and “Healthy City”. Recently, experts of China CDC, together with experts of government agencies and other stakeholders, have jointly developed a practical guideline specific for various enterprises, standardizing the following 4 major advocacy action indicators, as listed in Table 1.
Action indicators Major contents 1. Developing health policy systems Refers to relevant organizations, staffing, funding, and policies; contracts; work injury insurances; and ensuring all staff participation. 2. Building healthy working environments Including general public area environments; office environments; and the production environments. 3. Providing health services Refers to general health services (e.g., infectious control, major foodborne diseases control, and regular health check-up especially for female workers); mental health services; and occupational health services. 4. Creating healthy culture Refers to workplace health promotion; the psychosocial work environment; and social responsibility of enterprises.
Table 1. Major advocacy indicators proposed by the Healthy Enterprise Action Plan.