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Worksite Health Promotion -- New Hampshire, 1992

Because a high proportion (85%) of the U.S. adult population is employed, the worksite setting offers immense potential for health-promotion efforts (1). Successful worksite health-promotion programs have targeted nutrition, cholesterol reduction, and cancer prevention (2-4). As part of an effort to strengthen such programs in New Hampshire, the Division of Public Health Services (DPHS), New Hampshire State Department of Health and Human Services, in collaboration with the University of New Hampshire and CDC, conducted a statewide survey of worksites from March through July 1992 to characterize employee health services. This report summarizes findings on the proportion of worksites that offered health-promotion activities.

A worksite was defined as any nonmilitary place of employment located in New Hampshire that had 50 or more employees at one location; branch offices and subsidiaries with 50 or more employees were included as individual worksites. Worksites were stratified into two groups based on participation in the New Hampshire Employee Health Forum (NHEHF), a program sponsored by the DPHS to address worksite health promotion. * From a total of 1565 worksites, a stratified sample of 500 (32%) was selected, consisting of 200 NHEHF participant worksites and 300 nonparticipant worksites. The sampled worksites were mailed a questionnaire and up to three follow-up questionnaires. A total of 304 (61%) eligible worksites responded; 150 (49%) were participants in NHEHF.

Of the worksites that responded, 113 (37%) were manufacturing firms, 75 (25%) were service companies, and 53 (17%) were health-care organizations. Of the 304 worksites, 157 (52%) were part of a larger organization, 54 (18%) were located at company headquarters, and 62 (20%) employed union workers. The average number of employees was 286 (range: 50-5005) (Table 1). Worksites that participated in the NHEHF were larger and consisted of higher percentages of manufacturing and health-care companies than nonparticipant worksites; because these two groups did not differ in prevalence of health-promotion activities, results for the groups were combined.

Of the worksites surveyed, 48% offered at least one health-promotion activity. The most frequently offered activities were fitness and exercise (21.4%), smoking cessation (21.4%), weight control (21.0%), nutrition education (20.1%), cholesterol control (19.9%), and blood pressure control (19.2%). The prevalence of each specific health-promotion activity increased with the number of employees at the worksite (Table 2, page 35). Worksites involved in the health-care industry were more likely to offer nutrition-education, stress-management, weight-control, and smoking-cessation programs than were other worksites (Table 2).

Reported by: J Nelson, M Roth, Univ of New Hampshire, Durham; K Zaso, Div of Public Health Svcs, New Hampshire State Dept of Health and Human Svcs. J Vaske, Colorado State Univ, Fort Collins. Office of Surveillance and Analysis, National Center for Chronic Disease Prevention and Health Promotion, CDC.

Editorial Note

Editorial Note: The findings in New Hampshire are consistent with national data in which the prevalence of health-promotion activities was directly associated with the number of employees at worksites (5). In addition, the findings indicated that New Hampshire slightly exceeded 1985 national baseline estimates for national health objectives for the year 2000 (1) in providing weight- control, blood pressure, and nutrition-education activities but lagged behind the national baseline in stress management and in providing at least one worksite activity (objectives 6.11, 2.20, 15.16, 2.20, and 8.6, respectively) (Figure 1). The findings also indicate areas that should be addressed by the NHEHF to increase the prevalence of worksite health-promotion activities in New Hampshire and to achieve the national health objectives for the year 2000 regarding worksite health promotion.

In this effort, during 1990, DPHS published Work Healthy New Hampshire: A Guide to Worksite Health and Safety Programs (6) that lists approximately 200 local businesses that provide health services for worksites. The guide is used by companies to establish worksite programs including health-promotion, occupational health and safety, and employee-assistance programs. The national Directory of Worksite Health Promotion Resources (7) has also been used as a resource by businesses establishing worksite health-related programs.

During 1993, DPHS will initiate a pilot worksite cervical and breast cancer education project at 40 manufacturing worksites to increase knowledge of cervical and breast cancer mortality risk factors and encourage use of Papanicolaou tests, clinical breast examinations, and mammograms. In addition, DPHS will link this education project to state-funded cancer screening programs.

In the fall of 1993, the Worksite Health Promotion Survey and operations manual will be available for public health agencies interested in monitoring worksite health promotion and national year 2000 objectives. Copies of the survey will be available free of charge from CDC's Preventive Health and Health Services Block Grant, Office of Surveillance and Analysis, National Center for Chronic Disease Prevention and Health Promotion, Mailstop K-30, 4770 Buford Highway, NE, Atlanta, GA 30341-3724.


  1. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives -- full report, with commentary. Washington, DC: US Department of Health and Human Services, Public Health Service, 1991; DHHS publication no. (PHS)91-50212.

  2. Bruno R, Arnold C, Jacobson L, et al. Randomized control trial of a nonpharmocologic cholesterol reduction program at the worksite. Prev Med 1983;12:523-32.

  3. Heimendinger J, Thompson B, Ockene J, et al. Reducing the risk of cancer through worksite intervention. State Art Rev Occup Med 1990;5:707-23.

  4. Eley WJ. Analyzing costs and benefits of mammography screening in the workplace. American Association of Occupational Health Nurses Journal 1989;37:171-7.

  5. Public Health Service. National survey of worksite health promotion activities -- a summary. Washington, DC: US Department of Health and Human Services, Public Health Service, 1987. {ODPHP monograph series.}

  6. Division of Public Health Services, New Hampshire State Department of Health and Human Services. Work healthy New Hampshire: a guide to worksite health and safety programs. Concord, New Hampshire: New Hampshire State Department of Health and Human Services, Division of Public Health Services; Blue Cross and Blue Shield of New Hampshire; American Heart Association, New Hampshire Affiliate, 1989.

  7. National Resource Center on Worksite Health Promotion. Directory of worksite health promotion resources. Washington, DC: National Resource Center on Worksite Health Promotion, 1990.

    • During 1986, the DPHS established the New Hampshire Employee Health Forum that targets worksite policymakers and health-promotion service providers; the forum provides monthly workshops on health-promotion, employee-assistance, and occupational health and safety programs.

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