Making a case for health promotion theoretically underpinned policies and practices around alcohol in workplace settings

Background

Against a backdrop of avoidable alcohol-related mortality, morbidity, and social problems; literature identifies that alcohol-related problems are also experienced in workplaces. Workplaces are an untapped setting with the potential to contribute towards reducing alcohol-related harm in employees, and one of the ways that workplaces can do this is through developing alcohol workplace policies and practices that are health-promoting. Very little empirical theoretically underpinned research explores whether current alcohol workplace policies and practices fully harness their health promotion potential.  

Methods

To address the current gap in knowledge, a qualitative case study of two public sector organisations in England was conducted. Data were collected from documents and 16 semi-structured interviews with policymakers and non-policy makers across both organisations.  Ritchie and Spencer’s (1994) Framework Analysis Method informed the data analysis approach, and all processes of data collection, analysis and interpretation were underpinned by a health promotion theoretical framework comprised of Bronfenbrenner’s Ecological Systems Theory (1979) and the WHO Healthy Workplace Framework (2010). 

Results

Themes of Misaligned Voices; The Grey Areas; and The Wider Determinants, Meanings and Purpose of Alcohol were identified, revealing some of the tensions regarding alcohol treatment versus prevention, and discipline versus treatment that have persisted over time. Alcohol workplace policies, although designed to enhance processes of managing and supporting employees who may be struggling with their alcohol use, were inadvertently contributing to reduced employee early help-seeking. The study captures how misaligned and divergent perspectives about ‘alcohol problem framing’ may also be contributing to inconsistent ways of managing alcohol problems in the workplace. Using the health promotion theoretical framework enabled the study to uncover the entangled influences of personal, socio-cultural, environmental/workplace and politico-economic factors on employee drinking and how policies and practices around alcohol are shaped in workplace settings. 

Conclusion

The study acknowledges that workplaces invest in systems of treatment and support for individuals who may be dependent on alcohol. However, the focus on prevention and the overall health-promoting potential may be limited because of the misaligned voices, grey areas and unintended consequence of the alcohol workplace policies reducing early help-seeking in employees.  Workplaces may benefit from considering policy and practices that are underpinned by health promotion theory, to address these challenges and enable a more proactive, upstream approach towards employee alcohol harm reduction. Such proactive approaches would empower employers and employees alike to recognise and support the reduction of alcohol-related harm.