Toward a sociology of worksite health promotion: A few reactions and reflections

Abstract

This collection of papers fairly represents the range and depth of current sociological thinking on health promotion at the worksite. In so doing, it invites scholarly attention to a field that is embryonic and in many ways still struggling to formulate workable answers to a cascade of pressing questions about what works best, and why, and at what price, borne by whom (whether wittingly or not). Sociological analysis of health promotion has been relatively rare. As Conrad observes in his introduction to this special issue, the literature on worksite health promotion programs has been concentrated mostly in health education, occupational health, and public health journals. Also, it has been bifurcated. By far the larger branch has been decidedly utilitarian, looking for practical insights into how best to organize programs the value of which is taken mostly for granted. The smaller, more critical branch has sounded alarms about social control, hidden agendas, and harmful and/or unintended consequences. The first group of writings has tended to adopt a positivist tone and to be basically atheoretical; the second has been more frankly polemical, but often short on valid or compelling data. The present collection begins to bridge the gap between the two branches and to adumbrate what sociology can bring to the study of health promotion on the job. More than answers, the worksite health promotion field urgently needs a more self-conscious approach to the posing of answerable-and fundamental--questions. This question posing is what the authors of these eight new papers are struggling to do, with varying degrees of success because the field is so new. Nevertheless there is much we can learn from these papers: from what they say or neglect to say and from difficulties they encounter. Rather than try to canvass all the terrain they collectively cover, I will dwell on the two issues they raise that seem to me most salient. They are intertwined and can be thought of as issues of meanings and questions of motives.