The role of universities in
promoting healthy
Judy Orme
Professor of Public Health and
A Settings Approach
• Ottawa Charter (WHO, 1986)
“Health is created and lived by people within
the settings of their everyday life; where they
learn, work, play and love.”
• Settings approach – starting point for
health promotion programmes: “…shifting
the focus from the deficit model of disease
to the health potentials inherent in the
social and institutional settings of everyday
life”. (Kickbusch 1996)
Healthy settings approach
• A settings approach advocated since mid
• Socio- ecological model of health
• Dynamic complex systems
• Whole system thinking
• Examples – schools, universities,
hospitals, sports stadia, workplace, cities.
Determinants of health and
Health Map
- Barton, H. and Grant, M.
downloadable under a creative
commons licence from
Obesity – perhaps not quite so simple! – Foresight obesity causal
Policy context
‘Working for a Healthier Tomorrow’
(Black, 2008)
• ‘Improving Health and Work’ - The
Government’s Response (2008)
• ‘NHS Health and Well-Being Review’
(Boorman, 2009) This report found that NHS
organisations that prioritise staff health and wellbeing performed better, in terms of quality, patient
satisfaction, staff retention and sickness absence.
Working for a healthier tomorrow
3 principal objectives
•Prevention of illness and promotion of
health and wellbeing
•Early intervention for those who
develop a health condition
•An improvement in the health of those
out of work
Public health & public health economics
• PH Outcomes Framework 2012
• Mental health problems and Musculoskeletal disorders are major causes of
sickness absence
• Lifestyle behaviours – smoking + obesity
• 175 million working days lost to illness in 2006
• Annual economic costs of working age illhealth estimated over £100 billion
• SROI type calculations e.g. £1 invested in
workplace health brings a return of £3.50
Government response
• Creating new perspectives on health and
e.g.Fit note; GP education; Regional
coordinators; Evidence base
• Improving work and workplaces
e.g. NHS workforce review; OH helpline;
National strategy for Mental health &
• Supporting people to work
e.g. Fit for Work pilots
Active Workplace Initiative
Rochdale Council 2006-10
Average sick days per employee
Cost of sickness absence
Reduction in sickness costs
£10.57 million
£660 k
£9.35 million
£560 k
£8.79 million
£560 k
£38.62 million
£1.78 million
Employer benefit evidence
• Royal Mail – health & wellbeing initiatives
• British Gas – back care workshops
• Parcelforce – comprehensive wellbeing
• SMEs?
Developing Leadership and
Governance for Healthy Universities
• 169 HEIs
• 2.4m students
• 370,000 staff
Wellbeing & engagement
In UK HE sector:
• £270m cost of sickness absence per year
• 10% reduction in average sickness
absence = £27m per year (e.g. £400K for
Univ of Sheffield)
• If a 10% increase in performance is worth
minimum of 5% of salary (£1,606 per
employee) £600m potential financial gain
per year(e.g.£9.6m per year to Univ Bristol)
7 Government indicators
1. Improving knowledge about the importance of
work  health + health  work.
2. Improving the promotion of health & well-being
3. Reducing the incidence of work-related ill-health
and injuries and their causes.
4. Reducing proportion of people out of work due to
5. Improving self-reported health status
6. Improving access to health service support.
7. Improving business productivity
Public Health Responsibility Deal
– [email protected] pledges
• Occupational health
• Health and wellbeing
• Chronic conditions
• Healthier staff
Higher Education Sector
Project findings-health & wellbeing
• Leadership and Governance of Healthy
Universities (HEFCE)
• Improving performance through wellbeing
& engagement (HEFCE)
Healthy Universities
“A Healthy University aspires to create a
learning environment and organisational
culture that enhances the health, well-being
and sustainability of its community and
enables people to achieve their full potential.”
Healthy Universities
Examples of Integrative Work
 Transport: sustainable transport policies are increasingly
being developed and championed across higher education
sector, contributing to action on climate change by reducing
carbon emissions and helping tackle obesity and other
chronic diseases by promoting physical activity.
 Food: ‘whole university’ healthy and sustainable food
frameworks can also impact positively on health and carbon
reduction, helping to address interconnected procurement,
catering, retail, education, research and advocacy roles in an
integrated way.
 Curriculum: universities can also embed health and
sustainable development into their core business through
means of curriculum development linked to research and
knowledge exchange – with an emphasis on inter-disciplinary
transformative learning.
Orme and Dooris, 2010
Case study
Healthy and Sustainable Food @ UWE
Date added: 8th November
Author: Peter Cockburn and Judy
Organisation: University of the West of
Case Study Summary
Food is an issue that clearly highlights the interconnectedness of health and sustainable development agendas.
UWE have developed a whole-system approach ensuring that they focus on multi-pronged aspects of food and
health including procurement, catering, retail, education and research. This case study highlights what has been
achieved, what is still to do and the challenges a comprehensive food and health strategy presents for
Related Guidance Package:
Communicating Health Messages as Part of a Whole System Healthy Universities Approach
Case study
Active Travel
Date added: 29th October 2010
Author: Steve Ward
Organisation: University of the West of England
Case Study Summary
Sustainable transport policies are increasingly being developed and championed across the higher education
sector. These contribute to action on climate change by reducing carbon emissions and helping tackle obesity
and other chronic diseases by promoting physical activity. This case study highlights a range of achievements to
date which demonstrate an holistic approach to travel planning but also indicates the work that still needs to be
done and the challenges to progressing such an important agenda for health and wellbeing.
National HEFCE funded project
Findings from UCEA project
Better scores for
workplace factors
-higher levels of
-better psychological
-lower perceived stressors
….is significantly
associated with
better performance
in NSS and RAE.
Business case for Wellbeing
and Engagement in HE
• Comprehensive literature review
Promotion of employee wellbeing 
• increased commitment +job satisfaction;
• staff retention;
• improved productivity and performance;
• reduced staff absence
Initiatives with some impact
• Psychological contract
• Stress management- briefings, training
programmes, promotion of physical activity (gym
• Resilience training for senior managers
• Employee communications
• Board level communications and engagement
• Training modules for middle managers – coping
with major change; leading major change
• New sickness absence procedure + support
Focus on the South West
• Strategic Healthy Workplace Alliance
• Bristol Workplace Health and Wellbeing
Workplace Wellbeing Charter
Self assessment standards for
businesses in England
Attendance management
H&S requirements
Mental health and wellbeing
Smoking and tobacco-related
- Physical activity
- Healthy eating
- Alcohol and substance abuse
Structure of Bristol economy
~17,500 employers in Bristol
Organisations with 50 or
fewer staff account for
almost 50% of employees
Large organisations
(250+ employees) account
for almost a third of all
Examples of good practice
City Council takes on the big three!
Bristol City Council takes on the big three!
During an otherwise typical British summer of 2010, something extraordinary was happening at Bristol City
Council, a commitment to make a change: to support staff to improve their fitness and health. Focusing on
three bastions of good health; eating well, physical activity and mental wellbeing, the halls and notice boards
were coloured with activities and challenges for employees to try.
Full steam ahead!
To start programming, the newly appointed Health at Work Co-ordinator dove straight in with exciting and supportive
activities for staff to tap into. The Be Active! Challenge was launched to build physical activity into daily
routine. Messages included helpful reminders to try the stairs instead of the lift, active travel and lunchtime walks. For
those wanting more of a challenge during their lunch hours and after work, an array of fun, team-building and fitnessboosting taster sessions was held.
For people looking for guidance around their diet, Healthy Eating MOTs were held for staff to ask questions and get tips
from nutritionists. This included a look at various types of food from a health point of view as well as lifestyle (vegetarians,
ethnic, allergies).
Looking to increase the availability of counselling for employees, the internal
Occupational Health and Counselling team held drop in sessions for staff for the first time. While the process usually
requires a referral from a line manager, opening up to ability to talk to a counsellor was very popular and helped to highlight
the need to open up the service for these types of sessions to be held more frequently.
Spreading the word
Exemplar: Ginsters
• On average earnings are 25%
below the UK national
• Ginsters is located in
Callington, once a busy mining
area, main industries now
farming and tourism.
• Ginsters used to have a high
staff turnover, high sickness
absence, disengaged staff
Example of good practice: Ginsters
Started July 2006. UWE project evaluation.
On-site fitness suite: workplace coordinator
Active workplace coordinator
Health surgeries (alcohol, BP, BMI, diabetes)
Around 15 regular physically-based activities
Taster sessions (e.g. canoeing)
New menus in Restaurant + free fruit for all staff
Family and Community activities, e.g. allotments
Reaching out to their suppliers and neighbouring
small companies
• Integrated locality programme
Ginsters -continued
Improvements in health and wellbeing
Sustainable business
One business
• Role of university is very broad in terms of its
contribution to workplace health
• Universities are major employers
• Perhaps the concept of a ‘healthy workplace’
needs to redefined during such difficult and
challenging economic times
• A focus on both large and SMEs needs to be

The role of universities in promoting healthy workplaces