Defining Culture of Health: Beyond Workplace Wellness

Many companies are interested in the concept of "Culture of Health" to improve health and well-being throughout their organization. But some current definitions don't encompass the full range of social influences essential for building a Culture of Health, according to an editorial in the November Journal of Occupational and Environmental Medicine.

"The goal of a Culture of Health initiative is to align social influences with healthy beliefs and behaviors," write Richard Safeer, MD, of Johns Hopkins Medicine and Judd Allen, PhD, of Human Resources Institute, LLC. "However, much of this potential will be unrealized if 'Culture of Health' becomes a popular buzz phrase that lacks any reference to key culture frameworks and concepts."

Drs. Safeer and Allen note that some definitions of Culture of Health — notably including that of the Centers for Disease Control and Prevention (CDC) — don't account for cultural beliefs, norms and traditions, peer support, and other social influences that affect employee health and well-being. Toward a more inclusive definition, the authors present a "conceptual map," encompassing six overlapping spheres of cultural influence:
  • Formal and informal leadership support at all levels
  • Shared values, with employee health and well-being as a "top-tier priority"
  • Organizational norms to promote health; "the way we do things around here"
  • Peer support to increase assistance for adopting healthy practices
  • "Touch points," or formal and informal systems reinforcing healthy behaviors
  • Key factors for building a positive social climate
The authors also stress the need to develop "accurate, reliable, and reproducible" tools to measure all aspects of the culture of health. Evaluation tools shouldn't be just a "checklist" of workplace wellness programs — which typically aim at changing individual health, rather than the overall culture.

"[We] are concerned that the indiscriminate use of the phrase 'Culture of Health' might result in little substantive change in the approach employers and vendors take in creating a healthy workplace," Drs. Safeer and Judd conclude. "By providing a framework for understanding the spheres that influence the culture within the workplace, we anticipate organizations will be able to more successfully navigate options to support the health of their employees."
About the Author
Dr. Safeer may be contacted for interviews at
ACOEM (, an international society of 4,000 occupational physicians and other health care professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.
About the Journal of Occupational and Environmental Medicine
The Journal of Occupational and Environmental Medicine ( is the official journal of the American College of Occupational and Environmental Medicine. Edited to serve as a guide for physicians, nurses, and researchers, the clinically oriented research articles are an excellent source for new ideas, concepts, techniques, and procedures that can be readily applied in the industrial or commercial employment setting.


Safeer R, Allen J. Defining a culture of health in the workplace. J Occup Environ Med. 2019;61(11):863-7.