Society faces multiple challenges, including a growing incidence of non-communicable diseases with major public health implications, especially as both the general population and the workforce get older. At the same time, global climate change, driven by high greenhouse gas emissions, demands immediate action. A lifestyle that promotes healthy lifestyle choices and environmentally conscious behavior is considered a ‘sustainable’ lifestyle and offers a promising approach to addressing both public and planetary health. This thesis investigates how the office of the future can promote a healthy lifestyle and sustainable development from employee, organizational, and public health perspectives. The thesis is part of the comprehensive research project Sustainable Office of the Future (SOFCO), and investigates different dimensions of health and sustainable development. Study I explores office companies’ current vision for workplace health promotion, how health promotion is organized and provided, how wellness allowances are used, as well as potential facilitators and barriers for workplace health promotion related to physical activity by interviewing managers and human resource personnel. Studies II and III investigate whether an office-based intervention study where health education imbedded in the context of sustainable development results in more extensive behavior change compared to only receiving health education. Also, Study II explores participants’ personal behavior change goal-setting as well as factors that facilitate or hinder their ability to achieve them, and Study III explores the barriers and facilitators of healthy and sustainable behaviors in the built, social, and organizational environments at the office. Finally, Study IV investigates the association between a healthy and sustainable lifestyle index and the metabolic syndrome among office workers in the population-based LifeGene study.
Study I shows that workplace health promotion is implemented to maintain employee health, productivity, and is part of employee branding. Considerable investments are made in terms of finances and organizational support. Key facilitators include easily available information and convenient access to storage, locker rooms, and fitness facilities. The study underscores the importance of involving employees in creating workplace health programs and in overcoming work–life balance constraints that may hinder a healthy lifestyle.
Study II found that the intervention arm receiving education about sustainable lifestyle reduced their total diet-related carbon footprint, expressed as CO₂e, by 0.8kg per day, while the control arm, who only received education about healthy lifestyles, reduced CO₂e by 0.4kg. Statically significant interaction effects between time and lifestyle were found when diet-related carbon footprints were expressed as kg CO₂e per 1000kcal per day, indicating different effects for respective arms over time. Moreover, the intake of vitamin C increased by 8.0mg and 12.5mg per 1000kcal per day for the sustainable and healthy arms, respectively, indicating increased intake of fruits and vegetables. In addition, total sedentary time decreased by 0.4 hours per day in the sustainable arm, but not in the healthy arm. In total, participants formulated 22 diet-related personal goals for behavior change that were categorized into 9 main categories, along with 8 barriers and 5 facilitators to achieve the desired behavior change.
Study III shows that office workers perceive stairwells, locker rooms, indoor bike storage, green areas, and sidewalks as facilitators for active transportation within the office as well as to and from work. Spaces within the built environment that are convenient and attractive for daily breaks, recovery, and social interaction were perceived as places that promote employee well-being. Several conflicts of interest—i.e., profit margin vs. supporting healthy behaviors—in health promotion were identified; for example, vending machines since they contain both healthy and unhealthy food items. Furthermore, the citizen science method Our Voice was found to be a useful intervention function for increasing employee engagement and empowerment regarding healthy behavior at the office.
Study IV presents a Sustainable Lifestyle Index considering several healthy and sustainable behaviors simultaneously, including food habits, physical activity, sitting time, alcohol intake, tobacco use, and diet-related carbon footprint. High adherence to the Sustainable Lifestyle Index among 2641 office workers lowers the relative risk of metabolic syndrome by 65%, compared to the group with poor adherence to the index; i.e., unhealthy behavior. Metabolic syndrome was defined as having 3 out of 5 established metabolic risk factors. Although only 4% of the relatively young population exhibited 3 or more risk factors, a correlation between poor health behaviors and an increasing number of risk factors was observed, known to increase the risk of both cardiovascular disease and type 2 diabetes.
This thesis shows that promoting a healthy and sustainable lifestyle among office workers and providing accessible opportunities in the built, organizational, and social environment of the office are important for supporting and maintaining healthy employees. However, health promotion needs to be tailored and adjusted to the needs, capability, and interest of employees as well as to the workplace.