How do employees within a sheltered workplace conceptualize health and health promotion? A secondary qualitative analysis using an intersectional approach among employees from a sheltered workplace with a SEP and able-bodiedness perspective.

Abstract

There are persistent socioeconomic health inequalities in the Netherlands, with lower socioeconomic position (SEP) individuals living up to 25 years shorter in good health, compared to higher SEP individuals. Workplace health promotion interventions in the sheltered workplace are considered promising for addressing these health inequalities, particularly for low SEP individuals and those with disabilities. But differences in conceptualizations of health (and health promotion) between intervention developers/policymakers and those who are targeted, together with the lack of acknowledging diversity within the lower SEP group can possibly be the cause of the ineffectiveness of these interventions. This study takes an intersectional perspective to consider how SEP and able-bodiedness interact and thereby shape one’s conceptualization of health and health promotion by following the guidelines for secondary intersectional analysis as proposed by Muntinga et al (2020). For this analysis, transcripts of individual interviews and group dialogues with employees of a sheltered workplace were used. The findings of this study highlight the influence of capital (e.g. economic resources, knowledge, and social networks), responsibility, and the role of environmental contexts in shaping conceptualizations of health and health promotion among employees at the sheltered workplace. These conceptualizations have been shaped by internalized neoliberal thoughts focusing on self-reliance, accountability, and responsibility. By recognizing the complexities following intersections on these conceptualizations, policymakers can develop approaches for worksite health promotion that are more suitable for the specific needs and opportunities of this group regarding health. In the future, interventions aiming to tackle health inequalities should be accompanied by policies that aim to tackle the structural barriers for those working at a sheltered workplace.