7. Worksite health promotion programs improve the health of those who have access to them.

Over the past several decades, corporations have recognized the benefits of programs that improve the health of their employees. Many programs began as worksite safety programs to guard against the risks and hazards of specific jobs and, over time, expanded to address a broader range of health needs such as immunizations and training in smoking cessation, stress management, exercise, nutrition and back care. Fielding makes distinctions among programs that prevent disease (such as clinical screenings), promote health (such as smoking cessation programs) and protect health (such as injury prevention).³¹ Donaldson, Gooler and Weiss observe that prior to 1991, analyses of health promotion programs were generally critical of their effectiveness but since that time research studies have shown positive benefits associated with health promotion programs.³² A review of 316 studies that evaluated worksite health promotion programs found positive results for weight control programs, borderline positive results for nutrition, exercise and cholesterol programs, and weak results for health risk appraisals.³³ Other literature reviews of smaller numbers of studies have reported overall positive impacts of worksite programs.^{34, 35} In California, significant job-growth is occurring in small businesses, and important attention is beginning to be directed to the practice of instituting health promotion in these smaller organizations.³⁶