Equitable Health and Wellbeing: Addressing Multi-Level Barriers Among Employees in Low-Wage Jobs

PurposeTo explore front-line employees' perceptions of multi-level factors which influence their participation in health and well-being (HWB) programs in a healthcare organization.DesignA qualitative research design with 12 semi-structured focus groups.SettingThis study was conducted in a mid-Atlantic healthcare system.ParticipantsSixty-one employees, mostly from lower-wage occupations across different departments, including environmental services, security, clinical services, and administrative support.MethodsWe used thematic analysis to analyze the data. Discussions centered on employees' perceptions of organizational health and culture, awareness and use of HWB programs, and barriers to participation.ResultsOur findings highlight six multi-level barriers to HWB program participation. Participants appreciated the organization's emphasis on employee HWB and the variety of program offerings. However, the perceived lack of employee appreciation and trust negatively impacted their participation. Inaccessible communication and limited access to computers contributed to a lack of awareness of available offerings.ConclusionIn addition to individual characteristics, employees faced organizational-level barriers to program participation, including mistrust and a lack of appreciation. Organizations can embrace a systems-based approach to address structural barriers to ensure more equitable access to resources among low-wage workers, and to engage employees in the development of programs to improve employee appreciation and trust.