A Context Analysis with Stakeholders' Views for Future Implementation of Interventions to Prevent Health Problems Among Employees with a Lower Socioeconomic Position.
R Schaap, F G Schaafsma, M A Huysmans and 3 others
PMID 34731392WHAT IT FOUND
Stakeholders in Dutch occupational health described a system where no one takes responsibility for employees' complex health and life problems.
Occupational services are seen as business advice, prevention is underfunded, and occupational and curative care do not collaborate.
Key findings
01Occupational health services are perceived as commercial providers of business advice to employers, not as care providers, and they do not take responsibility for solving problems outside the workplace.
02Employers determine the content of occupational health services, and basic contracts rarely include prevention, focusing instead on managing long-term sick leave.
03Collaboration between occupational and curative healthcare is difficult because the two systems are strictly separated, and general practitioners often lack the time and expertise to address work-related issues.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study did not include the perspectives of employees with a lower socioeconomic position, meaning the findings reflect only the views of professionals and policymakers. Stakeholders were recruited using snowball sampling, which may have resulted in a sample that was already interested in the topic and held more positive views about their own role in implementation. The study focused on the Dutch healthcare and occupational context, which may limit the direct applicability of the specific systemic barriers to other countries.
Declared interests
The study was supported by non-U.S. government funding. The authors declared no specific conflicts of interest.
The easy way to misread this
Do not interpret the stakeholders' recognition of the problem as evidence that current systems are functioning well. The paper describes a context where responsibility is explicitly avoided by all parties, and prevention is underfunded, meaning the identified need for action is not currently being met by the healthcare system.