Environmental assessments in the workplace: an analysis of workplace wellbeing facilities for women of reproductive age April 2024, Volume 34, Issue 1

Introduction

Workplaces are well positioned to support the wellbeing of preconception, pregnant, and postpartum (PPP) working women¹, as 75% of Australian women of reproductive age are in the workforce.² Further, employers have a duty of care to the health and safety of their employees.³ Workplace wellbeing programs for women often seek to improve individuals’ health behaviours⁴ and the physical and social environment can play an important role in preventive health by making “healthy choices easy choices” and providing individuals with greater control over factors impacting their health.⁵ Availability of family-friendly supports (for example, flexible working arrangements) has been associated with reduced parenting stress.⁶ Conversely, negative perceptions of workplace family support have been associated with poor physical health, depression and increased absenteeism.⁷ Additionally, working conditions (for example, psychosocial factors) may affect preconception health practices, pregnancy-related conditions, fetal health and development, reproductive health, and pregnancy outcomes.^8,9

Formative research to develop a holistic workplace program to promote the wellbeing and health practices of PPP women at the University of Tasmania, Australia, indicated dissatisfaction with the availability of parenting supports and a lack of policy focus on overall wellbeing.⁸ Therefore, to explore the potential points of intervention at an environmental level, we conducted a survey and environmental assessment to investigate the availability and access to health and wellbeing resources for women working across the reproductive years at a university workplace.

Methods

We conducted a 67-question cross-sectional Work and Wellbeing Survey (See Supplement S1, available from: figshare.com/s/d4d0268f637983aab6b6h) at the University of Tasmania in November 2018. To facilitate recruitment, the survey was emailed once to all female staff aged 18–45 years (2599; 37% total staff), by the university’s People and Wellbeing (human resources) team, and was advertised in staff newsletters. The survey aimed to capture data on women’s wellbeing needs and access to resources, and included items relating to general health, exercise and fitness, diet, sleep and stress, workplace (organisation), work and parenting.

We also conducted an environmental assessment using a modified 53-question Environmental Assessment Tool (EAT; Supplement S2, available from: figshare.com/s/d4d0268f637983aab6b6) adapted from DeJoy et al.¹⁰ Modifications to the original EAT included units of measurement (imperial to metric), employee demographics (e.g., ethnicity), and inclusion of supports specific to the PPP years (e.g., breastmilk storage facilities). Female employees with a knowledge of local facilities and programs that promoted wellbeing (as indicated in recruitment material), and a minimum 2 years’ employment were recruited from university campuses with 10 or more female staff (aged 18–45 years). Participants were recruited to complete the EAT through department newsletters, the staff portal and emails sent to the executive assistants of senior employees. The EAT was completed by 10 participants across 10 university campuses (small to large campuses located across four distinct regions in Tasmania and Sydney; Supplement S3 for scale, available from: figshare.com/s/d4d0268f637983aab6b6) between November 2020 and April 2021. At one campus where there was more than one volunteer, the first to respond was selected to complete the survey.

Data were collected using REDCap¹¹ and analysed using IBM SPSS Statistics (version 25.0) and RStudio (version 4.2.2). This study was approved by the University of Tasmania Human Research Ethics Committee (H0017313 and H0022986). All participants provided informed consent.

Results

Survey results

There were 241 valid responses to the Work and Wellbeing survey (9% response rate), with more than 80% of respondents aged 32–45 years old (Table 1). Half were caring for children and 70 respondents (29%) planned to start or add to their family in the next 2 years. The median participant BMI was in the ‘normal’ range (24.4 kg/m²), however 76% wanted to weigh less. The median sitting time of respondents was considerably higher at work (85% time), compared with away from the university (30% time). Most respondents disagreed (‘disagree’ or ‘strongly disagree’) with the statement “my health is not the responsibility of the university”(n = 143, 64%) and the majority (n = 168, 76%) felt the workplace had a role in supporting the transition to parenthood. Access to supports for PPP employees (e.g., parenting facilities or flexible working arrangements) was not universally available. Access to general amenities (e.g., shower and changing facilities) varied among respondents (Supplement S4, available from: figshare.com/s/d4d0268f637983aab6b6).

Table 1.     Description of survey respondents (N = 241)^a

Data source: University of Tasmania Work and Wellbeing Survey, 2018.
^a  Variable n according to total number of responses.
^b  Academic A–C = Lecturer to Senior Lecturer (sometimes also Assistant Professor); Academic D–E = Associate Professor to Professor; HEO 1–7+ = Higher Education Officer, professional employees of increasing skill, expertise and experience level.
^c  Outliers excluded based on data cleaning procedures from Australian Longitudinal Study on Women’s Health¹²: Weight > 139.9 kg; height > 200 cm and < 120 cm

Environmental assessment results

The EAT found that there was access to shower or changing facilities (n = 8, Figure 1) at most campuses, however few provided lockers (n = 2). Parenting amenities (for example, childcare) were unavailable at most worksites. Access to flexible work arrangements (a university-wide policy) varied according to work role, workload, manager and available cover. Respondents indicated that policies or procedures were in place to support employee mental health at more than half the campuses (n = 6) but not to support physical fitness, healthy eating, or pregnancy or parenting (Figure 2). Availability of resources to support fitness (e.g., walking paths, staff physical activity challenges, gym resources) and healthy eating (e.g., onsite cafes) varied across campuses. Vending machine images provided by participants demonstrated ease of access to discretionary foods (See Supplement S3, available from: figshare.com/s/d4d0268f637983aab6b6).

Figure 1. Campus characteristics, facilities, and programs to support wellbeing from the environmental assessment (N = 10 campuses) (Click figure to enlarge)

Data source: Environmental assessment at University of Tasmania.
^a n = 9.
^b Under certain circumstances.

Figure 2. Campus policies to support wellbeing from the environmental assessment (N = 9 campuses)^{a (Click figure to enlarge)}

Data source: Environmental assessment at University of Tasmania.
^a One participant did not complete questions relating to current health promotion policies.

Discussion

To our knowledge, we are the first to assess access to wellbeing resources for PPP female employees in a workplace and, more specifically, within a higher education workplace setting. Survey participants indicated that the university plays a role in their health and supporting the transition to parenthood. However, awareness and/or availability of amenities to complement the health and wellbeing of employees across the PPP periods was variable or absent. This included physical amenities (for example, parenting rooms in each building) and written policies and procedures (for example, to support healthy eating).

In capturing the workplace wellbeing needs and expectations of PPP working women and variation in access to corresponding resources, this study highlighted the inequitable resource distribution for female employees of reproductive age. Embracing a future where workplaces actively seek to “protect, serve and promote health”¹³ should include monitoring for such inequities among subgroups of workers, as they may result in disproportionate impacts on health.¹⁴ Given the potential for far-reaching, intergenerational benefits to health¹ and emerging evidence linking work to the health practices and wellbeing of PPP working women⁹, there is a compelling need to improve the work environment.

Limitations of this study included a low survey response rate (9%), and that the sample rated diet and fitness highly compared to national averages.¹⁵ This may be due to the use of self-reported data, the high education status of respondents, or nonresponse bias (leading to an underrepresentation of those with lower health status).¹⁶ Thus, caution is required when extending findings from this sample to the wider university population. The original EAT survey¹⁰ was designed to be undertaken by researchers, however the local knowledge of participants was valuable for overcoming previously identified gaps in wellbeing provision (e.g., uncoordinated or unsustained advertising of wellbeing activities).⁸ Our EAT was conducted during the coronavirus disease 2019 (COVID-19) pandemic, across a 6-month time frame. Therefore, there may have been some variability in resource availability, as many activities are organised around teaching semesters. This suggests that current supports may be targeted at students, rather than staff.

Application of this work

While the current findings will contribute to the development of a place-based workplace program, there is a need to address work processes and structural inequities in the higher education settings internationally, as demonstrated in the US and UK.^17,18 This can range from the decreased representation of women holding higher-level academic positions¹⁹ to the nature of academic work, which results in work intensification and adversely affects employees’ work-life-family balance.²⁰ The breadth of such inequities may be clarified by applying an environmental assessment, and subsequently modifying inherent biases and impacts on health and wellbeing at an organisational level.

Conclusion

There are deficiencies in the working environment to support general employee health and, especially, that of employees in the preconception, pregnancy and postpartum years. Growing awareness of the pathways between work and health suggests that such deficiencies may have tangible impacts on PPP working women.⁹ Caution is required in generalising the current findings, however regulatory change may be required to elaborate on employers’ duty of care to address the pitfalls and inequities of the physical working environment for PPP female employees.

Acknowledgements

The researchers would like to thank Ms Emily Green for her assistance with manuscript administration tasks and Dr Cate Bailey for her guidance in refining the Work and Wellbeing Survey.

Funding for this research was provided by the Australian Government’s Medical Research Future Fund (MRFF; TABP-18-0001) and the National Health and Medical Research Council (NHMRC) through the Centre for Research Excellence in Health in Preconception and Pregnancy (GNT1171142).

SM was funded by an Australian Government Research Training Program (RTP) Stipend and RTP Fee-Offset Scholarship. Funding for the creation and distribution of the Work and Wellbeing Survey was provided by People and Wellbeing at the University of Tasmania, Australia. AH and BH were funded by an NHMRC Early Career Fellowship (GNT 1120477) and Australian Research Council Discovery Early Career Researcher Award (DE230100704). MRFF funding was provided to The Australian Prevention Partnership Centre under the MRFF Boosting Preventive Health Research Program.

This paper is part of a special issue of the journal focusing on: ‘Collaborative partnerships for prevention: health determinants, systems and impact’. The issue has been produced in partnership with the Collaboration for Enhanced Research Impact (CERI), a joint initiative between The Australian Prevention Partnership Centre and NHMRC Centres of Research Excellence. The Prevention Centre is managed by the Sax Institute in collaboration with its funding partners.

Peer review and provenance

Externally peer reviewed, invited.

Copyright:

© 2024 Madden et al. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, which allows others to redistribute, adapt and share this work non-commercially provided they attribute the work and any adapted version of it is distributed under the same Creative Commons licence terms.