Blue-collar workplaces: a setting for reducing heart health inequalities in New Zealand?

Aim: To review the evidence for the effectiveness of workplaces as settings for cardiovascular health promotion and reduction of heart health inequalities in New Zealand.

Methods: Literature review and structured appraisal of 154 articles meeting inclusion criteria, of which one review and three trials addressed cardiovascular interventions specifically, and four systematic reviews addressed the effectiveness of workplace health promotion programmes generally.

Results: The reviewed studies showed that workplaces have good potential as settings for health promotion. We found mixed but largely supportive evidence that workplace interventions can lead to improvements in health outcomes, workplace environments, lifestyles, and productivity. Workplace programmes that ranked highest in both clinical and cost-effectiveness targeted industries employing large numbers of blue-collar workers, tackled multiple risk factors, intervened at both individual and environmental levels and incorporated occupational safety components. Such programmes appear to offer a substantial return on investment for employers in other countries, but local evidence is lacking.

Conclusions: Employers and workers in blue-collar industries should be encouraged to participate in comprehensive heart health promotion programmes as a strategy for reducing existing socioeconomic and ethnic disparities in health. However, high-quality evidence of improved employee health and productivity is needed from well-designed New Zealand-based research to ensure that these programmes are optimally configured for effectiveness and attractive to employers and employees alike.