The future of health promotion/disease prevention programs: the incentives and barriers faced by stakeholders.

According to Healthy People 2010, 95 % of employers with more than 50 employees reported that they offered at least one health promotion activity by 1999. Employment-based health promotion/disease prevention (hp/dp) programs have significantly increased in frequency and scope since 1985. Yet, 20 years later, the reported results for employee health lag behind the literature documenting the impact of lifestyle-related health risks on morbidity, healthcare utilization, and costs. In this article, we consider the key stakeholders involved-employers, health plans, and employees-and explore their legitimate and feasible roles in employment-based hp/dp programs, including the incentives and barriers they face to program participation. We argue for the integration of hp/dp programs into the traditional health protection mission of occupational health and safety professionals.