Organizational Health 573subordinates. Many of those managers may already have
very good relationships with their subordinates; thus, their
subordinates are not at risk of stress-related problems due to
poor supervision. Secondary interventions focus on people
who are believed to be at risk for injury or illness. An exam-
ple of a secondary intervention might be the initiation of fre-
quent breaks for data-entry operators who are known to be at
risk for musculoskeletal distress from prolonged use of key-
boards. Tertiary interventions target people who are experi-
encing symptoms of illness or injury and attempt to restore
them to health. Examples of tertiary interventions might be
individual counseling to reduce anxiety or establishing a
return-to-work plan for an injured worker.
OHP concentrates on primary prevention interventions al-
though it may include secondary interventions in which
known risk factors in the work environment are eliminated.
The previous examples describe interventions conducted at
the individual level. However, it is possible that interventions
can target workgroups, teams, departments, and organiza-
tions. Cooper and Cartwright (1994) have suggested that
healthy organizations will reduce the need for secondary or
tertiary interventions. However, when primary prevention is
not feasible or effective, occupational health psychologists
must be able to recognize situations where individual em-
ployees may need tertiary treatments (Quick, 1999b). Given
the vast array of potential risk factors in the work environ-
ment and the interdependencies among individuals in the
work environment, OHP is truly multidisciplinary in nature
and training models need to re”ect this.
ORGANIZATIONAL HEALTH
This section discusses the evolution of the concept of organi-
zational health; develops the scientist-practitioner model;
reviews the public health functions of assessment, surveil-
lance, and evaluation; and concludes with a case illustration
of the organizational health center concept as a practice
model. OHP seeks to promote the systemic health of organi-
zations. The discipline has evolved in concept and applica-
tion over the last decade of the twentieth century. Whereas
health, well-being, and especially work-related health were
once viewed solely as a personal concern and responsibility
of the individual worker, the focus has shifted to a more eco-
logical or systems view in which organizations and leaders
bear increasing responsibility. This shift has expanded the
worldview of occupational health to include a transactional
relationship between workers and the workplace, with an
equal emphasis on the psychosocial context and the physical
work environment. Individuals function in a mutually inter-
dependent relationship with the work structure and process.
The concept of organizational health has grown from this
perspective: Organizational health is inherently systemic. To
promote organizational health requires the joint achievement
of both individual well-being and organizational effective-
ness. Because organizations are dynamic, multidimensional
systems (Katz & Kahn, 1966), disease, or dysfunction in any
element in the organization disrupts the balance in the system
and negatively impacts other elements. Similarly, intervention
at any one point in the system in”uences all other elements.
Like individual health, organizational health is not a state
of being or a “xed characteristic of the or ganization; it is a
process that requires continuous management. Organizations
operate in a state of continuous change and ”ux. Only or ga-
nizations that are able to ”ex with short-term change and
adapt to long-term cycles of growth and transformation are
able to achieve, maintain, and enhance levels of organiza-
tional health. In keeping with the ”uidity of the process, or-
ganizational health runs along a continuum, from high levels
of effectiveness to organizational disease (Adkins, Quick, &
Moe, 2000). Promoting organizational health involves more
than the reduction of illness and injury of workers or the min-
imization of organization distress. OHP seeks to promote
optimal functioning of the organizational system rather than
focusing only on de“cit-based change.
Optimizing organizational health requires a broad,
problem-solving perspective to assess and intervene in this
multifaceted, ”uid or ganizational system. OHP moves away
from a narrowly specialized “eld of vision into a more inte-
grative, collaborative model, looking across disciplinary
lines to “nd the most ef fective methodologies to apply in the
organizational context. No one professional domain can hold
all the knowledge necessary across such a broad landscape.
Thus, occupational health psychologists often “nd them-
selves in the role of integrating agent, bringing together in-
terdisciplinary teams to provide knowledge and insight into
all facets of the system. They also work collaboratively in the
workplace, forming positive relationships with both manage-
ment and labor to build capacity in the social capital of the
organization.
Thus, effective organizational health programs, from
proactive prevention through tertiary intervention, consider
the processes, structure, systems, and culture of the organiza-
tional client as well as individual differences of the workers.
Promoting individual health and well-being in the workplace
is expected to lead to or support organizational effectiveness.
Programs, such as worksite health promotion (Terborg, 1986)
and worksite stress management interventions (Ivancevich,
Matteson, Freedman, & Phillips, 1990), boast the bene“ts to
both the individual and the organization of proactively devel-
oping healthy workers and minimizing the potentially