Six Questions That Separate a Culture of Health from a Wellbeing Policy
Every organisation has a wellbeing program. Very few have a culture of health. Harvard Medical School’s Culture of Health Audit framework draws a sharp line between the two and offers six questions to find out which side of it you’re on.
1. Does health language appear in your strategy, your board reports, and your capital planning?
The most common failure in workplace health is what might be called the HR quarantine: health sits inside a people and culture team, generates annual program spend, and never appears in governance reporting, executive scorecards, or property investment decisions. This signals that health is a support function rather than a performance input.
Pull up your last board report. If an executive from another organisation read it without context, would they find any reference to employee health outcomes, environmental quality, or wellbeing as a performance lever? If the answer is no, health will consistently lose to the financial and operational priorities that dominate executive attention.
A genuine culture of health appears in the criteria used to evaluate workplace investment, in the metrics reviewed at board level, and in the language leaders use when they talk about performance.
2. Do your senior leaders visibly model healthy behaviours?
Behavioural norms set at the top define what the organisation treats as normal. When senior leaders send emails late at night, stay visibly connected across weekends, and skip lunch as a default, they communicate to everyone below them what is valued here.
A leader who protects focus time, prioritises movement and breaks, and treats boundaries as a sign of professional maturity rather than limited commitment builds more than compliance. Sustained pressure without recovery depletes the cognitive and physical reserves people need to perform when it genuinely matters. The teams that respond best to a critical deadline or an unexpected pivot are usually the ones that have not already been running on empty for six months.
That leadership behaviour also determines whether a workplace strategy lands. An organisation can invest in activity-based environments, recovery spaces, and neighbourhood zoning designed to support different work modes. But if senior leaders never use those spaces as intended, neither will anyone else. Workplace strategy requires leaders to model the behaviours the environment was designed to enable. Many organisations partner with a workplace strategy consultant to map out these shifts. Without that, the investment in space governance and change management produces a fit-out, not a shift in how the organisation works.
Leadership modelling is one of the lowest-cost, highest-leverage levers available to any organisation serious about health.
3. Does your workplace enable the health outcomes your communications describe?
An organisation can hold a genuine commitment to wellbeing and operate spaces that directly contradict it. Open floors with no acoustic refugethat strip people of spatial predictability. Breakout areas designed for aesthetics rather than recovery. Meeting rooms at 100 per cent utilisation with no buffer between sessions.
The built environment is one of the most consistent health exposures people encounter across their working lives. Air quality, thermal comfort, acoustics, and natural light all influence cognitive performance and stress regulation in ways the research has established clearly.
Workplace strategy can help close the gap
Most organisations treat environmental shortfalls as something to resolve in the next fit-out. Workplace strategy addresses them earlier, by asking how people across different roles work across the week, where the mismatches between working patterns and available environments sit, and how space allocation should evolve as the organisation changes.
Ready to build a workplace where people truly thrive?
4. Does your measurement framework capture what’s driving outcomes, or only what’s already gone wrong?
Sick leave is a lagging indicator. By the time absence rates are climbing, the conditions driving them have typically been present for months. The WHO estimates that noncommunicable diseases, many of which are directly influenced by sedentary behaviour, poor air quality, and chronic stress, account for 74 per cent of all deaths globally, with workplace conditions a recognised contributing environment. The National Human Activity Pattern Survey found that people spend approximately 90 per cent of their time indoors, making indoor environmental quality one of the highest-exposure health variables in any adult’s life.
A mature culture of health looks upstream. This involves tracking Indoor Environmental Quality, reviewing engagement data by floor, and using utilisation data to see if specific workplace zones designed for focus and recovery are being used as intended.
Without leading indicators, investment decisions get made on intuition and the return on any health initiative becomes indefensible to the people controlling the budget.
5. Is health investment consistent, or does it spike after a crisis?
Reactive investment follows a recognisable pattern. A retention crisis triggers a wellbeing audit. A surge in absenteeism prompts a new EAP offering. A visible burnout case at senior level generates a policy refresh.
Consistent investment sits as a line item in the annual planning cycle, reviewed with the same rigour as property costs and headcount. It includes forward-looking decisions about environmental quality before problems emerge, rather than in response to them. Organisations that treat health as a sustained capital commitment build environments that protect performance. Those that treat it as a discretionary spend manage symptoms.
6. Do employees have genuine agency over how and where they work?
Environments that offer people little control over their immediate conditions generate a persistent cognitive drain. Consider where they sit, how much noise surrounds them, and how they structure their day.
Agency allows for meaningful input into the conditions that shape daily work.
Neighbourhood-based zoning that preserves some spatial familiarity, consultation processes that influence design decisions, and policies that allow people to structure work around performance rather than presence all contribute to an environment that supports rather than strains the people in it.
What these six questions have in common
Each question in this audit targets a different layer of the organisation, but they converge on the same problem: health commitments that live in policy documents rather than in the decisions that shape how people work. Strategy sits in one conversation. Space planning sits in another. Leadership behaviour sits in a third. A culture of health requires all three to be aligned, and without a structured process to connect them, each decision made in isolation pulls the organisation further from its stated commitment.
Workplace strategy structures the evidence base that forces those decisions into the same planning process. It connects how an organisation’s people work to the environments they need to perform, grounded in occupancy analysis, work pattern mapping, and scenario modelling that reflects how teams function rather than how the organisation assumes they do. When Gallagher needed to reduce property expenditure across a national portfolio while rebuilding culture, PMG began with a strategic review of how each site’s teams worked, what the occupancy data revealed about how current environments were undermining required outcomes, and what a new workplace model needed to achieve at executive level.
Health sits inside that process. So does the clarity that makes the next workplace decision a confident one.
