2.1. Importance of Health and Health Awareness as a Social Sustainability Factor
Based on the Brundtland report, “sustainable development is a development that meets the needs of the present without compromising the ability of future generations to meet their own needs” (
WCED 1987). Similar to the original concept, a significant proportion of researchers start from the production and resource use side when assessing sustainability. Nevertheless, a much more practical and detailed approach has become popular in last few years, according to which sustainability is the ability to pursue a well-defined behavior indefinitely without the deterioration of natural, human, and intellectual resources (
Crittenden et al. 2011). Despite the many different definitions, it can be clearly identified that we can primarily evaluate sustainability along the well-known three basic dimensions—environmental, economic and social aspects. However, more recently, research have also been conducted from a consumption perspective. As a result,
Figure 1 demonstrates we can interpret and analyze the common sections of the basic dimensions—socio-economic (e.g., job creation, skills development, business ethics, etc.), socio-environmental (e.g., health and wellbeing, global environmental change, crisis management, etc.) and eco-efficiency (e.g., life cycle management, resource management, etc.) subdimensions (
ConocoPhillips Company 2006;
Barcan 2016).
Since more and more economies have recognized that our current consumer patterns and habits are no more sustainable long term and sustainable development has become a key issue in the level of policy decision makers both in international and national level, sustainable development goals were redefined and reformulated by United Nations in 2015. Good health condition and wellbeing can be connected directly to SDG 3 (Good health and wellbeing), however indirectly to SDG 8 (Decent work and economic growth)—through satisfied and healthy employees—and SDG 12 (Responsible consumption and production)—through healthy nutrition and sustainable consumption (
UN 2020).
The most commonly used and accepted concept of health was defined by the World Health Organization (WHO) in 1948. According to the Preamble to the Constitution of the WHO: “Health is a state of total physical, mental and social wellbeing and not merely the absence of disease or infirmity.” (
WHO 1948). The approach that maintaining and improving health requires not only scientific developments and various health services, but also the lifestyles represented by individual consumers and also the whole society, is becoming increasingly accepted. Furthermore, in the last decade WHO has placed increasing emphasis on the social and economic environmental aspect of health (
McMichael 2006). Consequently, our health is affected not only by genetics and basic sociodemographic characteristics such as gender or age, but also by income and social status, educational level, cultural diversities, physical environment, working conditions, social support networks, healthcare system and personal behavior (
WHO 2017). Several previous studies present relations between individual behavioral risk factors—such as physical inactivity, smoking, risky alcohol consumption and obesity or overweight—and noncommunicable chronic diseases and disabilities (
Loef and Walach 2012;
Fine et al. 2004;
Li et al. 2007;
Pharr and Bungum 2012;
Linardakis et al. 2015). The study focuses on working environment through health-related work benefits.
2.2. Workplace Health Promotion as an Internal CSR Activity
Researchers and practitioners interpret social responsibility in several different ways. In the literature, it is primarily identified with environmental awareness and environmental protection, however, it also has various other aspects today. Often, companies are not familiar with all aspects of this relatively new field, however, there is a growing tendency and willingness to try to find and apply CSR in practice. Social responsibility is undoubtedly one of the outstanding concepts of our economy today, which is briefly about how individuals, nations, and different companies can behave responsibly during their activities. Social responsibility and sustainability very often occur together in academic research, as in this situation the organization’s traditional, short-term market-oriented interest is pushed into the background and other longer-term plans come to the fore even if its interest may not be directly measurable (
Dos 2017). Moreover,
Kot and Brzezinski (
2015) emphasized in their research that a well-structured, organized and implemented, strongly enforced policy is crucial to facilitate the sustainable development. Furthermore,
Grabara et al. (
2016) stated that social responsibility itself has become a significant dimension of development at domestic and international level, in addition at micro and macroeconomic level. While most research agree that social responsibility is a strong business requirement, there is little consensus on what constitutes and how to implement it into corporate operations. The problem is that knowledge develops in parallel in different business disciplines, therefore opinions, ideas and feasibility intentions appear in many different ways. In addition, there are the cultural differences found in the global business environment (
Kashyap et al. 2011). Similarly,
Taras et al. (
2011) stated that many researchers have verified that national culture values significantly influence the attitudes over the organizational culture.
The term of corporate social responsibility (CSR) has become dominant in the life of organizations nowadays, though there are also opponents of this concept (e.g.,
Chwistecka-Dudek 2016). Due to the many different definitions and approaches of CSR, it is often misunderstood and misinterpreted; or hardly understood its role in sustainable business models (
Dahlsrud 2006;
Doh et al. 2015;
Ling 2019). The first formal definition derived from
Bowen (
1953) who stated that companies have a decision-making power which may have an impact on their actions and influence also the society as a whole. Although there is not a unified definition of CSR, the most accepted and most frequently cited version is determined by the European Commission: “CSR is the responsibility of enterprises for their impact on society” (
European Commission 2010). In order to meet their corporate social responsibility requirements, enterprises should have in place a process to integrate social, environmental, ethical and human rights concerns into their business operations and core strategy in close collaboration with their stakeholders (
Macassa et al. 2017). This definition of CSR places the responsibility of enterprises on the three main above-mentioned pillars of sustainability, of which CSR and workplace health promotion are in the social pillar (
Cochran 2007;
Stawicka 2018). One of the leading paradigms of corporate social responsibility is Carroll’s CSR Pyramid framework which determines four dimensions (economic, legal, ethical and philanthropic) (
Carroll 1979;
Carroll 2016). Friedman stated that CSR activities represent an unnecessary investment of shareholders, and that social responsibility should be the personal choice of individuals, not a business issue (
Friedman 1970;
Thao et al. 2019). Furthermore,
Szegedi et al. (
2020) developed a CSR index in accordance with stakeholder theory and examined the relationships between CSR and financial performance.
Based on the groups of stakeholders, two different areas of CSR activities can be distinguished—external activities related to external stakeholders (consumers, competitors, government and suppliers), and internal activities related to internal stakeholders (employees and other shareholders) as
Figure 2 illustrates.
Despite the fact that most research still focuses on external CSR activities (
Lichtenstein et al. 2004;
Sen et al. 2006), some recent studies assess the impact of companies’ CSR activities on employee attitudes and behaviors (
Brammer et al. 2007;
Turker 2009;
Zhu et al. 2014). Studies found a significant, positive and long-term impact of CSR on community health, especially in developing countries and among socially excluded groups of population (
Werner 2009). In Hungary, some companies already have started to introduce CSR activities, however it is mainly typical in life of multinational companies and even less easy and effective at the SME level.
The WHO has been working on occupational health since 1950, emphasizing that not only work and the workplace affect the physical and mental health of employees, but also the health of employees affects the company and its business performance (
Szabo and Juhasz 2019). Based on the Ottawa Charter (
WHO 1986), health promotion is “the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social wellbeing, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment” (
WHO 1986). If we talk about occupational health, it is necessary to properly determine the definition of workplace health promotion (WHP). The most integrated and widely cited meaning is described by the European Network for Workplace Health Promotion (ENWHP) as a “modern corporate strategy which aims at preventing ill-health at work (including work-related diseases, accidents, injuries, occupational diseases and stress) and enhancing health-promoting potentials and wellbeing in the workforce” (
ENWHP 2007). According to the
ENWHP (
2007), the most important areas where various measures and/or activities can be taken related to health promotion consist of lifestyles, ageing, corporate culture including leadership, development of employees, work-life balance, mental health and stress management, wellness, nutrition and physical health, corporate social responsibility (CSR). In contrast, few research show that CSR activities can motivate employees to initiate commitment, however, CSR performance does not result increasing job performance (
Houghton et al. 2009;
Vlachos et al. 2014).
Due to the market and profit-oriented approaches, it can be easily forgotten that corporate image and performance should not be evaluated only through financial performance or profit (
Stojanovic et al. 2020;
De Roeck et al. 2016).
Kot (
2014), for example, examined the research field by distinguishing five main areas of CSR business benefits: a positive effect on company image and reputation, a positive effect on employee motivation, retention and recruitment, cost saving, revenue increases from higher sales and market share, CSR-related risk reduction and management. Other research shows that healthier employees are already able to perform better physically and mentally in the short term, and they become more health-conscious, more efficient, more productive, more satisfied, more motivated and more loyal (
Szabo and Juhasz 2019;
Ozminkowski et al. 2016;
Hendriksen et al. 2016;
Gubler et al. 2017). In addition,
Dumitrescu and Simionescu (
2015) conducted empirical analyses based on accounting measures to determine company financial performance related to CSR. Besides increasing revenues, other financial benefits of CSR have been observed through costs of production and equity reduction (
Matthiesen and Salzmann 2017). Moreover,
Fehér and Reich (
2020) verified in their research that workplace health management has a significant positive impact on the attractiveness of the workplace and employer. In addition, it may improve also the image of the company.
Table 1 summarizes the most relevant benefits of WHP in short, middle and long term.
2.3. Employee Wellbeing, Satisfaction and Loyalty
As previous researchers have stated, the concept or issue of wellness is usually examined and discussed in terms of multiple dimensions. Most of them distinguish five–six dimensions (
Roscoe 2009;
Harari et al. 2005;
Hettler 1984;
Adams et al. 1997). One of the most well-known and cited methods to measure wellness is the Perceived Wellness Survey which include six following dimensions of wellness: physical, emotional, social, psychological, intellectual and spiritual (
Adams et al. 1997). The criticism of this method is the excessive fragmentation of the psychological dimension into emotional, intellectual, psychological, social and spiritual parts; however, these concepts can be easy to confuse. Similarly, Hettler’s Wellness Hexagon consists of six different dimensions: physical, emotional, social, intellectual, spiritual and occupational. Wellbeing is a multidimensional and conceptually similar concept to wellness. For example,
Hooker et al. (
2021) examined eight dimensions of wellbeing in their model. Based on
Linton et al. (
2016) wellbeing includes several dimensions related to mental wellbeing (happiness and emotional quality of life), social wellbeing (social relationships and communities), spiritual wellbeing, activities and functioning (having activities to fill one’s time), physical wellbeing (quality of physical performance and functioning); and personal circumstances (environmental and socioeconomic pressures and concerns). Summarizing the related literature sources physical health can be connected to the current psychical status of the people, mental health can be defined through the cognitive abilities and mental confusion—it is determined by various biological, environmental and socioeconomic factors. Social and emotional health is closely linked to the wellbeing and happiness arising from recognition, social relationships and activities (
WHO 2018;
Soo You and Lee 2006). The following model with eight dimensions of wellbeing—illustrated by
Figure 3—can be divided by internal and external factors and includes both personal satisfaction (as spiritual harmony) and employee satisfaction (as occupational harmony).
Knowledge economy and knowledge-based society have become more important phenomenon today and therefore employee satisfaction and loyalty have become critical issues (
Matzler et al. 2003;
Renzl 2003). Employee motivation and retention are important determinants here as in the case of lean thinking and implementation of lean management system (
Olah et al. 2017). There is no doubt that employee satisfaction is an important variable which is able to provide a general view about general emotion and feelings of employees about their job and workplace. However, it is difficult to measure due to its latent determinants. Employee satisfaction is measured and evaluated in several empirical studies either as an overall feeling about the work itself, or as a related set of attitudes about various aspects of the work (
Spector 1997). Some researchers started to observe this area at the beginning of the last century.
Taylor (
1911), for example, recognized the economic importance of employee satisfaction, that employees work harder for cash rewards and higher pay.
Locke (
1976) have collected nearly 3000 studies that address some aspect of employee satisfaction. These surveys are mostly about the measure of the relationships between satisfaction and some other factor such as task management, leadership, reward system, group processes and so on. According to
Locke (
1976), employee satisfaction is a pleasant, positive feeling that results from an appreciation of work-related experiences which definition is closely correlated to Tayler’s original concept. According to
Hoppock (
1935) employee satisfaction can be determined as a mix of cognitive, physiologic and environmental factors that make the employees satisfied or dissatisfied with their work. Once employees are satisfied with their work, they will have a positive attitude towards it, and this is true in the opposite direction (
Armstrong 2006).
Herzberg’s (
1966) two-factor theory distinguishes between job characteristics: satisfaction can be caused by internal (motivating) factors such as responsibility, promotion, development opportunity, recognition, content and significance of the task; and external (so-called hygiene) factors not directly related to work: corporate policy and administration, management style, working conditions, personal relationships with the manager, employees and subordinates, position, job security, salary, remuneration system (
Tietjen and Myers 1998).
Several empirical studies have found strong relationships between employee satisfaction, organizational commitment and loyalty (e.g.,
Mak and Sockel 2001;
Martensen and Gronholdt 2001). Some of them also stated that employee satisfaction is negatively related to turnover (e.g.,
Tekleab et al. 2005;
Ward 1988) and absenteeism (e.g.,
Muchinsky 1977). By creating joint values and socially responsible engagement enterprises can gain such competitive advantages as increasing competitiveness, image building or a satisfied and loyal workforce (
Shpak et al. 2018). So called fringe benefit is suck a work benefit as the material and nonmaterial incentives the company offer and provide to its employees to commit them to the company. Employees received these benefits in addition to their wages or salaries, in some cases also after retirement (
Khuong and Tien 2013). According to the result of
Artz (
2010) work benefits have significant and positive impact on employee satisfaction, and it is likely to have a profound impact on employee loyalty. It plays as a motivator factor helping to improve employee performance and to reduce employee turnover (
Kasper et al. 2012).
Empirical studies started to deal with also the effects of COVID-19 pandemic on CSR activities, workplaces and work itself. Health sensitivity has significantly increased; important health factors have to be emphasized by not only policy decision makers but also employers. The workplaces can be redesigned, and work can be reimagined in response to the current health challenge. For example, currently empty workplaces can be changed creating and building opportunities for standing desks, healthy snacks or workplace activity/exercise programs. Furthermore, it can be clearly seen that companies especially from legal, financial or technology sectors—where employees can work from home—remain as productive and competitive with the transition to home office (
Duffy et al. 2021;
Zhang et al. 2021;
O’Brien et al. 2021).
Table 2 summarizes all health-related work benefits (as independent variables) which may have significant effects on employee wellbeing, satisfaction and through of them on loyalty (as dependent variables) based on our assumption.
Table 2 includes also the relevant scientific literature sources related to each variable and offer a brief description about them.
Based on the above-discussed literature sources, and previous studies performed by Authors, indicators of exogenous variables and items connected to employee wellbeing are newly established and tested through exploratory factor analysis. Indicators related to employee satisfaction and loyalty are adapted from
Homburg and Stock (
2000,
2004), respectively. The following hypotheses were formulated for testing in this research by using the PLS—structural equation modelling (SEM) path modelling. A corresponding research framework highlighting the path and hypotheses are presented in
Figure 4.
The hypotheses are presented as below:
Hypothesis 1 (H1). There is a positive impact of emotional health towards employee loyalty.
Hypothesis 2 (H2). There is a positive impact of emotional health towards employee satisfaction.
Hypothesis 3 (H3). There is a positive impact of emotional health towards employee wellbeing.
Hypothesis 4 (H4). There is a positive impact of healthcare support towards employee loyalty.
Hypothesis 5 (H5). There is a positive impact of healthcare support towards employee satisfaction.
Hypothesis 6 (H6). There is a positive impact of healthcare support towards employee wellbeing.
Hypothesis 7 (H7). There is a positive impact of healthy nutrition towards employee mental health.
Hypothesis 8 (H8). There is a positive impact of healthy nutrition towards employee physical health.
Hypothesis 9 (H9). There is a positive impact of Insurance towards healthcare support.
Hypothesis 10 (H10). There is a positive impact of mental health towards employee emotional health.
Hypothesis 11 (H11). There is a positive impact of physical health towards employee loyalty.
Hypothesis 12 (H12). There is a positive impact of physical health towards employee satisfaction.
Hypothesis 13 (H13). There is a positive impact of physical health towards employee wellbeing.
Hypothesis 14 (H14). There is a positive impact of preventive care towards healthcare support.
Hypothesis 15 (H15). There is a positive impact of employee satisfaction towards employee loyalty.
Hypothesis 16 (H16). There is a positive impact of employee wellbeing towards employee loyalty.