Strategic Framework
The Nine Dimensions of Health
The Total Health and Wellness (THW) approach recognizes that a complex set of factors impact personal health, moving beyond the focus on physical and mental health. It recognizes that while personal health is impacted by psychosocial and physical aspects of an individual’s work environment, work can also be affected by aspects of an individual’s life. Therefore, a comprehensive approach to health demands is required.
Figure 3 represents the nine health dimensions associated with the workplace (on the left), personal life (on the right) and the individual (in the centre). The individual dimensions, composed of physical, mental, and spiritual, are shown straddling both the personal and work environment, demonstrating that both work and personal factors can have an effect on individual health. Furthermore, an effective, holistic approach to health and wellness must target all the spheres of influence inside the institution. As seen in Figure 4, these spheres include: the member/employee, executive leadership and managers, and the organization. More detailed information on the nine dimensions of health and the spheres of influence can be found in sections 2.1 and 2.2 of the THWS.
Figure 3 - The Nine Dimensions of Health and their Environments
Figure 4 - Spheres of Influence
Long description of Figure 3
A comprehensive approach to health requires balancing the competing demands of an individual’s work and their personal life. The Strategic Framework for Total Health and Wellness identifies nine dimensions of health in three groups: workplace, individual, and personal life. At the centre is the individual (physical, mental and spiritual) balanced between both the work environment (psychosocial and physical) and their personal life (family, social/cultural, financial and physical environment).
Long description of Figure 4
Supporting behavioural change toward the adoption of healthier lifestyles and creating a culture of health and wellness in the workplace is a shared responsibility among individuals, leadership, and the DND/CAF. Individual Defence Team members are at the centre of change and are therefore the central sphere of influence on health and well-being, due to the control employees/members have over their personal health. Defence Team individuals are supported by a number of mediating organizations, such as unions, bargaining agents, and ICCM; connecting the individual sphere to the next sphere, leaders. Military and civilian leaders throughout the DND/CAF surround the individual sphere, having considerable capacity to influence the well-being of Defence Team members, through their leadership/management style, role-modeling, coaching, and their capacity to inspire employees/members in the workplace. The Organization is the largest sphere, encompassing both leaders and individuals due to the breadth of their influence on health and wellness, through abiding by legislation, Treasury Board regulations, and setting the policies, programs, systems (e.g. compensation, grievance, information systems, ethics/values, collective agreements), and processes that direct and support both leaders and their staff in the performance of their jobs.
Spectrum of Interventions
Alongside covering the nine dimensions of health, the THW approach additionally recognizes that to maximize the improvement of health and wellness outcomes, programming must target a spectrum of interventions including: assessment, promotion, empowerment, prevention, care, and support.
Action items covered by the THWS address the entire spectrum of interventions, recognizing that a multi-pronged approach is required to adequately support and protect the health and wellness of Defence Team members. There are action items to assess and identify needs and opportunities for improvement in the development of programs and services, those that aim to prevent health and wellness issues through health promotion and empowerment programs, and those that aim to provide quality care and support to respond to health and wellness issues. More detailed information can be found in section 2.3 of the THWS.
COVID-19 Pandemic
In order to comprehensively report on the initiatives and actions being implemented to improve and support the health and wellness of Defence Team members, it is important to acknowledge the COVID-19 pandemic and the impact it has had on the THWS as well as the Defence Team itself.
Figure 5. Joint Task Force IMPACT Flight Surgeon and Pharmacy Officer unpack a shipment of the Moderna COVID-19 vaccine at Ali Al Salem Airbase, Kuwait on April 16, 2021. Photo: Cpl Bryce Cooper, Canadian Armed Forces Image Tech.
Since March 2020, DND and the CAF have taken unprecedented measures to protect the health and well-being of both civilian and military members of the Defence Team. In order to promote a safe and holistic approach to continue work, where possible, the majority of Defence Team personnel have been working from home or have been provided a safe environment in the workplace.
Although these measures have protected the health and wellness of Defence Team members, they have also undoubtedly impacted the provision of services. In response to the COVID-19 pandemic, many in-person services have been unavailable or have a reduced capacity to conduct their work. Additionally, in order to adequately respond to the COVID-19 pandemic there has been a redistribution of focus in some areas. The combination of the shift to teleworking and redistribution of focus has resulted in the delay of some action items within the THWS action plan, which will be discussed with each individual action item.
Figure 6. Members from 4th Battalion, Royal 22e Régiment provide assistance to the residents of Villa Val Des Arbres long term care centre during Operation LASER in Verdun, Quebec on May 6, 2020.
As an example of a redistribution of focus, the COVID-19 pandemic created an urgent call of support from the CAF to help protect the health and safety of all Canadians. In the first few months of the pandemic, the military was called upon to deploy to long-term care facilities in Quebec and Ontario, help Public Health Ontario with contact-tracing efforts, assist the Public Health Agency of Canada in managing and distributing personal protective equipment and COVID-19 vaccines, and directly support northern and remote communities. Through Operation LASER and Operation VECTOR, the Defence Team is continually working towards responding to the current needs of Canada and its population. Additionally, the D365 Engineering and Integration Team were responsible for navigating the information management (IM)/information technology (IT) landscape during the pandemic. With a sudden shift to remote work, connecting and increasing connectivity for Defence Team employees required a quick response that was unforeseen before the COVID-19 pandemic.
Despite protective measures, the COVID-19 pandemic has resulted in unprecedented impacts across the Defence Team. As of April 19, 2022, 7093 positive COVID-19 cases have been reported amongst CAF members since the beginning of the pandemic, a significant number corresponding to over 7% of CAF members being infected one time.Footnote 1 Exact COVID-19 case numbers are not known for civilian Defence Team members.
Furthermore, the COVID-19 pandemic and the associated protective measures have had an unprecedented influence on the greater health and wellness of Defence Team members. The results of two different surveys, the 2021 Your Say Survey (YSS) and the 2020 Public Service Employee Survey (PSES) indicate the impact COVID-19 has had on Defence Team members. For CAF members, the biannual Your Say Survey (YSS) that was administered on the Defence Wide Area Network (DWAN) between 11 March 2021 and 26 May 2021 included a COVID-19 Focus Section to gauge the impact that the pandemic was having on members. For Civilian Employees, the 2020 PSES that was conducted from 30 November, 2020, to January 29, 2021, included several questions related to COVID-19 and its impact on National Defence employees. Further details on the COVID related results from both of the surveys can be found in Annex B. The results of these surveys were shared with CMP to help inform Return to Work Plans as well as with THW Sub-Committee members to inform and provide insight on COVID-19 related impacts to relevant programs and services. As the COVID-19 pandemic has caused unprecedented impacts, the results of these surveys can help to inform organizational considerations in program design and delivery to address the challenges Defence Team personnel may be facing and support their well-being.
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