Sex/Gender and age differences in health behavior of employees participating and not participating in work health promotion measures in the German Federal Armed Forces - a cross-sectional study
Authors: Ludwig S , Reinhold T , Roehle R , Dickob C , Bauer M D , Hauck M , Ucar J , Arnold L , Willich S N , Seeland U , Roy R 
Published: June 2024

Abstract

Background
The health of military and civilian employees is important to guarantee the ability to defend state interests. In the German Federal Armed Forces workplace health promotion measures (WHPM) are implemented since 2015. In the present study we aim to assess if there are sex/gender and age differences in health behavior and risk factors of employees participating in WHPM and employees not participating in WHPM.

Methods
In an interdisciplinary process, a semi-standardized questionnaire was developed and sent to all military and civil employees of all ranks &gt;= 18 years of the German Federal Military Service (N=223967, w: 20.3%). The survey was conducted online with the software SoSci Survey and paper based in the period of 06 to 09/2022. In the study participants were asked about their health behavior such as nutrition, regular physical activity and smoking in the last 12 months. All participants gave their written informed consent.

Results
A total of 23.568 (10.5%) employees participated in the survey (women (w): 29.0% (6791/23428)). Out of these 54.6% (6772/12406) stated having participated in WHPM (w: 36.1% (2431/6727); men (m): 63.7% (4282/6727) / w &lt;40 years (y): 40.4% (980/2550); m &lt;40 y: 36.5% (1561/2550)). Employees having participated in WHPM indicated with a higher proportion that they are eating healthy 82.5% (5566/6743) vs. no WHPM: 76.8% (4313/5616). This was especially the case for women ≥40 y (90.2% (1297/1438); w &lt;40 y: 86.4% (847/980)) and for men in this age group (m: 80.1% (2168/2707); m &lt;40 y: 77.5% (1205/1554)). It was higher for women in both age groups. Employees having participated in WHPM smoke less (14.6% (982/6734)) than those not having participated (18.8% (1057/561614)). Out of these having participated, more female employees &lt;40 y (17.3% (169/977)) smoke than women ≥40 y (13.7% (197/1436)) and more men &lt;40 y smoke (17.5% (272/1551); ≥40 y: 12.4% (335/2709)). Furthermore, employees having participated in WHPM (84.2% (5672/6736)) indicated to be more physically active than those not having participated (75.8% (4253/5614)). This was also the case for women and men ≥40 y (w: 89.2% (1282/1437); m: 85.3% (2307/2705)) compared to those &lt;40 y (w: 82.8% (811/980); m: 79.0% (1225/1552)) with more women having been physically active than men.

Conclusion
Employees participating in WPHM smoke less, are more physically active and eat healthier. There are sex/gender and age differences between the groups of employees participating and not participating in WPHM with women over 40 years old showing the best health consciousness and health behavior. The main target group for WPHM should therefore be younger employees under 40 years with the main focus on young men to improve health consciousness and behavior and thus reduce health risk factors and contribute to a lower prevalence of chronic diseases in the future workforce of the German Federal Armed Forces.