Creating healthy organizations: an integrated culture of care in high-demand sectors-a qualitative study of private-sector organizations in Sweden.

INTRODUCTION

"High-demand sectors" are characterized by substantial physical, psychological, and emotional demands, alongside persistent recruitment and retention challenges. Despite growing interest in shaping healthy organizations, research has largely focused on workplace- or individual-level determinants. The aim of this study was to deepen the understanding of organizational-level health-promoting factors by exploring experienced managers' perspectives and visions regarding the promotion of a healthy work environment in high-demand sectors.

METHODS

Using an exploratory qualitative design, semi-structured digital interviews were conducted with 16 managers from 15 organizations in the transport, health and social care, construction, and retail trade sectors. The data were analyzed using an inductive-to-abductive thematic analysis informed by relevant theory on organizational health-promoting factors.

RESULTS

The findings indicated that healthy organizations are understood not as products of isolated wellbeing initiatives, but as organizations characterized by an integrated culture of care embedded in structures, routines, and leadership practices. Four interrelated themes were identified: integrated occupational health and safety management system, strategic efforts to promote organizational attractiveness across the employee lifespan, present and supportive leadership focused on employee wellbeing, and effective communication structures. Managers emphasized systematic and participatory occupational health and safety practices, structured onboarding, competence development, flexible accommodation across the employment life course, visible and relationally close leadership, and open, psychologically safe communication as central organizational resources for balancing high demands and sustaining both employee wellbeing and organizational functioning.

DISCUSSION: This study extends prior research on healthy organizations by highlighting the importance of a lifespan-oriented workforce strategy and by framing an organization-wide culture of care as a unifying condition for resilience, retention, safety, and long-term work ability in high-demand sectors.