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Healthier Workplaces = Healthy Profits

Patricio V. Marquez's picture

The debate in the United States on how to change a health system that is geared to treat illnesses to one that focuses on preventing people from getting sick stirred my curiosity on how companies can improve employee health.  After all, employees spend most of their waking hours at the workplace.

There is robust body of evidence showing that investment in workplace wellness programs is not only good for employees but also for the bottom line of companies. These programs, which are employer-organized and sponsored, help employees, and in some cases, their families, adopt and sustain behaviors that reduce health risks associated with chronic diseases and injuries. Both employees and employers value these programs because they help reduce health risks, absenteeism and employee turnover.

We know from a recent study that the entry point for participation in these programs is employee health risk assessments, coupled with clinical screening for risk factors (e.g., blood pressure, cholesterol, and body mass index) that provide the baseline for subsequent interventions.  Other methods include self-help education materials, individual counseling with health care professionals, and on-site group activities led by trained personnel.  Besides obesity and smoking cessation, programs commonly focus on stress management, nutrition, alcohol abuse, and blood pressure, and on preventive care such as the administration of the flu vaccine. Companies have begun giving incentives to motivate healthy behavior, such as bonuses for completing health risk assessments, reimbursements for the cost of fitness center memberships, or lower health insurance premiums if employees adopt healthier behaviors (e.g., quit smoking).

As we continue to make strides in global health, we need to see the workplace as another promising “entry point” to tackle not only unhealthy behavior among individuals but also to reduce community health risks (e.g., through the adoption of programs to better train truck drivers and conduct regular vehicle inspections to prevent road traffic deaths).

So what are the essential pillars of these programs? According to an assessment in the Harvard Business Review, they are:

Engaged leadership: Johnson & Johnson helps employees living with HIV/AIDS access antiretroviral drugs. Additionally, all of its facilities are smoke-free.

Strategic alignment with the company’s identity and aspirations:  To promote a culture of health in a company where 60%-70% of jobs are safety-sensitive, Chevron has made fitness for duty a central concern on oil platforms and rigs, in refineries, and during the transport of fuel.  Its wellness program includes a comprehensive cardiovascular health component, walking activities, fitness centers, stress-injury prevention, and work/life services.

Design that is broad in scope and high in relevance and quality:  To be relevant to the needs of their employees, companies have adopted programs that are not just about physical fitness but also focus on mental health issues such as depression and stress, which are major sources of lost productivity. 

Broad accessibility:  SAS, a software firm, makes low- or no-cost services a priority.  This is complemented with convenient arrangements that ensure high employee participation, for example, recreation facilities that are open before and after work and on weekends.

Internal and external partnerships: Companies offer services, such as biometric health screenings, at the worksite. These, in turn, are used to devise “individualized” programs with a local sport club and medical practice for at-risk employees.

Effective communications: To help overcome employee apathy or sensitivity about personal health issues, some companies are sharing information about wellness in regular corporate e-mails, health-related messages on intranet portals, and wellness “clues” in the workplace, such as the availability of bicycle racks in parking garages with showers nearby to make cycling to work appealing.

What are the returns on this investment?  In the case of Johnson & Johnson, since 1995 the percentage of employees who smoked dropped by more than two-thirds, and the number who had high blood pressure or were physically inactive declined by more than half.  The companies reaped financial rewards as well: Thanks to wellness programs in the workplace, medical costs for U.S. firms fell by about US$3.27 and illness-related absenteeism costs dropped by about US$2.73 for every dollar spent on such programs. 

Governments can play an important role in helping implement and expand employer wellness programs, not only to improve the health of the population, but also to control health care spending. The 2009 Affordable Care Act, adopted by the U.S. Government to expand health insurance coverage, is a good example as it expands employers' ability to reward employees who meet health status goals by participating in wellness programs and to require employees who don't meet these goals to pay more for their employer-sponsored health coverage.

Follow the World Bank Health team on Twitter: @worldbankhealth.

Comments

Very interesting post, Patricio! I would like to suggest to add an important (and not very complicated) point: recent publications are showing the relationchip of the work environment (or classroom environment for children) and general health, psychological health, stress perception or mental concentration. The presence of "green" (trees, grass, a leisure "natural" park, even single plants) seems to act as positive buffers for everyone. See, for example: Green space as a buffer between stressful life events and health Agnes E. van den Berg, Jolanda Maas, Robert A. Verheij, Peter P. Groenewegen Social Science & Medicine 2010; 70: 1203-10 Kind regards.

Submitted by Patricio V Marquez on
Thanks for your additional perspective which adds to the discussion on healthier work environments. In full agreement.

Submitted by Baktybek Zhumadil on
Hi, Patricio! Hope all is well on your side. Thanks a lot for sharing this post. It is highly relevant to what Kazakhstan is trying to do now - moving to the concept of "shared responsibility" for citizen's health, that is, instead of expecting everything from the state, both citizens themselves and their employers must also share this responsibility by adequately taking care of their health (citizens) and introducing measures and providing incentives so that employees care about their own health (employers) - this is the President's direct instruction. Your post is about the employer-based incentives part of the shared responsibility. Could you please share some more materials that would be relevant to this concept of shared responsibility in general, including, if available, the provision of incentives to Targeted Social Assistance recipients to timely undergo necessary preventive health examinations and conducting healthy life styles this is a particular and urgent task for the MOH now). Thanks a lot in advance, Baktybek

Submitted by Patricio V Marquez on
Thanks for your comments Baktybek. Perhaps analogous to the concept of "shared responsibility" is what Porf. Michael Porter", a global guru and professor at the Harvard Business School, calls "creating shared value". In a recent article in Harvard Business Review, Prof. Porter and Mark Kramer convincingly argue that "the purpose of the corporation must be redefined around Creating Shared Value." They note that "Not all profit is equal. Profits involving a social purpose represent a higher form of capitalism, one that creates a positive cycle of company and community prosperity." Beyond corporate social responsibility, they advocate the adoption of "the principle of shared value, which involves creating economic value in a way that also creates value for society by addressing its needs and challenges. Businesses must reconnect company success with social progress " If we accept the above propositions, then perhaps we could pose that the adoption by governments, private firms and international agencies of “shared value” principles, which combine economic and social concerns, could help redress socil deficits in across the globe. This type of approaches is needed to generate collective action by winning political and community support and forging public and private partnerships to advance the global health agenda.

Patricio, Great post! Providing health services to female employees and wives of male employees will mean not only a healthier workforce, but also healthier families and might contribute to an improved bottom line for companies. This is in sync with the vision, mission and goals of Pink Ribbon Red Ribbon, a public-private partnership that leverages already established healthcare platforms to cost-effectively add cervical and breast cancer prevention, screenings and treatment - making it possible for women to access multiple health services in one clinic visit. Pink Ribbon Red Ribbon aims to reduce deaths from cervical cancer by 25% among women enrolled in the program; reduce deaths from breast cancer through early detection; significantly increase access to HPV vaccination, as well as breast and cervical cancer awareness; and create innovative models that strengthen health delivery and health systems as a whole. By providing HPV vaccination to young adolescents and preventing most cases of cervical cancer, we will be developing a female workforce free of cervical cancer. We are delighted to be collaborating with The World Bank in this endeavor to save women's lives. We can do more by extending the services within and outside the workplace.

Submitted by Wolf on
Hi Patricio, You raise a good point and there is a lot of movement in the field of workplace health promotion at the moment, not just in the US but worldwide. The WHO has been actively promoting the Healthy Workplace Framework across countries and the Global Healthy Workplace Awards Program (http://globalhealthyworkplace.com) is directly aligned with the framework. With regard to the cost-benefit aspect, I agree with you, an interesting article (Is It Time To Re-Examine Workplace Wellness ‘Get Well Quick’ Schemes?) challenging large parts of this notion can be found at http://healthaffairs.org/blog/2013/01/16/is-it-time-to-re-examine-workplace-wellness-get-well-quick-schemes/print. Wolf

Submitted by Patricio V Marquez on
Thanks for your comment Wolf. The work that your organization is doing is helping advance this agenda. The first Global Healthy Workplace Awards summit in London, planned for 10th-12th April, 2013, that you are organizing is indeed an exciting upcoming event to highlight case studies from across the world as well as presentations by leading experts. As you said, there is "a lot of movement" in this field. This evidences that the workplace is a promising entry point for health promotion and disease prevention, not just in the US but worldwide. Hope that the summit in London is a great success.

Submitted by Khushi on
In India, health concerns amongst corporates has been consistently increasing. Also read a recent study which reflected the stress levels of Indians and picture wasn't very positive. However, companies have taken health and wellness of employee seriously. Witnessed number of interesting and engaging activities to motivate employees to stay fit. One such program that my company along with 142 more corporates took up was Stepathlon. It was a fun 100 day race around a virtual world wherein employees were suppose to walk atleast 10,000 steps every day as that's the minimum limit to stay active and healthy. Since, we were competing with teams within our company and other participating companies, there was a spirit of competition which motivated us to go beyond 10,000 every day. We were also motivated with number of certificates and health goodies throughout the race. All in all, the competition seeped the idea of staying active and walking in us in a fun way. Such initiatives can really help an average lathargic employee to turn fit without disturbing his/her work schedule.

Submitted by Patricio V Marquez on
Many thanks for your excellent observations. The competition and recognition elements that you mention are critical from moving from a culture compliance based on regulations and norms to a culture where healthy behaviors and practices are interiorized, accepted, and adopted by staff and management because they are intrinsically good for individuals, corporations, and society at large. At the end of the day the sustainability of institutional initiatives largely depend on a "change of mentelity" among those involved to guide behaviors and actions.

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