Published on Investing in Health

The case for physical and mental wellness programs in the workplace

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The launching of the iPhones 8 and X and the advent of genomic-based precision medicine for disease treatment and prevention, are new reminders that technological innovation is fueling momentous change in our daily lives. Indeed, as Professor Klaus Schwab, the chairman of the World Economic Forum describes, the physical, digital and biological trends underpinning what he calls 'the fourth industrial revolution', are unleashing changes “unlike anything humankind has experienced before.”  

In the face of rapid and disruptive economic and social change, what can be done to build social resilience, keeping people at the center of the development process?  

One way to address this question is to heed the advice of Prof. Schwab and promote as a shared value proposition, the notion that organizations and businesses have in their role as employers a great responsibility to nurture employee resilience. A healthy workforce is after all vital to a country’s competitiveness, productivity, and wellbeing. The latter is easily grasped when one considers that poor health and well-being costs the UK economy up to US$75 billion a year in lost productivity due to a combination of absenteeism, employees not being at work, and presentism. 

But let’s be clear. The reduction of health risks for physical conditions needs to be complemented with action to prevent and address mental ill health, an often-ignored reality in the workplace.  Mental ill health is a condition of the brain that should not be treated differently than other chronic health conditions, such as heart disease or cancer. Nor, in fact, are they truly separable: If untreated, mental illnesses can negatively affect management of such co-occurring diseases as tuberculosis and HIV, diabetes, hypertension, cardiovascular disease, and cancer.

Workplace wellness programs: good for employers and employees

As most of the working population spend a majority of their time at work, the workplace provides a unique but often ignored opportunity to raise awareness about physical and mental health risks and to offer programs under benefit plans that guide and incentivize individuals to develop healthier behaviors. In turn, these programs can have a positive multiplier effect, as employees integrate health and well-being into the daily routines of families and communities. Workplace wellness programs include in general screening activities that use self-administered questionnaires on health‐related behaviors (e.g., physical activity, use of seat belts when driving), risk factors (e.g., tobacco use), and psychological conditions (e.g., stress, anxiety and depression), as well as clinical screenings to collect biometric data—e.g., height, weight, blood pressure, and blood glucose. The data from these assessments help identify health risks and interventions to promote lifestyle changes. As part the programs, guidance and incentives are offered to employees to participate in primary prevention activities to modify risk factors for chronic disease (lifestyle management) and secondary prevention activities for dealing with manifest chronic conditions (disease management).  Other common health promotion activities include on-site flu vaccination and counseling support.

The business case for supporting these programs is sound: Employers expect that wellness programs will improve employee health and well-being and lower medical costs, especially with the growing burden of chronic conditions such as cardiovascular disease, cancer, diabetes, and mental ill-health.  Also, these programs can help to attract and retain talented workers, increase productivity, and reduce absenteeism. 

There is growing evidence on the significant impact of these programs.  In the United States alone, wellness programs are now a US$6 billion industry, with more than half of firms with at least 50 employees offering these programs. Results of a 2013 national survey conducted by the Rand Corporation showed that meaningful improvement among program participants in exercise frequency, smoking cessation, and weight control over a four-year period.  The study also found that participation in a wellness program over five years is associated with a trend toward lower health care costs.  The return-on-investment is noteworthy when comparing the ratio of reductions in health care costs (e.g., keeping people healthy and out of hospital) to program costs: wellness programs generated a return of $1.50 for every $1 invested and a return of $3.80 for every $1 spent on disease management. 

A study done by the World Economic Forum, covering 25 firms with 2 million employees in 125 countries around the world, also shows that firms that champion workplace wellness are reaping significant benefits measured in terms of increased productivity, reduced cost of employee healthcare, and increased employee engagement that lead to reduced turnover.

Where wellness programs often fall short

While physical health-related metrics are promising, tackling mental illness in the workplace is lagging. This is a major challenge that needs to be addressed head on given the enormous burden of mental ill health at home and the workplace, aggravated by widespread stigma and discrimination of affected people. In the UK, for example, about 40 percent of the workforce’s sickness absence, was due to stress, depression, or anxiety – an average of 23 days per affected person- in 2013-2014.

Helping address mental ill health risks in the workplace could contribute to generate significant benefits for workers and firms alike. A study prepared for the 2016 World Bank Group-World Health Organization Global Health Conference estimated that the returns on this investment in a country can be substantial as measured by a favorable benefit-to-cost ratio, ranging between 2.3-3.0 to 1 when economic benefits only are considered and 3.3-5.7 to 1 when social returns are also included. 

Moving forward

Properly implemented, wellness programs in the workplace are a “good buy” for any organization and business, with significant returns in terms of health and economic gains. These programs can also contribute to accelerate the progressive realization of universal health coverage by engaging and leveraging resources and know-how from organizations and businesses for the benefit of workers and families alike.

Nurturing the development of healthy work environments that promote the physical and mental well-being of employees is not only the right thing to do, but it’s a smart economic decision to improve productivity and competitiveness of firms, both crucial to help national economies combat poverty and achieve sustainable development. 

Rand Corporation: Do Workplace Wellness Programs Save Employers Money?
Rand Europe: Health, wellbeing and productivity in the workplace: A Britain's Healthiest Company summary report
World Economic Forum: Seven actions towards a mentally healthy organization
Lancet Psychiatry: Scaling-up treatment of depression and anxiety: a global return on investment analysis
Healthier Workplaces = Healthy Profits
Time to put “health” into universal health coverage
World Bank Group Mental Health
World Bank Group Global Tobacco Control Program


Patricio V. Marquez

Former World Bank Group (WBG) Lead Public Health Specialist

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