Published on Investing in Health

Healthier Workplaces = Healthy Profits

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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.


Patricio V. Marquez

Former World Bank Group (WBG) Lead Public Health Specialist

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