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The case for physical and mental wellness programs in the workplace

Patricio V. Marquez's picture



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. 

Related
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

Comments

Submitted by Shekhar Saxena WHO on

Excellent piece, highlighting a substantial issue. What is good for mental health is also good for productivity and bottom-line! Indeed, much can be done by making workplace mentally healthy. Also see the following recent material from WHO:
http://www.who.int/mental_health/in_the_workplace/en/

Submitted by Giovanni on

The workplace, where we spend approx 33% of our total waking hours! good buy indeed

thank you

Submitted by Brian Davey on

Excellent article, and very timely considering the Health and Wellness program we have just launched for WBG staff, retirees, and their dependents (which incorporates mental health as a seamless extension of the total individual health spectrum). What a great opportunity this is to take what we learn from promoting the health of our own staff, and to apply that for our clients. The workplace is an untapped forum from which health risk management principles can be extended across a community, and ultimately a nation.

Submitted by Julian on

Agreed. One 'behaviorally-informed' option is to proactively give people time set aside to deal with mental health. This has been successfully implemented for financial wellness: https://www.nytimes.com/2017/06/27/your-money/asset-allocation/new-perk-a-day-off-to-take-care-of-your-financial-health.html

Submitted by Priyam S. on

Thanks for a great blog. The societal burden of mental health issues is exacerbated by non-detection, misdiagnosis and inappropriate treatment. If we add these costs to the productivity loss, we have an even high economic burden on society. This would necessitate including assessments on mental health systematically in health surveys in LICs and MICs. Some evidence for South Asia: http://ecommons.aku.edu/pakistan_fhs_mc_chs_chs/301

Submitted by Garen Staglin on

Thank you, Patricio, for sharing this information and for the World Bank’s commitment to wellness in the workplace. World Bank President Jim Yong Kim’s recent comments about the importance of “investing in people,” including their health and education, is a call to action on behalf of the world’s future economic growth.
Workplace mental health is absolutely a shared value proposition, with unmet needs felt not only at the national level in terms of lost competitiveness, productivity and wellbeing, but also at the corporate level in businesses of any size in terms of direct and indirect costs to employers. To help quantify this impact, One Mind Initiative at Work has developed a calculator that costs out the ramifications of depression to demonstrate to employers the business case for mental health promotion activities. Our research indicates for every dollar invested in workplace mental health, the return is three to five dollars!
Oftentimes corporate leadership, while convinced of the evidence to act, remains at a loss for how to invest in mental health and have a meaningful impact. To guide them, we have developed a series of pillars for success. Among our best practices, employers should start with expanding access to mental health services through existing channels such as telemedicine and a collaborative care model. Employers should also call for value-based payment in mental health that incorporates outcome measures that speak to effectiveness of treatments rather than the cost of their use. Finally, employers must embrace the potential of digital tools and interventions to accelerate connecting the workforce to available services. One Mind Initiative at work has developed a charter for employers with a series of key commitments aimed at evaluating and implementing mental health initiatives. Please visit www.onemindintiative.org for more information and to use the cost calculator.
Eliminating the stigma of mental health conditions, maximizing access to available services, and truly engaging managers as peer support specialists must be prioritized to fully address the negative impacts of mental health conditions on employers and put people in the workforce first. We believe each incremental step forward, and each demonstration of leadership that we make toward improving workplace mental health makes a difference – to the bottom line, to the corporate culture, and most importantly, to the employee who is now able to receive the support that he or she needs.

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