What is workplace wellness?

As the health of workers falls under a brighter spotlight, organizations are scrambling for ways to prevent ill health and promote good health of their workers.  Many organizations turn to implementing “Wellness programs” to save on health care costs and increase productivity.   The Centers for Disease Control and Prevention (CDC) defines a workplace health program as involving “a coordinated and comprehensive set of health promotion and protection strategies implemented at the worksite that includes programs, policies, benefits, environmental supports, and links to the surrounding community designed to encourage the health and safety of all employees.”

Most workplace wellness programs focus on physical health.  Program components usually include:

  • Screening
  • Lifestyle Management
  • Disease Management
  • Health Promotion/Education

Many organizations are now asking the question – are wellness programs worth the investment?  

Typical wellness programs tend to be front-loaded with fixed costs such as program staff, ergonomic furniture, exercise facilities, etc., and also present variable costs such as incentives.  Organizations want to know if programs they have implemented are effective in reducing ill-health and promoting good health among their workers.  HealthyWorkplaces reviewed the literature that examined ROI on workplace wellness programs.  The main studies involved in this review included a Baicker et al. 2010 meta-analysis and a RAND 2013 review.  

These study findings revealed many things about the way we evaluate workplace wellness programs and also about how we measure the return on investment of these programs.  HealthyWorkplaces observed that most ROI studies look simply at health care costs as outcome measures and occasionally absenteeism rates or “workplace satisfaction” rates.  Researchers and organizations are not measuring all the physical and psychological outcomes, which also contribute to direct and indirect return on investment.  For example, we know that reducing elements of stress in the workplace (such as from job design, unpredictable work schedules, or altering workplace design to include elements of nature) will avoid burnout in workers, thereby reducing sick days, avoiding employee turnover, and preserving worker physical health from the physiological effects of stress.  Many of the effects outcomes are indirect and often have long latency periods.  Unfortunately, some organizations don’t even formally assess the impacts of their wellness programs, and so these effects on worker health (direct or indirect) and worker outcomes like productivity and engagement that contribute to ROI are never revealed.  We see a great need for better evaluation programs to assess ROI in workplace wellness programs.  

Non-traditional measures of health and well-being and the hidden ROI

Most wellness studies are one-dimensional based on single interventions, when in reality, the focus should be on a complex interplay of multiple factors.  One reason why organizations may be seeing conflicting ROI reports in the literature, or unimpressive ROI after investing in the health of their workers, is because many effects of these programs take time – for example, health markers like blood pressure or sustained weight loss.  In addition, other factors that determine health and productivity are not being studied – stress levels, sleep quality, and feelings of psychological well-being, for example.  

Furthermore, looking beyond the traditional “wellness program,” there are great opportunities to make meaningful changes to positively impact physical health and psychological well-being that many organizations are overlooking.  For instance, employee turnover rates can be quite costly, so workers who stay because they feel healthy and happy at work can result in big savings.  Some elements that American Journal of Health Promotion (AJHP) Editor in Chief Michael O’Donnell identifies as being most important for a successful and effective health program are all elements that mirror the principles of the HealthyWorkplaces framework and that should be “baked into” the organization.  Some of these elements include support from top management, having leadership engaged in the program as advocates for the program, having employees involved in the development and implementation of the program, having access to nutritious foods and safe, fun physical activity spaces, and changing the cultural norm to embrace positive lifestyle habits.  

A call for more comprehensive wellness

Workplace wellness program results should therefore be interpreted with caution because the profiles of program participants and non-participants may be different.  Our conclusions are that we need to investigate workplace health and wellness programs in a more comprehensive way.  Sure, some organizations do see a $3.80 return on every $1.00 invested in a wellness program – but these are mainly health care savings, which HealthyWorkplaces sees as important but incomplete savings.  What about worker productivity? Workplace satisfaction? Customer relations?  Collaboration and creativity? Acceptance of change? Loyalty?   

In response to a recent systematic review of the literature on the ROI of workplace health promotion programs (Baxter et al., 2014), Michael O’Donnell, Editor in Chief of the AJHP, rightly observed:

“There is no one ROI from health promotion.  It really does depend!  More importantly, we need to refine the way we define the gold standard for measuring the health and financial impact of workplace health promotion programs and we need to refine the way we critique studies of these efforts.”

HealthyWorkplaces is working to design a study that addresses this issue – research to refine what a comprehensive wellness program would look like, as well as defining the gold standard for measuring health and well-being of workers.