The Case for Workplace Health

Despite spending more on healthcare than any other country in the world, America’s health lags behind other peer nations. According to the Centers for Disease Control and Prevention (CDC), approximately half of all American adults have a chronic disease,1 and we spend more than eight out of every 10 dollars treating people with chronic conditions – many of them preventable. Worryingly, more than one in four Americans have multiple, concurrent chronic conditions, and these people suffer from suboptimal health outcomes and incur rising healthcare expenses.

Many people believe that the majority of costs are incurred by treating the elderly, however, spending on working adults accounts for two-thirds of healthcare costs. What’s more, people don’t know how unhealthy they are. According to a recent survey conducted by the American Heart Association and Nielsen, three-quarters of employees report being in good or very good health, yet nearly half of those employees also report being diagnosed with a chronic illness.2 This isn’t just a medical and public health crisis, it is also an economic crisis. Researchers at the Vitality Institute cite three key ways an unhealthy workforce undermines America’s ability to compete in the global economy:

  • Employees may be unable to work because of their own poor health, or have to leave the workforce to care for a sick relative.
  • Employers must concurrently manage increased absenteeism and lower productivity with skyrocketing healthcare costs.
  • For America as a nation, rising healthcare costs reduce other critical investments, including education, defense and infrastructure.3

Thankfully, America’s employers increasingly view health and well-being programs as a strategic imperative rather than an added benefit.4 Approximately half of all employers with 50 or more employees offer workplace health and wellness programs.5 Furthermore, more than three-quarters of U.S. employers say they plan to increase support for health and productivity programs over the next two years.6 The decision to invest in the health of employees has an additional benefit for their families and the communities where they live, potentially creating far-reaching benefits for the company. Employers report numerous benefits from these programs, including improved employee health, lower healthcare cost trends and increased employee satisfaction.7 However, not all employee health programs have yielded these results, which has generated negative publicity and created doubt about the effectiveness of workplace wellness programs.8

Why the varied results?

While many employers offer workplace health programs, not all of them are truly comprehensive. The CDC defines a workplace wellness program as comprehensive if it meets five criteria (see table), yet, according to a 2004 national survey, less than seven percent of workplace wellness programs were comprehensive according to the CDC’s definition. In general, larger companies are more likely to implement comprehensive programs when compared to smaller companies.

Benefits of Employee Health Programs

  • Improved employee health
  • Controlled healthcare costs
  • Increased productivity
  • Reduced absenteeism
  • Improved job satisfaction
  • Improved employee recruitment and retention

Five Elements of a Comprehensive Workplace Health Program

  1. Health education focused on skill development and lifestyle behavior change
  2. Supportive social and physical environments
  3. Integration of a workplace program into an organization’s benefits
  4. Links between health promotion and related programs like employee health and safety
  5. Health risk screenings followed by education and counseling9

To yield positive results, a workplace health program not only needs to be comprehensive, it also has to be fully implemented and rigorously evaluated. Not all businesses have the organizational capacity, resources and readiness to design, implement and evaluate their workplace health programs. Barriers often exist that undermine the justification for investing in comprehensive wellness programs. These include:

  1. Lack of a sufficiently compelling and well-understood business case;
  2. The pervasive belief that preventive services must save money to be worthwhile (as opposed to improving health like other healthcare services);
  3. Lack of insight about what is required to effectively connect with community resources;
  4. The complexity of working with multiple stakeholders in collaborative, long-term health initiatives; and
  5. Lack of clarity on the most effective implementation models 10

An analysis of three high-profile workplace health promotion programs that yielded mixed results – and negative publicity – highlighted the following key lessons that can be learned from workplace wellness research and practice:

  1. Multiple outcomes need to be considered when evaluating the overall effectiveness of programs (not just direct medical costs).
  2. A long enough timeline is usually needed to show a positive return on investment (usually three or more years).
  3. Evaluation methods need to be transparent when reporting results.11

A 2015 advisory from the AHA issued a set of recommendations to optimize workplace health using a common set of measures to recognize workplace health programs.12 The AHA’s Workplace Health Playbook is designed to help employers address challenges with comprehensive, credible and actionable advice about what works in workplace health.


  1. Centers for Disease Control and Prevention. Chronic Disease Prevention and Health Promotion. (2014). at
  2. American Heart Association and Nielsen. Employee Health Survey Results. (2014). at
  3. Vitality Institute. Investing in Prevention: A National Imperative. (2014). at
  4. Harvard Business Review. What’s the Hard Return on Employee Wellness Programs? (2010). at
  5. Rand Corporation. Workplace Wellness Programs Study: Final Report. (2013). at
  6. Towers Watson. The Business Value of a Healthy Workforce 2013/2014 Staying @ Work Survey Report. (2014). at
  7. Pronk, N.P. Placing Workplace Wellness in Proper Context: Value Beyond Money. Prev Chronic Dis 11, 140128 (2014).
  8. Ibid
  9. Linnan L. et al. Results of the 2004 National Worksite Health Promotion Survey. Am J Public Health. 98, 1503–1509 (2008).
  10. American Heart Association. Workplace Wellness Recognition for Optimizing Workplace Health: A Presidential Advisory from the American Heart Association. (2015). at
  11. Goetzel, R.Z. et al. Do workplace health promotion (wellness) programs work? J Occup Environ Med. 56, 927–934 (2014).
  12. American Heart Association. Workplace Wellness Recognition for Optimizing Workplace Health: A Presidential Advisory from the American Heart Association. (2015). at

  • “With comprehensive, credible, actionable advice, the AHA Playbook helps you better understand what works in workplace health and design your programs accordingly.”