Workplace wellness, also known as corporate wellbeing outside the
United States
The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
, is a broad term used to describe activities, programs, and/or organizational policies designed to support healthy behavior in the
workplace
A workplace is a location where someone works, for their employer or themselves, a place of employment. Such a place can range from a home office to a large office building or factory. For industrialized societies, the workplace is one of the ...
. This often involves
health education,
medical screenings,
weight management programs, and onsite fitness programs or facilities or off site retreats. It can also include flex-time for exercise, providing onsite kitchen and eating areas, offering healthy food options in vending machines, holding "walk and talk" meetings, and offering financial and other incentives for participation.
Companies most commonly subsidize workplace wellness programs in the hope they will reduce costs on employee health benefits like health insurance in the long run. Existing research has failed to establish a clinically significant difference in health outcomes, proof of a return on investment, or demonstration of causal effects of treatments. The largest benefits have been observed in groups that were already attempting to manage health concerns, which indicates a strong possibility of
selection bias
Selection bias is the bias introduced by the selection of individuals, groups, or data for analysis in such a way that proper randomization is not achieved, thereby failing to ensure that the sample obtained is representative of the population inte ...
.
History
Wellness programs originated in the early 1900s, as
labor unions
A trade union (British English) or labor union (American English), often simply referred to as a union, is an organization of workers whose purpose is to maintain or improve the conditions of their employment, such as attaining better wages ...
fought for workers' rights and as employers saw the advantages of having a vital, alert, and rested workforce. A few key manufacturers invested in programs to keep their employees healthy and
productive. In the 1950s, Dr. Halbert L. Dunn, chief of the
National Office of Vital Statistics, introduced the concept of "high-level wellness" to encourage individuals to maximize their potential progress towards better living.
Impact
Workplace wellness programs have been shown not to prevent the major shared
health risk factors specifically for
CVD and
stroke
Stroke is a medical condition in which poor cerebral circulation, blood flow to a part of the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemor ...
.
While the stated goal of workplace wellness programs is to improve employee health, many US employers have turned to them to help alleviate the impact of enormous increases in
health insurance
Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among ma ...
premiums experienced over the last decade. Some employers have also begun varying the amount paid by their employees for health insurance based on participation in these programs. Cost-shifting strategies alone, through high copayments or coinsurance may create barriers to participation in preventive health screenings or lower medication adherence and hypertension.
[Healthy Workforce 2010 and Beyond. (2009). Partnership for Prevention. Labor, Immigration & Employee Benefits Division: U.S. Chamber of Commerce.] While it was once believed that for every dollar spent on worksite wellness programs, medical costs fell by $3.27,
that hypothesis was disproven by a subordinate of the author of the original study.
One of the reasons for the growth of healthcare costs to employers is the rise in obesity-related illnesses brought about by lack of physical activity, another is the effect of an
ageing workforce and the associated increase in chronic health conditions driving higher health care utilization. In 2000 the health costs of overweight and obesity in the US were estimated at $117 billion.
Each year obesity contributes to an estimated 112,000 preventable deaths. An
East Carolina University
East Carolina University (ECU) is a public university in Greenville, North Carolina, United States. It is the List of universities in North Carolina by enrollment, fourth largest university in North Carolina and the only one in the state with s ...
study of individuals aged 15 and older without physical limitations found that the average annual direct medical costs were $1,019 for those who are regularly physically active and $1,349 for those who reported being inactive. Being overweight increases yearly per person health care costs by $125, while obesity increases costs by $395.
A survey of
North Carolina Department of Health and Human Services employees found that approximately 70 cents of every healthcare dollar was spent to treat employees who had one or more chronic conditions, two thirds of which can be attributed to three major lifestyle risk factors: physical inactivity, poor diet, and tobacco use.
Obese employees spend 77 percent more on medications than non-obese employees and 72 percent of those medical claims are for conditions that are preventable.
[Healthy Workforce 2010 and Beyond. (2009). Partnership for Prevention. Labor, Immigration & Employee Benefits Division: U.S. Chamber of Commerce]
According to Healthy Workforce 2010 and beyond, a joint effort of the US Partnership for Prevention and the
US Chamber of Commerce, organizations need to view employee health in terms of ''productivity'' rather than as an exercise in health care cost management. The emerging discipline of Health and Productivity Management (HPM) has shown that health and productivity are "inextricably linked" and that a healthy workforce leads to a healthy bottom line. There is now strong evidence that health status can impair day-to-day work performance (e.g.,
presenteeism
Presenteeism or working while sick is the act or culture of employees continuing to work as a performative measure, despite having reduced productivity levels or negative consequences. Reduced productivity during presenteeism is often due to illnes ...
) and have a negative effect on job output and quality.
Current recommendations for employers are not only to help its unhealthy population become healthy but also to keep its healthy population from becoming sick. Employers are encouraged to implement population-based programs including health risk appraisals and health screenings in conjunction with targeted interventions.
However, a large and growing body of research shows that workplace wellness has far more deleterious effects on employee health than benefits, and that there are no savings whatsoever.
[ Indeed, the most recent winner of the industry's award for the best program admitted to violating clinical guidelines and fabricating outcomes improvement.
Investing in worksite wellness programs not only aims to improve organizational productivity and presenteeism, but also offers a variety of benefits associated with cost savings and resource availability. A study performed by ]Johnson & Johnson
Johnson & Johnson (J&J) is an American multinational pharmaceutical, biotechnology, and medical technologies corporation headquartered in New Brunswick, New Jersey, and publicly traded on the New York Stock Exchange. Its common stock is a c ...
(J&J) indicated that wellness programs saved organizations an estimated $250 million on health care costs between 2002 and 2008. Workplace wellness interventions performed on high-risk cardiovascular disease employees indicated that at the end of a six-month trial, 57% were reduced to a low-risk status. These individuals received not only cardiac rehabilitation health education but exercise training as well. Further, studies performed by the U.S. Department of Health and Human Services and J&J have revealed that organizations that incorporated exercise components into their wellness programs not only decreased healthcare costs by 30% but improved lost work days by 80%. Thus, investing in preventative health practices has proven to not only be more cost effective in resource spending but in improving employee contributions towards high-cost health claims.
Researchers from the Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention (CDC) is the National public health institutes, national public health agency of the United States. It is a Federal agencies of the United States, United States federal agency under the United S ...
studied strategies to prevent cardiovascular disease and found that over a two- to five-year period, companies with comprehensive workplace wellness programs and appropriate health plans in place can yield $3 to $6 for each dollar invested and reduced the likelihood of employee heart attacks and strokes. Also, a 2011 report by Health Fairs Direct which analyzed over 50 studies related to corporate and employee wellness, showed that the return on investment
Return on investment (ROI) or return on costs (ROC) is the ratio between net income (over a period) and investment (costs resulting from an investment of some resources at a point in time). A high ROI means the investment's gains compare favorab ...
on specific wellness related programs ranged between $1.17 to $6.04. In general, it is estimated that worksite health promotion programs result in a benefit-to-cost ratio of $3.48 in reduced health care costs and $5.82 in lower absenteeism costs per dollar invested, according to the Missouri Department of Health & Senior Services. Additionally, worksite health programs can improve productivity, increase employee satisfaction, demonstrate concern for employees, and improve morale in the workplace.
Leadership involvement in wellness programs can additionally impact employee health outcomes just as well as the programs themselves. A study performed by David Chenoweth indicated the managers who were passionate and committed about their wellness programs increased employee engagement by 60%, even if their wellness goals were not achieved. Leaders are not only tasked with creating the organizational culture but also in coaching and motivating employees to be engaged in that culture.
However, it turns out that employees generally detest these intrusive programs, and wellness's "Net Promoter Score" of -52 places it last on the list of all industries in user satisfaction.
Barriers
The major barrier to further implementation of these programs is the increasing realization that they fail to produce benefits and may harm employees.[ Savings are so elusive that a $3 million reward is offered for anyone who can find any. In 2018, the ]National Bureau of Economic Research
The National Bureau of Economic Research (NBER) is an American private nonprofit research organization "committed to undertaking and disseminating unbiased economic research among public policymakers, business professionals, and the academic co ...
(NBER) found no positive impact. Also in 2018, Medicare found no savings. Further, the NBER study concluded that the previous estimates of savings were largely invalid, due to a pervasive error in study design.
Low participation rates by employees could significantly limit the potential benefits of participating in workplace wellness programs, as could systematically differences between participants and non-participants. Research performed by Gallup indicated that out of the 60% of employees who were aware of their company offered a wellness program only 40% participated. Ongoing management support and accountability are critical to successful worksite health promotion programs.
Framework
Workplace wellness programs can be categorized as primary, secondary, or tertiary prevention efforts, or incorporate elements from multiple types.[Goetzel, R.Z., Ozminkowski, R.J. The health and cost benefits of work site health-promotion programs. Annual Review of Public Health. 2008;29:303-323] Primary prevention programs usually target an employee population which is already considered healthy and encourages workers to more frequently engage in health behaviors that will encourage ongoing good health (such as stress management
Stress management consists of a wide spectrum of techniques and psychotherapy, psychotherapies aimed at controlling a person's level of psychological stress, especially chronic stress, generally for the purpose of improving the function of everyda ...
, exercise
Exercise or workout is physical activity that enhances or maintains fitness and overall health. It is performed for various reasons, including weight loss or maintenance, to aid growth and improve strength, develop muscles and the cardio ...
and healthy eating
A healthy diet is a diet that maintains or improves overall health. A healthy diet provides the body with essential nutrition: fluid, macronutrients such as protein, micronutrients such as vitamins, and adequate fibre and food energy.
A he ...
). Secondary prevention programs are intended to reduce behavior which is considered a risk factor for poor health (such as smoking cessation
Smoking cessation, usually called quitting smoking or stopping smoking, is the process of discontinuing tobacco smoking. Tobacco smoke contains nicotine, which is Addiction, addictive and can cause Substance dependence, dependence. As a resu ...
programs and screenings for high blood pressure). Tertiary health programs are designed to address existing health problems (for example, by encouraging employees to better adhere to specific medication or self-managed care guidelines).
Worksite wellness programs including nutrition and physical activity components may occur separately or as part of a comprehensive worksite health promotion program addressing a broader range of objectives such as smoking cessation, stress management, and weight loss. A conceptual model has been developed by the Task Force for Community Preventive Services (The Community Guide) and serves as an analytic framework for workplace wellness and depicts the components of such comprehensive programs. These components include worksite interventions including 1) environmental changes and policy strategies, 2) informational messages, and 3) behavioral and social skills or approaches.
Worksite environmental change and policy strategies are designed to make healthy choices easier. They target the whole workforce rather than individuals by modifying physical or organizational structures. Examples of environmental changes may include enabling access to healthy foods (e.g., through modification of cafeteria offerings or vending machine content) or enhancing opportunities to engage in physical activity (e.g., by providing onsite facilities for exercise). Policy strategies may involve changing rules and procedures for employees, such as offering health insurance benefits, reimbursement for health club memberships, healthy food and beverage policies or allowing time for breaks or meals at the worksite.
Informational and educational strategies attempt to build the knowledge base necessary to inform optimal health practices. Information and learning experiences facilitate voluntary adaptations of behavior conducive to health. Examples include health-related information provided on the company intranet, posters or pamphlets, nutrition education software, and information about the benefits of a healthy lifestyle, including diet and exercise. Behavioral and social strategies attempt to influence behaviors indirectly by targeting individual cognition (awareness, self-efficacy, perceived support, intentions) believed to mediate behavior changes. These strategies can include structuring the leadership involvement and social environment to provide support for people trying to initiate or maintain lifestyle behavior changes, for example, weight change. Such interventions may involve individual or group behavioral counselling, skill-building activities such as cue control, use of rewards or reinforcement, and inclusion of coworker, manager/leader or family members for support.
Health economics of workplace wellness programs
Wellness programs are typically employer sponsored and are created with the theory that they will encourage healthy behaviors and decrease overall health costs over time. Wellness programs function as Primary Care
Primary care is a model of health care that supports first-contact, accessible, continuous, comprehensive, and coordinated person-focused care. It aims to optimise population health and reduce disparities across the groups by ensuring equitable ...
interventions as they are an example of primary prevention methods to reduce risks to many diseases or conditions. These programs are widely known as employee assistance programs or EAPs and include various physical and mental health services to employees.
Workplace wellness programs have been around since the 1970s and have gained new popularity as the push for cost savings in the health delivery system becomes more evident as a result of high health care expenditures in the U.S. Employer wellness programs have shown to have a return on investment of about $3 for every $1 invested over a multi-year period, making them appealing to many as an effective way to achieve results and control costs. Most recently, the 2016 winner of the "best wellness program" award, Wellsteps, was shown to have harmed employees at the Boise School District and fabricated its savings figures.
Workplace wellness programs have many components to help improve health outcomes and decrease health disparities. These components include smoking cessation programs, fitness center memberships, nutrition aids, and biometric screenings, often in exchange for health insurance premium reductions. The benefits of wellness programs are not limited to corporations and their employees; Otenyo and Smith argue that engaging in such programs produces positive spillover effects for society that are not reflected in markets, leading to them under consumption.
Workplace wellness programs benefit employers as well; while the various components of the wellness programs helps to keep employees healthy, employers are able to increase recruitment and retention of workers. Some employers have also utilized penalties to improve employee participation within the company wellness program. Wellness programs can reduce employer costs by linking employees' health insurance rates to their participation and success in meeting wellness goals. While wellness programs promote healthier lifestyles and can bring significant cost savings, concerns about invasion of privacy and participation costs have arisen.
The future of wellness programs as a valid method of preventative healthcare is still up for debate. Evidence of improved health outcomes for participants is mixed in terms of effectiveness. Some studies attempt to address the question if "more is always better in the workplace," and the value that can be found through wellness program components and their outcomes.
One large study though, did not find health improvements for premium incentive-based workplace weight loss programs.
Writing in the New York Times
''The New York Times'' (''NYT'') is an American daily newspaper based in New York City. ''The New York Times'' covers domestic, national, and international news, and publishes opinion pieces, investigative reports, and reviews. As one of ...
, Frank and Carroll laid out several concerns with wellness programs, including limitations in empirical studies and the possibility that employers use these programs to shift costs to employees. That said, the 2019 Kaiser Family Foundation Employer Health Benefits Survey indicates that organizations continue to enact such programs due to their perceived benefits for employee health, morale, and productivity.
Wellness programs have created a $6 billion industry due to its reputation of reducing health care costs. In their 2013 Workplace Wellness Programs Study, RAND Corporation
The RAND Corporation, doing business as RAND, is an American nonprofit global policy think tank, research institute, and public sector consulting firm. RAND engages in research and development (R&D) in several fields and industries. Since the ...
researchers concluded that while lifestyle-focused wellness programs can reduce risk factors and motivate healthy behavior, the reductions in healthcare costs are less than previously reported. However, most wellness studies that report the positive results of the wellness programs are not of high quality, indicate only short-term results, and do not justify causation. Moreover, these studies are sponsored by their own wellness industry, creating bias
Bias is a disproportionate weight ''in favor of'' or ''against'' an idea or thing, usually in a way that is inaccurate, closed-minded, prejudicial, or unfair. Biases can be innate or learned. People may develop biases for or against an individ ...
. Other studies find that the programs don't improve health outcomes or reduce health care costs.
In fact, a decrease of employers' health care costs has been simply passed on the employees. Based on the Affordable Care Act
The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act (PPACA) and informally as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by Presid ...
, employers are able to charge unhealthy employees up to 30 to 50 percent more of total premium costs. This has resulted in pushback from employees who have not met mandated health goals like quitting smoking or reducing body mass index (BMI).
On the other hand, research on the 2003 PepsiCo
PepsiCo, Inc. is an American multinational corporation, multinational food, snack, and beverage corporation headquartered in Harrison, New York, in the hamlet of Purchase, New York, Purchase. PepsiCo's business encompasses all aspects of the f ...
Healthy Living program suggests that the wellness plan helps reduce health care costs after the third year of implementing the disease management components of the program. But, the wellness program does not show evidence of lower costs due to the lifestyle changes in the short run. This result is consistent with the one-year study with the 3,300 employees of the University of Illinois at Urbana-Champaign
The University of Illinois Urbana-Champaign (UIUC, U of I, Illinois, or University of Illinois) is a public land-grant research university in the Champaign–Urbana metropolitan area, Illinois, United States. Established in 1867, it is the f ...
in 2016. The study indicates that participation in a wellness program does not result in healthier employees or reduced health care costs. The research also shows that without an incentive, about 46.9 percent participated in the wellness program. Then, the change in monetary incentive from $0 to $100 increases participation by 12 percent, from 46.9 percent to 58.5 percent. An additional incentive of $200 increases the participation from 58.5 to 62.5 percent. This study shows that when the company increases participants by only 4.5 percent or reduce 4.5 percent of non-participants or high medical spending employees, it will compensate the total cost of the specific wellness program. This result is consistent with other studies that the wellness programs do not help lower health care costs, but only have passed on the costs to other employees. Regarding the employment and productivity, the participants believe that management places an importance on health, fitness, and safety. However, the study shows no significant difference on the happier feelings or more productive at work among the participants.
''Affordable Care Act'' and effects on workplace wellness
There are conversations surrounding the role of the Affordable Care Act and in general insurance on its effects on workplace wellness. Sixty percent of Americans obtain their insurance coverage solely in their respective workspaces. However, larger companies are more inclined to offer employee health insurance
Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among ma ...
and wellness programs than those in small businesses. It is critical for workplace wellness to have increase participation, provisions under insurance coverage for small employers to increase incentives expands participation for small businesses. The Affordable Care Act
The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act (PPACA) and informally as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by Presid ...
(ACA) includes the Prevention and Public Health Fund whereby provisions are created to address and expand community prevention, public health infrastructure and training, clinical prevention, and workforce wellness research in the large American working demographic.
The role of the ACA increases programs for worksite wellness is a strategy to tackle the growing rate of chronic diseases in the United States. In a study by the CDC, the implementation of worksite wellness incurs a three-time investment over a dollar spent and have been reported positively by companies such as Johnson & Johnson
Johnson & Johnson (J&J) is an American multinational pharmaceutical, biotechnology, and medical technologies corporation headquartered in New Brunswick, New Jersey, and publicly traded on the New York Stock Exchange. Its common stock is a c ...
, Citibank
Citibank, N.A. ("N. A." stands for "National bank (United States), National Association"; stylized as citibank) is the primary U.S. banking subsidiary of Citigroup, a financial services multinational corporation, multinational corporation. Ci ...
, Duke University
Duke University is a Private university, private research university in Durham, North Carolina, United States. Founded by Methodists and Quakers in the present-day city of Trinity, North Carolina, Trinity in 1838, the school moved to Durham in 1 ...
, Chevron etc.
Included in the Affordable Care Act are chronic diseases management to be offered in the essential health benefits. As workers age, health care costs and chronic diseases such as depression, anxiety
Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
and diabetes
Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or the cells of th ...
are proportional to its growing increase. Owing to this increase, the negative effect on workplace productivity and presentism is declining. ACA implements these management benefits to reduce the declining and negative effects.
In the CDC study on workplace wellness and ACA, the solution resolves to health culture and its strength in workplaces given that only 26% reported that their employees have strong culture of health in their organizations. In 2014, it was found that the Affordable Care Act expands incentive limit by 10 percent. Implementing incentives such as discounts that puts value in health choices and behavior illustrated a 73% positive feedback. In addition, increasing tax on sugar-sweetened drinks, would decrease obesity levels in US adults by 3.5%. The study then concluded towards preventative practices and reform promotes health and quality on workers and increasing productivity. Included with ACA's incentive plan is a non-discriminatory law or HIPAA to requiring availability to alternative wellness programs if need be.
The Affordable Care Act has importance in contextualizing health care promotions in the workplace. The Affordable Care Act, in its revisions and improvements not only persuades workspaces both low and high wage industries to implement health care promotion. Small employers often are underrepresented in the surveys and data for ACA, low wage industries in the past have been underrepresented under the Affordable Care Act, however, with improvements in representation to cover both low and high earning workers, more participation can be seen in workplace wellness.
According to research by Hoffman and Kennedy-Armbruster (2015) in the American College of Sports Medicine ''Health & Fitness Journal'', the top nine workplace/worksite wellness best practices include:
# Leadership support (i.e., modeling, resource allocation, etc.)
# Relevant and personalized programs (using employee interests and available aggregate data)
# Partnership with employees, employer, organizations, and local community.
# Comprehensive and evidence-based programs (using eight dimensions of wellness can be a helpful tool- emotional, environmental, financial, intellectual, occupational, physical, social, and spiritual)
# Implementation that is well planned, coordinated, fully executed, and evaluated for success and accountability
# Employee engagement through organization and planning wellness efforts
# Formal and comprehensive communication strategies/plan
# Data driven decisions that include measurement, evaluation, reporting, and analytics
# HIPAA compliant programs."
Importance of leadership support
Lawrence et al. (2015) indicates strengths and weakness of current worksite wellness models providing key considerations for the development of a strong program. Key strengths indicated were "leadership
Leadership, is defined as the ability of an individual, group, or organization to "", influence, or guide other individuals, teams, or organizations.
"Leadership" is a contested term. Specialist literature debates various viewpoints on the co ...
commitment, organizational culture
Organizational culture encompasses the shared norms, values, corporate language and behaviors - observed in schools, universities, not-for-profit groups, government agencies, and businesses - reflecting their core values and strategic direction. ...
and environmental structure" to build a culture of health, ultimately promoting the improvement among non-communicable diseases. Furthermore, Lawrence et al. (2015) suggest that these characteristics are indicative of a "high-quality program regardless of the model used: 1) leadership support, 2) clear importance of health and wellness by organization culture and environment, 3) program responsiveness to changing needs, 4) utilization of current technology, and 5) support from community health programs".
A recent survey conducted by Harris Poll and reported the American Psychological Association
The American Psychological Association (APA) is the main professional organization of psychologists in the United States, and the largest psychological association in the world. It has over 170,000 members, including scientists, educators, clin ...
(APA) (2016) stated just over 30% of Americans indicate participation in worksite wellness programs, and 44% indicate that employee wellness is supported by their workplace culture. Furthermore, this data indicates when senior leaders are involved and committed to wellness program initiatives 73% of employees feel their organization supports a healthy lifestyle and their overall well-being; however, only 4 of 10 Americans said that their leadership team supports wellness initiatives. Further evidence reported by RAND (2013) stated "evidence from case studies suggests that for programs to be a success, senior managers need to consider wellness an organizational priority to shift the company culture. Buy-in from direct supervisors is crucial to generate excitement and connect employees to available resources."
Furthermore, Hoert, Herd, and Hambrick (2016) used the Leading by Example instrument to find "employees experiencing higher levels of leadership support reported higher wellness program participation, lower stress, and higher levels of health behaviors". Stokes, Henley and Herget (2006) reported on findings from a wellness initiative pilot program using the North Carolina Department of Health and Human Services. This organization was selected as the pilot due to the leadership support model and its large size. This program focused on "reducing major chronic diseases (including cardiovascular diseases), demonstrating the effectiveness of a wellness program model that includes a full-time department-level director, establish wellness committees to sustain work environments that promote and support employee health and wellness, and change policies and environments to help employees be more active, make healthier food choices, avoid tobacco, and manage stress". Results after the first year of this program indicated that 62% of employees participated in at least one wellness activity, 51% exercising more often, 50% stating wellness programs as the most popular activity, 49% eating more fruits and vegetables, 27% were closer to a healthy weight, and 106 employees stopped smoking and 149 reduced tobacco use.
Finally, Ross et al. (2013) report the increased importance of physical activity
Physical activity is defined as any voluntary movement produced by skeletal muscles that requires energy expenditure.Global Recommendations on Physical Activity for Health, 2009. World Health Organization. Geneva, Switzerland. Accessed 13/07/2018 ...
at the workplace with the increasing sedentary job responsibilities, and the positive effect of worksite physical activity programs have on health outcomes, including cardiovascular disease and metabolic conditions. Additionally, their research indicates appropriate models for these successes are through "a health and wellness culture driven by leadership support, specialized programs designed for the employee population, and strategic plans that partner with current organizational goals".
Program development and best practices example
Example
The framework of The Community Guide, program components (goals and objectives) set out by Health People 2020, the Workplace Health Model outlined by the CDC, and other best practices provides a comprehensive foundation for a worksite wellness platform regarding program development, implementation, and evaluation. Using the components above, an employee (or employer) can use employee interest, employee aggregate health data, and the LHIs as priorities to guide goals and objectives, develop programs and evaluation to facilitate, collaborate, and motivate their employees to improve their health. The following example will use the above-mentioned workplace wellness program components as it relates to the goal of weight reduction by increased physical activity through leadership support in order to decrease cardiovascular disease, ultimately impacting the Healthy People 2020 LHI "Nutrition, Physical Activity, and Obesity". The following is a simplified example for (a fabricated) Company ABC:
Assessment
An employee (or Company ABC Human Resource Department) reviews the current aggregate data provided by the employer insurance company as it relates to weight, physical activity, and cardiovascular measures, including cholesterol, blood pressure, biometric screening, physical activity, smoking, or other indicators. Company ABC will review the available company culture survey results as it relates to wellness for both social and environmental supports. Conversations and focus groups will be established to assess and determine employee engagement, interests, concerns, and other wellness related brainstorming.
Implementation
Using The Community Guide, Health People 2020, CDC recommendations, and other peer-reviewed research (evidence-based programs) an organization can design and implement recommended intervention, policies, programs, or environmental supports to ensure the success of the desired goals and outcomes. Based on the CDC's recommendation to include a multidimensional intervention framework, the wellness coordinator for Company ABC has decided on the following programs to support the goals of physical activity through leadership support to help improve cardiovascular health.
* Promoting leadership success stories on with physical activity and movement through the organization's monthly newsletter
* Marketing with leadership photos inviting participants to come to the planned event
* Revised smoking and smokeless tobacco policy which will be enforced by leadership support
* Health coaches for increase physical activity, nutritional changes, and tobacco cessation, including quit kits and available pharmaceuticals in the onsite wellness clinic
* Promotion of health insurance health coaches for physical activity and nutrition through telephonic support
* Quarterly health education lunch and learn on cardiovascular health topics (cholesterol, heart disease, metabolic disease, etc.) as it relates to physical activity (including nutrition)
* Implementation of recommended (informal) policy for walking meetings, especially led by senior leadership and managers
* Implement point-of-decision prompts to use the stairs
* Physical activity challenge led by leaders at Company ABC
* Free and onsite health risk assessment and blood draw events for employees, spouses and dependents
* Onsite blood pressure cuffs for blood pressure self-monitoring
Evaluation
Utilizing past aggregate data from health insurance claims and company culture survey from Company ABC a baseline will be established prior to the program implementation. Following the wellness coordinators strategic plan for Company ABC, measures post-program (1 year) will be collected, including an employee satisfaction survey, informal forums, a collection of corresponding year aggregate data from the insurance company and data from the annual culture survey. Data analysis will be conducted on program successes, strengths, opportunities, threats, and weakness; furthermore, interpretation of results will be collected and reported back to the leadership team for review and support for the next year's strategic planning. Additional comparisons can be made to th
Healthy People 2020 LHI's Report Card
to determine how the employees of Company ABC are doing in comparison to the reported United States data, as well as how they are supporting the overall goals of the Healthy People 2020 goals.
Impact
A meta-analysis of the literature on costs and savings associated with wellness programs, medical costs fell by about $3.27 for every dollar spent on wellness programs and absenteeism costs fell by about $2.73 for every dollar spent. A 2019 study in the journal ''JAMA
''JAMA'' (''The Journal of the American Medical Association'') is a peer-reviewed medical journal published 48 times a year by the American Medical Association. It publishes original research, reviews, and editorials covering all aspects of b ...
'' found that a workplace wellness program at BJ's Wholesale Club
BJ's Wholesale Club Holdings, Inc., commonly referred as BJ's, is an American regional membership-only warehouse club chain based in Marlborough, Massachusetts, operating in the eastern United States in addition to Ohio, Michigan, Louisville, Ke ...
had a very limited impact. The study found no impact on health measures or health care costs, but participants in the study did report that they became more knowledgeable about health behaviors.
The Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention (CDC) is the National public health institutes, national public health agency of the United States. It is a Federal agencies of the United States, United States federal agency under the United S ...
conducted a case study of a workplace wellness program at Capital Metro, the local transit authority in Austin, TX. The study found that there was a reduction in costs associated with employee health care and absenteeism after the workplace welfare program was implemented. In one large study of 1,542 participants across 119 workplaces, 57.7% of participants showed significant reductions in 7 of the 10 cardiovascular health risk categories studied. Johnson & Johnson, one of the world's largest companies, has saved $250 million on health care costs within the last decade as a result of wellness programs; from 2002 to 2008, the return was $2.71 for every dollar spent.
Artificial Intelligence and Workplace Wellness
The rapid proliferation of artificial intelligence (AI) systems into the modern workplace
A workplace is a location where someone works, for their employer or themselves, a place of employment. Such a place can range from a home office to a large office building or factory. For industrialized societies, the workplace is one of the ...
has ignited a wide-ranging discourse concerning the potential implications for employee well-being. As these sophisticated technologies become increasingly integrated into organizational processes and workflows, valid apprehensions have arisen regarding the potential erosion of job security, autonomy, privacy, and ethical decision-making. In light of the expanding influence of artificial intelligence (AI) across various industries, a recent survey by Ernst & Young LLP reveals that 71% of US employees harbor apprehensions about its implications. The study discloses that 48% of respondents express heightened concerns about AI compared to a year ago, with 41% attributing their unease to the perceived rapid evolution of AI technology. Moreover, 75% of employees fear that AI may render certain jobs obsolete, and 65% are uneasy about the prospect of AI replacing their roles. Concurrently, proponents highlight the myriad opportunities AI affords to enhance workplace wellness through task automation, human-machine collaboration, personalized well-being support which includes corporate wellness retreats, and fostering inclusivity. This piece aims to critically examine both the challenges and potential benefits of AI integration concerning employee welfare, and propose recommendations for a responsible and ethically grounded approach to harnessing this transformative technology.
The advent of artificial intelligence
Artificial intelligence (AI) is the capability of computer, computational systems to perform tasks typically associated with human intelligence, such as learning, reasoning, problem-solving, perception, and decision-making. It is a field of re ...
in the modern workplace undoubtedly introduces a multitude of challenges and opportunities concerning employee well-being. While valid concerns exist regarding job insecurity, erosion of autonomy, privacy violations, and the perpetuation of biases, AI systems also hold immense potential to enhance workplace wellness through task automation, human-machine collaboration, personalized well-being support, and fostering inclusivity. However, realizing these benefits while mitigating the risks necessitates a responsible, ethically grounded, and human-centric approach to AI integration.
By prioritizing transparent communication, robust training and skill development initiatives, ethical AI governance and oversight, human-centered design principles, and interdisciplinary collaboration, organizations can navigate this complex landscape effectively. Ultimately, the impact of AI on workplace wellness will be shaped by the choices and actions taken by organizational leaders and their commitment to leveraging these transformative technologies in a manner that genuinely supports, empowers, and promotes the holistic well-being of their workforce.
Challenges to Workplace Wellness Posed by AI Implementation
Job Insecurity and Occupational Stress
One of the primary concerns encompassing AI's encroachment into the workplace sphere is the fear of technological unemployment
The term technological unemployment is used to describe the loss of jobs caused by technological change. It is a key type of structural unemployment. Technological change typically includes the introduction of labour-saving "mechanical-muscle" ...
. As AI systems become increasingly adept at performing tasks traditionally conducted by human labor, trepidations surrounding potential job displacement have intensified. This perceived job insecurity
Job security is the probability that an individual will keep their job; a job with a high level of security is such that a person with the job would have a small chance of losing it. Many factors threaten job security: globalization, outsourcing ...
can precipitate heightened stress levels, anxiety
Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
, and an overarching sense of precariousness among the workforce. Prolonged exposure to such occupational stressors has been empirically linked to adverse physical and psychological health outcomes, including burnout, depression, and cardiovascular disease
Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases (e.g. angina, heart attack), heart failure, hypertensive heart disease, rheumati ...
. In advanced economies, about 60 percent of jobs may be impacted by AI. Roughly half the exposed jobs may benefit from AI integration, enhancing productivity and for the other half, AI applications may execute key tasks currently performed by humans, which could lower labor demand, leading to lower wages and reduced hiring. In the most extreme cases, some of these jobs may disappear. In 2022, 19% of American workers were in jobs that are the most exposed to AI, in which the most important activities may be either replaced or assisted by AI.
Erosion of Autonomy and Self-Determination
A further challenge posed by the integration of AI systems is the potential diminution of human autonomy and self-determination within the workplace. As these technologies assume an increasing array of decision-making responsibilities and automate intricate processes, employees may experience a concomitant reduction in their perceived sense of control and agency over their professional roles. This deprivation of autonomy
In developmental psychology and moral, political, and bioethical philosophy, autonomy is the capacity to make an informed, uncoerced decision. Autonomous organizations or institutions are independent or self-governing. Autonomy can also be ...
can detrimentally impact job satisfaction
Job satisfaction, employee satisfaction or work satisfaction is a measure of workers' contentment with their job, whether they like the job or individual aspects or facets of jobs, such as nature of work or supervision. Job satisfaction can be me ...
, engagement, and overall eudaimonia
Eudaimonia (; ) is a Greek word literally translating to the state or condition of ''good spirit'', and which is commonly translated as ''happiness'' or ''Well-being, welfare''.
In the works of Aristotle, ''eudaimonia'' was the term for the hig ...
well-being, as humans inherently thrive when imbued with a sense of volition and self-directedness.
Privacy Concerns and Workplace Surveillance
The deployment of AI in workplace contexts often necessitates the collection and analysis of vast troves of employee data to train and optimize these systems. This data could potentially be leveraged for continuous performance monitoring, productivity tracking, and even predictive modeling of employee behavior and prospective tenure. While such practices may ostensibly aim to enhance operational efficiency, they raise significant ethical concerns regarding privacy rights and could engender an environment of pervasive surveillance and mistrust, undermining psychological safety and well-being.
Perpetuation of Bias and Discrimination
Despite their computational sophistication, AI systems are not immune to the insidious bias
Bias is a disproportionate weight ''in favor of'' or ''against'' an idea or thing, usually in a way that is inaccurate, closed-minded, prejudicial, or unfair. Biases can be innate or learned. People may develop biases for or against an individ ...
es and flaws inherent in the data they are trained upon or the algorithms they employ. In the absence of rigorous ethical oversight and debiasing protocols, AI applications in the workplace run the risk of perpetuating or even amplifying existing societal biases related to protected characteristics such as gender
Gender is the range of social, psychological, cultural, and behavioral aspects of being a man (or boy), woman (or girl), or third gender. Although gender often corresponds to sex, a transgender person may identify with a gender other tha ...
, race, age
Age or AGE may refer to:
Time and its effects
* Age, the amount of time someone has been alive or something has existed
** East Asian age reckoning, an Asian system of marking age starting at 1
* Ageing or aging, the process of becoming older
...
, or disability
Disability is the experience of any condition that makes it more difficult for a person to do certain activities or have equitable access within a given society. Disabilities may be Cognitive disability, cognitive, Developmental disability, d ...
status. This could precipitate unfair treatment, discriminatory practices, and a hostile work environment for affected employees, adversely impacting their psychological and emotional welfare.
Potential Benefits of AI for Cultivating Workplace Wellness
Automation of Tedious and Physically Arduous Tasks
Despite the concerns surrounding occupational displacement, the judicious implementation of AI systems also presents opportunities to alleviate the burden of physically and cognitively tedious tasks on human workers. By automating these repetitive, monotonous processes, AI can effectively reduce the mental and physical strain experienced by employees, mitigating risks of burnout, musculoskeletal disorder
Musculoskeletal disorders (MSDs) are injuries or pain in the human musculoskeletal system, including the joints, ligaments, muscles, nerves, tendons, and structures that support limbs, neck and back. MSDs can arise from a sudden exertion (e.g. ...
s, and psychological distress
Mental distress or psychological distress encompasses the symptoms and experiences of a person's internal life that are commonly held to be troubling, confusing or out of the ordinary. Mental distress can potentially lead to a change of behavior, ...
. This could enable employees to reallocate their efforts towards more engaging, stimulating, and fulfilling aspects of their roles, potentially enhancing job satisfaction and overall well-being.
Human-Machine Collaboration and Capability Augmentation
Rather than conceptualizing AI as a replacement for human labor, an alternative paradigm envisions a symbiotic relationship wherein these technologies augment and enhance human capabilities. AI systems can function as intelligent virtual assistant
A virtual assistant (VA) is a software agent that can perform a range of tasks or services for a user based on user input such as commands or questions, including verbal ones. Such technologies often incorporate chatbot capabilities to streaml ...
s, providing real-time insights, analysis, and data-driven recommendations to support complex decision-making processes. This collaboration between humans and AI could effectively reduce cognitive load, improve productivity, and foster a more efficient and rewarding work experience for employees.
Personalized Employee Well-being Support
AI can also be leveraged to directly support and promote employee well-being initiatives within organizations. AI-powered applications could facilitate personalized well-being assessments, tailoring recommendations for stress management techniques, mindfulness practices, or lifestyle interventions based on individual needs and preferences. Furthermore, conversational AI agents could potentially provide virtual coaching or counseling services, offering a more accessible and scalable approach to mental health support. By harnessing the vast computational power and data processing capabilities of AI, organizations can offer highly customized and effective well-being resources to their employees, promoting better mental and physical health outcomes.
Fostering Inclusion, Accessibility, and Workplace Belongingness
AI technologies also hold significant promise in fostering more inclusive, accessible, and supportive workplace environments. For instance, AI-driven language translation and transcription services can facilitate seamless communication and collaboration among employees with diverse linguistic
Linguistics is the scientific study of language. The areas of linguistic analysis are syntax (rules governing the structure of sentences), semantics (meaning), Morphology (linguistics), morphology (structure of words), phonetics (speech sounds ...
backgrounds, mitigating barriers to participation and fostering a sense of belongingness. Additionally, AI-powered assistive technologies can aid employees with disabilities in performing their roles more effectively, enabling greater autonomy, productivity, and full participation in the workplace. By leveraging AI to create more equitable and accommodating workspaces, organizations can cultivate a culture of inclusivity, enhancing overall employee well-being and organizational commitment.
The global artificial intelligence market size was valued at US$196.63 billion in 2023 and is projected to expand at a compound annual growth rate (CAGR) of 37.3% from 2023 to 2030. This growth has been driven in part by the immense cost savings and productivity gains AI can offer businesses. AI applications in workplaces are estimated to save over 300 billion hours of worker productivity annually. China has emerged as a global leader in AI implementation, on research, for example, China produced about one-third of both AI journal papers and AI citations worldwide in 2021. In economic investment, China accounted for nearly one-fifth of global private investment funding in 2021, attracting $17 billion for AI start-ups.
Recommendations for Responsible AI Integration and Ethical Governance
To effectively navigate the intricate landscape of AI's impact on workplace wellness, and mitigate potential challenges while capitalizing on the opportunities, organizations must adopt a responsible, ethically grounded, and human-centric approach to AI integration. The following recommendations provide a framework for achieving this objective:
Transparent Communication and Employee Involvement
Fostering an environment of open communication and actively involving employees in the decision-making processes surrounding AI implementation is paramount. Organizations should prioritize transparent dissemination of information regarding the intended purposes, functionalities, and anticipated impacts of AI systems on work processes and employee roles. Furthermore, providing avenues for employee feedback, concerns, and active participation in shaping AI integration strategies can help alleviate fears, build trust, and ensure that these technologies are deployed in a manner that genuinely supports employee well-being.
Robust Training, Upskilling, and Professional Development
To address concerns surrounding job displacement and the evolving skill requirements precipitated by AI adoption, organizations must invest in comprehensive training
Training is teaching, or developing in oneself or others, any skills and knowledge or fitness that relate to specific useful competencies. Training has specific goals of improving one's capability, capacity, productivity and performance. I ...
, upskilling, and professional development initiatives for their workforce. By equipping employees with the requisite technical competencies and cognitive capabilities to effectively collaborate with AI systems, organizations can foster a sense of adaptability, resilience, and future-proof their human capital. This proactive approach to skill development not only enhances workforce preparedness but can also mitigate job insecurity
Job security is the probability that an individual will keep their job; a job with a high level of security is such that a person with the job would have a small chance of losing it. Many factors threaten job security: globalization, outsourcing ...
and promote a growth mindset among employees.
Ethical AI Governance, Oversight, and Algorithmic Auditing
Establishing a robust ethical governance framework and rigorous oversight mechanisms for the development, deployment, and continuous monitoring of AI systems within the workplace is a crucial imperative. This includes conducting thorough assessments to identify and mitigate potential biases in AI algorithms and training data, implementing strict data privacy
Information privacy is the relationship between the collection and dissemination of data, technology, the public expectation of privacy, contextual information norms, and the legal and political issues surrounding them. It is also known as data ...
and security protocols, and ensuring that AI decision-making processes are transparent, explainable, and subject to human oversight and accountability measures. Independent external audits, algorithmic impact assessments, and regular ethical reviews can further strengthen governance and ensure compliance with established principles and industry best practices.
Human-Centered Design and Preserving Employee Agency
Throughout the AI integration process, organizations should prioritize a human-centered design philosophy that places the needs, preferences, and well-being of employees at the forefront. This involves actively soliciting and incorporating user feedback, ensuring intuitive and accessible human-machine interfaces, and empowering employees to maintain agency, control, and decision-making autonomy over their work processes. By adopting a human-centered approach, organizations can effectively mitigate concerns regarding the erosion of autonomy
In developmental psychology and moral, political, and bioethical philosophy, autonomy is the capacity to make an informed, uncoerced decision. Autonomous organizations or institutions are independent or self-governing. Autonomy can also be ...
and foster a sense of empowerment, enhancing job satisfaction and overall eudemonic well-being.
Interdisciplinary Collaboration and Stakeholder Engagement
Navigating the complex interplay between AI, workplace dynamics, and employee well-being necessitates a multidisciplinary approach that transcends traditional organizational silos. Organizations should actively foster collaboration among diverse stakeholders, including technologists, human resource professionals, legal and ethical experts, occupational health specialists, and employee representatives. This interdisciplinary collaboration can yield holistic perspectives, identify potential blind spots, and inform comprehensive strategies that harmonize technological innovation with a genuine commitment to employee welfare.
See also
* '' Booster Breaks''
* Employee assistance programs
* Employee benefit
Employment is a relationship between two party (law), parties Regulation, regulating the provision of paid Labour (human activity), labour services. Usually based on a employment contract, contract, one party, the employer, which might be a cor ...
* Health fair
* Managed care
In the United States, managed care or managed healthcare is a group of activities intended to reduce the cost of providing health care and providing health insurance while improving the quality of that care. It has become the predominant system o ...
* Obesity
Obesity is a medical condition, considered by multiple organizations to be a disease, in which excess Adipose tissue, body fat has accumulated to such an extent that it can potentially have negative effects on health. People are classifi ...
* Occupational cardiovascular disease
Occupational cardiovascular diseases (CVD) are diseases of the heart or blood vessels caused by working conditions, making them a form of Occupational disease, occupational illness. These diseases include Coronary artery disease, coronary heart dis ...
* Organisation climate
* Organizational culture
Organizational culture encompasses the shared norms, values, corporate language and behaviors - observed in schools, universities, not-for-profit groups, government agencies, and businesses - reflecting their core values and strategic direction. ...
* Participatory ergonomics
* Philosophy of happiness
* Pre-work assembly
* Presenteeism
Presenteeism or working while sick is the act or culture of employees continuing to work as a performative measure, despite having reduced productivity levels or negative consequences. Reduced productivity during presenteeism is often due to illnes ...
* Sick building syndrome
Sick building syndrome (SBS) is a condition in which people develop symptoms of illness or become infected with chronic disease from the building in which they work or reside. In scientific literature, SBS is also known as building-related illn ...
* Total Worker Health
Total Worker Health is a trademarked strategy defined as policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being. ...
* Work–life balance
In the intersection of Employment, work and personal life, the work–life balance is the equilibrium between the two. There are many aspects of one's personal life that can intersect with work, including family, leisure, and health. A work–lif ...
* Workplace health promotion
* Workplace stress
Occupational stress is psychological stress related to one's job. Occupational stress refers to a chronic condition. Occupational stress can be managed by understanding what the stressful conditions at work are and taking steps to remediate thos ...
References
{{DEFAULTSORT:Workplace Wellness
Occupational safety and health
Management cybernetics
Workplace