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Well-being in the workplace: Is it worth the investment for employees and companies?

INTRODUCTION

On May 26, 2020, the Journal of the American Medical Association (JAMA) published a research article titled “Effects of a Workplace Wellness Program on Employee Health, Health Beliefs, and Use medical”. The article described a two-year randomized clinical trial with 4,834 employees at a large US university.

The result was the following:

Employees who joined the wellness program showed no significant differences in biometrics, medical diagnoses, or medical usage relative to the control group. The intervention increased self-reports of having a primary care physician…but did not significantly affect clinical outcomes.

The JAMA issue also featured a guest commentary by Jean Marie Abraham titled “Evaluating the Effectiveness of Employers’ Wellness Program: Where Should Employers Invest?”

The author prefaced his comment with this general description:

Today, most large US employers offer their workers access to wellness programs as part of their compensation. These programs typically include a coordinated set of activities for employees to assess their health risks and engage in lifestyle behavior modification. Historically, employer investments in these programs have been motivated by the prospect of an economic return in the form of lower medical costs for workers and increased worker productivity as a result of disease prevention or better management of illnesses. conditions, such as diabetes, heart disease, depression, and low back pain.

A BRIEF HISTORY OF WELLNESS IN THE WORKPLACE

Ever since the first workplace wellness programs were introduced in the late 1970s and early 1980s, enthusiasts and skeptics alike have debated their usefulness. Differences abound about almost every aspect of the well-being of the worst.

Enthusiasts and detractors cannot agree on much, and in particular they disagree on:

• Whether wellness in the workplace benefits the sponsoring organization, ie it offers positive returns on investment.
• Whether employees become healthier as a result of participation.
• What incentives, if any, are effective in motivating workers to participate in such offers.
• Whether and to what extent productivity, morale and/or other factors are affected, for better or worse.

Naturally, wellness advocates, particularly those directly or indirectly supported by wellness in the workplace, are enthusiastic and think that the programs, if done right, are gloriously wonderful and beneficial. Nearly every wellness advocate is vocal about the benefits to participants, businesses, the community, the country, and even the planet. Critics aren’t impressed; some go so far as to proclaim that wellness in the workplace does more harm than good.

So what is reality?

Well, you’re coming to the right place to find out. The short answer is this: we do not know

But, you might ask, what about the aforementioned JAMA study and its evaluation? Do these recent academic research projects not answer these questions?

No they don’t and I can explain why not.

For almost fifty years, I have promoted the idea that educational wellness offerings in the workplace should be completely separate from so-called medically based wellness programs, which are almost always dominated by medical personnel performing medical activities. The study and report on it show that nothing has changed, although now the focus is on what kind of goalposts to erect as return measures.

The invited commentary notes that the CDC suggests that wellness programs should be further diluted, homeopathically style, with other fringe benefits (eg, health insurance, employee assistance programs). Doing so would only ensure that there are no genuine wellness molecules left in any of those offerings.

A REAL ASSESSMENT OF THE WELFARE OF STUDIES

The JAMA article is a waste of words. The authors do not know what they are talking about. The study design is weak because its thinking about wellness is weak. If public funds were used for this project, those responsible should be prosecuted.

Although the study evaluated programs with the name wellness attached, the programs described were almost entirely prevention, medical compliance, and risk reduction, not health improvement, or activities that had much to do with the enjoyment of life or otherwise focused on positive education for well-being. The commentator stated that more than 80 percent of reform attempts fail to achieve lasting change. I’d be surprised if a program like this bogus workplace wellness effort allowed employees to understand and make REAL commitments to wellness as part of their everyday lives.

It would be more than enough to offer an education that would enable people to improve their reasoning ability. No such efforts were observed in the program surveyed. How about increasing the chances that employees will enjoy a more exuberant life outside of work? None of that was noticed. How about increased interest and skills in making exercise a part of daily life and even methods of selecting healthy foods? Some of those efforts were included, but diluted with all the medical testing and training to avoid disease. No attention seems to have been devoted to teaching personal strategies to increase freedoms to live more in accordance with how employees would like to live.

RECOMMENDATIONS

Workplace wellness leaders could consider the following reforms:

Keep the medical and prevention offerings that exist, but separate them all from positive wellness education, defining REAL wellness in a way that removes the grab bag concept from health education and risk reduction offerings.

Don’t expect short-term medical improvements regarding illnesses, but instead focus on biometric measures of wellness, physical and mental.

• Don’t expect medical or financial outcomes, but give employees options and make sure the options are the kind that appeal to workers. You won’t have to pay people to learn, practice, and maintain attitudes and behaviors that deliver quality of life and satisfying returns. Why continue efforts that only 32% of employees believe will improve their lifestyle or (40%) say will meet their needs?

Wellness programs should focus on reason (critical thinking skills), exuberance (happiness/meaning, etc.), athletics (exercise and nutrition), and freedom or gaining greater personal freedoms.

Cultural and other supports are essential. Most of us who enjoy effective lifestyles started down those paths from the splendid modeling of influencers in our early lives and the environments (people and resources) that made it easy and natural to thrive.

All of this will require strong support from company leaders.

Dr. Judd Allen commented on my critique of this study, suggesting that when people become part of supportive environments and groups that exhibit healthy attitudes and behaviors, they are much more likely to value their well-being.

Let’s hear it for cultural support and REAL wellness. Medical and prevention programs disguised as wellness have no chance of reaching the hearts and minds of employees.