Employee health problems are not the greatest threat to worker productivity. Entry 11 - 2007

At a recent talk, I asked the audience a question. “True or false, employee health problems are the number one cause of lost productivity?” The vast majority answered “true.” Where did they get this impression? And is it correct?

The past six years of productivity research have emphasized the impact of health problems (1-10). Numerous studies have quantified the effects of health issues on worker productivity. Across most workforces, health problems produce significant decreases in productivity. Comparing the effects of different diseases, researchers find that chronic conditions—especially those that produce noticeable discomfort (pain, fatigue, trouble concentrating) and affect a significant number of people—tend to generate a significant amount of lost work time. We all know that any illness—even the common cold—will make a person less productive when they don’t feel well.

What we rarely discuss is the relative importance of health problems among many issues facing a worker each day. Is it the primary issue affecting productivity? Is it even among the top three? Or is it a symptom of larger and in fact, more controllable organizational issues?

To answer these questions, we included a familiar productivity question in our recent Health as Human Capital survey. We asked over 1,800 workers with different jobs and different employers across the country about the factors interfering with their ability to be productive. (Details of the survey are available in our overview report.)
Consistent with other research, health interfered with productivity. Twenty-five percent of employees reported that personal health problems made them less productive sometimes, frequently, or all the time.

However, respondents reported that other factors affected productivity more often. Overall, respondents reported health problems affecting their productivity less frequently than most other work issues.

As seen in the second graph, the most frequent issues were low motivation, low morale among their co-workers and poor communication. Inadequate training was reported more frequently than health problems as well. (click on the graphs to enlarge them)

It’s not that health is unimportant (as we all know from our own experiences of illness), but, when we look at health in isolation of other factors in the work environment, it often leaves us with the impression that health problems are the predominant problem for a workforce. They are not. One of my colleagues put it this way:

Think about your favorite sports team—or better yet, think back to a time when you may have played on a team. It goes without saying that it is best if all a team’s players are healthy enough to compete, but as a goal, perfect health pales in comparison to having talented players who are well-coached, know how to play together and have a desire to win. In fact, nowhere is the impact of motivation and the desire to win/perform more visible than in sports, but this affect is also alive and well in business, as suggested by these survey results.

In our special report, “Human Capital Motivation and Productivity,” we discuss the factors that most strongly predicted motivation problems. Among the strongest predictors of high motivation were the size of bonus a worker is eligible for (relative to a person's salary) as well as the perception that workers are recognized and rewarded for good work.

As decision makers think about workforce health, solutions must be addressed in the context of the overall work environment. Offering health management solutions in a context where employees do not feel rewarded may not be sufficient to overcome the dramatic effect of morale demonstrated here. In the big picture, business is about exchanging human capital for pay and rewards. If this exchange is poorly designed, such that workers do not have incentive to excel, health investments have little chance of being effective. People naturally seek value where it is available. If I am rewarded most for being at work and productive, I will respond to those incentives. If my compensation favors health benefits over bonuses, I will respond by seeking value in those benefits.

So in the end, if higher productivity is the goal, perhaps valuing the achievements of the person is the best medicine of all.

References

1. Burton, W. N. , C. Y. Chen, D. J. Conti, A. B. Schultz, G. Pransky, and D. W. Edington. 2005. The association of health risks with on-the-job productivity. J Occup Environ Med 47, no. 8: 769-77.

2. Burton, W. N. , D. J. Conti, C. Y. Chen, A. B. Schultz, and D. W. Edington. 2002. The economic burden of lost productivity due to migraine headache: a specific worksite analysis. J Occup Environ Med 44, no. 6: 523-9.

3. Burton, W. N., D. J. Conti, C. Y. Chen, A. B. Schultz, and D. W. Edington. 2001. The impact of allergies and allergy treatment on worker productivity. J Occup Environ Med 43, no. 1: 64-71.

4. Burton, W. N. , G. Pransky, D. J. Conti, C. Y. Chen, and D. W. Edington. 2004. The association of medical conditions and presenteeism. J Occup Environ Med 46, no. 6 Suppl: S38-45.

5. Goetzel, R. Z., K. Hawkins, R. J. Ozminkowski, and S. Wang. 2003. The health and productivity cost burden of the "top 10" physical and mental health conditions affecting six large u.s. Employers in 1999. J Occup Environ Med 45, no. 1: 5-14.

6. Goetzel, R. Z., S. R. Long, R. J. Ozminkowski, K. Hawkins, S. Wang, and W. Lynch. 2004. Health, absence, disability, and presenteeism cost estimates of certain physical and mental health conditions affecting U.S. employers. J Occup Environ Med 46, no. 4: 398-412.

7. Kessler, R. C., M. Ames, P. A. Hymel, R. Loeppke, D. K. McKenas, D. E. Richling, P. E. Stang, and T. B. Ustun. 2004. Using the world health organization health and work performance questionnaire (hpq) to evaluate the indirect workplace costs of illness. J Occup Environ Med 46, no. 6 Suppl: S23-37.

8. Kessler R. C., Greenberg P. E., Mickelson K. D., Meneades L. M., and P. S. Wang. 2001. The effects of chronic medical conditions on work loss and work cutback. J Occup Environ Med 43, no. 3: 218-25.

9. Lerner, D., D. A. Adler, H. Chang, E. R. Berndt, J. T. Irish, L. Lapitsky, M. Y. Hood, J. Reed, and W. H. Rogers. 2004. The clinical and occupational correlates of work productivity loss among employed patients with depression. J Occup Environ Med 46, no. 6 Suppl: S46-55.

10. Wang, P. S., A. L. Beck, P. Berglund, D. K. McKenas, N. P. Pronk, G. E. Simon, and R. C. Kessler. 2004. Effects of major depression on moment-in-time work performance. Am J Psychiatry 161, no. 10: