A study by researchers at Harvard and the University of Chicago suggests that employee wellness programs do not actually improve health outcomes for workers or reduce the amount of money that companies’ spend on healthcare.
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Although employees did demonstrate improvement in health behaviors such as weight management and exercising regularly, the wellness programs did not cut costs, reduce absenteeism rates or improve health outcomes.
The findings, which were recently published in JAMA, come amidst an expansion in the uptake of wellness programs. The programs now represent an $8 billion industry in the U.S., with more than 80% of large companies enrolling an estimated 50 million people.
Programs are highly variable, from providing small incentives to carry out a health assessment or join a gym, for example, through to asking workers to take health-related questionnaires or have their blood tested.
In one of the first studies of its kind, Zirui Song and Katherine Baicker have conducted a large-scale randomized, controlled analysis of more than 32,974 warehouse workers employed by BJ’s Wholesale Club across 160 worksites over an 18-month period.
The team found that among worksites that implemented the programs, 8.3% more employees reported regularly exercising and 13.6% more reported actively managing their weight, compared with companies that did not use the programs.
"There were no significant differences in other self-reported health and behaviors; clinical markers of health, health care spending or utilization, or absenteeism, tenure, or job performance after 18 months."
Among the measures for which the study demonstrated no improvement were self-reported health, weight, quality of sleep, cholesterol levels, absenteeism and job performance.
The finding that programs did change health behaviors and awareness can be read optimistically, given that the first step towards improving health outcomes has to be paying more attention and having the information and ability to pay more attention to such behaviors.
However, there is no evidence that these changes are enough to reduce blood pressure or improve diabetes, for example. The study found no difference in hypertension and high cholesterol levels between the experimental and control groups.
"If employers are launching a wellness program with hopes of a short-term or quick savings in health expenditures or absenteeism, this study should give them pause.”
Katherine Baicker, Lead Researcher
Baicker emphasises that one feature that was key to distinguishing this study from previous research into workplace wellness is its randomization.
Many previous studies have been limited by their failure to provide a comparison group or address the possibility that people who sign up for the programs are already somehow more healthy or motivated than people who do not sign up, she explains.
By randomly assigning 20 of the BJ’s Wholesale Club outlets to offer the wellness programs and then comparing the results with 140 stores that did not, the authors overcame this limitation.
“The studies that suggested improvements almost all suffered from not being able to tell what would happen in the absence of a program… if you don’t have a good control group, you will think it has a stronger association with positive health outcomes,” says Baicker.
Commenting on the study in general, the authors conclude: “These findings may temper expectations about the financial return on investment that wellness programs can deliver in the short term.”