Encouraging employees to lead a healthy lifestyle: what the research shows
Employers often ask whether encouraging healthy habits pays off. The honest answer is mixed: early analyses were optimistic, and large randomized trials found much smaller effects. Here is what the research shows, and where an employer’s effort is most likely to matter.
Why employers invest in employee health
Employers hope that healthier employees will miss less work and use less health care. Wellness programs, such as screenings, fitness challenges and coaching, are the usual way to try. The open question is whether the programs themselves cause those results.
What the research shows
Early analysis found savings
A 2010 meta-analysis by Baicker, Cutler and Song in Health Affairs reported that medical costs fell by about $3.27 for every $1 spent on wellness programs, and absenteeism costs fell by about $2.73 for every $1 spent. [Read the analysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC2873731).
A large randomized trial found little
In a 2019 JAMA trial by Song and Baicker, 160 worksites with 32,974 employees were randomized and followed for 18 months. Employees at program sites reported more regular exercise and more active weight management. Cholesterol, blood pressure, body mass index, health care spending, absenteeism, job tenure and job performance did not differ significantly. [See the abstract](https://pubmed.ncbi.nlm.nih.gov/30990549/).
Another randomized study agreed
The Illinois Workplace Wellness Study randomized individual employees and reported a negligible impact. A University of Chicago summary notes that incentive-based programs may attract healthy employees rather than improve anyone’s health. [Read the summary](https://news.uchicago.edu/story/workplace-wellness-programs-fail-improve-health-study-finds).
How to read the gap
Randomized trials are better at separating a program’s effect from who chooses to join it, which is why their results carry weight. Neither kind of study says that healthy habits do not matter. They show that a typical workplace program, on its own, did not measurably change costs or attendance over 18 months.
Where effort is more likely to pay off
Because broad programs show limited results, start with risks you can name. Work-related musculoskeletal problems build up from repeated loads and awkward positions, so a well-set workstation and early care for aches matter more than a step-count contest.
Fit the work to the person
Adjust workstations and tasks, rotate repetitive jobs and teach safe lifting.
Act on early symptoms
Aching, stiffness or tingling that comes with a task and fades at rest is an early warning. Make it easy to report and to get seen.
Be ready for emergencies
A written emergency plan, a stocked first aid kit and a plan for weather hazards protect people on their worst day.
Keep it voluntary and private
Let employees opt in, and be clear about who can see any health information they share.
Fitting the work to the person is covered in our guide to ergonomics and musculoskeletal injury prevention. A few daily lower back stretches are an easy place to start. Seeing a therapist at the first warning sign is what early physical therapy means in practice. Being ready for the worst day is covered in emergency equipment for the office.
Questions to ask before buying a program
What outcome will you measure, and over what period? Does the vendor report results from randomized or comparison groups, not only from participants? Is participation voluntary, and who sees employees’ health data?
Early evaluation is part of work injury care. More practical checklists are in our workplace health resources.
This page is general information. It is not medical or legal advice and does not replace the rules that apply to your workplace.
References
- Baicker K, Cutler D, Song Z. Workplace wellness programs can generate savings. Health Affairs. 2010.
- Song Z, Baicker K. Effect of a workplace wellness program on employee health and economic outcomes: a randomized clinical trial. JAMA. 2019.
- University of Chicago News. Workplace wellness programs fail to improve health, study finds.
About the clinical team behind this page
Dr. Pelham Williams IV is Regional Medical Director for Nova’s Southeast region, based in Atlanta. His practice centers on the evaluation and non-operative management of musculoskeletal and work-related injuries, including acute joint injuries and repetitive-strain problems, and he reviews content on occupational injury and sports injury diagnosis.
Dr. Arnaldo Manuel Mora is Medical Director and leads clinical governance at Nova. His background is in internal and occupational medicine. He oversees diagnostic intake, baseline laboratory review and the safety standards that apply before any prescription therapy, including pharmacy sourcing and contraindication screening as described in our safety guide.
Medical disclaimer: The information on this site is for education and does not replace a consultation, diagnosis or treatment. Full credentials are on our physicians and clinical governance page.
Keep reading
Individual results vary and no outcome is guaranteed. This page is general information, not medical advice.