How Healthy Are Employer Wellness Programs?
CONDUIT Spring, 2015 Guest Editorial
By Ted Kyle
Concern about the costs to employers of chronic diseases and obesity is driving a growing interest in employer-sponsored wellness programs throughout North America. But how healthy are these programs for employees and their relationship with employers? The answer, it seems, depends upon the characteristics of the program.
In both Canada and the U.S., wellness programs have included efforts to address the work environment, health risk behaviours and emotional health. Underpinning these programs is a presumption that employers and employees have a shared interest in maximizing the health and wellness of employees. A health risk assessment is a cornerstone of this approach that identifies key risk factors. The next step is for the employer to provide access to resources that will help employees address factors that pose the greatest risk to their health and wellness.
But in the U.S., some employers have begun investing more money in financial incentives to encourage employees to participate in wellness programs and to achieve specific health-related outcomes—very often expressed in terms of weight goals. Health reform legislation in the U.S. has given employers legal permission to offer larger incentives for such outcomes. These incentives can reach into thousands of dollars, a substantial amount for lower-income employees.
Relying on such large incentives is a mistake.
Employers who do so are abandoning the essential foundation of a successful wellness program, which is a deep commitment to the shared interest between employers and employees in maximizing health and wellness. People do not suffer from the chronic disease of obesity and its consequences because they lack incentive to improve their health. More often they lack access to the means to improve their condition. And without the means for meaningful improvement, people may become resigned to living with obesity.
Whatever effort and money might be going into financial incentives for health improvement will likely prove to be a waste. At best, in the U.S., it seems to be a tool for shifting costs onto people with chronic diseases.
These resources would be much better spent on reducing workplace factors that promote obesity and improving access to the full range of evidence-based treatments for obesity. The employers that are pursuing this path—and many are—will succeed with a healthier, more productive
workforce and better retention of talented employees.
Those that pursue a more adversarial path, coercing employees to participate through financial rewards and penalties, may find that it provides only short-lived results.