International Journal of Workplace Health Management

ISSN: 1753-8351

Article publication date: 27 June 2008


Edington, D.W. (2008), "Editorial", International Journal of Workplace Health Management, Vol. 1 No. 2. https://doi.org/10.1108/ijwhm.2008.35401baa.001



Emerald Group Publishing Limited

Copyright © 2008, Emerald Group Publishing Limited


Article Type: Editorial From: International Journal of Workplace Health Management, Volume 1, Issue 2

Health management programs at the workplace are often measured in terms of the productivity of individuals and overall organization productivity. Although the definitions vary across profit and non-profit business sectors and measurement techniques, health-related productivity of individuals, in a human capital framework, is often expressed as the sum of the measures of time away from work (absenteeism) plus the time lost while at work (presenteeism). These measures, taken together or taken separately, reflect the degree of individual lost or delayed health-related productivity. Assessing the productivity of the organization is more complex, but since human capital is one of largest investments of the organization, then special attention is needed to draw the most value from this investment.

While the concepts of absenteeism and presenteeism seem intuitive, the ability to measure and interpret the data remains non-standardized. The field of workplace health management is still searching for the correct measurement tools, the correct metrics to express what was measured, and a valid way to translate the metrics into financial terms. For example, measurement in the current strategy is often built around the focus on “time on task”: thus, absenteeism is assumed at zero productivity, while being present on the job is assumed at 100 percent productive minus presenteeism.

In the mean time, organizations around the world are having a near-crisis economic situation as those within the organizations struggle to manage the consequences of poor health within the workplace and the workforce while competing within the context of global competition. Thus, the editor and publisher thought it critical to address this global concern in an early issue of the journal.

The authors of the articles in this issue were selected because of their previous work in workplace health management, and specifically for their knowledge of the literature and thoughts related to productivity at the workplace and of the workforce. The authors speak to two major approaches to the topic of productivity at the workplace and of the workforce. The articles by Burton et al. and Loeppke present their respective comprehensive reviews of productivity outcomes related to mental health status and as a major component of the total value of health and the impact of prevention. The articles by Goetzel et al. and Tsui focus on the general state of the field and on the various models for approaching the study of productivity in North America and the Far East, respectively. The case study by Kirsten summarizes the current state of the field in Europe.

In “The association of worker productivity and mental health: a review of the literature”, W.N. Burton, A.B. Schultz, C. Chen and D.W. Edington review the literature on one of the major issues facing employers and employees worldwide: mental health and productivity. The authors point out that mental health is a relatively ignored issue in most settings and one that is only recently getting more attention as employers increasingly turn to considering the impact of poor health status on individual productivity. The study of mental health suffers from a lack of precise definition outside of the typical ICD-10 codes, which results in many mental health issues being untreated until they reach a serious state with an identifiable diagnosis. In general, the authors conclude that in the employed population depressive disorders are the most common form of mental health impacting productivity: absences, short-term disability and presenteeism. Also, the authors conclude that mental health problems increase individual absenteeism and presenteeism and that appropriate interventions can be effective in moderating the impact of these problems.

In “The value of health and the power of prevention”, author R. Loeppke presents a convincing argument for examining the total cost of health risks in relation to medical, pharmacy and productivity, and concludes that health risks are associated with decreases in each of these measures, including health-related productivity. He then proceeds to the next step and reviews articles which demonstrate the value of health management interventions in changing risks. The results of his review is that the investment in health and productivity programs results in improved productivity outcomes when the interventions are focused on “prevention and a culture of health rather than more treatment and cure”. He also reminds us that “there needs to be a focus on the quality and effectiveness of care rather than just the quantity and efficiency of the care”.

R.Z. Goetzel, R.J. Ozminkowski, J. Bowen, and M.J. Tabrizi focus on theory and models of integration of health promotion and health protection programs, specifically comparing and contrasting the psychological model, the public model and the human capital model in “Employer integration of health promotion and health protection programs”. Important to this effort is the elimination of silos of effort and the integration of resources, programs and data analyses. Decision-making would be most effective when managers take into consideration the consequences of the decision on all of the desired outcome measures.

In “Asian wellness in decline: a cost of rising prosperity”, A.H.H. Tsui reports that there is a growing decline in wellness throughout several countries in Asia, and much of it is coming from fatigue from overwork and stress overload resulting in a crisis in emotional wellness. Some of the mental stress is coming from the recent emphasis on wealth and the distribution of wealth in the region. Consistent with the emphasis on growth are more local issues related to workplace environments including major overtime work requirements, lack of preventive screenings and growing unhealthy lifestyles. There is a growing, although slowly, awareness of the practices that corporations and governments could implement to counter these growing health concerns.

W. Kirsten summarizes the needs of the workplace and workforce in “Health and productivity management in Europe”, and concludes that they are similar in Europe as in North America. However, he draws the distinction that there is an increased emphasis in Europe on the aging workforce, mental health and psychosocial issues. Substantial evidence is presented to begin to build the business case but the efforts are hindered by the lack of a number of initiatives at the workplaces. The author indicates that the amount of emphasis in Europe lags behind North America in all components of comprehensive and integrative health management intervention programs.

In summary the articles in this issue point out the growing awareness of a need for a serious business and economic strategy of health management programs as influencers on productivity of individuals and organizations and even regions of the world. It is clear that there is still worldwide indecision around the discussion of the processes of defining and measuring health-related productivity within a human-capital model. This is compounded by the lack of agreed upon effective methods to measure the components of absenteeism and presenteeism; however, it is also obvious that the interest and energy around these topics are similar worldwide and growing.

Dee W. EdingtonGuest Editor