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The purpose of this paper is to investigate the impact of changes of medical condition burden index (MCBI) and stress on absenteeism and discuss implications for policy/program design.

Sample: US utility employees that participated in Health Risk Appraisals (HRA) during 2009 and 2010 (n=3,711). Methods: the MCBI was created by summing number of medical conditions. Absenteeism was measured from administrative records. Change in MCBI and stress and impact on absenteeism was assessed according to incremental change, by low/high categorizations, and by using multivariate regression.

Incrementally, greater changes in MCBI or stress generally resulted in corresponding absenteeism change. For both MCBI and stress, high categories were associated with greater absenteeism compared to those in low categories. Those remaining in the low MCBI category decreased absenteeism (−0.10 days/year; p=0.01). Changes from low to high MCBI resulted in increased absenteeism (+0.12 days/year; p=0.04. Changes in stress from low to high or from high to low categories resulted in concurrent changes in absenteeism (+0.21 days/year; p=0.04 and −0.31 days/year; p=0.01, respectively). Regression analyses indicated the interaction between stress and MCBI as a significant contributor to absenteeism change.

Conclusions: MCBI, stress and their interaction appear to be direct determinants of absenteeism. Companies should consider both physical and emotional health simultaneously in program interventions in order to reduce absenteeism.

Unlike most studies illustrating cross-sectional relationships, this study shows how changes in stress and medical conditions relate to changes in absenteeism. The interaction between MCBI and stress in this context is also a novel addition.

The purpose of this study is to determine results of an environmental approach to improving employee health status in a government employer setting.

This is an observational study of one worksite and its employees from 2005 to 2007. Environmental interventions were part of the worksite environment, accessible, and applicable to employees regardless of health status. Outcomes were: change in the worksite environment using the Heart Check assessment, change in employee health risks using health risk appraisals (HRAs) and change in hours of sick time. The eligible population included active employees from 2005 to 2007 (n=2,276).

The Heart Check score increased by 26 percentage points. Despite aging of HRA participants, results showed maintenance of risk status with a non‐significant increase in percent at low risk (51.6 percent to 53.1 percent). Percent at high risk had a non‐significant decrease (21.1 percent to 20.2 percent). The three‐month average for hours of sick time decreased from 12.7 to 11.6 hours (p=0.03) for the larger eligible population.

This paper offers qualitative information for others seeking to implement population‐based health promotion interventions. This particular setting presented challenges related to union and non‐union regulations, sub‐contractors, and multiple administrative levels. Quantitatively, change of health risks and absenteeism serves as a reference to others engaging in workplace health promotion.

The purpose of this paper is to document the total return on investment (ROI) of a comprehensive worksite health program from 1999 to 2007 through two different analytic approaches.

Two analytical techniques were used: time period analysis and historical trend analysis of the entire study period. The time‐period analysis of ROI was performed among employees in four time periods: 1999‐2001; 2002‐2003, 2004‐2005; and 2006‐2007. The historical trend analysis on participation‐related savings was used to compare the financial trend differences between participants and non‐participants as well as the three different participation levels of continuous, sporadic, and non‐participants since the year 2000 among 2,753 employees who worked for and were covered by the company‐sponsored health plans for the entire study period.

The ROI from health care costs and time away from work ranged from 1.29 to 2.07 for the four time periods with a cumulative ROI of 1.66 over nine years. The historical trend analysis of 2,753 long‐term employees resulted in a 1.57 ROI for 2,036 program participants (t‐test: p<0.005) with statistically significant annual saving of $180 per participant per year.

The returns on comprehensive worksite health program were greater than the program investment as documented by both time‐period and historical trend analyses. Organizations seeking ways to manage the increases in health care and absenteeism costs of employees will be encouraged to see that positive returns can be generated by investments in employee health and wellness and steady or consistent participation is one key to generating success.

The goal of this review is to present the literature which provides evidence of the association between health risks and the workplace economic measures of time away from work, reduced productivity at work, health care costs and pharmaceutical costs.

A search of PubMed was conducted which combined the keyword search terms “health risks” with “health costs”, “pharmaceutical costs”, “absenteeism”, “productivity”, “workers compensation”, and “presenteeism”. High quality studies were selected and combined with studies known to the authors.

A strong body of evidence exists which shows that health risks of employees are associated with health care costs and pharmaceutical costs. A growing body of literature also confirms that health risks are associated with the productivity measures of time away from work, workers' compensation, absenteeism and presenteeism. Furthermore, studies have shown that changes in risks are associated with changes in health care costs, time‐away‐from‐work and presenteeism.

The paper shows that measures of success will continue to be important as the field of worksite health management moves forward. Research needs to progress beyond simple associations to the evaluation of changes in costs, trends and transitions over time.

The purpose of this paper is to evaluate a mail‐based educational intervention to improve knowledge of blood pressure and cholesterol values among members of a large insurance population.

As part of the 2004 health risk appraisal (HRA) follow‐up program, 48,429 members of WEA Trust received at least two mailings for the mail‐based blood pressure and cholesterol intervention. These members then completed a follow‐up HRA in 2006. Change in the knowledge and risks of blood pressure and cholesterol values were analyzed among two‐time participants. A survey was also completed six to nine months after the first mailing to study participants' awareness and perception of the program.

The 2004 and 2006 two‐time HRA participants showed a 13.9 percentage point gain (p<0.05) and 12.2 percentage point gain (p<0.05) in people who knew their blood pressure and cholesterol values, respectively, as well as a significant increase in the percent of people taking medication or under medical care for their blood pressure (+2.9 for overall and +11.3 for BP≥140/90 population; p<0.05) or cholesterol conditions (+3.8 for overall and +11.4 for cholesterol≥240 population; p<0.05). Among those who knew their values (BP or cholesterol) in both 2004 and 2006, there was a 3.9 percentage point increase (p<0.05) in the number of people with normal BP (BP<120/80 mmHg) and a 4.8 percentage point increase (p<0.05) in the number of people with normal cholesterol (cholesterol <200 mg/dL) in 2006. The majority (83 percent) of survey respondents found the materials useful for improving health and 22 percent contacted a physician because of the information they received.

This relatively low‐cost and easily implemented educational intervention was successful in increasing knowledge of blood pressure and cholesterol values, taking control of blood pressure and cholesterol risks and in encouraging appropriate follow‐up with a physician.

Knowledge of blood pressure and cholesterol numbers are an important first step in raising awareness of a person's health risks and disease status.

Health is inextricably linked to the productivity and therefore the economic viability of individuals, populations and nations. A global strategy for health enhancement would yield a multitude of benefits for humankind. The root cause of the escalating healthcare cost crisis is driven by a health crisis from a growing burden of health risks that are leading to an expanding burden of chronic illness yielding an unsustainable economic burden. This paper aims to present a general review of the business value of health and the power of prevention in addressing solutions for managing total health and productivity costs.

The paper reviews the scientific and economic business case for investing in health enhancement.

Highlights of employer case studies and published research demonstrate that comprehensive, integrated population health enhancement can lower health risks, reduce the burden of illness, improve productivity and lower total health‐related costs. The dominant components of the solution are a substantial commitment to prevention and a culture of health rather than just more treatment and cure. In addition there needs to be a focus on the quality and effectiveness of care rather than just the quantity and efficiency of the care.

The healthcare cost conundrum can be impacted by reducing the burden of chronic illness and health risk in populations, thereby improving the health and productivity of the workforce, the health of the bottom line for engaged employers and ultimately the health of a nation's economy. Ultimately, the broader value proposition of integrated population health and productivity enhancement should drive this strategy by leveraging the value of health and the power of prevention.

Depression and other mental health disorders have a large impact on the quality of life and productivity of millions of individuals worldwide. For employers, mental health disorders are associated with increased health care costs as well as productivity losses in the form of absenteeism, short‐term disability absences and reduced on‐the‐job productivity‐known as presenteeism. The purpose of this paper is to review the association of worker productivity and mental health.

This review summarizes the literature on the prevalence of mental health conditions among working adults, and the association between these disorders and productivity. Finally, the impact of interventions or workplace policies on the productivity of those suffering with mental health conditions is covered and recommendations for employers are suggested.

Depressive disorders are relatively common in most workforces compared to other mental health conditions. The majority of studies on mental health and productivity have been conducted as part of nationwide surveys or in patient populations rather than worksites. The majority of studies show associations between mental health conditions and absenteeism (particularly short‐term disability absences). When presenteeism is measured by a validated questionnaire, results show that depression significantly impacts on‐the‐job productivity (presenteeism). Studies also indicate that the treatment expenditures for employees with depression may be offset by reductions in absenteeism, disability and on the job productivity losses.

Workplace policies and benefits which support employees suffering with mental health disorders and provide access to evidenced‐based care adhering to best practice guidelines may improve the quality of life of employees and lead to reduced absenteeism, disability and lost productivity.

This article aims to describe the implementation of a health and wellbeing programme at Unilever in the United Kingdom.

The approach taken in the article is a descriptive analysis of the setting up and ongoing progress of the programme.

Finds that a large majority of participants had higher energy levels since joining the programme, probably because they were more physically active, and were better able to cope with the pressures and stressors of being senior executives in a large organization.

The article illustrates how the programme has proved to be of benefit not only to employees but also to the business itself: a true win/win situation.