Total Worker Health Program: Economic Factors

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Input: Economic Factors

Workplace and work characteristics and employer and worker behaviors are affected by many economic factors. This results in changes in the risk of worker injury and illness. Currently, several economic factors place greater emphasis on workplace efforts to improve worker health. In addition, some economic factors specifically point toward a new model that integrates protection from work hazards and efforts to promote improvement in personal health behaviors. The following examples and publications illustrate the effects of economic factors on the total health of workers.

Economic factors that affect the overall increase in workplace efforts to improve worker health include the following:

  1. Rising health care costs have resulted in lower wages, have led employers to reduce the health insurance benefits they offer to their workers, and have been difficult to control, putting periodic pressure on employer profits. They have also been the foremost contributor to national budget deficits. As a result, employers have increased efforts to improve worker health, and government has increased its interest in supporting these efforts, partially in order to reduce the burden of Medicare and Medicaid expenses (ACOEM, 2009; CDC, Workplace health promotion web page).
  2. The workplace is increasingly recognized as a setting with unique advantages for promoting healthier behaviors. Employers have the attention of their employees and the capacity to create incentives, provide facilities, and shape workplace culture to support health (Hymel, 2011).
  3. There has been increased recognition of the impact of employee health on productivity, as research continues to build evidence on the high cost of presenteeism (working while ill) and absenteeism (Pauly et al., 2008; Loeppke et al., 2009; Berry, Mirabito, and Braun, 2010). Deficits in work productivity due to ill health may be increasing at the same time that organizational restructuring and technological advances increase the demands on workers. Accelerated changes in communication and information technology has also led to more tightly coordinated, complex processes and have made markets more competitive in ways that intensify work (Maume and Purcell, 2007; Hassard, McCann, and Morris, 2009; Appelbaum et al. 2003). The increasing gap in earnings between those with and without college degrees is often attributed in part to the higher demands of the modern workplace (Autor et al., 2008; Cunha et al., 2011).

Economic factors that specifically point to workplace health improvement efforts that integrate the reduction of work hazards with the promotion of better personal health behaviors, such as healthier eating and exercise habits, include the following:

  1. Some diseases such as chronic obstructive pulmonary disease (COPD) or lung cancer have long been recognized as having the potential of being the product of both work and non-work exposures (Balmes et al., 2003; CDC, Lung Cancer Risk Factors; Seabury, Lakdawalla, and Reville, 2005). In addition, some health conditions that are considered mostly non-occupational in origin, such as depression, hearing loss, and obesity, have been more frequently observed in recent years to increase the risk of occupational injury and illness (Hymel et al., 2011). This suggests that employers, workers, and ultimately society overall, would benefit from integrated workplace programs that address these health conditions along with health promotion and disease management programs in order to reduce work injuries and illnesses and their costs.
  2. Workers may be more likely to change their personal health behaviors in response to a workplace health promotion program, if they believe that their employers are protecting them from workplace hazards, and if workplace exposures to hazards do not seem to reduce the benefits of personal health behavior change (Sorensen, 2004). Thus, health promotion programs have incentives to coordinate with and support occupational safety and health programs.
  3. There is increasing recognition of the impact of work and the work environment on personal health behaviors. For example, work schedules that are long, irregular, or include night hours may increase the tendency to smoke and decrease the tendency to exercise and get adequate sleep (Bushnell et al., 2010). Since occupational health specialists have expertise in protecting workers from risks due to work, health promotion programs have an incentive to draw on these specialists’ expertise and capacity to help shape working conditions, thus improving the effectiveness of health promotion programs.
  4. The prevalence of some chronic health conditions such as obesity and diabetes has been increasing, and are expected to continue to increase as the workforce continues to age. This suggests that employers and the nation will enjoy higher productivity if the workplace can facilitate disease management and safe medication use on the job (Hymel et al., 2011). In some cases, this may require not only health promotion, but the consideration of work characteristics that could be hazardous to those with certain health conditions, and potentially the alteration of tasks, schedules, and facilities.


Appelbaum, E, Bernhardt, A, Murnane, R, eds. Low wage America: How employers are reshaping opportunity in the workplace. 2009. New York. Russell Sage Foundation.

American College of Occupational and Environmental Medicine (ACOEM) Healthy Workforce/ Helathy economy: the role of helath, productivity, and disability management in addressing the nation’s health care crisis. (ACOEM Guidance Statement) 2009. J Occup Environ Med. 51:114-119.

Autor, DH, Katz, LF, Kearney, MS. Trends in wage inequality: Revising the revisionists. 2008. Rev. Econ Stat 90(2):300-323.

Balmes J, Becklake M, Blanc P, Henneberger, P, Kreiss, K, Mapp, C, Milton D, Schwartz, D, Toren, K, Veigi, G. American Thoracic Society Statement: Occupational contribution to the burden of airway disease. 2003. Am J Respir Crit Care Med. 167(5):787-797.

Berry, LL, Mirabito, AM, Baun, WB. What’s the hard return on employee wellness programs? 2010 (December) Harvard Business Review.

Bushnell, PT, Colombi, A, Caruso, CC, Tak, S. Work schedules and health behavior outcomes at a large manufacturer. 2010. Industrial Health. 48:395-405.

Centers for Disease Control and Prevention. Lung Cancer: Risk Factors. Accessed Nov. 21, 2011.

Centers for Disease Control and Prevention. Workplace health promotion. Acessed Nov. 21, 2011.

Cunha, F, Karahan, F, Soares, I. Returns to skills and the college premium. 2011. J Money Credit Banking. 43(Supp. 1):39-86.

Hassard, J, McCann, L, Morris, J. Managing in the modern corporation. 2009. Cambridge Unversity Press.

Hymel, PA, Loeppke, RR, Baase, CM, Burton, WN, Hartenbaum, NP, Hudson, TW, McLellan, RK, Mueller, KL, Roberts, MA, Yarborough, CM, Konicki, DL, Larson, PW. Workplace health protection and promotion: A new pathway for a healthier—and safer—workforce. 2011. J Occup Environ Med. 53(6):695-702.

Loeppke, R, Taitel, M, Haufle, T, Parry, T, Kessler, RC, Jinnett, K. Health and productivity as a business strategy: a multiemployer study. 2009. J Occup Environ Med. 51(4): 411-428.

Loeppke, R, Taitel, M, Richling, D, Parry, T, Kessler, RC, Hymel, P, Konicki, D. Health and productivity as a business strategy. 2007. J Occup Environ Med. 49(7): 712-721.

Maume, D, Purcell, DA. The ‘Over-paced’ American: Recent trends in the intensification of work. In BA Rubin et al., eds. Workplace Temporalities (Research in the sociology of work, Vol. 17) Emerald Group Publishing Limited, pp. 251-283.

Pauly, M, Nicholson, S, Polsky, D, Berger, ML, Sharda, C. Valuing reductions in on-the-job illness: ‘presenteeism’ from the managerial and economic perspective. 2008. Health Econ 17(4):469-485.

Seabury, S, Lakdawalla, D, Reville, R. The economics of integrating injury and illness prevention and health promotion programsexternal icon. 2005. Working paper WR-243=ICJ. Rand Corporation. Accessed Nov. 21, 2011.

Sorensen, G, Barbeau, E, Hunt, MK, Emmons, K. Reducing social disparities in tobacco use: A social-contextual model for reducing tobacco use among blue collar workers. 2004. Am J Public Health. 94(2):230-239.


Page last reviewed: March 28, 2018