Making the Business Case for Total Worker Health®
This page provides examples of how Total Worker Health approaches can benefit your workers and your organization. Today’s employers face new and complex challenges in addition to well-known workplace safety and health concerns. Some of the leading physical and mental health conditions contributing to medical costs and lost productivity for U.S. employers are depression, musculoskeletal disorders, and other chronic diseases [CDC 2018]. Chronic diseases and injuries in the workforce cost U.S. employers more than half a trillion dollars in lost productivity each year [IBI 2020]. The economic impact of preventable workplace injuries in 2018 alone was an estimated 170.8 billion dollars [NSC 2020].
Comprehensive efforts to promote worker well-being and reduce worker safety risks can have notable effects on costs, productivity, and performance indicators [Grossmeier et al. 2016; Loeppke 2008]. Approaches that improve workplace policies, programs, and practices can lead to better retention rates and improved productivity. Examples of these approaches are described below.
- Comprehensive programs: L.L. Bean, an outdoor clothing, shoe, and equipment company, reported a positive return on investment from all four years of a comprehensive worker well-being program. Results ranged from $1.70 to $5.30 saved for every dollar invested [Hudson et al. 2019]. Return on investment is a ratio
- Flexible work: A study of workers from different types of employment showed that more time-flexible work policies were associated with multiple positive outcomes. Workers reported an increase in loyalty to their employer and fewer stress symptoms. Policies were also associated with lower costs to employers due to reductions in days late for work or leaving early from work, missed deadlines, and absenteeism [Halpern 2005].
- Paid sick leave: A NIOSH study found that workers with access to paid sick leave were 28% less likely to suffer nonfatal occupational injuries than workers without access to paid sick leave [Asfaw et al. 2012]. Another study found that providing paid sick leave could have saved employers $0.63 to $1.88 billion in reduced influenza-like illness-related absenteeism costs per year [Asfaw et al. 2017].
- Supportive supervision: Workers with supportive supervisors report less pain, more sleep, and have lower risk of cardiovascular disease [O’Donnell et al. 2012; Berkman et al. 2010]. A NIOSH study found that supervisor support might help prevent reduced engagement resulting from job insecurity. Supervisor support increased the odds of engagement of job insecure workers by 13% [Asfaw and Chang, 2019].
- Supporting work-family needs: Workers in an intervention that increased control over work and improved supervisors’ support for work and family reported: better sleep, increase in children’s time sleeping, more time with their children, better mental well-being for caregivers, improved schedule control, reduced cigarette smoking, and lower work-family conflict [Hudson et al. 2019].
Learn more about approaches that can help improve the safety, health, and well-being of your workforce.
- High work stress: Research shows that high stress levels, especially when experienced for prolonged periods of time, can lead to high blood pressure, heart disease, obesity, and diabetes. Workers who report stressors like high job strain (high demands, with low levels of decision-making power) have an increased frequency of heart disease [Theorell et al. 2016]. Work-related stress can also lead to depression, which contributes to absenteeism, presenteeism (workers going to work when they are sick), disability, and unemployment, which lead to higher costs for employers [Schnall et al. 2016].
- Job insecurity: Studies show that downsizing and job insecurity are associated with poor physical and mental health, absences due to sickness, and increased use of disability pensions [Schnall et al. 2016; Howard 2016]. A NIOSH study found that job insecurity decreased the odds of engagement of workers by 37% [Asfaw and Chang 2019]. A NIOSH Science Blog highlights more ways economic security affects worker well-being, including the link between economic factors, like job insecurity, and negative health and psychological outcomes [Pana-Cryan et al. 2020].
- Unpredictable, demanding schedules: Role overload occurs when job demands exceed the time available to complete those tasks which can result in increased anxiety, fatigue, burnout and depression. It can also lead to decreased job and family satisfaction, lower organizational commitment, and higher absenteeism [Duxbury et al. 2008]. Having control over one’s work (how, where, and when people work) is beneficial for work-family balance and worker well-being [Kelly and Moen 2007].
Learn about other issues relevant to advancing worker well-being using Total Worker Health (TWH) approaches.
Measuring the value of integrated approaches can go beyond the traditional measure of return on investment. Studies evaluating TWH approaches and other comprehensive workplace health initiatives have shifted their focus from return on investment to value of investment [Goetzel et al. 2016, Cherniak 2013]. Value of investment looks at outcomes such as workplace program participation rates, higher worker morale, and lower turnover and injury risk [Goetzel 2016].
One Minneapolis-based company, TURCK, measures the success of their comprehensive culture of safety and health through turnover, employee satisfaction, and engagement [Hudson et al. 2019]. Since 2010, turnover rates at TURCK have stayed around 1% to 4%, compared to industry averages of 11% to 13%. When surveyed, 93% of employees strongly agreed with the statement: “I give my best effort every day,” and 91% strongly agreed with the statement: “I put in extra time and effort as needed to do my work effectively.”
Find more real-world examples of how organizations see positive results using comprehensive workplace policies, programs, and practices.
- Asfaw A, Pana-Cryan R, Rosa R . Making the case for paid sick leave. NIOSH Science Blog, https://blogs.cdc.gov/niosh-science-blog/2012/07/30/sick-leave/.
- Asfaw A, Rosa R, Pana-Cryan R . Potential economic benefits of paid sick leave in reducing absenteeism related to the spread of influenza-like illness. J Occup. Environ. Med. 59(9):822-829.
- Asfaw A and Chang C . The association between job insecurity and engagement of employees at work. J Workplace Behav. Health 34(2):96-110.
- Berkman LF, Buxton O, Ertel K, Okechukwu C . Managers’ Practices Related to Work–Family Balance Predict Employee Cardiovascular Risk and Sleep Duration in Extended Care Settings. Journal of Occupational Health Psychology 15(3): 316–329.
- CDC . Workplace health strategies. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, https://www.cdc.gov/workplacehealthpromotion/health-strategies/index.html.
- Cherniak M . Integrated health programs, health outcomes, and return on investment. JOEM 55(12):S38–S45.
- Duxbury L, Lyons, S, and Higgins C (2008). Too much to do, and not enough time: An examination of role overload. In K. Korabik, D. S. Lero, and D. L. Whitehead (Eds.) Handbook of work-family integration (pp. 125-140.) Burlington, MA: Academic Press.
- Goetzel R . The do’s and don’ts of workplace health and wellbeing programs: why building a culture of health is a true differentiator. Virgin Pulse, http://community.virginpulse.com/goetzel-building-a-culture-of-health.
- Goetzel R, Fabius R, Fabius R, Roemer EC, Thornton N, Kelly RK, Pelletier KR . The stock performance of C. Everett Koop Award winners compared with the Standard & Poor’s 500 Index. JOEM 58(1):9–15.
- Grossmeier J, Fabius R, Flynn JP, Noeldner SP, Fabius D, Goetzel RZ, Anderson DR . Linking workplace health promotion best practices and organizational financial performance. ACOEM 58(1):16–23.
- Halpern . How time‐flexible work policies can reduce stress, improve health, and save money. Stress and Health, 21: 157-168. https://doi.org/10.1002/smi.1049external icon.
- Howard J . Nonstandard work arrangements and worker health and safety. Journal article. Am J Indust Med 60(1):1-10, doi: 10.1002/ajim.22669.
- Hudson H, Nigam J, Sauter S, Chosewood CL, Schill A, Howard J . Total Worker Health. In:
Goetzel R, Roemer E, Kent K, and McCleary K, eds. Integration of workplace prevention programs and organizational effectiveness. Washington, DC. American Psychological Association.
- IBI . Cost of poor health infographic. Oakland, CA: Integrated Benefits Institute, https://www.ibiweb.org/resource/cost-of-poor-health-infographic-2019-data/external icon.
- Kelly EL and Moen P . Rethinking the clockwork of work: Why schedule control may pay off at work and at home. Advances in Developing Human Resources, 9, 487-506.
- Loeppke R . The value of health and the power of prevention. International Journal of Workplace Health Management 1(2): 95-108.
- NSC . Work injury costs. National Safety Council, https://injuryfacts.nsc.org/work/costs/work-injury-costsexternal icon.
- O’Donnell EM, Berkman LF, Subramanian SV . Manager support for work/family issues and its impact on employee-reported pain in the extended care setting. J Occup Environ Med 54(9): 1142–1149.
- Pana-Cryan R, Ray T, Bushnell T, and Quay B . Economic security during the COVID-19 pandemic: A healthy work design and well-being perspective. NIOSH Science Blog, https://blogs.cdc.gov/niosh-science-blog/2020/06/22/economic-security-covid-19/.
- Schnall P, Dobson M, Landsbergis P . Globalization, work, and cardiovascular disease. Intl J Health Serv 46(4):1–37.
- Theorell T, Jood K, Jarvholm S, Vingard E, Perk J, Ostergren PO, Hall C . A systematic review of studies in the contributions of the work environment to ischemic heart disease development. Eur J Public Health 26(3):470–477.