Workplace wellness programs return few benefits, study suggests
The idea that employee programs serve to improve health, reduce spending on benefits may not be accurate
The long-held idea that workplace wellness programs serve to improve employees' health and reduce overall spending on medical benefits may need to be re-examined, according to a new study by U.S. researchers.
A Harvard University and University of Chicago study following almost 33,000 workers at one American retail company found that an employee wellness program designed to help them improve their nutrition, physical activity and stress management had no clinically measurable impact on employee health.
What's more, it didn't save the employer any money in health-care spending.
"The results may lead employers to think a bit more about their investment in a workplace wellness program," said Dr. Zirui Song, a co-author of the study.
Published in the medical journal JAMA, the new research examined the experience of workers at the American warehouse chain, BJ's Wholesale Club, from the beginning of a wellness program to 18 months later.
The results could draw the attention of U.S. employers and anywhere else wellness programs are popular, as some businesses that have invested in such programs as a way to improve workers' health and reduce spending on medical benefits may be seeking proof that the expense is worthwhile.
According to the researchers, little experimental evidence exists on the effects of workplace wellness programs.
How the study worked
Song and his research partner were invited to study the rollout of an employee wellness program at BJ's Wholesale Club early enough in the process to make sure it was designed in a way that allowed for its results to be tracked.
The study involved randomly selecting 20 BJ's Wholesale locations where workers would receive wellness treatment, then comparing those sites to another 140 randomly selected stores without a wellness program.
The wellness programming was delivered by registered dietitians who made weekly visits to store locations. Modules on topics such as nutrition, physical activity and stress reduction involved both individual and team-based activities.
Employees who volunteered to participate in the program received modest incentives for taking part — often in the form of $25 store gift cards.
The chain referred all questions on the study to the researchers.
While workers involved in the program reported making better food choices and getting more exercise, potential benefits from those changes were not confirmed by medical tests taken 18 months into the effort, which evaluated factors such as blood pressure and sugar levels.
In addition, no meaningful savings in health-care costs or reduced absenteeism could be shown after that year-and-a-half period.
It provides a supporting piece of evidence for employers who may be leaning away from a workplace wellness program.- Dr. Zirui Song, Harvard Medical School
Song, a practising physician who has a PhD in health policy, cautions the study is a "window in time" view of a specific program at a specific company. But, he said, "it provides a supporting piece of evidence for employers who may be leaning away from a workplace wellness program."
Michael Rouse, with the Ivey Business School at Western University in London, Ont., thinks companies viewing this study as a possible justification to cut wellness programs are missing the broader picture.
"Everything in this study is positive," he said, "but not statistically significant."
Rouse believes the results would bear out as meaningful over time, based on his analysis of the scientific literature on multiple wellness programs, as well as his own original research.
"The benefits of workplace wellness programs don't actually kick in until about year five. They grow, grow, grow until about year five — and then they grow much more slowly and, at some point, plateau out."
An important difference
While the Harvard study is limited to just one company, it's significant based on its approach. The university, BJ's Wholesale Club and Wellness Workdays, the company that executed the program, agreed it would be implemented as a randomized clinical trial.
Many prior studies on wellness programs have compared participants to non-participants and are more vulnerable to a self-selection bias, where workers who are already engaged in healthy behaviours and physical activity are more inclined to participate, influencing the results.
Monitoring a large, randomly selected control group of workers with a range of health levels and conditions outside of the wellness program helps offset that problem.
According to Song, the partnership made possible a "rigorous study design to assess the effectiveness of a workplace wellness program in a way that could bring us better scientific evidence for the field."
Followup study to come
Song is also currently evaluating the results of a followup study conducted with BJ's Wholesale at the three-year mark of the wellness program. While health indicators didn't change over the first 18 months, he'll now get to see if doubling the length of the program makes a difference.
There are a whole slew of benefits that nobody has put any monetary value to that come along with workplace wellness programs.- Michael Rouse, of the Ivey Business School at Western University
According to Rouse, more than just medical indicators should be evaluated when it comes to research in this area.
"There are a whole slew of benefits that nobody has put any monetary value to that come along with workplace wellness programs," he said.
He sees such programs as a tactic that can enhance creativity and increase employee engagement, which can be part of a broader strategy to invest in and retain workers as a competitive advantage.
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