Working as an engineer for British Gas involves a great deal of lifting, stretching and crouching in the course of fixing faulty boilers around the UK.
That might sound like an ideal fitness workout, but for many of the company’s employees it can lead to a bad back.
Recognising the problem, the company introduced back care workshops and a range of other measures to help engineers avoid musculoskeletal disorders. The result was a 43 per cent reduction in back-related absences and a return of £31 on every £1 invested in the programme.
Similar initiatives have sprung up across the public and private sectors in recent years, as employers wake up to the cost of poor health in the workplace. More than 130m work days were lost through sickness absence last year in the UK alone, costing an estimated £32bn. Back pain was one of the biggest causes of absence; stress was another.
“People are realising the cost is not just in absenteeism but also lost productivity from employees with health problems who are still coming to work,” says Fiona Adshead, director of public wellbeing and health at Bupa, the UK health insurer. “Health doesn’t happen in a doctor’s surgery; it happens in people’s everyday lives – and the workplace is a big part of that.”
Policy makers are also recognising the importance of employers in helping tackle big public health challenges, from obesity to depression. Non-communicable diseases, such as diabetes, cancer and heart disease, account for three-quarters of all deaths worldwide and the number is growing as populations age.
Meanwhile, industrialisation and urbanisation in the developing world are leading to less healthy diets and lifestyles that will greatly increase the reach of preventable conditions previously concentrated in western countries. Workplaces will be a crucial battleground in the fight against these diseases – and the heavy costs they impose on health systems and economies.
Dr Adshead argues there is even a role for employers to play in controlling the growing burden of Alzheimer’s – a condition that usually arises deep into retirement. “Problems that materialise in older age often have their origins in mid-life when people are working,” she says, pointing to evidence of a range of lifestyle factors that could increase risks of dementia.
Many helpful measures have already been widely adopted by employers, such as making canteen menus healthier and providing gym membership and medical check-ups. First Scotrail, the Scottish train operator, provides physiotherapy, chiropody and massages to its employees and runs awareness programmes on diet, alcohol and smoking. Absenteeism fell from 6.2 per cent to 4.2 per cent after the campaign was launched.
Advocates say workplace health provides a convergence of public and private interests. “The return on the balance sheet by investing in workplace health is, over a five-year period, normally at least double and sometimes triple the amount spent,” said Carol Black, an adviser to the UK government on work and health, at an awareness event this year.
Incentives for investment in workplace health are strongest in the US, where employers bear a large share of healthcare costs through employee insurance schemes. Among US employers offering health benefits, almost all large organisations and nearly three-quarters of smaller ones provide at least one so-called “wellness” programme to staff, according to the Kaiser Family Foundation, a health-focused US non-profit group. Such schemes typically include counselling for those with medical conditions to encourage them to stick to their treatments – as well as advice on lifestyle and diet.
More than a third of large employers provide a financial incentive for staff to participate in health programmes and 8 per cent penalise workers financially – based on screening of risk factors such as weight, blood pressure and cholesterol.
Punitive measures of this kind are less likely to be adopted in Europe, where largely public health systems shield employers from the full cost of ill health. However, there is growing understanding on both sides of the Atlantic and beyond about the case for encouraging a healthy workforce.
There are some positive signs of progress. Days lost through health-related absence in the UK have fallen to an average of 6.6 per employee this year, from 7.6 in 2013, according to the UK Chartered Institute of Personnel and Development (CIPD).
Sceptics believe this could simply reflect an increased tendency to continue working while sick. Frances O’Grady, general secretary of the UK’s Trades Union Congress, says: “The real health threat we face is the culture of presenteeism, where unwell staff are pressed into coming to work by their bosses. This can prolong illness, spread diseases and cause stress.”
While overall absenteeism is down, two-fifths of UK companies report increased stress-related absence and mental health problems, including anxiety and depression, in the latest CIPD survey.
It is not clear to what extent this reflects rising incidence of such conditions or simply a growing readiness on the part of employers and employees to recognise a problem previously swept under the carpet.
Either way, the issue is a serious one for business in a knowledge-based era, when employees’ brains are many companies’ most valuable assets.
About half of long-term absences from work are due to mental issues. Research from the OECD group of developed economies found that mental illness costs the UK about £70bn a year, or 4.5 per cent of gross domestic product.
A group of leading UK employers in April launched a campaign to tackle the problem – including a pledge to help remove the stigma surrounding mental ill health that often deters people from seeking help. Backers included BT, Royal Bank of Scotland and Procter & Gamble.
“Unless prevention is embedded into how businesses manage and nurture people, issues that could be resolved simply can develop into ill health, absence and disengagement,” says Louise Ashton of Business in the Community, a charity focused on the relationship between business and society.
Mary Ann Baynton, of Mindful Employer Canada, which promotes mental health in the workplace, says a good work-life balance is crucial for mind, body and soul.
“Overworked employees are bad for productivity. The more they work, the more their productivity declines,” she says. “The body and mind are one system. When something is wrong in one part, it affects others.”
Yet, doing less work does not always lead to improved health. Many studies have shown that the unemployed suffer more health problems – including mental ones – than those in work and that the longer people stay off work when sick, the less likely they are to return.
Arguably the biggest health priority for employers and policy makers, therefore, should be getting more people into jobs – and using wellness programmes to keep them there.