September 2019 Issue

Focus on Fitness: Workplace Wellness
By Jennifer Van Pelt, MA
Today’s Dietitian
Vol. 21, No. 9, P. 52

Workplace wellness programs have expanded substantially over the last decade, a time when the 2010 Affordable Care Act incentivized employers to offer such programs. Since then, the workplace wellness industry has more than tripled in revenue size—it’s now worth $8 billion—and covers more than 50 million American employees.1 The American College of Sports Medicine (ACSM) defines workplace wellness as “a range of programs and services provided by employers to improve the health and wellness of workers, integrated with systems to support the evaluation of and reporting on the impact on health, costs, and productivity.” The ACSM has tracked workplace wellness trends for many years. Until 2018, ACSM only considered employee wellness programs to be those delivered onsite at the workplace. In its most recent survey of 2019’s top fitness trends, the ACSM added programs supported by employers that are delivered at local gyms. After dropping out of the top 20 fitness trends for 2018, “worksite health promotion and workplace well-being programs” landed at No. 15 in the ACSM’s top 20 trends for 2019.2

Workplace wellness programs may appear to be a recent development; however, they have their roots in the company towns of the late 1800s, when large companies established employee-only houses, schools, stores, and athletic facilities. Some of these companies implemented daily breaks for exercise and, in the early 1900s, even built gyms and swimming pools for employees. Interest in employee fitness continued in the 1950s and 1960s, expanding beyond exercise to behavioral health; some companies adopted alcohol awareness and cessation programs. In 1970, the establishment of the Occupational Health and Safety Administration further increased attention to employee health, emphasizing safety, productivity, and prevention of work-related illnesses. From the 1980s and 2000s, employers began offering more health programs, including stress management, weight loss and nutrition, and smoking cessation, in addition to exercise.3

Today, workplace wellness programs can range in design from simple motivational tips and incentives to exercise provided by employers to onsite fitness classes to full-size gyms and preventive health services offered at company worksites. Wellness programs don’t necessarily have to include onsite activities or services at the workplace; many employers offer gym membership discounts and other benefits accessible outside the workplace. Regardless of the structure of the wellness program, incentives for employee participation vary and might include discounts on monthly health insurance premiums, cash, health-related prizes (eg, fitness trackers, gift cards for fitness providers), and team prizes to departments. Some companies develop and manage their own programs, while others offer programs managed by health insurance providers or workplace wellness service providers.

Workplace wellness programs increasingly are offered as employee benefits, and substantial offerings, such as onsite fitness facilities and financial incentives, may even be used to attract employees. But do these wellness programs work as intended? Do they improve employee wellness behaviors and health outcomes? Results from published studies are mixed. A few recently published studies include the following:

• A randomized trial published in April 2019 included 20 randomly selected worksites offering wellness programs with 140 randomly selected worksites that didn’t offer wellness programs. Programming offered at study sites focused on nutrition, stress reduction, exercise, and other health issues; RDs implemented the 18-month program at study sites. Data were gathered for 32,974 employees and included outcomes for self-reported health and related behaviors (collected via employee surveys), clinical measures from health screenings, health care spending and utilization, and employment. Significantly greater engagement in regular exercise and active weight management were found in the employees participating in workplace wellness programs. However, no significant differences were found in clinical health, health care spending and utilization, or employment outcomes.4

• A study sponsored by the National Institutes of Health and the National Bureau of Economic Research, published in June 2018, reported the results of the first year of a workplace wellness program at a large Illinois company with more than 12,000 employees. More than 56% of employees participated in the program, and they had lower health care costs and more healthful behaviors than employees who didn’t participate. However, the researchers didn’t find significant differences in overall company medical expenditures, employee productivity, or self-reported employee health status. They also noted that the program attracted those employees with already lower medical costs and more healthful behaviors.1

• A December 2017 study analyzed the use of employee wellness programs and preventive health care services, such as influenza vaccinations and regular blood pressure and diabetes checks, in 17,699 employed adults. Data were collected from the 2015 National Health Interview Survey. Based on the survey data, approximately 46% of employees surveyed had access to employee wellness programs. Those with access to employee wellness programs were significantly more likely to get influenza vaccinations, preventive blood pressure and cholesterol screening, diabetes screening or monitoring checks, and mammograms.5

There are hundreds more published studies on different aspects of workplace wellness. From the aforementioned studies, it appears that employee wellness programs do have some individual benefits, such as increasing regular exercise and certain preventive health screenings, but they may not be as effective at improving overall health outcomes. Due to the many variations of workplace wellness program delivery and the large body of published evidence, firm conclusions about efficacy are challenging.

These few recent studies suggest that employee participation in workplace wellness programs isn’t optimal for reaching all employees, especially those whom these programs might benefit. Encouraging clients to take advantage of employer-offered wellness programs may help with their motivation to exercise, manage weight, improve diet, and other health-related behaviors.

In addition to the traditional fitness and nutrition offerings, workplace wellness programs appear to be evolving to include, and even emphasize, work-life balance and mental health outcomes, as well as web-based wellness. Smaller companies without the space or finances to offer onsite fitness and health services can contract with providers of online, on-demand fitness classes, nutritional counseling, stress reduction, and more. The “workplace” setting is no longer just a physical space, and employee wellness has evolved—and will continue to evolve—to provide wellness benefits wherever and whenever the employee wants.

— Jennifer Van Pelt, MA, is a certified group fitness instructor and health care researcher in the Lancaster, Pennsylvania, area.

References
1. Jones D, Molitor D, Reif J; National Bureau of Economic Research. What do workplace wellness programs do? Evidence from the Illinois Workplace Wellness Study. https://www.nber.org/papers/w24229.pdf. Updated June 2018.

2. Thompson WR. Worldwide survey of fitness trends for 2019. ACSMs Health Fitness J. 2018;22(6):10-17.

3. Khoury A. The evolution of worksite wellness. Corporate Wellness Magazine website. https://www.corporatewellnessmagazine.com/article/the-evolution-of

4. Song Z, Baicker K. Effect of a workplace wellness program on employee health and economic outcomes: a randomized clinical trial. JAMA. 2019;321(15):1491-1501.

5. Isehunwa OO, Carlton EL, Wang Y, et al. Access to employee wellness programs and use of preventive care services among U.S. adults. Am J Prev Med. 2017;53(6):854-865.