In 2009, Dee Edington wrote “Wellness in this country went down the wrong path when the decision was made to focus solely on individuals in specific programs. This strategy typically results in extremely low participation rates… Low participation coupled with low success at behavior change results in almost no change in company outcomes. The effective focus needs to shift to programs for populations, which translates, when successful, into total population engagement.” As compelling as the research, business case, and information in his book Zero Trends is, unfortunately, not many organizations listened.
Despite that being written more than a decade ago, there’s been very little change. The vast majority of organizations and brokers are still trying to push the latest best-in-class wellness point solution and attempting to create a “culture of wellness” by stacking disparate independent puzzle pieces, despite the overwhelming evidence that they achieve very little at the population level.
Fast forward to today, and we’re still essentially having the same conversation. Richard Safeer’s 2023 book A Cure for the Common Company discusses the way in which traditional point-solution wellness initiatives depend too much on individuals taking responsibility for their own health in isolation and how that is incredibly difficult to do without a more collective and united shift in group behavior or workplace culture. Yes, a different angle, but essentially calling out the same problem as Edington over a decade ago.
A genuine wellness value proposition is still there if you can effectively engage your employee population in positive health behaviors. The American College of Lifestyle Medicine shows how 8 poor health behaviors are the key drivers of 15 chronic conditions which are responsible for 80% of disease burden and cost in this country. Various data indicates that very few American’s (less than 5%) maintain what is considered to be a healthy lifestyle and a study from UNC determined only 12% of American’s are “metabolically healthy”. So, a massive value potential still exists for organizations that can genuinely shift the needle on their population’s health behaviors.
To truly improve employee health and wellbeing to a level that impacts organizational performance, a more integrated approach to promoting health education and positive health behaviors at a population level is more effective than the more common model of stacking isolated point solutions. And because most organizations still haven’t adopted it – doing so still presents an incredible competitive advantage for those who do.
Why the Most Common Workplace Wellness Model is Ineffective
There are quite simple and logical reasons why pieced together wellness programs fail to get, and keep your employees engaged, and thus achieve very little sustainable outcomes:
- Having an array of small and targeted programs available to selectively eligible employees divides and isolates your population as opposed to uniting them towards a common goal and more collective culture of health. Many employees targeted for disease management feel marginalized. When points and incentives are involved participation becomes transactional and finite, neither of which leads to sustainable changes in health behaviors or organizational benefits.
- Having multiple point-solutions requires employees to be proactive in order to engage, and often not just once, but if you actually expect them to participate in all the parts or programs they could benefit from, you’re expecting them to repeatedly engage and re-engage. Most people simply don’t have the time or energy to bother navigating them.
- As a direct result of point 2 above, trying to make employees aware of all the available programs and encourage them to find and participate in the ones that are relevant means there is constant campaigning. Campaign fatigue is a real thing. It’s inefficient for your HR and benefits team and it becomes incredibly annoying to your employees.
- When programs are built by stacking point solutions, they become incredibly disjointed. They are often managed by multiple vendors and participating in different program elements become distinctly independent experiences as opposed to helping provide a clear and progressive pathway for an individual to improve their health. At best, this probably gives employees pieces of information that require individuals to figure out the parts in between, but at worst, they may get conflicting information from different programs.
- Health is complex. Health behaviors and health outcomes are intricately intertwined. It simply doesn’t make sense to try to address individual elements of health in isolated programs. It makes far more sense, and creates a far clearer understanding and pathway to health improvement when people are taught to understand the inter-relations between health behaviors and how they can impact multiple elements of overall health and wellbeing (physical, mental, and emotional health linked with workplace safety and performance).
I fully understand how we got here. Making dramatic changes to the work environment and culture are difficult. It’s easier to add peripheral benefits than to change how your company operates. On paper, it also makes sense: As Richard Safeer explores, we are a society that praises individual achievement, while underappreciating collective effort. We talk about individual choices, individual work ethic and being self-made. Often, we think offering choices and opportunities should be enough to let our go-getters take advantage and advance themselves. So, as long as we’ve offered a compelling and competitive list of health benefits, then the rest it up to our employees, right?
That does fit with our society, but just look at how that approach has failed us. I don’t even need to list health statistics. You already know we’re the sickest, fattest, loneliest and most medicated bunch of people ever to roam. We also know that the average participation rate in workplace healthy lifestyle and health coaching initiatives is (depending on your source) around 12-17% or less of most workforce populations, and even those figures are somewhat inflated as a result of dubious definitions of “engaged”. What’s more, those numbers have remained stagnant for over a decade despite all the fancy apps, new tools, A.I., and fancy latest and greatest marketing of your point solution vendors. Why is that so? Because people simply do not respond to this model as per the 5 simple reasons above.
A Better Way to Improve Employee Health and Wellbeing
What if we go back to the model that Edington spoke about a decade ago? What if we shift away from divided programs and shift towards more simple, more consistent, consolidated programs that are properly integrated into the work environment and that garner more organic collective engagement from our people as a normal part of their workflow?
This is no longer theoretical as Edington posed it in describing the business case for a “Champion Company”. It is happening in other countries, and slowly emerging within forward thinking companies here in America.
In those organizations, ongoing participation in health and lifestyle education and behavior change programming exceeds 80-90% of the total employee population, even without the need for incentives. With that level of captive, progressive education, the rates of positive and sustained health and lifestyle behavior change are significant, and, as lifestyle is a key driver of so much disease burden and cost, these organizations can measure significant reductions in the prevalence of chronic health risks and associated health savings. Sound too good to be true? I invite you review data that accompanies the 2022 Koop National Health Award winner. They maintain in excess of 90% of their total population being touched by the program annually and in excess of 30% of their total employee population achieving measured health risk reductions. That’s more than double the volume or people making cost saving health improvements than average organizations even get participating in healthy lifestyle programs.
Having a significant positive impact on employee health and wellbeing isn’t incredibly complicated. It does require a little hard work and a shift in current thinking. Believe it or not, most people want to be healthy, and in the same way that progressive education helps people learn any skill, consistent and progressive health programming properly integrated into the work environment is also very effective at building the skills for your people to live a healthier, more product, and more fulfilling lifestyle.
We can’t keep doing the same thing we’ve been doing for the past decade. If you really want to get ahead and gain a competitive advantage then you can’t simply keep doing the same thing your competitors are doing.
If you would like to design a better workplace health initiative that is more likely to provide sustainable value for your people and your organization, I encourage you reach out and we can provide insight and case study examples to show how these programs work in the real world, and how they can transform the health of your team.