How can Employers Influence Health for Good?
Employers have a powerful role in supporting health. Thoughtful workplace well-being programs can benefit employees, strengthen teams, and support the business over time.
Employers, I’ll start with you: this post and several follow-ups are for you. Because of your uniquely powerful position, you may be better able to improve health than any other stakeholder.
If people work for you, you have a unique position: although you’re probably not a physician, you can positively influence how they feel. The average American spends almost as much time at work as they do sleeping (31% versus 32%), though sometimes it feels like they're doing both at once. That's a lot of time at work, whether you work outside or inside, with a computer or a power tool, drive to work, or drive for work.
If you have ever supervised anyone, you know intuitively that when one person on a team gets sick, the whole team feels the burden. This impact on team dynamics is just one part of the broader costs of employee health, which can affect not only the individual but also the employer. These costs extend beyond medical spending to include absenteeism and reduced productivity. (Martinez et al., 2025, pp. 645-655) For example, many employees may go to work regardless of how they feel because of financial obligations. (Coronavirus and Work: An Open Thread, 2020) This phenomenon, known as presenteeism, actually costs employers more than absenteeism and disability combined (Stave et al., ACOEM Guideline, 2023). Notably, absenteeism alone has been estimated to cost around $118 billion a year (Wee et al., BMC Public Health, 2019), highlighting the substantial financial impact of unaddressed workplace health issues.
The natural consequence of reduced presenteeism, then, is increased productivity. That is exactly what Stave et al. found in that same 2023 study! Reduced health risks improved productivity, and for workers whose risk went up, productivity reflexively dropped. And from the business side, who doesn't like a more productive workforce? Think about it: if you strengthen your workplace health and safety climate, you don't lose productivity; you improve it. If your employees are less depressed, have less back pain, and are healthier? Your own business will be healthier. (Katz et al., American Journal of Preventive Medicine, 2019). And I suspect your well-being would benefit from this, too!
Now you might be reading this and saying to yourself, “Ah, Doctor Aston! That is some pie-in-the-sky Shangri-La wet-eared naivete! We can't afford that kind of investment; we are a small shop, and we are just making ends meet, or we've got corporate on our backs complaining that we are not producing enough as it is! We can't waste our time with feel-good stuff for our employees!" These concerns about costs and feasibility are valid—particularly for small businesses or organizations operating on tight margins and under significant productivity pressure—because well-being initiatives require both financial investment and infrastructure that aren't always readily available. Skeptics may also argue that well-meaning wellness programs could divert limited resources from core business functions, or that their return on investment is not always immediate, let alone guaranteed. Those criticisms are understandable. However, evidence increasingly suggests that focusing solely on short-term costs can lead to significant long-term missed opportunities. Neglecting employee well-being may raise healthcare expenditures, increase presenteeism, lower morale, and increase employee turnover, all of which carry substantial financial and organizational costs.
Furthermore, well-tailored interventions can help organizations achieve meaningful improvements in productivity and resilience while fostering a culture that supports talent retention. In highly competitive markets, organizations with robust well-being programs also gain a recruiting advantage, as prospective employees increasingly view visible commitment to staff welfare as a key factor. (Employee Wellbeing Strategy: A Practical Guide, 2023)
Well-being initiatives shouldn't be a “nice to have” corporate-branded knick-knack. No! They should be strategic imperatives. They are a must-have foundation for employers (Fisher, American Journal of Health Promotion, 2025; Fortuna et al., PLoS One, 2024) that protects the company and everyone who works there. It is an investment in employee futures. For every dollar you spend investing in a well-implemented health promotion program, you get between $3 and $15 back in the form of about a 28% reduction in sick leave absenteeism, around a 26% lower health care cost, a 30% reduction in workers’ compensation disability claims, improved recruitment, retention, and even corporate image (Carnethon et al., AHA Policy Statement, 2009). Keep in mind that the return on this type of investment usually appears over years, not days, weeks, or even months (Baid et al., American Journal of Preventive Medicine, 2021). This is a long-term investment, like a mutual fund, not a real-estate flip.
Workplace safety programs already in place have improved output and reduced costs: injuries slow production, raise costs, and reduce productivity (Liu et al., BioMed Research International, 2019). This is a bellwether for similarly designed wellness programs and may be considered an extension of safety culture. Well workers work well. And well-cared-for employees care for their employer. They will stick with you through tough times because the company values them and shows continued support. (Xiu et al., 2019, pp. 281-299)
But some caveats apply to this idea of company wellness programs. For starters, individual results may vary. The biggest effects tend to show up at workforce and population levels (Virtanen et al., Lancet Public Health, 2025). Secondly, programs must be tailored to your workforce- generic programs are one size fits no one. They don’t produce measurable results; if you want results, design the program for your employees (Abraham, JAMA, 2019; Pesis-Katz et al., JAMA Internal Medicine, 2021). For example, education-heavy programs are less effective for blue-collar and manual-labor workers; they reach them less and lose them faster, making gaps worse, not better (Damen et al., Health Promotion International, 2023).
Much remains to be done to improve health through better workplaces, and the dividends will benefit everyone involved for years. It is worth the time, effort, and finances not just for the resulting increase in output, but also for the stronger community and goodwill that will result from these efforts. (Song & Baicker, 2019, pp. 1491-1501)
Former military, strength athlete, and physician who rebuilt his own health after struggling with weight through training and residency. Dr. James writes about the real causes of chronic disease and what it actually takes to fix them.
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