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Health, Absence, Disability, and Presenteeism Cost Estimates of Certain Physical and Mental Health Conditions Affecting U.S. Employers

Goetzel, Ron Z. PhD; Long, Stacey R. MS; Ozminkowski, Ronald J. PhD; Hawkins, Kevin PhD; Wang, Shaohung PhD; Lynch, Wendy PhD

Journal of Occupational and Environmental Medicine: April 2004 - Volume 46 - Issue 4 - p 398-412
doi: 10.1097/

Evidence about the total cost of health, absence, short-term disability, and productivity losses was synthesized for 10 health conditions. Cost estimates from a large medical/absence database were combined with findings from several published productivity surveys. Ranges of condition prevalence and associated absenteeism and presenteeism (on-the-job-productivity) losses were used to estimate condition-related costs. Based on average impairment and prevalence estimates, the overall economic burden of illness was highest for hypertension ($392 per eligible employee per year), heart disease ($368), depression and other mental illnesses ($348), and arthritis ($327). Presenteeism costs were higher than medical costs in most cases, and represented 18% to 60% of all costs for the 10 conditions. Caution is advised when interpreting any particular source of data, and the need for standardization in future research is noted.

From the Institute for Health and Productivity Studies, Cornell University (Dr Goetzel); The MEDSTAT Group (Dr Goetzel, Ms Long, Dr Ozminkowski, Dr Hawkins, Dr Wang); and Lynch Consulting (Dr Lynch).

Address correspondence to: Ronald J. Ozminkowski, PhD, The MEDSTAT Group, Inc., 777 East Eisenhower Parkway, 804B, Ann Arbor, MI 48108; E-mail address:

©2004The American College of Occupational and Environmental Medicine