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Health and Productivity as a Business Strategy: A Multiemployer Study

Loeppke, Ronald MD, MPH; Taitel, Michael PhD; Haufle, Vince MPH; Parry, Thomas PhD; Kessler, Ronald C. PhD; Jinnett, Kimberly PhD

Journal of Occupational and Environmental Medicine: April 2009 - Volume 51 - Issue 4 - p 411-428
doi: 10.1097/JOM.0b013e3181a39180
Fast Track Article

Objective: To explore methodological refinements in measuring health-related lost productivity and to assess the business implications of a full-cost approach to managing health.

Methods: Health-related lost productivity was measured among 10 employers with a total of 51,648 employee respondents using the Health and Work Performance Questionnaire combined with 1,134,281 medical and pharmacy claims. Regression analyses were used to estimate the associations of health conditions with absenteeism and presenteeism using a range of models.

Results: Health-related productivity costs are significantly greater than medical and pharmacy costs alone (on average 2.3 to 1). Chronic conditions such as depression/anxiety, obesity, arthritis, and back/neck pain are especially important causes of productivity loss. Comorbidities have significant non-additive effects on both absenteeism and presenteeism. Executives/Managers experience as much or more monetized productivity loss from depression and back pain as Laborers/Operators. Testimonials are reported from participating companies on how the study helped shape their corporate health strategies.

Conclusions: A strong link exists between health and productivity. Integrating productivity data with health data can help employers develop effective workplace health human capital investment strategies. More research is needed to understand the impacts of comorbidity and to evaluate the cost effectiveness of health and productivity interventions from an employer perspective.

From the Alere (Dr Loeppke), Brentwood, Tenn; Alere (Dr Taitel, Mr Haufle), Rosemont, Ill; Integrated Benefits Institute (Dr Parry, Dr Jinnett), San Francisco, Calif; and Department of Health Care Policy (Dr Kessler), Harvard Medical School, Boston, Mass.

Address correspondence to: Dr Ron Loeppke, MD, MPH, 5166 Remington Dr. Brentwood, TN 37027; E-mail:

©2009The American College of Occupational and Environmental Medicine