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Anxiety and Depression Mediate the Relationship Between Perceived Workplace Health Support and Presenteeism

A Cross-sectional Analysis

Laing, Sharon S. PhD; Jones, Salene M.W. PhD

Journal of Occupational and Environmental Medicine: November 2016 - Volume 58 - Issue 11 - p 1144–1149
doi: 10.1097/JOM.0000000000000880

Objective: This study investigates the mediation effect of anxiety and depression on the relationship between perceived health-promoting workplace culture and presenteeism.

Methods: Paper surveys were distributed to 4703 state employees. Variables included symptoms of depression (Patient Health Questionnaire-2 [PHQ-2]); anxiety (General Health Questionnaire-12 [GHQ-12]); perceived workplace support for healthy living and physical activity; and presenteeism (Work Productivity and Activity Impairment Questionnaire). Correlational analyses assessed relationships among culture, mental health, and productivity.

Results: Indirect effects of workplace culture on productivity, mediated by anxiety and depression symptoms were significant (P's = 0.002). Healthy living culture and anxiety were significantly associated (r = −0.110, P < 0.01), and anxiety and presenteeism were significantly associated (r = +0.239, P < 0.01).

Conclusion: Anxiety and depression determine the impact of perceived health promotive workplace culture on employee productivity. The paper highlights importance of health promotive practices targeting employee mental well-being.

Nursing and Healthcare Leadership Programs, University of Washington Tacoma, and Health Promotion Research Center, University of Washington, Seattle (Dr Laing); and Group Health Research Institute, Seattle (Dr Jones), Washington.

Address correspondence to: Sharon S. Laing, PhD, Nursing and Healthcare Leadership Programs, Box 358421, University of Washington Tacoma, Tacoma, WA 98402 (

This research was supported by a contract from State of Washington Health Care Authority. Additional research support was provided by the University of Washington Health Promotion Research Center (HPRC), one of the Centers for Disease Control and Prevention research centers (HPRC cooperative agreement number U48 DP001911–01).

The authors have no relationships/conditions/circumstances that present potential conflict of interest.

Copyright © 2016 by the American College of Occupational and Environmental Medicine