Health, Wellbeing and Productivity in the Workplace

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Photo by Creativa/Fotolia


Although downward trends in fatal and non-fatal injuries at work in many industrialised countries reinforce the perception that ‘tough jobs’ are declining, health and wellbeing in the workplace remains an issue thanks to a range of factors, including decreased job security, potentially worsening working conditions and reduced opportunities to combine work with other private and social responsibilities. From 1990 to 2008, the rate of self-reported work-related illness – due to stress and related conditions in particular – doubled, jumping from 820 per 100,000 employed in 1990 to 1,620 in 2008.

The issue of workforce health and wellbeing is perhaps even more critical in the current climate given the perceived lingering effects of the economic crisis on the mental health of the working population. At the same time, there is increased evidence in the UK and other industrialised countries that problems related to modifiable health behaviour are becoming much more prevalent.

According to the Health and Social Care Information Centre (2014) the proportion of adults having a normal body mass index (BMI) decreased between 1993 and 2001 (from 41 to 32 per cent for men and 49.5 to 41 per cent for women), whereas the proportion of adults classified as obese increased from 13 to 24 per cent for men and 16 to 25 per cent for women over the same period. These factors result in costs to the economy and society at large. The economic costs of obesity to the NHS, for instance, rose from £479.3m in 1998 to £42bn in 2007 – an eightfold increase in less than a decade (National Obesity Observatory, 2010).

Improving health and wellbeing can therefore have real societal, economic and personal benefits above and beyond their value to business alone. Clearly, addressing wellbeing more effectively at work – with company programmes promoting health and wellness – may lead overall to increased life satisfaction, reduced healthcare utilisation and, potentially, a lower benefits bill.


The health insurer VitalityHealth commissioned RAND Europe, in collaboration with the University of Cambridge, to conduct an employer and employee survey for the Britain’s Healthiest Company competition. The competition seeks to give employers an assessment of the health of their workforce and of their current health-promotion interventions. To that end, RAND Europe collected a large-scale dataset which we use in this work to understand the relation between a broad set of health and lifestyle risk factors and workplace productivity.

Building on existing quantitative and qualitative evidence, our research team sought to:

  1. Report on the prevalence of modifiable and other health risks among the large-scale study population including smoking, alcohol consumption, physical activity and nutrition, as well as mental health conditions.
  2. Identify determinants of workplace productivity loss due to sickness absence or presenteeism—that is, being at work but not functioning at a normal level due to sickness or medical conditions—with special focus on a set of health risks.
  3. Identify recommendations to help businesses improve the effectiveness of their current health and wellbeing interventions.

Wherever necessary, we make the assumptions, limitations and potential caveats of our analytical approach explicit in our report.


In order to address the research objectives formulated above, our research incorporates three strands:

  1. We review the available literature in order to collect currently available evidence about the relation between various personal health risks, organisational factors and workplace productivity;
  2. We use general descriptive statistics to highlight the prevalence of health risk factors among the employees in companies participating in the 2014 Britain’s Healthiest Company competition;
  3. We use multivariate regression approaches to investigate the determinants of workplace productivity loss. These analytical methods enable us to look at associations between the outcome of interest (productivity loss) and its determinants, such as personal health risk factors, work environment and other organisational characteristics.


Our findings suggest that lack of sleep, financial concerns and giving unpaid care to family members or relatives are negatively associated with productivity. Mental health problems are also found to cause significant productivity loss, especially in the form of presenteeism. In line with existing research we also found that employees with musculoskeletal and other (chronic) health conditions report higher rates of absenteeism and presenteeism than workers without such conditions.

When looking at work-environment factors we find that workers who are subject to workplace bullying report significantly higher levels of absenteeism and presenteeism than those who are not. We also find that more than 45 per cent of those studied reported being subject to unrealistic time pressures, which we find to be another significant cause of productivity presenteeism. Other work-environment factors associated with relatively higher levels of presenteeism included strained relationships at work.


Project Team

Marco Hafner
Christian van Stolk
Catherine Saunders
Joachim Krapels
Ben Baruch