The underestimated cost advantage of workplace health management

by Natalia Czulak

The labour market is changing – and with it the demands on employers and employees. This is one of the reasons why workplace health management and workplace health promotion is becoming a big success factor for many companies – so let’s take a closer look at the topic.

Digitisation and globalisation are creating completely new areas of work and job opportunities, which simultaneously brings new challenges. These challenges are just as noticeable at company level as they are at the level of the individual. Complexity, flexibility and a fast-paced life can overstrain employees and lead to psychological and physical stress. 

To counteract this, more and more companies are turning to workplace health management. This means integrating health issues into their mission statement and corporate culture as well as into the processes of a company. Here’s how you can benefit from the promotion of employee health and the ways that corporate health management can help you achieve your goals:

WHM and WHP – knowing the difference

Workplace Health Promotion (WHP) is often mistakenly used as a synonym for workplace health management (WHM). The common definition describes WHM as:

“The development of operational framework conditions, structures and processes, which aim at the health-promoting design of work and organisation, and the enabling of health-promoting behaviour of employees.”

Badura/ Hehlmann, Betriebliche Gesundheitspolitik. Der Weg zur gesunden Organisation, Springer Verlag, 2013
  • Workplace health management focuses on the sustainable and long-term health and performance of employees. In contrast to the WHP, it is about conscious and structured management and holistic integration. 
  • Workplace health promotion is part of WHM and focuses on the behaviour of the employees. This includes, for example, promoting fitness and nutrition. Both WHP and WHM are voluntary for the company – integration is therefore left to the employer.

Strengthening healthy parts – the basic model of WHM 

A widespread concept of WHM is the basic model of salutogenesis by Aaron Antonovsky (Antonovsky, 1997). Salutogenesis starts in health promotion and deals with the factors that keep us healthy. Pathogenesis aims at prevention and focuses on those factors that make us ill. WHM therefore tries not only to react to and improve already occurring problems and diseases, but also to strengthen healthy parts.

3 challenges for employers

Every company combines individual needs and ideas – but most of them face the same challenges. We have summarized 3 of them:

1. Nobody wants to hear it, but employees are getting older, including you.

For some time now, demographics have shown that the overall population is ageing and will continue to do so in the future. In 2018, almost a third of the total German population*¹ was over 50 years old. By 2050, it is estimated that around 40 percent of a company’s employees*² will be between the ages of 50 and 64 years old.

In many cases, these employees are invaluable or even indispensable to the company because of their professional experience and knowledge. However, it  cannot be denied that ageing has an impact on health and mental resilience. Therefore it is all the more important to practice health and sustainability as early as possible.

2. Absence and presenteeism – underestimated costs for the company

“Almost every second employee goes to work sick.”

Deutsches Ärzteblatt | Vol. 106 | Issue 38 | 18. September 2009

Admit it, like many others you have gone to work despite being sick. Often the focus is on reducing absenteeism, which is good. But there is another, quite relevant problem: presenteeism.

Presenteeism: Beeing at work although being sick

Presenteeism*³ is when employees appear at work despite being ill. Their reasons*⁴ range from a fear of losing their job, to a sense of responsibility towards colleagues or the assumption that they are completely indispensable. According to research by the German Federal Statistical Office and Statista Research*⁵, the cost of presenteeism of €2,399 per employee per year – that’s even higher than the cost of days off work which is €1,199 per employee per year. So to be clear:

Low sickness rates in the company do not equal healthy staff.

To stay in the loop, pay attention to whether the error rate is increasing, for example, or whether productivity is deteriorating.

3. The increasing importance of mental health

The amount of people impacted by mental illnesses has increased significantly in recent years. However, people affected in Germany has remained steady*⁶ for some time.  What has changed, however, is the perception and significance of mental health*⁷. In the past mental health problems were a taboo subject, whereas nowadays they are discussed more openly – even in the workplace. 

According to the German Federation of Trade Unions, the Federal Ministry of Labour and Social Affairs and the German Employers’ Associations, the percentage of days of incapacity to work attributable to mental health*⁸ in 2013 was 13%. This figure is rising and should therefore not be underestimated. Research also found that mental illness is the main reason for early retirement. According to the IWD, the number of mental disorders*⁹ in 2017 was already 16.6%.

Depending on gender, age and analysis, mental health problems are one of the two most common reasons for sick leave and leads to the longest absence of employees. The reasons*¹⁰ for this can be many and varied, such as high time pressure, constant work routines or insufficient rest periods. The behaviour of management can have a strong influence on the health and stress factor of the employees*¹¹.

4 reasons to implement WHM in your company

Why should a company invest in WHM when integration is voluntary for the company and also presents challenges? What advantages does it bring? While many companies already integrate certain WHP measures, you can achieve long-term success with sustainable implementation. Here are the 4 most important benefits of WHM implementation for your company:

  1. Employee health: Your employees will become healthier and you’ll prevent physical and mental ailments that have a direct impact on productivity.
  2. Employee retention: With WHM measures you optimize the satisfaction in your company, create a pleasant working atmosphere and keep valuable employees in your teams.
  3. Employer attractiveness: WHM contributes to your employer branding, increases your employer attractiveness and equips you to face the competition.
  4. Cost reduction: By reducing absenteeism and presenteeism and increasing efficiency, you save costs in the long term.

Remember that improvements depend on your priorities and objectives. In general, the criteria are interrelated and therefore one factor carries different levels of progress. 

The impact of WHM on your return on investment

Fear of making a bad investment

Even though the implementation of a WHM has many advantages, many companies are still unsure. The reasons for this range from a lack of resources and knowledge to operational priorities or the fear of excessive implementation costs. Let us illustrate the concrete financial benefits of a well-implemented WHM with a calculation example:

Depending on the company and industry, the costs of a day of incapacity to work range between 300 – 500 euros per employee. On average, the days of illness are well over 10 days per year. Let us assume that your company has 40 employees. If each of these employees is absent due to illness for 10 days per year, the costs for this are about 160,000 euros per year. If good health management can only prevent one day of absence per employee, the costs will already be reduced by 16,000 euros per year. Sounds like a good investment, doesn’t it?

The proven cost advantage

Meta analysis: Return on Investment WHM
iga.Report 28 (2015), Meta-Analysis Chapman (2005), O‘Donnell (2005), HBR (2010)

4 steps to your WHM

Are you ready to introduce WHM to your company? Here’s how to implement a structured and sustainable WHM in your company in 4 steps: 

1. Analysis

Every company has individual needs and a WHM should be based on these. Therefore it is important to analyse prerequisites, requirements and possible problems in advance. You should not forget to take existing health benefits and health promotion measures into account. If this analysis shows that your employees have no needs and are happy and healthy then that’s even better.

2. Planning of the WHM

In order to guarantee the success of a workplace health management system, the strategic and operational objectives are an essential part of the process. Only in this way can success be measured, evaluated and optimised. After evaluating the analysis, you should clearly define what is to be achieved with a WHM and whether you want to introduce a preventive or corrective strategy.

When implementing it for the first time, however, you should not take up too many different areas at the same time so as not to lose the overview. It makes sense to look for suitable external support, as this allows experience to be brought to bear on the process and strategy development.

The goals you define directly influence the choice of WHM measures and depend on your individual needs as well as on the size of your company. Often the focus is primarily on strategic goals such as ROI, growth and cost reduction. A distinction is made between hard and soft criteria*¹². The hard criteria include, for example, increasing productivity, avoiding early retirement or reducing absenteeism. Soft criteria include increasing employee satisfaction and motivation, creating a good working atmosphere and promoting teamwork.

3. Implementation of health measures

No matter how good your objectives and planning, without the cooperation of your employees the WHM will fail and won’t achieve positive results for the company. As already defined above, health should be promoted sustainably and in the long term. A healthy lifestyle should become the norm. In doing so, you are faced with two main challenges*¹³: 

  • Benefits and health programs are mostly used by healthy and sporty employees, while inactive employees continue to show no participation.
  • The New Year’s Eve effect – As with New Year’s resolutions, employees may initially take advantage of the new offers, but after a certain period of time they’ll fall back into old habits.

To meet these challenges, employees should be informed and encouraged. Possible measures could include promoting health risk awareness or educating employees about health benefits. If the employee manages to make a habit of the behaviour, the probability of falling back into old patterns is lower. In this case, frequent repetition of activities over a period of time will help.

The health manager often starts with a kick-off event such as a health day to present the measures and get started. The measures themselves can vary greatly, depending on how your objectives are set. Examples are medical examinations in the company or seminars and consultations on psychological and physical problems. Again, it is important to establish a routine for the employees as a measurable basis for evaluation.

4. Evaluation of the WHM

In the end, processes and results should be continuously evaluated and optimized. It is important to repeat the analyses in order to obtain a meaningful result. It makes sense to use the same work area and the same groups of people in order to incorporate as few deviations as possible due to individual differences.

These analyses can be carried out, for example, through employee surveys, interviews or regular reports on employee health. The approach should be a holistic one to measure both physical and psychological aspects.

Which measures are the right ones for my company?

The measures you can take to improve corporate health are manifold – therefore it is important to be aware of the specific requirements in your company. Many companies already attach importance to healthy nutrition and sports, which is the right approach. Sport has been proven to reduce stress, increase productivity and can be used for team-building events. The right sports benefits will also offer diversity – meaning every employee finds what he or she is looking for. No matter which option you choose, in order to reap long-term benefits, sustainability must be guaranteed. 
Healthy staff is a big investment for your company – so what are you waiting for?


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