workplace wellness workplace wellness workplace wellness, also known as corporate wellbeing outside the united states, is a broad term used to describe activities, programs, and/or organizational policies designed to support healthy behavior in the workplace. this often involves health education, medical screenings, weight management programs, and onsite fitness programs or facilities. recent developments in wearable health technology have led to a rise in self-tracking devices as workplace wellness. other common examples of workplace wellness organizational policies include allowing flex-time for exercise, providing onsite kitchen and eating areas, offering healthy food options in vending machines, holding "walk and talk" meetings, and offering financial and other incentives for participation. over time, workplace wellness has expanded from single health promotion interventions to describe a larger project intended to create a healthier working environment. companies most commonly subsidize workplace wellness programs in the hope they will reduce costs on employee health benefits like health insurance in the long run. although the academic debate is still unsettled, existing research has failed to establish a clinically significant difference in health outcomes, prove a return on investment, or demonstrate causal effects of treatments. the largest benefits have been observed in groups that were already attempting to manage health concerns, which indicates a strong possibility of selection bias. additionally, this rationale has been critiqued for conflating productivity with physical and emotional wellbeing and prioritizing profit-centric measures over genuine attempts to create a healthy workplace environment. history wellness programs originated in the early 1900s, as labor unions fought for workers' rights and as employers saw the advantages of having a vital, alert, and rested workforce. a few key manufacturers invested in programs to keep their employees healthy and productive. for example, in 1905 milton hershey started building a leisure park for employees of the hershey chocolate factory, wanting a "more pleasant environment for workers and residents than any typical factory town of the time". we witnessed the implementation of regulated hours, negotiated salaries, and a fresh emphasis on occupational risks during this time. 1950s in the 1950s, as america was recovering from the second world war, employers were faced with an influx of returning veterans, as well as an increase in women entering the workforce. companies started using a more structured approach to their employees' wellbeing, with the introduction of alcoholism-related programs to help reduce workplace accidents and stop alcohol and substance abuse. these initiatives took shape as employee assistance programs (eaps), expanding to include help for mental health issues such as depression and ptsd. larger corporations also experimented with new employee fitness programs, promoting the importance of physical activity as well as leisure time. in the later half of the decade, dr. halbert l. dunn, chief of the national office of vital statistics, introduced the concept of "high-level wellness" to encourage individuals to maximize their potential progress towards better living. his work didn't significantly change workplace wellness yet, but it laid the groundwork for what was to come in the next 20 years. 1970s the 1970s was a time of great cultural turbulence, where marginalized groups fought for equality, technological advancements changed how we work, and the world saw major financial inflation. at work, employers now bore the brunt of financial responsibility for their employees' health care costs. emerging studies also showed the cost of employees’ unhealthy habits—namely, smoking, alcoholism, poor nutrition, and preventable injuries—made the cases even stronger for employer intervention. employers were chiefly concerned with reducing both healthcare claims and workers’ compensation cases. new “workplace health promotion” programs were one way of combating that. in 1971, the u.s. dept. of labor establishes the occupational health and safety administration (osha) to ensure safe and healthful working conditions. researchers also link this expanding interest in employer-sponsored wellness with broader cultural movements towards occupational safety, behavioral changes to improve health, and recreational fitness. 1980s during the 1980s, physical fitness was the main focus in many newer corporate wellness programs. during the week, more people were becoming sedentary and working at desks with personal computers (pcs). working hours slightly increased to around 43 per week, thanks to corporate culture that encouraged long hours as a sign of dedication to the company. culturally, there are huge increases in cycling, jogging, aerobics, health clubs and gyms, and even marathoning. at this time, some larger corporations built on-site fitness centers and started offering aerobic classes during lunch breaks or evenings. for the first time, scholarly journals started legitimizing workplace wellness programs as a means to reduce absenteeism and potentially attract top talent. the biggest development was in smoking cessation. early in the decade, surgeon general c. everett koop wrote a report that compared the addictive properties in nicotine to those found in heroin and cocaine and challenged americans to create a “smoke-free society by 2000.” 1990s–2000s during the 1990s to 2000s, corporate wellness programs were still focusing on risk management and trying to make a dent in ballooning healthcare costs. outcomes-based wellness programs were all the rage, requiring participants to achieve specified health-related goals in order to receive a reward or incentive (for example, lowering your blood pressure or bmi within a certain time frame). many programs tried using punitive measures, increasing healthcare premiums for employees deemed unhealthy. low participation rates and high failure rates made these programs unsuccessful. the reason being that this style of wellness program was exclusive to certain groups, did little to boost morale or encourage positive change, and ignored all the other employees who needed encouragement. furthermore, outcomes-based wellness was complicated by legal issues, ada compliance, and concerns about giving healthy employees preferential treatment. rationale there are numerous reasons to implement workplace wellness programs into the workplace. to begin, many americans spend the majority of their time in the workplace. additionally, the cost of healthcare is continually rising as result of chronic diseases in the us, workplace wellness programs can help abate this cost. workplace wellness programs were once thought to also decrease overall cost of healthcare for participants and employers. unfortunately, workplace wellness programs have been shown not to prevent the major shared health risk factors specifically for cvd and stroke. since preventing these major health risks through workplace wellness can't help decreasing costs for both parties, the implementation of these programs is quite controversial. while the stated goal of workplace wellness programs is to improve employee health, many us employers have turned to them to help alleviate the impact of enormous increases in health insurance premiums experienced over the last decade. some employers have also begun varying the amount paid by their employees for health insurance based on participation in these programs. cost-shifting strategies alone, through high copayments or coinsurance may create barriers to participation in preventive health screenings or lower medication adherence and hypertension. while it was once believed that for every dollar spent on worksite wellness programs, medical costs fell by $3.27, that hypothesis was disproven by a subordinate of the author of the original study. the subordinate was working on behalf of the national bureau of economic research. one of the reasons for the growth of healthcare costs to employers is the rise in obesity-related illnesses brought about by lack of physical activity, another is the effect of an ageing workforce and the associated increase in chronic health conditions driving higher health care utilization. in 2000 the health costs of overweight and obesity in the us were estimated at $117 billion. each year obesity contributes to an estimated 112,000 preventable deaths. an east carolina university study of individuals aged 15 and older without physical limitations found that the average annual direct medical costs were $1,019 for those who are regularly physically active and $1,349 for those who reported being inactive. being overweight increases yearly per person health care costs by $125, while obesity increases costs by $395. a survey of north carolina department of health and human services employees found that approximately 70 cents of every healthcare dollar was spent to treat employees who had one or more chronic conditions, two thirds of which can be attributed to three major lifestyle risk factors: physical inactivity, poor diet, and tobacco use. obese employees spend 77 percent more on medications than non-obese employees and 72 percent of those medical claims are for conditions that are preventable. according to healthy workforce 2010 and beyond, a joint effort of the us partnership for prevention and the us chamber of commerce, organizations need to view employee health in terms of productivity rather than as an exercise in health care cost management. the emerging discipline of health and productivity management (hpm) has shown that health and productivity are "inextricably linked" and that a healthy workforce leads to a healthy bottom line. there is now strong evidence that health status can impair day-to-day work performance (e.g., presenteeism) and have a negative effect on job output and quality. current recommendations for employers are not only to help its unhealthy population become healthy but also to keep its healthy population from becoming sick. employers are encouraged to implement population-based programs including health risk appraisals and health screenings in conjunction with targeted interventions. however, a large and growing body of research shows that workplace wellness has far more deleterious effects on employee health than benefits, and that there are no savings whatsoever. indeed, the most recent winner of the industry's award for the best program admitted to violating clinical guidelines and fabricating outcomes improvement. benefits investing in worksite wellness programs not only aims to improve organizational productivity and presenteeism, but also offers a variety of benefits associated with cost savings and resource availability. a study performed by johnson & johnson (j&j) indicated that wellness programs saved organizations an estimated $250 million on health care costs between 2002 and 2008. workplace wellness interventions performed on high-risk cardiovascular disease employees indicated that at the end of a six-month trial, 57% were reduced to a low-risk status. these individuals received not only cardiac rehabilitation health education but exercise training as well. further, studies performed by the u.s. department of health and human services and j&j have revealed that organizations that incorporated exercise components into their wellness programs not only decreased healthcare costs by 30% but improved lost work days by 80%. thus, investing in preventative health practices has proven to not only be more cost effective in resource spending but in improving employee contributions towards high-cost health claims. researchers from the centers for disease control and prevention studied strategies to prevent cardiovascular disease and found that over a two- to five-year period, companies with comprehensive workplace wellness programs and appropriate health plans in place can yield $3 to $6 for each dollar invested and reduced the likelihood of employee heart attacks and strokes. also, a 2011 report by health fairs direct which analyzed over 50 studies related to corporate and employee wellness, showed that the return on investment (roi) on specific wellness related programs ranged between $1.17 to $6.04. in general, it is estimated that worksite health promotion programs result in a benefit-to-cost ratio of $3.48 in reduced health care costs and $5.82 in lower absenteeism costs per dollar invested, according to the missouri department of health & senior services. additionally, worksite health programs can improve productivity, increase employee satisfaction, demonstrate concern for employees, and improve morale in the workplace. leadership involvement in wellness programs can additionally impact employee health outcomes just as well as the programs themselves. a study performed by david chenoweth indicated the managers who were passionate and committed about their wellness programs increased employee engagement by 60%, even if their wellness goals were not achieved. leaders are not only tasked with creating the organizational culture but also in coaching and motivating employees to be engaged in that culture. however, it turns out that employees generally detest these intrusive programs, and wellness's "net promoter score" of -52 places it last on the list of all industries in user satisfaction. barriers the major barrier to further implementation of these programs is the increasing realization that they fail to produce benefits and may harm employees. savings are so elusive that a $3 million reward is offered for anyone who can find any. in 2018, the national bureau of economic research (nber) found no positive impact. also in 2018, medicare found no savings. further, the nber study concluded that the previous estimates of savings