In 1891, Dr. Luther Gulick proposed a red triangle as the YMCA symbol. In his words, the equal sides of the triangle stood for “man’s essential unity–body, mind, and spirit–each being a necessary and eternal part of man, being neither one alone but all three.”
True then, and equally true today, it highlights what’s missing from traditional workplace wellness programs–a holistic focus on individual wellbeing, which includes not only physical health but also the mental, emotional, and spiritual components that constitute the entire human experience.
Many use the terms wellness and wellbeing interchangeably. At first glance, the words do not appear very different. But make no mistake; each word signifies a different concept. And though the two concepts are interrelated, it’s important to understand the difference and how each constitutes a different aspect of employee health within the workplace.
Wellness
Our society and our medical community have generally viewed health through the lens of physical health rather than mental and emotional health and defined good health mostly by the absence of illness or disability.
This explains, in part, why employers and vendors have used the same limitations to shape the types of programs that they have adopted as part of workplace wellness. What was good enough for the medical community understandably could be seen as good enough for the workplace.
“Workplace wellness” is usually linked with the word “health” as in “health and wellness,” and is characterized by programs that focus mostly on employee physical health, seeking to address physical ailments or conditions (obesity; high blood pressure; diabetes; smoking). Examples, which represent the vast majority of such programs, are weight loss, nutrition, exercise, gym membership, biometric testing, and smoking cessation.
The idea behind these efforts was that to the extent employee physical health was improved, medical treatment and thus claims expense would decrease with resulting decreases in the cost of employee healthcare coverage.
On its surface, that was a reasonable assumption in light of how our society pictures health and wellness, and today almost all large American employers have adopted some form of workplace wellness program.
None of that was bad per se. However, by itself, it just didn’t work.
That is confirmed by the 2013 RAND study (Workplace Wellness Programs Study Final Report); a 2013 article reporting a study on JBC Healthcare, and the 2014 RAND/Pepsico study, that showed negative ROIs resulting from workplace wellness programs other than disease management efforts. All of this is pretty much confirmed by experts with Gallup/Sharecare, Limeade, and Virgin Pulse Institute whom I’ve talked to.
Perhaps nothing more emphatically shows that wellness hasn’t worked (and that wellbeing will) than the comments of Michael O’Donnell and Ron Goetzel (long-time proponents of workplace health promotion) who both admit that perhaps as high as 95% of today’s workplace programs either “don’t work” or fail “to have much impact.”
These same proponents, supported strongly by Gallup-Sharecare and others, teach us that wellbeing, and workplace culture and environment of wellbeing, is the necessary foundation.
For example, Ron Goetzel in JOEM Vol. 56, No. 9 (9/2014) Do Workplace Health Promotion (Wellness) Programs Work? acknowledges that most such programs don’t “work” because they are “not structured or designed properly….” He further posits the necessity of a “comprehensive” program built upon a foundation of a “culture of health.”
And the data overwhelmingly confirms that American workers are increasingly unhealthy, disengaged, unproductive, and chronically ill. Moreover, despite employers spending upwards of $8 billion on wellness programs, these investments have not lowered employer healthcare costs, which have continued to rise unabated
Accordingly, the fundamental flaw in today’s workplace wellness is its randomness, lack of strategic approach, and its failure to address the basic needs of employees as a whole, beyond the physical, to the mental, emotional, and spiritual. In other words, today’s programs all but ignore the most critical drivers of or barriers to long-term behavior change leading to healthier lifestyles.
Wellbeing
Wellbeing, on the other hand, embraces more than just physical health. It takes into account the entire person, both body and mind, and not merely by the “absence of illness.” Its approach to “health” includes the presence of positive mental states, emotions, and moods.
In its simplest terms, wellbeing can be described as a state of good health, happiness, fulfillment, and purpose, judging one’s life positively and feeling engaged. Engagement, from a workplace standpoint, is the emotional connection employees have with their work, their teams at work, their employer, and their higher purpose gained from working where they do.
According to the Centers for Disease Control & Prevention, wellbeing centers on judging one’s life positively and feeling good. “Wellbeing integrates mental health (mind) and physical health (body) resulting in more holistic approaches to disease prevention and health promotion.”
Plainly, employees with high levels of wellbeing tend to not just physically healthier, but more productive and engaged at work. CDC notes that higher levels of wellbeing are associated with decreased risk of disease, illness, and injury; better immune functioning; speedier recovery; and increased longevity.
Thus, wellbeing is far more comprehensive than health or wellness, incorporating as it does the entire person rather than disparate parts, as well as a positive feeling of fulfillment, happiness, engagement, and the like. These are extremely important points, missed by much of today’s workplace wellness programs and today’s medical delivery system.
The medical delivery system, even today, fails to adequately integrate mental healthcare with physical healthcare. Likewise, psychologists focus all too much on getting rid of the negative–getting people back to baseline so to speak. Of course, that is valuable work, but it shouldn’t stop there. As pointed out by Shawn Achor in The Happiness Advantage:
“You can eliminate depression without making someone happy. You can cure anxiety without teaching someone optimism. You can return someone to work without improving their job performance. If all you strive for is diminishing the bad, you’ll only attain the average and you’ll miss out entirely on the opportunity to exceed the average.”
And how important is wellbeing? Consider: “The most important dial on any leader’s dashboard for the next 20 years will be well-being,” said Jim Clifton, Gallup chairman and chief executive officer. “The money that well-being improvement means for companies—both for performance and productivity gains as well as healthcare cost reduction—is substantial.”
Approaching employee health in a one-dimensional physical health-only manner that ignores the barriers to good health through healthier lifestyles is doomed to failure. And the primary barriers to behavior changes are usually stress, depression, and even substance abuse.
When one focuses on this point, its validity becomes clear.
There is little that is more debilitating than severe stress or depression. But traditional workplace wellness programs tend to focus on obesity and smoking. Without first addressing the mental/emotional barriers, the likelihood of success with obesity or smoking is almost nil.
The health impacts of weight loss or smoking cessation, while substantial, are much longer term. Accordingly, from an ROI standpoint, focusing on obesity and smoking rather than stress and depression makes little sense.
Employees who are obese or smoke can be quite engaged and productive. And even if an employee loses 30 pounds or gives up smoking, they will not immediately become measurably more engaged or productive at work, nor will they likely see reduced healthcare costs for the following decade or more.
Consider, however, the impact on an employee of a substantial reduction of stress or depression. It is immediate, and it will reap returns to the employer and employee far more quickly (e.g., 3-6 months). The potential for returns on wellbeing, when analyzed in this light, is undeniable.
But for this to happen, employers must adopt specific programs for that purpose. Companies that commit to a culture of wellbeing always make coaches or mentors available and ensure there are avenues for employees to seek help, whether for physical issues or for mental/emotional issues that disable their attempts to achieve wellbeing and improved health and contribute effectively to the organization.
The sorts of programs that might be envisioned for employee wellbeing, in addition to the physical programs cited earlier in this chapter, include stress reduction financial counseling, meditation, yoga, support groups, substance abuse counseling and support, assistance in achieving mental health services, and outreach to families to set goals and achieve them.
Accordingly, from this point forward, employers must stop promoting “workplace wellness” and start promoting “workplace wellbeing,” which is the only practical strategy within employers’ control to address the crises of poor employee health and skyrocketing health coverage costs.
