This week the wellness debate heated up again with a New York Times article titled “Worksite Wellness Programs Don’t Work Well. Why Some Studies Show Otherwise.” The story challenged the validity of studies promoting cost savings from employer wellness programs.
The controversy is more than an academic debate between true believers and eternal skeptics as wellness has become big business. Worksite wellness represents an $8 billion industry that currently impacts roughly 50 million U.S. workers. The reality is a few programs work better than most, and usually it depends on the methods an employer uses to engage employees.
Arguing the merits of academic studies is useful but often leaves one more confused than ever. Following are five key observations based on our review of the scientific literature and real-world experience.
- Diet and lifestyle choices such as regular physical activity, nutrition, smoking cessation, adequate sleep, managing stress and social support are clearly associated with living a longer, healthier life.
- Evidence-based diet and lifestyle interventions are often the most clinically effective, cost effective, least risky, least invasive options for preventing, treating and even reversing a host of chronic health conditions.
- Financial incentives can increase employee participation but have demonstrated virtually no impact on long term changes in behavior, health status or healthcare costs. In addition, substantial incentives may offer significant employee discrimination and bias risks.
- Traditional worksite wellness programs relying on health risk assessments and annual physician physicals/biometric screenings are inconsistent with clinical practice guidelines and tend to be ineffective in improving health or lowering costs.
- However, interventions that align with clinical practice guidelines and adhere to more strenuous lifestyle medicine evaluation standards are demonstrating themselves to be both clinically and cost effective.
Our bottom line recommendation for employers is to avoid status quo worksite wellness programs that rely upon coercive financial incentives and screenings that may lead to over-diagnosis and over-treatment. Instead focus on building a supportive health culture, such as onsite gyms, cafes, healthy vending and offering voluntary, evidence-based diet and lifestyle interventions.
Bryce Williams is vice president of Lifestyle Medicine for Blue Shield of California. He leads development and implementation of clinically proven lifestyle medicine programs for Blue Shield of California’s members.