Deconstructing Studies on Wellness

In case you haven’t noticed by reading my blog, I read – a whole lot. There is a significant amount of attention within the benefits and HR world on the topic of wellness so I end up reading tons of studies, research, and pretty much anything I can get my hands on. A lot of it is pure crap.

Frankly, most media coverage of health issues are pure sensationalism.

There – I said it! Many wellness articles don’t contain enough facts, don’t provide the source or link to the research, and simply don’t provide information to do anything meaningful with the research.

So let’s deconstruct an article…

I came across this article at Occupational Health & Safety Magazine. The heading sounds good – it would be great if there are available studies that show the wellness reduces absenteeism. It would help with all sorts of business cases. I was excited to read the story. And then I actually read it…

Worksite Health Promotion Program Reduces Absenteeism, According to Study

The health program emphasized low-pressure, low-intensity interventions—geared not only to employees’ individual health risks, but also to their readiness to make lifestyle changes.

My comment: This article does not provide any actual information about what was included in the health program. What is a low-press, low-intensity intervention? Is that an email? Was there some activity like drinking more water? There is no concrete information provided. In the magazine’s defense, they might have limits on the number of words in the story.

Workers participating in a “comprehensive” workplace promotion program had a one-fifth reduction in absenteeism during the first year, reports a study in the April Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).

My comment: It would be quite useful to a reader if the study was linked or was actually mentioned by name. In order to find the actual study, you have to get access to the April Journal and then read through to find the study they are referencing here.

Led by Maurice A.J. Niessen of the NDDO Institute for Prevention and Early Diagnostics, Amsterdam, the researchers evaluated a Web-based worksite health promotion project at a large Dutch financial services company. The program used a “computerized knowledge-based reasoning system,” which integrated the best available risk prediction equations with research-proven prevention and early diagnostic steps.

My comment: Here we find out that it was some web-based system and a bunch of fancy words. It sounds to me like to was simply a Health Risk Assessment with some follow up actions.

The program emphasized low-pressure, low-intensity interventions—geared not only to employees’ individual health risks, but also to their readiness to make lifestyle changes. Another key feature was assessment of mental health issues leading to burnout, a major cause of work disability in the Netherlands.

Of about 11,250 employees invited, 3,900 enrolled in the program. After one year, the estimated absenteeism rate was approximately four percent for employees who participated in the program versus five percent for nonparticipants. Thus employees participating in the program had a 20 percent reduction in absenteeism in the first year.

My comment: This is where it gets a little interesting.

  1. If you look at the numbers, the participation rate was 30% – an interesting  data point in wellness programs since they rarely have high participation.
  2. The “estimated” absenteeism rate was 4% for participants and 5% for non-participants. This is interesting because the results are estimated – not any definitive hard measure of absenteeism. Also, the results were only 1% different – it would have been more useful if there was an estimated absenteeism rate for the groups prior to and then after their participation.
  3. The absenteeism rate looks off.  The usual calculation is something like days lost/days worked = absenteeism rate. If you back into the 4 or 5%, assuming a 260 day work year (which is probably high for the Netherlands), you end up with the rough result that employees were absent 10.4 days if they were on the wellness program or 13 days if they were not on the program. What the heck!? What did they include in the absenteeism calculation – probably not just sick days – unless culturally individuals in the Netherlands take significantly more sick days than in the US. The number just seems absurdly high. 

A growing number of companies are interested in workplace health promotion programs, with the goal of reducing health risk factors that lead to illness and lost job productivity. Studies of previous programs haven’t consistently shown reduced rates of absenteeism.

My comment: The author does get points here for mentioning that studies of previous programs haven’t consistently shown reduced rates. It would be interesting to pull together all of the published studies and do an in-depth analysis of the data to make an actual determination of whether or not these programs work and if so, what aspects of them work. (Hint, Hint for any PhDs that need a research topic)

The comprehensive worksite health promotion program evaluated in the new study led to a significant drop in absenteeism rates, the authors said. Niessen and colleagues speculate that the program may have improved employees’ psychological well-being or stress levels—perhaps as a result of making healthy lifestyle changes or getting help with mental health problems.


The moral of the story: don’t take articles about studies at face value.

Always go back to the source and read the information directly from the author. The media does not always pull the correct conclusion from studies.


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