Workplace Wellness Programs Don’t Work. Time for a Home Office Reboot?

We humans spent our first 3 million years as hunter-gatherers, and over that long period, we came to expect certain benefits: sunshine, fresh air, fresh food, and above all physical activity. And our biologic selves still require these conditions to thrive. When researchers set out to discover where people were the healthiest and longest-lived, they found that people in these so-called Blue Zones were richly endowed with these basic requirements.

Unfortunately, our contemporary workplaces fail to deliver any of these basic requirements for human wellbeing. These fundamental shortcomings are amplified because we spend so much time at work, more time than any other activity. But modernity has offered other benefits, such as clean water, reliable sanitation, and a scientific understanding of disease and public health, benefits that in concert have provided for longer lives despite the basic physical shortcomings of our modern workplaces. And over the last century this bargain with our fundamentally deficient workplaces was sweetened by employers who provided other sorts of benefits: secure employment, a living wage, health care, medical leave, and upon retirement a pension. And so, on balance this deal was one that workers accepted; not perfect, certainly, but acceptable. Besides, what was the alternative?

In more recent times employers seeking to cut costs have radically scaled back benefits: “lifetime employment” is rare, wages are stagnant, health care is ever more expensive, medical leave is less available, and retirement is now pretty much now the worker’s responsibility. As the employment bargain has become progressively less attractive for workers employers have been faced with the predictable adverse consequences: a less satisfied, less loyal, and less productive work force. Additionally, the costs of employee replacement and training mount as increasingly dissatisfied workers move on.

Recognizing these problems, for the last decade or two employers have sought to add on “workplace wellness” programs, programs that it was hoped would increase workers’ satisfaction and, perhaps more importantly, create a more productive workforce that would incur lower health care costs.

A couple of years ago I went along to a 5 day “Wellness in the Work Place Summit”. This was a large academic conference/tradeshow where those working in the field presented papers discussing the opportunities and successes of workplace wellness interventions; notably absent was any discussion of failures. On the tradeshow side different companies offering a variety of approaches claimed to increase workplace wellness pitched their ideas and companies to very large employers: Boeing, Cysco Systems, Google, all the big players were in attendance. I’m an MD and lifetime academic researcher, and I have seen a good deal of research over my long career, some good and some bad. But I have to say I was appalled by the goings on at this conference. Not only were all the “research” papers presented embarrassingly deficient in both data and analysis, but the solutions being pitched to combat the burgeoning problems of obesity, hypertension, diabetes were mostly aps that reminded workers to do pushups or brush their teeth. Worse yet, there was no statistically legitimate evaluation of the effectiveness of any of these interventions. And yet, astonishingly, large companies were buying these programs for eyewatering sums of money. I came away with the feeling that the buyers had no idea of how to evaluate such programs, but felt they had to offer such programs to employees to remain competitive. There was little interest in actual workplace wellness; only the appearance of workplace wellness seemed to matter.

Recently careful research by unbiased academics has looked into the claims of workplace wellness programs, and the results are as expected: there’s nothing there. A randomized clinical trial conducted by a team of MD/PhD researchers (Song and Baicker) published last year in the prestigious Journal of the American Medical Association concluded: “… there were no significant differences in clinical measures of health, health care spending, or employment outcomes after 18 months”.

If wellness in the workplace programs are a failure, is there anything that can be done? Well, perhaps. Rather than solutions based on the ease and cheapness with which they can be created and deployed (aps!, gamification of steps taken in a day!!), perhaps a careful reexamination of the workplace giving consideration to workers’ basic requirements would be more productive. It’s not obvious how one might introduce more sunshine, fresh air, fresh food, and above all physical activity into the workplace, but we can be sure that if we were to square this circle actual gains in workplace wellness would follow.

It’s deeply ironic that our current corona health crisis may finally provide an opportunity for far healthier workplaces. The sudden requirement for social distancing has required that many of us decamp from our failed workplaces to our homes, allowing for a complete reboot of our workplaces. Many employers (e.g. Google) are facilitating this transition by providing stipends for the home offices of their employees’ futures. Every home office will evolve, and with luck will come to incorporate the basic features that help humans thrive. More light and air are straightforward, of course, but how to inject more activity into an office? Well, in part this can be a matter of new habits (e.g. walking around while on calls, 10-minute yoga breaks between projects, etc.). But activity can also be encouraged by our built environment. For example, simply swapping out a standard passive office chair for an active chair can add a lifetime of greater physical activity at a single stroke.

Active sitting may actually turn out to be the most cost-effective approach to improving employee health possible. Ironic, actually, because when I was discussing active sitting at that “Wellness in the Work Place Summit” conference two years ago there wasn’t much interest from the big players. It seemed that office furniture as a way to improve employee health was just too big a stretch for the corporate ken. But I’m guessing individual workers will prove more imaginative. After all, it’s their health that’s on the line.