Benefits Think

New research says wellness isn’t working. Here’s where it’s wrong

New attention-grabbing research is questioning the value of workplace wellness programs.

A new JAMA article looked at the experience of 33,000 employees at BJ’s Wholesale Club over a year and a half, and found that while those enrolled in wellness programs said they exercised more and watched their weight, they experienced no significant long-term outcomes like lower blood pressure or sugar levels.

The new article adds to the litany of research studies, including the Illinois Workplace Study, that question the value of workplace wellness programs. While it’s essential that leading researchers investigate the best strategies to create a healthier workforce, these studies point toward missed opportunities for analysis.

Instead of directing corporations to the future of employee health, recent research has disappointingly focused on a single — typically anachronistic — program to make sweeping statements on wellness programs more broadly.

JAMA’s study, for instance, noted that the researchers “wanted to explore the causal effects of workplace wellness programs using the rigorous methods of an experimental design in order to help policymakers and employers make informed decisions about investing in wellness.”

But there are two elements in this assertion that would benefit from discussion: The notion that all corporate wellness programs are the same, and whether the impact of corporate wellness should be assessed as a function of a short-term ROI or a long-term investment in employee health.

The JAMA study focuses on a program that is built on eight modules around nutrition, physical activity, stress and related topics with the programs varying from four to eight weeks. The modules range in sophistication, but focus largely on webinars and related educational content, as well as basic tracking and activity logging.

BJWholesale.Bloomberg.4.18.19.jpg
Employees Mark O'Connor, right, and Dan Bucci, move a heavy item for a customer inside a BJ's Wholesale Club in Yorktown Heights, N.Y. Wednesday, may 20, 2009. BJÕs Wholesale Club Inc., the third-largest U.S. wholesale club chain, posted first-quarter earnings excluding some items of 45 cents a share, beating the average analyst estimate by 3.5 percent. Photographer: Craig Ruttle/Bloomberg News
CRAIG RUTTLE/BLOOMBERG NEWS

Although education is a central component of helping individuals make informed health decisions, it’s not a known driver of behavior change. Pairing this with the fragmented nature of the programs, which ran periodically, with relatively small incentives (gift cards from the employer, BJ’s Wholesale, for use at BJ’s with an average incentive value of $25 and a maximal potential incentive of $250) seems inadequate for instilling longer-term healthy behaviors.

Recent years have not only brought about a technological revolution in everything from wearables to digital health, but also have been a renaissance for the field of behavioral economics. With both Daniel Kahneman and Richard Thaler having won the Nobel Memorial Prize in Economic Sciences, the power of understanding often irrational, human behavior has become a central area of inquiry. Their groundbreaking research has provided companies with the opportunity to combine leading science with technology and incentives to develop programs that generate sustained healthy behavior change.

Healthy behavior change should be the central tenet of wellness programs, since short-termism is woefully inadequate for an area as complex as health. To this end, conceptually simply — yet scientifically-robust — interventions have been found to be effective drivers of behavior. For instance, an Apple Watch, when paired with a rich incentive ecosystem, has been found to be associated with sustained improvements in physical activity across a variety of risk profiles in a corporate setting.

However, targeted and smart incentives are all for nothing if one is unable to facilitate a broader culture of health within an organization. Wellness cannot exist within a vacuum.

Research from Stanford University illustrates this point, finding that workplace stressors contribute to 120,000 annual deaths, making it the fifth leading cause of death in the United States. Given that behaviors are often a function of the individual’s environment, understanding how to create healthy (both physical and mental) workplaces is of paramount importance. Holding companies accountable to measure and report on employee health would be another important milestone toward organizational health.

Research into the most impactful health interventions is desperately needed. So we look to leading researchers to investigate the problems faced by employees. After all, the long-term health and well-being of employees and employers alike is at stake.

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