Do Workplace Wellness Programs Improve Employee Health and Productivity in the Long Run?
- Greg Thorson
- Mar 14
- 5 min read
The research examines whether a workplace wellness program, Healthy-at-Work, improves employee health and productivity in the long run. Using a randomized controlled trial with 7,660 elderly care workers in Denmark and up to 12 years of follow-up data, the study finds that treated employees had fewer primary care visits (6% decrease) and reduced prescription drug purchases (5-7% decrease). However, there were no significant effects on hospitalizations, absenteeism, turnover, or earnings. While short-term benefits were observed, the financial costs outweighed gains. The study also found small spillover effects on spouses’ healthcare utilization, highlighting potential broader social influences of workplace interventions.
Full Citation and Link to Article
Simonsen, Marianne and Lars Skipper. "Healthy at Work? Evidence from a Social Experimental Evaluation of a Firm-Based Wellness Program". AMERICAN ECONOMIC JOURNAL: ECONOMIC POLICY (FORTHCOMING) .
Extended Summary
Central Research Question
The study investigates whether a workplace wellness program, Healthy-at-Work, effectively improves employee health, reduces healthcare utilization, and enhances work-related outcomes. Specifically, it examines whether employer-sponsored interventions—such as health screenings, exercise opportunities, and wellness education—have a lasting impact on healthcare utilization, absenteeism, turnover, and productivity. The study also explores potential spillover effects on employees’ family members, particularly spouses. Given the rising prevalence of chronic diseases linked to workplace sedentary behavior, the research aims to provide rigorous evidence on whether such programs can generate meaningful health and economic benefits for employers and employees.
Previous Literature
Prior research on workplace wellness programs has yielded mixed results. Some studies suggest that wellness initiatives lead to improved self-reported health and healthier behaviors, yet few have demonstrated significant long-term effects on objective health measures or labor market outcomes. Notably, Song and Baicker (2019) analyzed a workplace wellness program at a large U.S. retail company and found increased self-reported health awareness but no measurable improvements in clinical health indicators, healthcare costs, or productivity. Similarly, Jones, Molitor, and Reif (2019) evaluated a university wellness program and found no statistically significant benefits in terms of medical expenditures, absenteeism, or productivity.
The Healthy-at-Work study builds on this literature by offering a large-scale experimental design with an extensive follow-up period of up to 12 years. Unlike previous studies, which focused on short-term effects, this research provides a longer horizon to observe potential lasting impacts of workplace wellness initiatives. It also explores spillover effects within households, a relatively underexamined area in wellness program research.
Data
The study uses a randomized controlled trial (RCT) involving 7,660 healthcare workers in elderly care across 314 work-units in Denmark. The sample consists predominantly of female employees (96%), with an average age of 43 years. The intervention group received access to the Healthy-at-Work program, while the control group continued with business as usual.
Administrative register data from Statistics Denmark allowed the researchers to track healthcare utilization (primary care visits, prescription drug purchases, hospitalizations) and work-related outcomes (absenteeism, turnover, hours worked, earnings) over an extended period. The study also leveraged administrative data to examine potential health spillover effects on employees’ spouses.
Methods
The researchers employed an RCT design, randomizing treatment at the work-unit level rather than the individual level to account for possible spillover effects within workgroups. The intervention included:
Health screenings to identify high-risk employees
Employer-sponsored exercise for up to two hours per week
Wellness education sessions on lifestyle factors like diet, stress, and smoking cessation
Access to free fruit, municipal pools, and health lectures
To estimate the program’s effects, the authors used a difference-in-differences approach, comparing outcomes between treated and control employees over multiple time horizons: short-term (1-2 years post-intervention), medium-term (3-7 years), and long-term (8-12 years).
Findings/Size Effects
Primary Care Visits: The intervention led to a 6% reduction in primary care physician visits in the first year. This effect persisted up to seven years after randomization, with treated employees having 0.4 fewer visits per year on average compared to controls. The reduction was more pronounced for employees classified as high-risk before the intervention. However, the effect faded in the very long run (8-12 years post-intervention).
Prescription Drug Purchases: The program resulted in a significant decrease in prescription drug use. Participants in the treatment group reduced their medication use by 5-7% over 3-7 years, with the largest reductions observed among high-risk employees. This suggests that healthier behaviors initiated during the program may have had lasting effects on medication reliance.
Hospitalizations: No significant reductions in hospitalizations were observed, either in the short or long run. The lack of an effect on severe health outcomes suggests that while the intervention may have improved health behaviors, it did not substantially alter the incidence of major medical events requiring hospitalization.
Absenteeism and Turnover: The program did not significantly impact absenteeism rates or employee turnover. This finding contradicts the common managerial expectation that workplace wellness programs will improve workforce stability and reduce absenteeism. The absence rate remained statistically unchanged between the treatment and control groups over all time horizons.
Labor Market Outcomes: The program had no measurable effect on employees’ working hours, retention with the same employer, or earnings. The lack of an earnings effect suggests that improved health behaviors did not translate into increased productivity or financial gains for employees.
Spillover Effects on Spouses: The study found limited evidence of spillover effects on spouses. While there was a small reduction in primary care consultations among employees' spouses in the first year, this effect did not persist in later years. There were no significant changes in spouses’ prescription drug use or hospitalizations.
Cost-Benefit Analysis: A financial assessment revealed that the costs of implementing Healthy-at-Work far exceeded the economic benefits. The cost per treated employee was approximately €1,100 (DKK 8,500), while savings from reduced healthcare utilization and productivity gains were insufficient to offset these costs. This suggests that while the program had some positive health effects, it was not financially viable from an employer’s perspective.
Conclusion
The Healthy-at-Work study provides valuable insights into the long-term effects of workplace wellness programs. While the program led to sustained reductions in primary care visits and prescription drug use—particularly among high-risk employees—it failed to produce significant improvements in absenteeism, turnover, or earnings. Additionally, no meaningful reductions in hospitalizations were observed.
The findings contribute to a growing body of evidence suggesting that while workplace wellness programs can improve certain health behaviors, their broader impact on labor market outcomes and financial sustainability is limited. The study underscores the need for realistic expectations regarding the effectiveness of workplace wellness initiatives, particularly in terms of cost-effectiveness and employer benefits.
Given the modest benefits and high costs, future workplace wellness programs may need to be more targeted—focusing on employees most likely to benefit rather than offering universal interventions. Additionally, integrating workplace wellness with broader public health initiatives could enhance effectiveness by addressing multiple determinants of employee health.
Overall, Healthy-at-Work highlights the importance of rigorous evaluation in workplace health policy. While well-intentioned, wellness programs may not always deliver the anticipated economic returns, and their implementation should be guided by evidence rather than assumptions about their benefits.
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