Evidence about the total cost of health, absence, short-term disability, and productivity losses was synthesized for 10 health conditions. Cost estimates from a large medical/absence database were combined with findings from several published productivity surveys. Ranges of condition prevalence and associated absenteeism and presenteeism (on-the-job-productivity) losses were used to estimate condition-related costs. Based on average impairment and prevalence estimates, the overall economic burden of illness was highest for hypertension ($392 per eligible employee per year), heart disease ($368), depression and other mental illnesses ($348), and arthritis ($327). Presenteeism costs were higher than medical costs in most cases, and represented 18% to 60% of all costs for the 10 conditions. Caution is advised when interpreting any particular source of data, and the need for standardization in future research is noted.

We review the state of the art in work site health promotion (WHP), focusing on factors that influence the health and productivity of workers. We begin by defining WHP, then review the literature that addresses the business rationale for it, as well as the objections and barriers that may prevent sufficient investment in WHP. Despite methodological limitations in many available studies, the results in the literature suggest that, when properly designed, WHP can increase employees' health and productivity. We describe the characteristics of effective programs including their ability to assess the need for services, attract participants, use behavioral theory as a foundation, incorporate multiple ways to reach people, and make efforts to measure program impact. Promising practices are noted including senior management support for and participation in these programs. A very important challenge is widespread dissemination of information regarding success factors because only ∼7% of employers use all the program components required for successful interventions. The need for more and better science when evaluating program outcomes is highlighted. Federal initiatives that support cost-benefit or cost-effectiveness analyses are stressed, as is the need to invest in healthy work environments, to complement individual based interventions.

A multi-employer database that links medical, prescription drug, absence, and short term disability data at the patient level was analyzed to uncover the most costly physical and mental health conditions affecting American businesses. A unique methodology was developed involving the creation of patient episodes of care that incorporated employee productivity measures of absence and disability. Data for 374,799 employees from six large employers were analyzed. Absence and disability losses constituted 29% of the total health and productivity related expenditures for physical health conditions, and 47% for all of the mental health conditions examined. The top-10 most costly physical health conditions were: angina pectoris; essential hypertension; diabetes mellitus; mechanical low back pain; acute myocardial infarction; chronic obstructive pulmonary disease; back disorders not specified as low back; trauma to spine and spinal cord; sinusitis; and diseases of the ear, nose and throat or mastoid process. The most costly mental health disorders were: bipolar disorder, chronic maintenance; depression; depressive episode in bipolar disease; neurotic, personality and non-psychotic disorders; alcoholism;, anxiety disorders; schizophrenia, acute phase; bipolar disorders, severe mania; nonspecific neurotic, personality and non-psychotic disorders; and psychoses. Implications for employers and health plans in examining the health and productivity consequences of common health conditions are discussed.

For all chronic conditions studied, the cost associated with performance based work loss or "presenteeism" greatly exceeded the combined costs of absenteeism and medical treatment combined.

Objective-To determine the accuracy of self-reported healthcare utilization and absence reported on health risk assessments (HRAs) against administrative claims and human resource records.Methods-Self-reported values of healthcare utilization and absenteeism were analyzed for concordance to administrative claims values. Percent agreement, Pearson's correlations, and multivariate logistic regression models examined the level of agreement and characteristics of participants with concordance.Results-Self-report and administrative data showed greater concordance for monthly compared to yearly healthcare utilization metrics. Percent agreement ranged from 30 to 99% with annual doctor visits having the lowest percent agreement. Younger people, males, those with higher education, and healthier individuals more accurately reported their healthcare utilization and absenteeism.Correspondence to: Ron Z. Goetzel. Conclusions-Self-reported healthcare utilization and absenteeism may be used as a proxy when medical claims and administrative data are unavailable, particularly for shorter recall periods. NIH Public AccessAuthor Manuscript J Occup Environ Med. Author manuscript; available in PMC 2010 July 1.

Insomnia is associated with a significant economic burden for younger and older patients.

Increased efforts should be directed at disseminating the experiences of promising practices. However, more research is needed in this area, so that additional public and private funding is made available for applied research in "real-life" business settings. Finally, employers should be provided effective tools and resources to support their HPM efforts.

Employers are very concerned about rising mental health care costs. They want to know whether their health care spending is improving the health of workers, and whether there is a productivity payback from providing good mental health care. This article addresses the subject of employee depression and its impact on business. The literature suggests that depressed individuals exert a significant cost burden for employers. Evidence is mounting that worker depression may have its greatest impact on productivity losses, including increased absenteeism and short-term disability, higher turnover, and suboptimal performance at work. Although there is no conclusive evidence yet that physical health care costs decrease when depression is effectively treated, there is growing evidence that productivity improvements occur as a consequence of effective treatment, and those improvements may offset the cost of the treatment.