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17 Nov 2021
by Jim Gutierrez and Simon Hodes

How to use an evidence-based approach to support your health and wellbeing strategy

Many of us spend most of our waking time at work, and so there is a huge potential for employers to make positive impacts on the health, happiness, and also productivity, of their employees. By improving employee health, benefits will be felt not only by individuals, but also by their co-workers, their families and society at large.




The impact of employee health on employers is stark: in the UK alone, 131 million working days are lost through sickness absence a year. In 2019/20 in the UK, more than 38 million days were lost due to work-related ill health or injuries, with almost half of those being due to stress, depression or anxiety, and almost a quarter due to musculoskeletal disorders. Long-term conditions are increasing and the pandemic has led to a mental health crisis, with 42% of workers experiencing a decline in their mental health

A health and wellbeing strategy with impact

Improving the health and wellbeing of employees can lead to tangible gains: reduced staff turnover, less sick leave, a more resilient and healthier workforce, and the organisation becoming a more attractive place to work. But how can employers implement a strategy that will have real impact?

At Cleveland Clinic in the US, a ground-breaking employee health programme began over 10 years ago. It has involved introducing onsite fitness centres and wellness spaces, banning smoking and providing smoking cessation support, subsidising fitness trackers and encouraging their use, and chronic disease management and weight loss programmes designed to support employees and their families. The programme incentivises staff via a reduction in their medical insurance premiums if they sign up and participate, and an additional reduction if they achieve their health goals.

The programme has demonstrated what can be achieved, not only through incentives, but through creating a culture of wellness that supports healthy lifestyle choices and taking personal responsibility for health.

An integrated approach to employee health and wellbeing

The key to successful health and wellbeing programmes is that they are not tokenistic or working in a silo; instead, they are wide-ranging, holistic and coordinated. It is important to integrate all employee health programmes, from fitness and occupational health to disease prevention and management.

A health and wellbeing strategy must take in all aspects of a person’s health, including physical, mental and social. It must ensure that barriers to prevention and management are removed, and that access to the tools to improve health and wellbeing are easily accessible, equitable and straightforward.

Key elements of a health and wellbeing strategy

Given that mental health and musculoskeletal problems make up around three-quarters of all work-related ill-health, they are key areas for employers to focus on, with the biggest potential gains.

A recent Deloitte analysis found that investment in mental health by employers has an average return on investment of £5 for every £1 spent. Culture change and raising awareness among all employees can be simple and cost-effective interventions. A more formal mental health strategy could include promoting or mandating mental health first aid training for all staff, providing access to free confidential counselling, encouraging open conversations, and ensuring a healthy work-life balance attitude.

Initiatives that encourage employees to make healthy lifestyle choices is now expected within the workplace. But the evidence shows that this should not be a piecemeal approach; it should be multi-component and cover physical activity, healthy diet, smoking cessation, weight management, long-term health condition management, sleep hygiene and more.

Musculoskeletal problems are likely to have become more common over the past 18 months as employees have worked from home and many have been less active. Simple interventions by employers can be highly effective, such as training in lifting and handling, and avoiding accidents in the workplace. Workstations can be assessed, and staff can be educated in good posture.

The pandemic has also exacerbated chronic conditions such as high blood pressure, diabetes and asthma, with many employees being unable to access routine health checks, and many on waiting lists for hospital care. A health and wellbeing strategy must encompass all of these issues and help employees take action to tackle them.

Demonstrable results

The employee health programme at Cleveland Clinic has seen impressive results, with improvements in weight control, even among those not enrolled on the programme, demonstrating a cultural shift towards wellness. There has been improved management of chronic health conditions, and reductions in sick leave, staff turnover and private medical insurance claims.

Bruce Rogen, chief medical officer of the Cleveland Clinic Employee Health Plan, said: “Wellness programmes that are tied to clinical outcomes, and organisational health and wellbeing strategies, can help employees stay healthy and stay on the job. But it needs to be introduced in a slow, stepwise approach that is integrated across the organisation and encompasses all aspects of health and wellbeing.”

The authors are Jim Gutierrez, chief of quality, safety and patient experience at Cleveland Clinic London, and Simon Hodes, general practitioner at Cleveland Clinic London GP Institute.

This article is provided by Cleveland Clinic.

In partnership with Cleveland Clinic

Cleveland Clinic, now in its centennial year, is a nonprofit multispecialty academic medical center.

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