A survey of 450 large employers identified “employees’ poor health habits” as the number one challenge named by employers as they try to maintain affordable health benefit coverage (National Business Group on Health and Watson Wyatt, 2009). A majority of large employers responding to this survey offer health risk appraisals (83%) and weight management programs to reduce obesity among employees (74%). Based on survey data, observed growth in vendors and suppliers of corporate wellness programs, and employers’ testimony, a tipping point may have been reached that leading large employers now have, or believe they should have, wellness programs in place, according to the National Business Group on Health.
In striking contrast, relatively few small employers have adopted comprehensive health promotion (or weight management) programs. The most recent National Worksite Health
Promotion Survey results actually suggest a decline in offerings by employers with fewer than 750 employees between 1999 and 2004 (Linnan et. al., 2008).
The survey reports that only 6.9% of this nationally representative sample of employers offers wellness programs. Reported barriers included a lack of employee interest, lack of resources, and lack of management support. Because small businesses (fewer than 500 employees) employ 50% of the private sector workforce, this survey provides an important, albeit sobering, perspective on the typical American worksite.
Although an estimated 100 or more very large employers have substantial wellness programs affecting a few million employees, and some small and midsized employers are following suit, many others have been slow to react.
Once employers, public or private, offer wellness and health promotion programs, it is up to employees to participate and take advantage of these offerings. Disappointing levels of program participation are the Achilles heel of many corporate wellness programs. Even when programs are launched with employee input and leadership support, are well communicated, are subsidized or priced for affordability, and are offered at convenient times and locations, low participation can be a barrier to success.
“Build it and they will come” is not a strategy for success. Instead, companies are adopting incentive programs to attract participation (e.g., in voluntary health assessments) and, increasingly, to reward program completion (e.g., health coaching). Premium incentives for nonsmokers are on the rise in the wake of new evidence showing financial incentives have an impact on smoking cessation and weight loss in a corporate setting. However, survey data indicates almost half of employees say financial incentives will not encourage them to participate in healthy lifestyle programs.