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Clear And Present Danger


By: Paula Allen

Those employees who show up on the job instead of booking off sick are not to be applauded. While they may be at work, they are probably not really functioning, writes Paula Allen, of FGIworld.

Most of us have done it, crawled into work with a pounding headache, a sore back, streaming allergies, or a bad case of the blues. We’re not sick enough to book off work, but we’re certainly not firing on all cylinders. Our employer should be happy right? At least we came in.

But employers should not be happy. They should be very concerned. This scenario is an example of a growing problem in the North American workplace, a problem that is costing the economy billions of dollars. Economists have dubbed it presenteeism and defined the term as referring to those employees who are at work but, because of a medical condition, are not really functioning. In other words, those of us who are working sick.

Presenteeism is not about goofing off at work. It’s about real health problems that may not be severe enough to cause absence or disability leaves, but are chronic enough to affect productivity. These include conditions such as migraines, arthritis, allergies, asthma, depression, and gastrointestinal problems. Many managers and HR professionals merely concentrate on keeping absenteeism and disability leaves to a minimum. This is a mistake.

Many more operate under the assumption that if people are at work, they’re productive. This is an even greater mistake. Losses from presenteeism can be as high as 60 per cent of the total cost of worker illness, exceeding the costs of absenteeism and extended healthcare and disability benefits. For conditions like allergies and headaches, productivity losses account for more than 80 per cent of employers’ total illness costs.

The Cost Of Presenteeism
The exact price is hard to quantify because presenteeism is often hidden and invisible. However, a 2004 study by Medstat and the Cornell University Institute for Health and Productivity Studies estimated the cost of presenteeism on businesses to be approximately $255 per employee per year (see Chart 1).

In a 1999 U.S. study by the Employers Health Coalition, researchers calculated that the costs of lost productivity are 7.5 times greater than costs due to absenteeism.

A subsequent study conducted by Cornell University’s Institute for Health and Productivity Studies reported:

While a good work ethic is an admirable personal trait, being unfocused, distracted, tired, and inefficient is a liability to an organization. If the medical problem is ongoing, then so is the liability.

It doesn’t help that chronic allergies, gastrointestinal problems, depression, and arthritis are relatively benign medical conditions and, therefore, do not garner much sympathy from employers. Lifethreatening diseases, such as cancer, generate the majority of a company’s direct healthrelated costs, but illnesses people take with them to work, even though they incur far lower direct costs, tend to account for a far greater cost to productivity because they are so prevalent and often go untreated.

We can also be our own worst enemies, expecting ourselves to ‘soldier on’ or ‘suck it up.’ That attitude does no one any good. Employees who are not pulling their weight work-wise force other staff members to pick up the slack by assuming a greater work load and working longer hours. Over a period of time, this increased workload will cause morale to drop and increase staff turnover, stress-related illnesses, absenteeism, and disability leaves.

So too will employee presenteeism. Presenteeism does not only affect a handful of employees, it will eventually have a negative impact on the entire company.

So recognizing the problem is one thing, what to do is another.

Tackling Presenteeism
Company decision-makers will do nothing about presenteeism if they don’t consider it to be a problem. Therefore, the first hurdle to overcome is to make senior management aware of the problem and its negative impact on the organization.

Secondly, you can’t tackle presenteeism if you don’t know what health issues are actually causing the problem. Therefore, a formal study is needed to find out what health challenges are facing your particular workforce. Every workforce is different so every workforce will have its own unique health blueprint. For example, if your workforce is predominately female, your workforce will probably have a higher incidence of migraines as women are more likely to suffer from this condition than are men. However, men are more likely to suffer from heart disease. An older workforce is more likely to suffer incidents of arthritis and diabetes than a younger population, but younger workers will experience more stress-related conditions. It’s all about demographics.

Armed with this information, you can take the third step which is educating employees on how they can better manage their illnesses.

Understanding the triggers for migraines and learning what new medications are currently available will help individuals and companies alike. Education programs should focus on what employees can do to improve their quality of life such as dietary changes and stress reduction. Health fairs, brochures, newsletters, web pages, and workshops are great ways to relay information on recent medical breakthroughs and the new generation of medications available. Promoting health and well-being as a corporate objective will encourage people to consider and take action to better manage their symptoms.

The fourth step is to provide sick employees with the necessary support. Having programs available to provide credible information and resources shows an employer is concerned about the health and careers of employees and reinforces the objective of employees taking care of themselves.

Companies might also consider setting up programs to ensure that illnesses and health risks aren’t going unrecognized because employees don’t realize they have a problem.

Improved Employee Health
For example, irritable bowel syndrome, a major culprit in presenteeism rates, is often undiagnosed or misdiagnosed. If employees are unaware that they can benefit from a health support program, then that program is of little value. As such, awareness campaigns and screening programs are invaluable in setting a course toward improved employee health. These can include on-line health risk assessments to help employees understand their own unique risk factors and blood pressure clinics to detect hypertension.

Supporting ailing employees includes making counselling available to tackle depression – a leading cause of presenteeism, absenteeism, and short- and longterm disability. It’s estimated that 1.4 million working Canadians suffer from depression and less than one-third have sought help. A recent U.S. study found that depressed workers averaged 1.8 hours of unproductive time in a regular eight-hour day. And those figures are rising. The World Health Organization predicts that by 2020, depression will be the leading cause of disability worldwide.

Depression is also a common secondary medical condition for people coping with the daily pain of arthritis or other health issues. Providing counselling through an EAP or other program may cost a company money upfront, but will save an enormous amount in lost productivity and benefit costs down the road.

Finally, preventative programs are essential. By 2010 – that’s just five years from now – more than 51 per cent of the workforce will be 40 or older, a 33 per cent increase since 1980. This is the result of the aging Baby Boom generation, that huge demographic bulge that has dominated our society for the past 50 years.

By 2020, the number of workers aged 55 and older will comprise 20 per cent of the labour force, a 13 per cent increase from 2000. As the Boomers increase in age, the number of workers with age-related diseases will rise accordingly.

Younger Generation
The younger generation has health issues of its own. Those under the age of 35 hold the dubious distinction of being the first generation in history to be less healthy than their parents.

For a start, they suffer from higher rates of obesity and can expect high rates of obesity- related diseases, such as type 2 diabetes, as they age. Companies would be wise to initiate nutritional and fitness programs to improve the younger generation’s overall health before the effects of their sedentary lifestyle start to take their toll at the same time the Boomers start feeling the effects of age-related diseases. If presenteeism is a problem now, one shudders to think what the future holds.

Sean Sullivan, of the Institute for Health and Productivity Management, says “better management of employee health can lead to improved productivity, which can create a competitive business advantage.” This is wise advice, but nothing new. More than 200 years ago, Adam Smith wrote in his Wealth of Nations that workers are less likely to work productively “when they are frequently sick than when they are generally in good health … [Sickness] cannot fail to diminish the produce of their industry.”

The bottom line is that by treating employees as an asset to be protected and invested in, companies will see an improvement in both health and productivity because more employees will be fully engaged with the work at hand. That improvement in productivity can mean all the difference in a competitive marketplace – today and over the coming decades.

Paula Allen is the business leader for health and human resource support services with FGIworld.

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