Coping with Presenteeism

The lights are on, but nobody's home: Are your employees present in body and mind?

Thursday, February 1, 2007
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Employees who think they are doing their employers a favor by showing up for work when they really aren't up to the job need to think twice. That's because they end up costing their company money in lost productivity -- a phenomenon known as presenteeism.

While employers are still concerned about absenteeism, presenteeism is quickly gaining momentum and becoming one of the biggest drains on companies today. But the underlying roots of both problems are the same: stress, poorly managed health care, work burnout and work-life imbalance.

However, companies that take a comprehensive and proactive approach to health care, early intervention and disease management are apt to keep their employees healthy and keep rising health care costs at bay, as well as reduce indirect costs associated with absenteeism and presenteeism.

What is presenteeism?

The Employers of Health Coalition defines presenteeism as the measure of lost productivity cost due to employees actually showing up for work, but not being fully engaged and productive mainly because of personal health and life issue distractions.

Researchers have found that presenteeism is caused by several, often interactive, elements:

* Burnout at work

* Poor physical health

* Poor mental health

* Work distractions

* Life distractions

* Entitlement

As companies are under more pressure to improve productivity to compete in today's global marketplace, employees, too, feel the pressure to work -- or at least to appear to work. By the same token, they may rarely use vacation or sick time for fear of appearing less committed to their jobs.

The result: employees come to work when they aren't feeling well or aren't able to give 100 percent, leading to lost productivity just when companies need to maximize it most. Studies show that this is a growing problem -- figuratively and financially. For example:

* Employees who work at diminished capacity cost their employers an estimated $250 billion each year, according to a 2002 Bureau of National Affairs bulletin.

* Presenteeism accounts for 61 percent of an employee's total lost productivity and medical costs, according to a new Cornell University study published in the 2004 Journal of Occupational and Environmental Medicine.

* Presenteeism costs employers $2,000 per employee each year, according to that Cornell study.

* Researchers at the Cornell Institute for Health and Productivity Studies and the health-information firm Medstat estimate that companies' on-the-job productivity losses from presenteeism are possibly as high as 60 percent of the total cost of worker illness -- exceeding the costs of absenteeism and medical and disability benefits.

Although many costs related to presenteeism are indirect and difficult to attribute, everyone knows that when someone doesn't feel well, they simply aren't as productive and the quality of their work suffers. They may also spread illnesses to co-workers, who in turn either call in sick or come to work sick, thereby affecting even more employees.

Just as it's difficult to attribute hard dollars lost to presenteeism, it may also be hard to identify the problem. While some companies can measure output per employee, for example, others need to rely on more subjective factors. If employees appear unfocused during meetings, continually miss deadlines, spend a lot of time on the phone working out personal problems or generally seem to be in poor health for an unusually long period of time, presenteeism may be to blame.

What causes presenteeism?

"Stress is the No. 1 cause of presenteeism," says Rob Kramer, senior director of business development at Ceridian Employee Effectiveness Services "And stress is both an outcome of many other problems, such as poor health and pressures at work or home, and a cause of other issues, such as recurring headaches and loss of focus at work."

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According to, an employee's productivity may drop for several days following a migraine attack. And, a World Health Organization study found that depressed workers averaged 1.8 hours of unproductive time in a typical eight-hour day. In addition, when other health issues, such as allergies or obesity, aren't managed properly, employees tend to be absent more often and are less productive when they are at work.

What can employers do?

A 2005 CCH survey asked employers what they are doing to reduce presenteeism. Sixty-two percent of responding organizations said they send sick employees home, 41 percent educate employees on the importance of staying home when sick and 36 percent try to foster a culture that discourages employees from coming to work sick.

"Educating employees about absence policies is important, but the key is to proactively help employees manage key drivers of presenteeism," Kramer says. "We want to help companies offer the tools and resources employees need so they can stay mentally and physically healthy and be focused on their work."

Companies should try to both identify and evaluate the root causes of why their employees are missing work or not focusing while at work, and what major health, psychosocial and work-life concerns exist inside their organization.

Solutions to address such issues may include full- and self-service leave administration, health and productivity assessment tools, life enhancement, integrated wellness, psychosocial and work-life balance coaching, return-to-work management, and disability and disease management. 

The ultimate goal is to help companies decrease absenteeism, reduce presenteeism and lower the risk of people developing or poorly managing their health conditions -- key factors in increasing health care costs and lost productivity for companies.

Zachary J. Meyer is the senior vice president of Ceridian Commercial EAP and Work-Life Services in Bloomington, Minn. He can be contacted at

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