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Abstract:
The effects of corporate wellness programs on employee stress, job satisfaction and absenteeism in Singaporean firms are studied. Results show employees in firms with wellness programs have more positive attitudes towards the company and higher job satisfaction. High job satisfaction leads to reduced stress and absenteeism which, in turn, improves employee motivation and productivity.
Introduction
Corporate wellness programmes are long-term organizational activities designed to promote the adoption of organizational practices and personal behaviour conducive to maintaining or improving employee physiological, mental, and social wellbeing (Wolfe and Parker, 1994). In Singapore, there is a growing trend for companies to offer wellness programmes at the workplace (The Straits Times, 1994). Research conducted by the National Productivity Board in 1992 on the Quality of Worklife reported that a majority of the companies in Singapore was concerned with the need to contain rising health costs. In 1991, for example, the Singaporean employer had to spend S$252 in medical costs on each worker, which was an increase of some 6.8 per cent over the previous year (Alsagoff, 1993). However, only a minority of these companies were actually considering the implementation of wellness programmes as a viable alternative to health care cost containment. Of those companies which had chosen to adopt wellness programmes, most of them cited that the main objective in doing so was to increase employee productivity, to improve employees’ welfare benefits and morale, and to enhance the corporate image of the company (Wong, 1993).
Another major concern of organizations today is the increased competition and technological changes. Global and domestic competition have resulted in efforts to make corporations “lean and mean” through cost reduction and downsizing, job elimination, reductions in “non-productive” repair and maintenance, and job speeding and combination. These changes undoubtedly will have negative effects on employee health or wellbeing by increasing the likelihood of overwork, work stress, job dissatisfaction and accidents (Wolfe et al., 1994).
Technological changes not only have resulted in reduced work concentration and efficiency, they have also created several stress-producing factors: work overload, work pressure, and job insecurity. The potential for stress and stress-related effects of technological changes is substantial (Donaldson, 1993), as are their costs to organizations (Manning, Jackson and Fusilier, 1996). This is because workers who feel stressed will not be able to perform to their fullest potential and their health may also be adversely affected thus lowering productivity levels.
Rationale for providing wellness programmes at the worksite include greater access to adults compared to other community programmes, reasonable stability of the target population, presence of organizational structures and management to support the programmes, ability to provide preventive medical services at lower costs, and opportunities to develop and provide more comprehensive, integrated health programmes than those possible through traditional medical care and public healthinstitutions (Opatz, 1994).
Evaluation of the effects of corporate wellness programmes
In 1992, only 9 per cent of organizations in Singapore had implemented corporate wellness programmes and these focused primarily on smoking cessation and exercise and fitness. Although most corporate wellness programmes in Singapore companies are in their infancy stage and no proper health records are available for evaluation, corporate health programmes in the West have a much longer history and have been found in many cases to be related in a beneficial manner to such important opportunity costs as health care costs (Cohen, 1985; Conrad, 1988), employee satisfaction (Schauffler and Rodriguez, 1994), job performance (Wolfe et al., 1994), employee turnover (Shephard, 1992), and absenteeism (Bertera, 1990; Golaszewski and Yen, 1992). Some companies have also enjoyed intangible benefits such as improved employee morale, health and productivity, employee attraction and retention, and improved image for the corporations (Connors, 1992).
The Johnson & Johnson “Live for life” programme is one of the better known large comprehensive wellness programmes. It advocates prevention, encouraging employees to believe in working towards a healthy lifestyle and, at the same time, providing them with knowledge, motivation, opportunities and professional expertise to do so. Preliminary data comparing about 700 employees who participated in the “Live for life” programme with about 700 of those who did not have revealed encouraging results. Table I summarizes these results and demonstrates that both objective and subjective improvements have been achieved (Bellingham and Cohen, 1987).
More recent studies conducted at Johnson & Johnson (Fielding, 1994) also indicated positive opportunity costs, business-unit-wide, of health promotion programmes. These studies found positive wellness programme effects on regular exercise participation, fitness levels, patients’ medical costs, employee satisfaction, smoker quit rates and on an indirect measure of productivity.
Health promotion programmes’ cost-benefit analysis was also found to be encouraging A study of the Travellers’ Insurance Company health promotion programmes reported a decrease in health claims, absenteeism and life insurance costs; an enhancement in productivity; and a return on investment of approximately US$3.40 for every US$1.00 spent (Golaszewski and Yen, 1992). Another cost-benefit study reported in the literature attributed decreased health care costs to Blue Cross and Blue Shield of Indiana’s health promotion programmes, which resulted in a return of US$2.51 for every US$1.00 of programme costs (Elias and Murphy, 1986).
According to Quick (1987), US organizations continue to lead most European and Asian organizations in employee health promotion. This, too, is the case for Singapore where the level of awareness or concern for corporate health promotion is low (Ministry of Health, Singapore, 1993). This is surprising in view of the high economic absenteeism rate arising from illness (averaging seven days of medical leave per worker in 1991) and the high corporate medical expenses (averaging $316 of medical cost per worker and annual corporate health care cost of approximately $416 million) (Malik, 1993).
Wellness programmes and stress, job satisfaction and absenteeism
Wellness programmes and stress
Stress in organizations is a growing concern among management practitioners because of its dysfunctional effects on organizational effectiveness. According to the 1993 World Labour Report from the International Labour Organization, stress has become one of the most serious health issues of the twentieth century. In the USA, job stress has been estimated to cost industries around US$200 billion annually, and in the United Kingdom, stress is thought to cost up to 10 per cent of the gross national product (Tang and Harumontree, 1992).
There is research evidence that consistently links occupational stress with certain physical health symptoms and diseases. Heart disease, ulcers, some form of cancer, allergies, migraine, back problems, depression and an increased frequency of minor ailments such as colds and flu have been associated with stress (Sethi and Schuler, 1990).
At present, there is a growing body of experimental and clinical research supporting the notion that physical fitness can lead to significant reductions in job stress. Regular, rigorous physical activity has been shown to reduce muscle tension, anxiety, blood pressure, heart rate and incidence of heart attacks – all stress-related symptoms. Research indicated that exercise can protect individuals by enhancing the state of resistance to any stimulus, so that the individual is less susceptible to the effects of stress (Tarkan, 1991). Experts also agreed that de-stressing activities such as fitness classes and educational seminars were most effective (Mobley, 1982).
Wellness programmes and job satisfaction
Job satisfaction has become a major concern in the workplace. Previous studies indicated that job satisfaction affects the wellbeing of employees and exerts a considerable impact on the organization. Interest in job satisfaction is particularly strong because of its consequences for the organization, such as absenteeism and turnover (Cherrington, 1989) and for the employee, such as mental and physical health (O’Donnell and Ainsworth, 1984). Thus, it can be suggested that a highly satisfied workforce will be beneficial for organizations.
Research has shown that employees with improved morale are likely to be more productive as a result of an increased sense of responsibility to the employer and an improved overall job satisfaction (Shinew and Crossley, 1988). The question, then, is whether having access to corporate wellness programmes would be able to boost employees’ morale sufficiently to result in higher job satisfaction?
Companies such as General Electric and Johnson & Johnson have been able to provide affirmation to this question. In 1987, for example, General Electric Company in Cincinnati, Ohio, USA served as host for a study to compare the benefits of employees’ recreation participation with those of employees’ fitness participation. A total of 900 employees were selected randomly from the computerized personnel file to compare absenteeism and overall job satisfaction among various employees. Results indicated that employees participating at any level showed less absenteeism and higher job satisfaction than employees who did not participate at all (Baun et al., 1986).
Wellness programmes and absenteeism
Absenteeism refers to the number of “sick hours” or “sick days” an employee uses during a calendar year (Leong, 1993). It is an important measure for monitoring the effectiveness of wellness programmes because of the bottom line cost savings that may be obtained. The economic impact of employee absenteeism derives mainly from the costs of decreased productivity because of absence from work, less experienced replacements and the additional expense of hiring substitute labour. In 1991, each worker took, on average, seven days of medical leave, resulting in 10.4 million man-days lost. Studies indicate that absenteeism in the workplace can be reduced by as much as 42 per cent through wellness programmes (Gebhardt and Crump, 1990). Recent research using control groups has found relations between reduction in health care costs, absenteeism, and turnover and implementation of comprehensive health promotion programmes (Klein, 1986).
It has been estimated that poor health and injury account for nearly 60 per cent of all lost hours from work (Conrad, 1987). Within this broad category of illness, the primary causes of absenteeism appear to be social psychological ones, which include work stress. Hence, strategies oriented towards improving employee physical and emotional wellbeing have the potential for impacting a major source of employee absence.
Much pre-experimental type literature supports the contention that improved employee fitness through wellness programmes results in reduced absenteeism. At Blue Cross/Blue Shield of Ohio, USA, for example, research showed that as frequency of vigorous exercise increased, short-term absenteeism because of illness decreased significantly. This translated to approximately one less day of absenteeism a year for each regular exerciser compared to non-exercisers (Lynch et al. 1990). A negative correlation between members’ participation rates and the frequency of absence from work was also documented at The Travellers’ Insurance (Shillingford and Mackin, 1991).
The aim of this study, therefore, is to determine the impact of corporate wellness programmes in Singapore organizations on employee outcomes such as job satisfaction, work stress and absenteeism. Additionally, the three employee outcomes would also be tested to determine the degree to which they influence one another [ILLUSTRATION FOR FIGURE 1 OMITTED].
Method
The sample
The Singapore organizations selected for this study were based on the proximity in staff size, targeting only white-collar employees. Of the 20 companies approached, six (30 per cent) organizations agreed to participate in the study. Reasons given by the 14 organizations who were unwilling to participate in the study included the fear of interruption to the work flow and confidentiality of the information required.
Of the six organizations involved in the study, three have corporate wellness programmes and the other three do not. The health administrators of Singapore Press Holdings Limited, Great Eastern Life Assurance and Hewlett Packard were interviewed regarding their companies’ wellness programmes. Each interview lasted from between half-an-hour to an hour. The descriptions of each of the companies are summarized below.
Singapore Press Holdings. Singapore Press Holdings is a locally-based newspaper publisher. It has a staff strength of approximately 1,800 employees over three centres. The wellness programme was launched in January 1994 with an objective of developing a corporate culture which provides a supportive environment for programmes and activities designed to help employees improve their health and productivity. The eight-week programme includes exercise sessions and workshops on managing stress and healthy eating. It begins with a pre-programme health screening and exercise test. Three months after the programme, follow-up sessions are conducted on health screening, exercise testing and feedback to assess participants’ progress and effectiveness of the programme.
Great Eastern Life Assurance. Great Eastern is an insurance company with approximately 550 employees stationed either at the head office or subbranches. The company’s wellness programme was launched in mid-1992. It aims to develop an awareness of a healthy lifestyle in employees and to encourage healthy living among its workforce through the implementation of the programme. The programme includes activities such as conducting seminars on topics like health, balanced diet and healthy lifestyles. Other activities include aerobic classes. The initial programme started with health screening which was eliminated at a later stage. Evaluation is carried out only prior to the participation to determine the health status of participants.
Hewlett Packard. Hewlett Packard (HP) is an American-based multinational corporation dealing with the manufacturing of computer products and related services. HP has approximately 4,000 employees who work in four core functions, namely manufacturing, marketing, sales and distribution. The wellness programme in HP, better known as the “Best of life” programme, was established in 1989. The purpose of HP’s wellness programme is to encourage employees to be more health conscious. It aims to improve the health and wellbeing of HP’s employees and to contain health care, accident and absenteeism costs. HP has a recreation club offering facilities such as a swimming pool, multi-purpose hall, gymnasium, aerobic area, squash courts and a cafeteria. In addition, there is a company-wide health screening programme carried out at the clubhouse to encourage employees to determine their own health profile. Programmes are then tailored especially for employees to address health concerns with the objective of improving their quality of life. Regular “lunch and learn” seminars on health-related subjects are also presented by members of the wellness team. To further support the programme, the cafeteria offers a variety of foods and provides information aimed at improving nutrition. There is also a wellness resource library in every HP site to provide employees with a convenient access to materials related to health improvement.
The three organizations which did not have existing wellness programmes are:
(1) Honeywell Pte Ltd, a locally registered company dealing mainly with the manufacturing of component parts, such as micro switches, fire alarms, etc… Honeywell has over 400 employees who work in four core functions, namely manufacturing, sales, finance, and personnel and administration.
(2) Yeo Hiap Seng, which started off as a family business based in Fujian, China. Today, it has become a multinational corporation which manufactures food and beverages. It has approximately 1,500 employees who work in four core functions, namely manufacturing, sales and marketing, finance and human resource.
(3) Housing and Development Board is a local statutory board, with a staff strength of approximately 4,000 employees who work either in the head office or the sub-branches. This organization deals mainly with the construction of public housing.
Sample characteristics
The sample is made up of 188 employees from six organizations. Table II shows the number of respondents (N) from each organization.
The personal data examined included gender and age. For the purpose of analysis, the sample is divided into those companies with and those without wellness programmes. It was found that, for both groups, there are more female than male respondents. For companies with wellness programmes, 66 per cent of respondents are females and for companies without wellness programmes, 52 per cent of respondents are females. For both groups, a majority of respondents are between the ages of 25 to 34.
Measures
The questionnaire method was employed as this enables the researcher to reach out to a large sample in the most efficient manner. However, because of organizations’ concern with the interruption of work, the questionnaire had to be as concise as possible. This being the case, a brief but concise questionnaire was developed for data collection. Most existing questionnaires were unacceptable to the participating organizations because of their length and the time involved in completing them.
Table II. Sample size: companies with and without wellness programme
With programme N
Singapore Press Holdings 35
Hewlett Packard 30
Great Eastern Life 30
Total 95
Without programme N
Honeywell Pte Ltd 32
Yeo Hiap Seng 31
Housing and Development Board 30
Total 93
The questionnaire contained 11 questions, divided into three sections, namely employee satisfaction, stress and absenteeism. Interval scales were employed to measure the level of employee satisfaction and stress in the organization. The respondent was also required to state the number of days he or she was absent from work, because of illness, in the past 12 months. Interval scales were not employed here as a relatively high degree of variance in absenteeism rates of the organizations was expected. Nominal scales were utilized to tap the demographic information of the respondents.
Results
Correlations
The Pearson correlation was employed to determine the degree of linear relationship between the three employee outcome variables: employee stress, job satisfaction and absenteeism (N = 188) (see Table III).
Table III indicates that there is a significant relationship between the three variables. Specifically, stress and job satisfaction are negatively correlated, thus indicating that the higher the stress level, the lower the job satisfaction. The correlational results also indicate that stress and absenteeism are positively correlated, and job satisfaction is negatively correlated with absenteeism.
Table III. Correlational table
Stress Satisfaction Absenteeism
Stress –
Satisfaction -0.251(***) –
Absenteeism 0.286(***) -0.188(**) –
Notes: ** p [less than] 0.01; *** p [less than] 0.001
Comparison of organizations with and without wellness programmes: significant differences
Three significant differences were found between organizations with and without wellness programmes. Specifically, results of t-tests indicate that employees in organizations with wellness programmes expressed:
(1) more positive attitude towards organizations (see Tables IV and V);
(2) higher overall job satisfaction (see Tables VI and VII); and
(3) higher level of satisfaction with organizations’ fringe benefits (see Table VIII and IX).
Finding 1. Employees in organizations with wellness programmes reported more positive attitudes towards their organizations. The results of a t-test for independent samples are shown in Tables IV and V.
Table VI. T-test: employees’ report of job satisfaction
Overall job satisfaction
Variable Number of cases Mean SD SE of Mean
With programme 95 3.7474 0.684 0.070
Without programme 93 3.3011 0.818 0.085
Notes:
Mean difference = 0.4463
Levene’s test for equality of variances: F = 8.577; p = 0.004
Table VIII. T-test: employees’ report on satisfaction with fringe
benefits
Satisfaction with fringe benefits
Variable Number of cases Mean SD SE of Mean
With programme 95 3.9158 0.710 0.073
Without programme 93 2.9570 0.908 0.094
Notes:
Mean difference = 0.9588
Levene’s test for equality of variances: F = 10.369; p = 0.002
Finding 2. Employees in organizations with wellness programmes express a higher level of job satisfaction.
Finding 3. Employees in organizations with wellness programmes express a higher level of satisfaction towards fringe benefits.
Comparison of organizations with and without wellness programmes: insignificant results
Five insignificant differences were found between organizations with and without wellness programmes. Specifically, results of t-tests indicate that no significant differences were found between organizations with or without wellness programmes in terms of:
(1) level of work stress experienced (t = -0.41, df = 179.51, p [greater than] 0.05);
(2) level of satisfaction with work conditions (t = 1.58, df = 186, p [greater than] 0.05);
(3) level of satisfaction with co-worker relations (t = 1.59, df = 186, p [greater than] 0.05);
(4) level of satisfaction with accomplishment (t = 1.35, df = 186, p [greater than] 0.05); and
(5) degree of absenteeism (t = -0.51, df = 154.9, p [greater than] 0.05).
Discussion
This study was conducted to assess the impact of corporate wellness programmes on employee stress, satisfaction and absenteeism. Although these variables are influenced by other factors within the individual and/or the environment, this preliminary study provides an interesting and valuable insight into the effects of wellness programmes in the Singapore context.
The results of the study indicate that organizations which offer wellness programmes to their staff are perceived more positively by their employees in terms of their attitudes towards the organizations, job satisfaction levels and satisfaction with fringe benefits. One perspective is that employers who provide wellness programmes are deemed to be demonstrating care and concern for the wellbeing of their employees (Shinew and Crossley, 1988) and, as a result, enhancing employees’ attitudes towards the organization.
In terms of job satisfaction, employees in organizations with wellness programmes express higher levels of job satisfaction than those without wellness programmes, thus implying that wellness programmes may well have a positive impact on employees’ job satisfaction. This finding is supported by the findings from the General Motor Company study which indicates that employees who participated in the fitness activities showed higher levels of job satisfaction than employees who did not participate (Baun et al., 1986). One reason is that regular exercise improves employees’ mood, self-image and self-esteem which in turn leads to a greater amount of satisfaction with the work he or she does (Pritchard et al., 1990).
Employees also expressed that they value wellness programmes as an important and worthwhile fringe benefit, and the presence of such a benefit may lead to greater employee satisfaction. This can be observed in the results whereby employees in organizations with wellness programmes were significantly more satisfied with their fringe benefits than their counterparts in organizations without wellness programmes. This finding is particularly relevant in Singapore as, on the one hand, the Government has been promoting “healthy living” (for example “The great Singapore workout”) thus causing people to be more health-conscious, and on the other hand, ironically, few organizations provide corporate wellness programmes for their employees and/or take it seriously enough to enable it to be beneficial for their employees. This finding is supported by a large study conducted in San Francisco, USA which found that employees who have participated in at least one health promotion programme are more satisfied than those who have not (Schauffler and Rodriguez, 1994).
In the field of health promotion evaluation, many of the anticipated benefits, such as the impact on employee medical costs, employee stress levels, lower absenteeism, etc., are medium or long-term outcomes. At the point at which this study was conducted, most organizations’ wellness programmes were still in their infancy stage, thus leading to non-significant results in terms of reductions in stress levels and absenteeism rates of employees in organizations with wellness programmes. Additionally, both stress and absenteeism may be influenced by many other extraneous factors, such as personal characteristics, employees’ values and expectations.
Thus, future research should build in a long-term perspective in order to accurately assess the cost-benefit analysis of wellness programmes as well as their impact on stress and absenteeism reduction. Meanwhile, proper employee health records and other relevant data should be maintained by organizations so as to facilitate evaluation. Additionally, future research including more organizations and a representative sample would enhance the generalizability of the findings.
Because of practical considerations, the questionnaire employed in this study had to be kept brief and could tap only the bare essentials. As a result, the variables tapped may not be comprehensive. Nevertheless, it is hoped that with the findings of this preliminary study highlighting the need for further in-depth research that would be useful for organizations, management would be more welcoming and open to methodologically rigorous research and evaluation of the impact of wellness programmes in organizations.
Conclusion
Corporate wellness programmes are observed to be beneficial not only for employee wellbeing, but also for organizational wellbeing. The results of the study indicate that wellness programmes have a positive impact on employees’ attitude towards their companies, job satisfaction and satisfaction with fringe benefits. When the level of job satisfaction is high, the levels of stress and absenteeism tend to be low (see Table III), which may well lead to a more motivated and productive workforce. Past research has also found that wellness programmes have a positive effect on important employee variables which affect productivity. Thus, it is recommended that management should seriously consider implementing a wellness programme in their companies, not only as a valuable employee benefit, but also as a productivity-enhancing tool.
There is no single model for a successful wellness programme. A programme can have a single element or multiple components. It can be targeted at a high-risk group or at the entire workforce. However, several factors are critical to the success of any wellness programme. These include long-term commitment, top management support, employee involvement, professional leadership, clearly defined objectives, strong and continuous promotional efforts and family involvement.
Thus, organizations can no longer afford to assume that employee health is only a private matter. The health of employees is increasingly a legitimate and important management concern. In the 1990s, no longer are these ideas simply a “bonus” for employees; they are not just perks, short-term frills, or the inventions of a few socially responsible companies. Now, more than ever, they are the requirements for running a successful business. As Pritchard et al. (1990) have said, “Healthy people make healthy companies. And healthy companies are more likely, more often, and over a longer period of time, to make healthy profits and to have healthy returns on their investments”.
