Chapter 2: The Business Case for the Integration of Employee Assistance,Work-Life and Wellness Services

SUMMARY

Employee assistance programs (EAP), work-life programs and wellness programs are three commonly provided kinds of interventions that have the goals of reducing healthcare costs, improving employee performance and fostering a healthier workplace culture. The integration of these kinds of programs is a recent trend that has the potential to offer additional synergistic benefits. New studies have linked comprehensive delivery services that support human capital needs with bottom-line financial success of the company. This evidence can be used to make the business case for offering EAP, work-life and wellness services in an integrated capacity. However, while promising, the scientific evidence thus far in this area has methodological limitations and there are critical aspects that require further study.     

Employee correlates of sickness presence: A study across four European countries

The model of sickness presence (SP) proposed by Aronsson and Gustafsson consists of two parts. The first postulates SP as an employee's reaction to his/her general state of health, and as depending on employee correlates relating to the individual and the job. The second proposes longitudinal relationships between SP and future health. The present study is the first to test the first part of the model outside Scandinavia. Positive sickness presence factors studied were work involvement and job satisfaction; negative presence factors were financial household contribution, time pressure at work, and perceived job insecurity. Control variables were general health, age, gender and autonomy. Data (N=2348) were gathered from a total of 110 organizations in four European countries (Belgium, Spain, Sweden and the UK) with differing welfare state regime, degree of employment protection, labour market and sickness absence-related indicators. The data were analysed by hierarchical multiple regression per country. The findings partially confirmed the Aronsson and Gustafsson model. In all countries, employee general health status was a prerequisite of SP, and time pressure at work related to SP. In Sweden and the UK, job satisfaction related to SP. In the UK, work involvement related to SP.     

The relationship between transformational leadership and follower sickness absence: the role of presenteeism

The impact of transformational leaders on employee health and well-being has received much attention. Less research has focused on the relationships between transformational leaders and followers’ sickness absenteeism. Transformational leaders promote a group climate that may lead to absenteeism, especially among vulnerable employees (those with high levels of presenteeism). In the present study we examined the relationships between presenteeism, group-level transformational leadership and sickness absence rates in a three-year longitudinal study of postal workers and their leaders in Denmark (N?=?155). Group-level transformational leadership in year 1 predicted sickness absenteeism in year 2, but not in year 3. In examining conditions under which transformational leadership may be linked to higher levels of sickness absenteeism, we found that presenteeism in year 1 moderated the link between transformational leadership in year 1 and sickness absenteeism in year 3, such that followers working in groups with a transformational leader and who were high in presenteeism reported higher levels of sickness absenteeism. Our results suggest a complex picture of the relationship between transformational leadership and sickness absenteeism; transformational leaders may promote self-sacrifice of vulnerable followers by leading them to go to work while ill, leading to increased risks of sickness absence in the long term.     

Previous sickness presence among long‐term sick‐listed in Norway and Sweden: A retrospective study of prevalence and self‐reported reasons

The aim of the present study was to analyse previous sickness presence among long‐term sick‐listed individuals in Norway and Sweden and the reasons given for sickness presence. The study was based on survey data for 3,312 persons in Norway and Sweden who had been sick‐listed for at least 30 days. Two questions were used. One measured prevalence: During the last 12 months prior to your current sick leave, did you go to work even when feeling so ill that you should have taken sick leave? The second question concerned reasons for sickness presence. Large differences were found between Norway and Sweden in the prevalence of sickness presence. More long‐term sick‐listed Norwegians than Swedes reported sickness presence [adjusted odds ratio (OR) for Sweden 0.65 (0.53–0.80)]. The Swedes more often reported financial reasons for sickness presence [adjusted OR 2.77 (2.1 to ?3.54)], while the Norwegians more often gave positive reasons related to work. The national differences may be related to differences in sickness insurance strategies.     

Sickness presenteeism and sickness absence over time: A UK employee perspective

This paper examined the influence of sickness presenteeism (SP), defined here as going to work despite illness, and sickness absenteeism (SA) behaviour on employee psychological well-being, work performance and perceived organisational commitment in a sample of 552 UK workers. Self-report measures were administered on 2 occasions, separated by 1 year, to employees from 4 public sector and 2 private sector organisations. Structural equation modelling was used to evaluate simultaneous influences of SP and SA on outcomes over time. Results suggested that employees reporting SP reported lower work performance in comparison to those reporting no SP, when measured concurrently but not over time. Employees reporting any SP in the previous 3 months showed relatively reduced psychological well-being but there was no significant association over time. Six or more days SP was associated with a reduction in employee perceptions that their organisation was committed to them, concurrently and over time. There were no significant influences of SA on any outcome measure. Our results strengthen previous research and suggest that SP, but not SA, has implications for individual outcomes. The findings have implications for the way organisations manage their sickness absence systems.     

Presenteeism and health over time among Chinese employees: The moderating role of self-efficacy

The aim of this study was two-fold: first, to examine both the immediate and the lasting effects of presenteeism on health; second, to explore the moderating effect of self-efficacy on the presenteeism-health relationship in a Chinese context. We employed a two-wave study design in which presenteeism, health (i.e. physical health, mental health and exhaustion), and self-efficacy were assessed at Time 1; health was measured again at Time 2 three months later. We surveyed a diverse sample of 345 full-time Chinese employees working in Taiwan and mainland China. Hierarchical regression analyses showed that presenteeism over the previous six months was negatively related to employees' physical health, mental health and exhaustion at Time 1. However, we found no association between presenteeism and health at Time 2, after controlling for the baseline level of health, indicating that presenteeism may not have a lasting effect. Self-efficacy was found to moderate the relationships between presenteeism and all three aspects of health at Time 2, suggesting that for some individuals presenteeism may not on balance be a bad thing. The study sheds light on the association between presenteeism and health. The findings on self-efficacy also extend the literature to incorporate individual characteristics in the presenteeism context.