00:00:00
There have been a number of um rigorous
00:00:02
studies, randomized control trials um
00:00:04
that tested uh with a comparison group,
00:00:08
a control group to see whether those
00:00:10
that were offered a program actually
00:00:12
changed their behavior and had different
00:00:14
outcomes. So changing their behavior
00:00:16
meaning you know whether they said that
00:00:18
they eat better or exercised more or
00:00:20
took part in like preventative care and
00:00:23
outcomes is like you know whether they
00:00:24
actually have lost weight or stopped
00:00:26
smoking had a lower risk for a heart
00:00:29
attack which is like a core uh target of
00:00:31
these programs and also whether they
00:00:34
report less absentism higher
00:00:36
productivity and lower health costs.
00:00:39
Welcome to the Ripple Effect, the
00:00:41
podcast that takes you on a journey
00:00:43
through the minds of Wargan faculty. I'm
00:00:45
your host, Dan Looney, and in each
00:00:47
episode, we'll be diving deep into the
00:00:49
inspiration behind the groundbreaking
00:00:51
research that Wharton professors have
00:00:53
conducted and exploring how their
00:00:56
findings resonate with the world today.
00:00:58
So, when you think about wellness in the
00:01:01
workplace, the topic of wellness
00:01:03
programs is discussed quite a bit. Not
00:01:06
just the companies who are providing
00:01:08
them, but do they actually make a
00:01:10
difference improving health outcomes?
00:01:13
Pleasure to be joined here in studio by
00:01:14
Ivon Barank who's associate professor of
00:01:17
business economics and public policy as
00:01:19
well as an associate professor of
00:01:21
management here at the Wharton School.
00:01:22
Ivon, it's been a while. Great to talk
00:01:24
to you again. How are you? It's
00:01:25
wonderful to see you too. Hello. Thank
00:01:27
you. Uh, all right. So, what are
00:01:30
companies trying to bring forward with
00:01:32
this idea of bringing in wellness
00:01:34
programs in the first place? Well, um I
00:01:37
thought that you would give me an easier
00:01:38
question first because there's no single
00:01:42
clearly defined structure or approach to
00:01:45
this. There's an overarching concern and
00:01:47
motivation behind these programs, but
00:01:49
there's no single definition. I think
00:01:52
what these uh wellness programs are all
00:01:54
about is uh some some form of a
00:01:56
programmatic approach and with a focus
00:02:00
on prevention with a focus on coaching
00:02:03
uh to help people to steer towards more
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healthy behavior and um and that is in
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contrast to other programs that
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companies have that are more driven by
00:02:14
legislation and administrative rules
00:02:16
about workplace safety. Um and I think
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here the the big component here is not
00:02:22
just that there's program that allows
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people to follow certain steps um that
00:02:27
are then dedicated towards particular
00:02:29
needs of each individual employees. So
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there's a back and forth between what
00:02:34
employees want and what they need and
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also there's a big data component to it
00:02:39
um which is like quite controversial but
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you know people's behavior is being
00:02:44
tracked more than before and the program
00:02:46
is tailored towards encouraging them to
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do that and sometimes rewards or
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sometimes punishments are attached to
00:02:52
that as well. So for a lot of the
00:02:54
companies there has to be a financial
00:02:56
component tied to this with when you're
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thinking about the cost of healthare the
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way that has gone up uh in recent years
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uh and the way the fact that if somebody
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is not healthier they are obviously more
00:03:07
likely to be uh spending money to fix or
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correct certain healthcare issues to
00:03:14
begin with. Absolutely. I mean the idea
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of workplace wellness programs goes back
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decades um where we wanted to encourage
00:03:21
people to really look after them
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themselves but there has been a big
00:03:24
change with the affordable care act that
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uh specifically allowed a a big
00:03:30
component of cost to be dedicated to
00:03:32
these wellness programs. Um and that was
00:03:34
a big change where now there was a
00:03:37
legislative platform on which these
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programs could be built. Um over time
00:03:42
the scenario became a bit more
00:03:43
complicated when it came to data
00:03:45
protection and disability care. But in
00:03:48
general there's the much more foundation
00:03:50
where companies can actually use costs
00:03:54
and incentives related to these wellness
00:03:56
programs compared to before. And um the
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the big question to me still is um you
00:04:02
know what is when does wellness programs
00:04:04
start and when do like amenities in the
00:04:06
workplace end? amenities being, you
00:04:08
know, tools or technologies or equipment
00:04:11
that help people be more productive um
00:04:14
help companies to attract and retain
00:04:16
people and increase satisfaction in in
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the workplace. So are uh is the the
00:04:22
component of that then just something
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that the company believes that they can
00:04:27
have as an add-on and it is a benefit on
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top of traditional benefits that
00:04:33
employees would have under their under
00:04:35
their uh benefits package. Yes. I mean
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how does this work in a inside an
00:04:41
organization or a company? I mean often
00:04:43
they invite a consultant u to advise
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them on what to do. um if it is more
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sophisticated they actually do some
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surveying among their employees to get a
00:04:52
sense of what they what they looking for
00:04:54
what are their real needs and then they
00:04:56
build a program around that. So say you
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know many times uh people who have to
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commute quite a bit they might find it
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difficult to uh to go in addition to the
00:05:07
work and to be with the duties at home
00:05:09
to go to the gym or to go for a run. So
00:05:12
they might want to see whether there's a
00:05:15
a gym at the workplace, which by itself
00:05:17
is just an amenity, but then whether
00:05:19
going to the gym is something that the
00:05:21
company rewards or fosters. And here's
00:05:24
an interesting additional component.
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Many times these wellness programs are
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are sought for by future employees as a
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signal that the company actually cares
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about them. They don't just want to
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squeeze the maximum productivity out of
00:05:37
them, but they really care about whether
00:05:38
they're doing well, whether they're
00:05:40
happy at the workplace. Well, and and I
00:05:41
guess off of that then when we went
00:05:44
through the pandemic, we saw a greater
00:05:46
focus on mental health as a component of
00:05:49
this. Yeah, the co 19 really accelerated
00:05:53
um a process whereby companies
00:05:55
re-evaluate what kind of work needs to
00:05:56
be done at at home and what can be done
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remotely. I mean we now know that zoom
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has become a much more mature platform
00:06:02
where we can do much more work remotely.
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Now with that came an interesting
00:06:08
challenge which is twofold. before we
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could really like measure people's
00:06:11
behavior much more clearly uh because
00:06:13
they're there in the workplace and we
00:06:15
can supervise them. Sometimes this is
00:06:17
possible with technology but you know
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when we go
00:06:21
remotely what has happened is many
00:06:23
companies now started to use devices of
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various sorts or like um other ways of
00:06:29
tracking people's behavior. So if
00:06:31
there's a program that encouraged people
00:06:32
to walk more then people companies would
00:06:35
give them like pedometers or an app that
00:06:38
tracks how much they they walked but you
00:06:40
know if it is more reward you know how
00:06:42
can you actually make sure that they
00:06:43
actually did it well I guess it becomes
00:06:45
important then because when co was here
00:06:48
and we were all working from home every
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day of the week I noticed it in my
00:06:53
neighborhood and I'm sure in
00:06:54
neighborhoods across the United States
00:06:55
and around the world you saw more people
00:06:58
out walking but it was because they had
00:07:00
more time on their hands and they, you
00:07:02
know, needed something to do. Now we're
00:07:04
kind of back into this normal lifestyle
00:07:07
and I wonder if people will continue to
00:07:09
do it as frequently as they did it 5
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years ago. Yeah, that's a that's a very
00:07:13
interesting question and I think the
00:07:14
data is not quite there yet to tell us
00:07:16
what has happened but yes, it is true.
00:07:18
You know, if you didn't have to commute,
00:07:20
you had a lot of time that you could
00:07:21
dedicate to to walking or exercising. Um
00:07:24
but it may also lead to situations where
00:07:27
there's a strain on mental health
00:07:29
because you're always at home, you're
00:07:30
always in the same environment where you
00:07:32
live and work and that is difficult to
00:07:34
set boundaries. So there the shift has
00:07:36
become much more towards uh supporting
00:07:38
people with their mental well-being so
00:07:40
that they are not burned out or that
00:07:42
they just get irritated. Note if you're
00:07:45
working remotely, you are isolated from
00:07:46
others. So for a while you can perhaps
00:07:49
tolerate uh you know the antiques of a
00:07:52
supervisor because you think this is
00:07:53
still a good company or good career to
00:07:55
pursue but when you reach a burning
00:07:57
point or a tipping point then you may no
00:07:59
longer be willing to do that and then
00:08:01
you might quit. Do companies enough
00:08:04
companies look at and invest in the
00:08:08
types of components to have in a
00:08:10
wellness program so that you're getting
00:08:12
the greatest benefit or is it somewhat
00:08:15
that is as you may have suggested before
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kind of thrown out there as a bonus as a
00:08:20
as a benefit to the employee. That's a
00:08:23
great question and I think uh when I
00:08:26
read the literature and also look at
00:08:27
what companies do it is often not quite
00:08:30
clear what the clear rational behind
00:08:33
these programs are. So if you wanted to
00:08:35
step back and be more academic about it
00:08:38
clearly one component is just a human
00:08:40
human capital theory idea. You know I
00:08:42
invest in their health people are then
00:08:45
healthier they are not absent and if
00:08:48
they're healthier then healthare costs
00:08:50
go down. So that's the rational behind
00:08:51
it. But if you sometimes think about
00:08:54
employee satisfaction, you know, then
00:08:56
companies offer it because they want to
00:08:58
make sure that people are happy and that
00:09:00
they want to come there. And many times
00:09:02
we see that um employees when they
00:09:04
consider companies or which companies to
00:09:06
go to, they highlight, oh, this company
00:09:08
has these programs as well, right? But
00:09:10
when we survey them later whether they
00:09:12
actually use it, they often don't have
00:09:14
time to use the gym or to make uh make
00:09:17
use of their you know their uh you know
00:09:19
their wellness programs because they're
00:09:21
too busy working on their careers. So it
00:09:23
mixes in the component of the company
00:09:25
wanting to do whatever they can to keep
00:09:27
the best employees in the company and
00:09:31
going to whatever lengths they need to
00:09:33
within reason to be able to do that.
00:09:35
Yes. You know, this has been not just
00:09:37
the Fed, but there was really like a a
00:09:39
horse race uh in the market where
00:09:40
companies offered more and more
00:09:42
elaborate programs and signal to them
00:09:44
like how in what comprehensive ways they
00:09:46
can really pay attention to them and
00:09:48
help them with their careers and uh but
00:09:51
then when we come to the data and look
00:09:54
at who who used what and whether it
00:09:56
actually made a difference, it it
00:09:57
becomes a much more nuanced picture.
00:09:59
What do you think needs to occur then
00:10:02
moving
00:10:03
forward to make sure that we maximize
00:10:06
the best components for the employees
00:10:10
and for the companies as well. So I
00:10:12
think with this question we are starting
00:10:13
to talk a little bit more about you know
00:10:15
what lessons can we draw from what
00:10:18
companies has offered what companies
00:10:20
have offered and whether these programs
00:10:22
actually work. Um and here I think it is
00:10:25
clear that we need to learn much more
00:10:28
about what we can actually do that makes
00:10:29
a difference to these uh employees. Um
00:10:31
there have been a number of um rigorous
00:10:34
studies, randomized control trials um
00:10:36
that tested uh with a comparison group,
00:10:40
a control group to see whether those
00:10:42
that were offered a program actually
00:10:44
changed their behavior and had different
00:10:46
outcomes. So changing their behavior
00:10:48
meaning you know whether they said that
00:10:49
they eat better or exercised more or
00:10:52
took part in like preventative care and
00:10:54
outcomes is like you know whether they
00:10:56
actually have lost weight or stopped
00:10:58
smoking had a lower risk for a heart
00:11:01
attack which is like a core uh target of
00:11:03
these programs and also whether they
00:11:06
report less absentism higher
00:11:08
productivity and lower health costs. And
00:11:11
here when we look at the two biggest
00:11:13
most prominent studies from these
00:11:15
randomized control trials, we see uh
00:11:18
that there is slight evidence that the
00:11:21
people report and have been shown to
00:11:23
change their behavior somewhat, but
00:11:25
there's no compelling evidence or no
00:11:28
significant evidence in terms of
00:11:30
outcomes that we care about like
00:11:31
absenteeism, productivity, health care
00:11:33
costs and and health risks. So these
00:11:36
were for quite comprehensive programs.
00:11:38
So to your question okay so given that
00:11:41
the abroad program does not work are
00:11:44
components of them working better right
00:11:46
so this is where there has been a shift
00:11:48
uh towards identifying specific uh uh
00:11:50
approaches one was to work on people's
00:11:53
fitness specifically uh encouraging them
00:11:57
more either with financial incentives or
00:11:59
through other peer pressure or or or
00:12:01
workplace norms to go to the gym and we
00:12:03
see that you know those programs
00:12:05
increased muscularkeeletal strength and
00:12:08
sometimes that translates into pro
00:12:10
productivity but you can imagine that
00:12:11
this is really really work specific. Um
00:12:15
another key component of these programs
00:12:17
which is something that I've studied a
00:12:18
lot in my own research was about using
00:12:21
financial incentives to specifically
00:12:24
target certain behaviors. You know econ
00:12:26
101 says that you know people are lazy
00:12:29
and they don't want to do stuff unless
00:12:31
you give them an additional reward for
00:12:33
doing it. So you have to overcome the
00:12:35
inconvenience or the displeasure of
00:12:38
doing something. So I've studied whether
00:12:41
offering people financial incentives to
00:12:43
take their statin medication which is
00:12:44
like for people who are at risk of a
00:12:46
heart attack whether this actually has
00:12:47
an impact and I've done two large NIH
00:12:50
funded randomized control trials and and
00:12:52
and have replicably shown that those
00:12:54
incentives actually have no impact on
00:12:56
cholesterol levels. Now though there are
00:12:59
some studies that show some benefits but
00:13:01
even the studies that show benefits the
00:13:04
interventions are not cost-effective. So
00:13:07
we are still out on the quest to
00:13:09
identify what are the components that
00:13:11
work well. Now the latest candidate for
00:13:13
these are really the wellness programs
00:13:14
that focus on mental health because this
00:13:17
is what people really say that they
00:13:18
struggle with the stress they struggle
00:13:20
with their motivation. You know why why
00:13:23
should I apply myself? This is really so
00:13:25
stressful and this is a clear candidate
00:13:26
where more research has has to come
00:13:28
about but again we lack the evidence
00:13:30
that is actually effective at this stage
00:13:32
but it is still a topic that will
00:13:34
continue to be used researched looked at
00:13:39
so that we can try and get better in
00:13:43
terms of
00:13:44
understanding what are the best types of
00:13:46
programs to have the components to have
00:13:48
in them so that you can have that that
00:13:52
that stronger relationship ship between
00:13:54
work and personal life so that the
00:13:57
employee feels like they are getting the
00:14:00
most from their benefits packages.
00:14:02
Absolutely. I mean the big challenge
00:14:04
that many employees face is to
00:14:06
understand you know how can I um manage
00:14:08
my life and achieve all the goals that I
00:14:11
have uh for myself. But now with the
00:14:14
remote work and also with the experience
00:14:16
of covid many people um uh have not been
00:14:20
able to develop a structure that allows
00:14:22
them to identify goals and pursue them
00:14:24
and manage their their life in an
00:14:26
effective way. So they still look uh
00:14:28
towards the company to help them in this
00:14:30
process. So sometimes a simple task like
00:14:33
you know optimally designing how you
00:14:35
should spend your time during the week
00:14:38
which is like the uh routine task that
00:14:40
everybody has to do. But evidence shows
00:14:42
that most people actually do not uh have
00:14:44
a good way of structuring their week to
00:14:47
get uh the most out of the time that
00:14:49
they want to allocate that uh that they
00:14:51
want to allocate to the company. Right?
00:14:54
Great to see you again. Thanks very much
00:14:55
for your time. It was a pleasure to talk
00:14:57
to you again. See you next time. Thank
00:14:58
you. Ivon Baron K, associate professor
00:15:00
of business economics and public policy
00:15:03
as well as uh management here at the
00:15:05
Wharton School. Thank you for listening
00:15:06
to the ripple effect. We hope you found
00:15:08
this episode informative and engaging.
00:15:11
Don't forget to subscribe and leave us a
00:15:13
review so that we can continue to bring
00:15:15
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00:15:17
School.
