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