Companies that improve their "culture of health" realize some important benefits, including reductions in employee health risks, medical visits, prescription drug use, and healthcare costs.

That's according to a study in the February 2019 issue of the Journal of Occupational and Environmental Medicine.

"Investments in internal culture of health predict improvements in some employee health risks and healthcare utilization," wrote Ron Z. Goetzel, Ph.D., of Johns Hopkins Bloomberg School of Public Health, and colleagues.

The research team analyzed changes in scores on the CDC Worksite Health ScoreCard for 21 large US employers from 2013 to 2015.

The CDC Worksite Health ScoreCard is a tool designed to help employers assess whether they have implemented evidence-based health promotion interventions or strategies in their worksites to prevent heart disease, stroke, and related conditions such as hypertension, diabetes, and obesity.

It provides guidance on key evidence-based strategies that employers can put in place to promote a healthy workforce, increase productivity, and reduce the risk and associated cost of poor employee health.

The scorecard includes measures of internal culture of health (COH-INT), focused on improving the health of workers, and external culture of health (COH-EXT), focused on improving the health of surrounding communities.

The analysis included data on health risks and healthcare resource use for up to 64,000 employees.

Research Findings

At companies with rising COH-INT scores, employees who initially had health risk factors were less likely to be at risk two years later, including reductions in obesity, poor diet, and tobacco use.

Companies with rising COH-INT scores also had slower growth in healthcare costs.
For employees not initially at risk, increased COH-INT scores were also associated with lower rates of most risk factors.

Companies with rising COH-INT scores also had slower growth in healthcare costs; reduced inpatient, outpatient, and emergency department visits; and fewer filled drug prescriptions.

Improvement in COH-EXT scores was associated with lesser reductions in health risks. For reasons that are unclear, increases in COH-INT were associated with higher stress levels, especially for employees who initially had high stress.

The study adds to a growing body of evidence that building a culture of health can improve employee health and reduce healthcare costs.

Strengths of the study include repeated assessment of COH-INT and COH-EXT scores using a validated scorecard and data on changes in health risks for a large number of employees.

"Policymakers and public health practitioners considering initiatives to improve community health should take steps to encourage employers to create healthy workplaces," concluded Goetzel and colleagues.


Participants in CBIA Health Connections have free access to CBIA Healthy Connections, a wellness program for small businesses that incents employees (and employers) to become more engaged in health and wellness, with the goal of optimizing the health and overall well-being of each employee.