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Presenteeism in the Workplace (And What You Should Do as a Benefits Provider)


We’ve all heard the phrase, “Showing up is half the battle,” particularly as it applies to job attendance. Ingrained into workplace culture is the idea that perfect attendance demonstrates commitment and loyalty—even if it comes at the cost of physical or mental wellbeing. 

According to a recent Zippia report compiling PTO usage data across a variety of industries, 84% of members with allotted PTO say they still go into work sick, exacerbating preventable conditions. It’s clear that presenteeism—or feeling pressure to show up to work despite feeling ill—is still rampant among today’s workers. But, given rising concerns around mental and physical ailments impacting engagement and performance, administrators are starting to prioritize their populations’ wellbeing over perfect attendance.

As more signs and symptoms are brought to the forefront, it’s up to benefits providers to find holistic, centralized wellness platforms for clients who are focused on creating an accessible hub for benefits and communication to boost their members’ total wellbeing.

What Does Presenteeism Look Like?

Presenteeism refers to when individuals make the choice to work despite battling temporary or ongoing health issues, such as medical or mental health conditions.

As such, illnesses are often left unchecked and untreated, leading to increased work-related stress, reduced productivity, and in the case of contagious illnesses, prolonged exposure to potentially serious diseases for others.

What compels workforces to make the decision to come to work despite feeling ill? According to Zippia, nearly 33% of members say their organizations promote a culture of working while sick, perpetuating the stigma that commitment trumps wellbeing. 

But presenteeism can manifest for a variety of reasons, including: 

  • Rising healthcare costs that limit medical spending
  • Fears around being absent, losing productivity, or asking for a mental health day
  • Participation in or encouragement of presenteeism from senior members of staff
  • Feelings of job insecurity
  • Staffing shortages, prolonged working hours, or time-consuming workloads
  • A lack of available sick leave
  • A dissolution of personal and professional boundaries

And while avoiding absenteeism has long been viewed as beneficial from an organizational perspective, presenteeism can actually result in reduced on-the-job performance and productivity.

What does this mean for TPAs and Health Plans? 

The secondary effects of presenteeism might manifest in multiple ways for benefits providers. You might notice:
  • An increase in high-cost claimants struggling with long-term health challenges
  • Higher usage of mental health and point solutions to begin addressing holistic health 
  • A rise in requests for holistic wellbeing solutions to manage employee engagement and health

The Impacts of Presenteeism in the Workplace

When sick individuals are physically present at work, they’re not always able to function at their full capacity. Ultimately, this can lead to impacted performance, increased errors or on-the-job injuries, and a net productivity loss. 

According to the U.S. Bureau of Labor Statistics, nearly half of non-fatal injuries of employees are caused by overexertion of job tasks stemming from untreated medical conditions. Coupled with prolonged working hours, insufficient breaks, and stigma around taking PTO, members face greater risks on the job when juggling underlying conditions.

From a community health standpoint, if an illness is contagious, it could spread, becoming a safety issue not just to members, but teams at large. Even a decade before the pandemic, scientists were raising concerns about presenteeism from a public health and disease control perspective, especially in large offices, warehouses, worksites, and healthcare settings.

But most importantly, presenteeism can pose serious problems to visible or underlying physical and mental health conditions. Zippia’s report found that more than half of members (54%) with PTO used sick time to take a mental health day in 2022—without reporting the reason to managers. Not only can delaying medical care increase morbidity and mortality risks, but not taking a sick day can quickly lead to burnout and exacerbate mental health symptoms.

However, the impacts of presenteeism don’t end with members. In addition to jeopardizing the health and safety of others, the atmosphere of a work environment changes when members are pushed to their limits.

For the organization itself, signs and symptoms of presenteeism may include:

  • Decreased morale and motivation: Sick individuals may not have the same energy or enthusiasm when interfacing with customers or other team members.
  • Lost productivity: Members can’t perform at their fullest capacity when they’re feeling ill or having a poor mental health day.
  • Diminished company culture: When members show up to work unwell, tired, and ready to leave, the overall morale of an organization can suffer.
  • Compromised inclusivity: Working parents and those with mental health issues may worry about the perception of taking a day off, instead preferring to “power through.”
  • Resenteeism: As members push themselves past the brink of burnout, resentment can build up and lead to increased absenteeism, attrition, and even turnover.

While many organizations discuss the causes of presenteeism through the lens of systematic challenges and economic hardships, these don’t paint the full picture. Instead, rising healthcare costs and pervasive gaps in care could be barring members from seeking treatment for preventable or chronic illnesses.

Between 2022 and 2023, the average healthcare expenses for individuals rose by nearly 6%, from $6,813 to $7,221. If members don’t have enough money to pay for these expenses or their illness isn’t covered by insurance, they’re faced with a real choice of working through the pain or going into medical debt.

But even if strong healthcare plans are in place, members might not know enough about their benefits to get the help they need. Transparent communication and information about insurance providers and coverage are essential, as many members will be deterred from seeking care or support due to the uncertainty of affordability alone. 

Presenteeism may seem like a complex issue with no obvious solutions, but there are ways to ensure members not only have access to the help they need, but can easily receive, understand, and learn about benefits information in one, centralized location.

With a holistic wellness program, administrators can give clients a comprehensive solution that meets members exactly where they are, inspiring engagement and promoting healthy habits long-term. But aside from offering personalized wellbeing activities, care pathways, and educational resources that can address presenteeism symptoms early on, these programs also provide a flexible wellness portal that can easily track participation, streamline benefits and reporting, and distribute member communications.

But what can employers do to reinforce the impacts of a holistic wellness program and catch presenteeism symptoms before they root? 

1. Look for Common Signs

The first step to prevention is identification. By taking a proactive approach in detecting signs of presenteeism, employers can keep a pulse on workloads and sentiments and intervene before anyone burns out. 

However, presenteeism is often far more subtle than outright absenteeism, making it challenging to spot.

An obvious sign is showing up to work visibly sick, but this isn’t always the case for every scenario, especially when it comes to mental health issues. Instead, look for factors such as:

  • Working long hours
  • Appearing tired or exhausted
  • Abnormal mood swings
  • Increased mistakes or injuries on the job

While not everyone with presenteeism will demonstrate these symptoms, they’re often indicative of an unsustainable workload or an individual on the verge of (or past the point of) burnout. If managers or other staff members identify these signs, they can encourage the use of PTO to focus on mental or physical wellbeing. 

2. Encourage a Culture of Wellbeing

Organizations must actively work on fostering a culture that prioritizes wellbeing. This executive support and commitment is essential for not only creating but ensuring the conditions for positive change.

What does this look like?

On a regular basis, managers should check in with members to see how they’re doing. More than work performance, this is a good opportunity to gain insight into their mental and physical health. If members are feeling overwhelmed, overworked, or generally ill, it’s often best for everyone to provide sick pay and tell them to take the day off.

3. Educate Members on Health Care Coverage

Unfortunately, many individuals with healthcare coverage are unaware that the services they need are actually affordable. Most health plans, including the Affordable Care Act, cover essential forms of preventive care, such as:

  • Vaccinations for a variety of common diseases
  • Select cancer and mental illness screenings
  • Blood work and diagnostic testing for high-risk populations

Members won’t need to pay a deductible or co-pay for these types of preventive care appointments, and many other healthcare services are also available at reduced cost with insurance.

Many organizations already use their open enrollment period as an opportunity to explain benefits packages in-depth, but it’s great to send reminders about preventive care throughout the rest of the year. That way, members will know they can always visit a doctor if a health problem comes up.

4. Incentivize Preventative Care Engagement With Health Screenings and Biometric Assessments 

In addition to regular appointments with healthcare providers, members might also have access to biometric screenings through their organization. These tests check important diagnostic criteria such as blood pressure, cholesterol, and glucose levels to spot health issues like early-onset diabetes before they become severe or malignant. 

Not every member will automatically get on board with wellness-oriented initiatives—especially if they’re already exhibiting signs of presenteeism. Incentives motivate members to complete these types of healthy activities or even schedule preventive care appointments.

At WellRight, we make it easy to develop and implement holistic wellness programs aimed at preventing risks like presenteeism. Our wellness platform enables clients to create personalized wellbeing plans, set up point-based reward systems, and encourage members to participate in fun activities that improve their health and reduce the risk of burnout.

5. Provide Mental Health Support and Resources

Just as it’s important to educate members on healthcare coverage, it’s also essential to promote any and all available mental health resources. 

Whether offering more breaks to focus on mindfulness and stress-reduction or providing access to counseling services or other professional mental health support, it’s crucial that members understand their options and that their organizations care. By integrating these resources into a larger programmatic structure, organizations can help destigmatize discussions around mental health and create a more nurturing environment.

6. Normalize and Promote a Healthy Work-Life Balance

Professional mental health services are critical for wellbeing, but they can’t always help when an issue is immediate and urgent. Put another way, there’s no predicting when someone may have a really bad day. 

But when members have the option to take time off for a mental health day, just like sick days, they get the time they need to focus on feeling better. This can also prevent burnout and the resulting productivity loss of overexertion on the clock.

Maintaining a healthy work-life balance is crucial to prevent presenteeism. Establishing clear expectations around working hours and enforcing regular breaks are practical solutions to preventing burnout. For instance, if several members are consistently coming in early and working late, leaders can have a discussion about why that is and create a game plan to navigate it.

Additionally, management should demonstrate a healthy work-life balance themselves by avoiding falling into the same habits that cause presenteeism.

7. Lead by Example To Encourage Workplace Wellbeing

Similarly, to promote overall wellbeing, employers need to lead by example. This means more than just taking a sick day when it’s needed. 

Managers and leaders should encourage open discussions about mental health to gather feedback and come up with relevant solutions for their unique workforces. With top-down support from executive leadership teams, members are more likely to see the value of wellbeing practices and participate in them. 

Addressing Presenteeism With Holistic Wellbeing

Client groups are looking for more ways to maintain and improve the overall health and wellbeing of their members. Offering a competitive solution centered around holistic wellbeing gives clients and members the resources they need to address the multifaceted causes of widespread problems like presenteeism, catch symptoms early on, and raise awareness around benefits for long-term growth and success.

Reach out to our team today to find out how a holistic wellness program can boost engagement, morale, and satisfaction throughout your and your clients’ organizations.


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