An Overview of Employee Wellness Programs (EWPs) in Large U.S. Cities
| Published date | 01 March 2017 |
| Author | Eric E. Otenyo,Earlene A. Smith |
| DOI | 10.1177/0091026016689668 |
| Date | 01 March 2017 |
| Subject Matter | Articles |
research-article2017
Article
Public Personnel Management
2017, Vol. 46(1) 3 –24
An Overview of Employee
© The Author(s) 2017
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Wellness Programs (EWPs)
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https://doi.org/10.1177/0091026016689668
DOI: 10.1177/0091026016689668
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in Large U.S. Cities: Does
Geography Matter?
Eric E. Otenyo1 and Earlene A. Smith1
Abstract
Although Employee Wellness Programs (EWPs) have been around for decades,
initiatives in government organizations typically lag behind initiatives developed in the
private sector in both magnitude and diversity. While city managers may invest in EWPs
with the intent of saving on health care costs and of enhancing employee productivity,
internal characteristics and incentive structures as well as the organizational culture
within each individual bureaucracy ultimately shape the nature and direction of EWP
management. Drawing upon the logic of geographic individuality of administrative
regions, the authors argue that organizations in different cities are likely to develop
and incorporate wellness services that reflect unique regional settings. By assessing
EWPs across the county, it is evident that the decision to implement certain wellness
services within a city unit are based, in part, on geography rather than technical
characteristics of the organization or wellness program. This means that geographical
attributes can be translated into the provision of services. Pressure to establish a
program likely comes from many arenas, and this assessment posits that geography
plays an important role in program adoption alongside the service distribution
argument of need and ability to pay.
Keywords
employee wellness programs, geography, health promotion
Introduction
Although Employee Wellness Programs (EWPs), also known as Workplace Wellness
Programs (WWPs), have been around for decades, it is generally understood that
initiatives in government organizations typically lag behind initiatives developed in
1Northern Arizona University, Flagstaff, USA
Corresponding Author:
Earlene A. Smith, Northern Arizona University, P.O. Box 15036, Flagstaff, AZ 86011, USA.
Email: eas96@nau.edu
4
Public Personnel Management 46(1)
the private sector in both magnitude and diversity. The range of programs and services
is far more sophisticated in the corporate world than in public agencies. Part of the
reason these programs are less extensive within public agencies has to do with the lack
of a uniform definition of what constitutes a “wellness program” (Mattke, Schnyer, &
Van Busum, 2012; Shemkus, 2013). Some organizations offer only a few informa-
tional tips on nutrition and exercise, and yet refer to the distribution of these resources
as a “wellness program.” Large organizations often offer much more comprehensive
plans that, in some cases, incorporate the use of mobile wellness apps and technologi-
cal wearable devices. In spite of the differences in size and scope of these programs,
the goals are similar. As Schneider (2007) explains, “the broader aim is to create a
more productive workforce and reduce health care costs for workers, the government,
and taxpayers” (p. 1B).
Abundant research continues to reaffirm the benefits of EWPs in general. For
example, the American Management Association (AMA; 2004); Berry, Mirabito, &
Baum (2010); and Levin (2007) report that wellness programs have excellent returns
on investments (ROI). The 2004 AMA study notes improvements in employee produc-
tivity and performance as clear benefits derived from EWPs. The most cited benefits
are in the areas of lowered levels of stress, fewer sick days and decreased absenteeism,
and lowered health and insurance costs (Loeppke et al., 2009). In addition, organiza-
tions that invested in EWPs exhibited higher rates of employee satisfaction, morale,
and retention than those that did not. The exact savings that accrue from EWPs varies
from study to study, but suffice it to say that each dollar invested is well spent for both
private- and public-sector organizations (Aon Hewitt, 2013; Baicker, Cutler, & Song,
2010; French, 2007; Goetzel & Ozminkowski, 2006). For example, Baicker et al.
(2010) observe that medical costs fell $3.27 per dollar spent on EWPs and that associ-
ated absenteeism costs declined by about $2.75 per dollar spent. Furthermore, Schaefer
(2015) notes that for every dollar invested in an EWP for one particular employer, $6
was saved through a decrease in medical claim costs. She states, “Interestingly, disease
management was responsible for 86 percent of the hard health care cost-savings, gen-
erating $136 in savings per member, per month, and a 30 percent reduction in hospital
admissions” (Schaefer, 2015). As Panepento (2004) observes, both employers and
employees benefit from having a healthier, more productive, and motivated staff. In
the event that a program does not work and does not save the organization money as
advertised, it is often a result of additional health screenings that are built into the
programs that encourage overuse of unnecessary care, increasing spending without
improving health outcomes (Frakt & Carroll, 2014). Corporate wellness programs
have also been criticized for cost-shifting practices (Early, 2013).
Typically, the range of services and programs covered under the rubric of EWPs is
vast. The interventions captured in Table 1 below are not exclusive or discrete, but
they do illustrate many components of a majority of comprehensive wellness pro-
grams. For example, stress management may be a part of the physical activities regime
and involve programs such as biking, walking, and organized exercises. The goals and
programs outlined in Table 1 reflect the range of services and programs offered in vari-
ous cities throughout the country.
Otenyo and Smith
5
Table 1. Selected Components of EWP Strategies.
Broad program goals
Strategies for achieving the goals
Physical Activities and
Walking meetings; organized exercises; flexible time; active
Weight Loss
transportation; support of bike racks; biking, running, or
workout trails; shower facilities; infrastructure changes that
include office lunch rooms with wellness equipment (e.g.,
hula hoops, Frisbees, balls); open streets; rooms for aerobic
exercises; athletic fields; weight rooms, fitness centers,
gymnasiums, and swimming pools; Weight Watchers at work;
group therapy; Zumba, Tai Chi, and dancing programs; karate
classes; treadmill and bike desks; encouraging the use of
stairwells instead of elevators; “Walk with a Doc”; walking
groups; and physical activity breaks.
Healthy Eating and
Policies encouraging employer-provided healthy foods; healthy
Nutrition Promotion
catering, healthy snack stations; food-for-sale cafeterias; access
to chemical-free produce; “Real Food Slim Down Challenge”
and other similar competitions; on-site gardens; healthy
potlucks; healthy snacks for meetings; water bottles; employer
provided insulated lunch bags or tote bags.
Tobacco Cessation
Tobacco Free Zones/campuses; cessation support programs;
Initiatives
discount coupons for Chantix; “Beat the Park”; “Quit Power”
(Baltimore); Quit with Us LA (Louisiana).
Stress Management,
Provision of treadmills; ergonomics and yoga coaching;
Back Pain Problem
educational sessions on stress management; Focused
Management, and
Meditation; Soothing Stress; Health Risk Coaching; massage
Biometric Screenings
therapy; cholesterol and diabetes screenings; health risk
assessments; flu shots; mobile mammography and prostate
screenings (i.e., gender appropriate screening); stress balls;
pedometers.
Breastfeeding Facilitation
Lactation room provisions; flextime and employee friendly
interventions; equipment uses; Workplace Milk Expression
programs; Healthy Pregnancy and Healthy Babies programs.
Wellness Advocacy,
Through online platforms; magazines (e.g., Bathroom Banter
Reporting, Promotion
in San Antonio, Texas; Weekly Review Magazine and online
and Wellness Coaches
websites complete with newsletters with food recipes in
Baltimore, Maryland); workshops on wellness issues; health
fairs; education sessions; Wellness Scores designed to
link health outcomes to policies (Oklahoma City); health
management tracking and data-driven programs; collaboration
with communities to pursue low-cost sustainable developments
that enhance healthy lifestyles; financial and other incentives;
collaboration with local universities; mayor and city-
government leadership; personal success story promotion;
Activity of the Week or Month events; Monthly Quick Read
newsletters via e-mail; health and wellness expos; telephonic
wellness/disease management coaching; Wellness Champions
and Ambassadors; Well City awards; Wellness Gift Cards.
Note. EWP = Employee Wellness Program.
6
Public Personnel Management 46(1)
Managerial Dynamics and Design of EWPs
The various programs identified above exist in hundreds of cities across the country.
The existence of EWPs in large cities seems to defy any one structural typology. Thus,
one would assume, because of the emerging hybrid forms of municipal government,
adoption of EWPs is less dependent on whether a city’s structure is classified as
mayor-council or council-manager. What we know is that the Department of Labor
recognized the existence of EWPs in at least 52% of local governments (Bureau of
Labor...
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