The harmful effects of presenteeism on employee health

presenteeism employee health

Need to know:

  • Presenteeism not only affects engagement, productivity and retention, but can also have a long-lasting impact on employee health.
  • Employees who are overworked and fatigued can develop health issues such as diabetes, are more likely to have accidents at work and are at greater risk of mental health issues.
  • Employers should foster a healthy, supportive culture that does not encourage practices that lead to presenteeism, such as encouraging overworking.

Presenteeism manifests in various forms, such as going into work when unwell, putting in long hours, taking too few breaks, or being unable to disconnect  outside of working hours.

On the surface, reduced sickness absence, longer hours for the same pay and keeping track of developments during the weekend might sound like an employer’s ideal. However, presenteeism has vastly detrimental effects on productivity, engagement, loyalty and retention, and ultimately, an organisation’s bottom line. It can also have a damaging impact on employees’ health.

With 46% of employees regularly turning up too tired to work according to a survey conducted by Westfield Health in September 2018, presenteeism appears to be an epidemic in modern offices.

Worsening health conditions

Research by Canada Life Group Insurance, conducted in August 2018, found that 88% admit to going into the office when suffering from a minor illness. Working while experiencing a communicable illness is likely to spread it to other employees, in addition to worsening symptoms for the original sufferer due to lack of proper rest and recuperation.

In turn, the pressure to work longer than contracted and take too few breaks can exacerbate existing health problems, or even create them, warns Cyrille Guillet, co-founder and chief operating officer at health consultancy iamYiam. “[Employees can] develop musculoskeletal issues, diabetes. It’s a vicious cycle that can be really difficult to get out of,” he explains.

Employees who sit for long periods are far more likely to be at risk of diabetes (112%) and heart disease (147%) than those who are active, according to Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis, published in Diabetologia in August 2012.

In addition to the health risks associated with a sedentary lifestyle, the sheer act of overworking can increase fatigue, reduce immune protection and lead to illness in the long term.

Accidents and emergencies

For those in office jobs, the sedentary lifestyle can be a killer. However, employees in active roles can also fall victim to the effects of presenteeism.

According to the aforementioned Westfield Health research, 46% of respondents regularly turn up to their jobs too tired to work. Not only is sleep vitally important to health and wellbeing, but fatigue can lead to some very real results in industries with significant health and safety concerns, with 23% of employees in construction and 28% in manufacturing roles admitting to falling asleep while working.

Mental health

The physical effects are many, whether they stem from spending too long at a desk, decreased immune defences, or fatigue in high-risk roles. However, presenteeism affects more than just physical health.

David Capper, chief executive officer at Westfield Health, explains: “The lack of work-life balance can lead to anxiety, stress, mental health issues, obviously fatigue, and that’s a self-perpetuating cycle that can really have a negative impact.”

Effects on others

Presenteeism in one employee can have a knock-on effect upon those around them, says Kevin Yip, senior consultant at Health@Work.

“If [employers have] got a room full of sick people, the one healthy person will, by human nature, come down to the same level,” he explains. “Whereas if [organisations have] got a healthy, thriving workforce then the one sick person can actually improve their health.

“It can [also] have a negative effect on the culture of the organisation, [as employees] think of the employer as not looking after them.”

Outside working hours

One of the key concerns when it comes to battling presenteeism is the pressure employees feel to take work with them when they leave.

Mike Blake, director, health and benefits at Willis Towers Watson, says: “There’s an encouragement for [employees] to look at stuff out of hours. Not being able to switch off and have time off does have an effect on employees’ health and mental health.”

Closely linked to the importance of sleep, being able to take a clean break from the stresses of work is an integral part of a healthy work-life balance. However, it is not always so simple as ensuring that employees do not look at their emails during the weekend.

“We’re all different as human beings,” says Capper. “If I don’t do my work, that might make more anxiety for me. So, sometimes it’s about discipline and [knowing that] everybody is different and recognising who [they] are.”

This issue rises to the fore when considering the increasingly common practice of flexible working. The increasing diversity of work schedules and locations within many organisations means that what looks like presenteeism in one employee might in fact be perfectly healthy.

Ask the employees

So, with all the health considerations at play, employers should certainly be looking to combat presenteeism. However, if the symptoms are likely to look different with every employee, or in some cases be invisible altogether, how can they hope to tackle the issue?

The first port of call, though often overlooked, should be the employees themselves, says Yip: “Staff surveys should include questions around presenteeism. People are reluctant, whether for historical, culture or stigma reasons, but communication is key. Employers assume the issues but forget about asking.”

Build a positive working culture

A bottom-up approach that takes guidance from the employees themselves should be complemented by a healthy leadership culture that combats presenteeism from the top-down.

“[It is about] making sure that [organisations] don’t make a situation that harbours a culture of presenteeism,” says Capper.

While it might be easy to blame presenteeism on modern technology or external societal pressures, managers and leaders need to understand their own roles in fostering a harmful culture.

Discussing the impact of technology on employees’ propensity not to disconnect, Blake notes: “These things are only tools. At the end of the day, it’s up to the employer to make decisions about how they’re used.”

To counterbalance a culture of presenteeism among employees, leaders should consider open communications that make it clear that overworking or answering emails out of hours will not be encouraged. Leading by example, such as by making sure to leave the office on time, can also be key to creating the correct message.

However, there are some industries in which practices that can lead to presenteeism are ingrained and unlikely to change in the short-term. Rather than simply accepting this, employers should factor it into their approach to the employee experience.

“[The] wellbeing programme can help,” explains Blake. “Ultimately, [employers] want people to be resilient.”

Practical approaches

There are some day-to-day methods that can help cut down on presenteeism, such as instigating email-free time periods. This might be too rigid for the increasingly diverse workplace of the future, but can be helpful as a method of sending a clear message to staff.

“What that message says is ‘you need to recover, you need your own time to step back, to think and get on with the work that is most important to you’,” explains Capper. “It’s the tone it sets, creating the right environment culturally.”

Other proactive approaches to preventing presenteeism, or at least helping mitigate its negative effects on mental and physical health, include providing counselling and education, access to cognitive behavioural therapy, providing yoga and Pilates sessions in the workplace and promoting mindfulness exercises and physical activity.

“On the leadership front, [employers] need to be giving employees more autonomy to do their own job,” adds Guiller. “Flexibility is [also] an important one: giving employees flexibility about where they do their work from.”

Performance and recovery

Few jobs are free from pressure; for most employees, having periods of time that call for longer hours and fewer breaks is par for the course. However, this does not automatically lead to presenteeism.  

“It’s about preparation to prevent burnout and anxiety, to prevent negative energy,” explains Capper. “[Employers should] equip people to understand their bodies and make better lifestyle choices, to maintain energy, to oscillate between high performance and recovery.

“[The] job as a leader is to create the environment where people can perform at their best, and that doesn’t necessarily mean stressed. [Employees] need to know how to oscillate between comfort and stretch zones. [Employees] need a certain amount of pressure, that’s not a bad thing, but if there’s too much for too long that can turn into stress.”

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