U.S. respondents spend an average of $163 per employee per year on wellness incentive rewards, up from an average of $100 two years ago.

Improving productivity by keeping employees healthy and working is emerging as the top business objective for employer-sponsored wellness programs around the world. The two exceptions are the United States, where reducing health care cost increases overwhelmingly continues to be the top goal, and Asia, where the most important objective is improving workforce morale.

These are among the latest trends identified by Buck Consultants' third annual global wellness survey, "WORKING WELL: A Global Survey of Health Promotion and Workplace Wellness Strategies," released today. The survey analyzed responses from more than 1,100 organizations representing 10 million employees in 45 countries.

"The heightened global focus on improving productivity is a significant trend," said Barry Hall, a Buck principal who directed the survey. "Business leaders around the world are increasingly recognizing the financial value of healthier workers and the need to better engage employees in reducing their health risks."

Stress is consistently cited as the top health risk driving wellness programs in all areas of the world, except for the United States and Latin America, where lack of exercise and poor nutrition are of top concern.

"Employers in the United States and Latin America seem to lag behind the rest of the world in addressing stress and its related conditions such as depression, anxiety, and fatigue," said Hall. "These are among the most significant drivers of productivity loss and absenteeism, as well as increased health care costs."

Effect of Economic Downturn

Wellness programs are still most prevalent in North America, where 77 percent of responding employers offer them. However, strong growth is reported from all regions of the world, despite current economic conditions. Globally, 24 percent of respondents indicated a decreased ability to provide wellness services, and 19 percent actually enhanced their wellness initiatives.

"Wellness programs appear to be holding their own as an organizational priority," said Hall. "Despite increased pressure on employers to cut budgets, many recognize that their wellness programs can help relieve the personal burdens that often affect their employees' health and productivity. Further, the prevalence of provisions in U.S. health reform legislation in support of wellness and prevention seems likely to propel wellness to even greater attention and investment in the United States."

Fastest-Growing Wellness Components

The fastest-growing components of wellness initiatives around the world are expected to increase 100 percent or more over the next three years. These include technology-driven tools, such as Web portals, online healthy lifestyle programs, and personal health records.

On-site programs, such as caregiver support, personal health coaching, and healthy vending machine food choices are also expected to rapidly increase.

Incentive Awards

Incentive awards, designed to improve employee participation and engagement in wellness program activities, are most prevalent in the United States (offered by 56 percent of respondents). The use of incentives in the United States has increased 63 percent since Buck's inaugural survey in 2007.

U.S. respondents spend an average of $163 per employee per year on wellness incentive rewards, up from an average of $100 two years ago. Twelve percent of U.S. respondents spend more than $500 per employee per year, with the largest incentive reported at more than $2,000 per year per employee.

Incentive rewards of various types are increasingly being offered in all parts of the world, especially Asia (42 percent) and Australia (33 percent).

Measuring Impact

Buck's annual survey continues to find that relatively few organizations are using metrics to validate the success of their wellness programs. Worldwide, only 22 percent have measured financial outcomes (although financial objectives are not a primary focus in most regions outside the United States).

"The fact that organizations continue to expand wellness programs, despite this lack of measurement, suggests that the intuitive value of improved employee health remains a major motivator for employers," said Hall. "Employers may recognize that health outcomes and behavior changes inspired by wellness programs are likely to take multiple years to fully manifest themselves in the form of measurable savings."

Among U.S. respondents who have measured the effect of wellness programs on their health care cost trend rate, 43 percent report a reduction in the trend rate. The typical reduction is two to five trend percentage points per year. "This is a significant savings on the massively growing health care bills of many employers," said Hall.