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Seventy percent of working adults think employers should offer programs that address important health issues such as diet, exercise, stress reduction, and how to manage chronic illnesses, such as diabetes, according to the study "Healthy at Work?" released by Rutgers University’s John J. Heldrich Center for Workforce Development.

According to researchers currently, nearly 4 in 10 working Americans said their employer provides some kind of a wellness program, ranging from classes in nutrition, to a newsletter, to a fitness center. Nearly one-third of those who have access to a wellness program said it has a major impact on the health of people in their workplace.

"Wellness programs show potential in the health policy arena to help people avoid or postpone serious diseases and curb healthcare costs," said Carl E. Van Horn, Ph.D., professor and director of the Heldrich Center. "However, wellness programs can develop into an equity issue, as we find that less-affluent and less-educated workers say they lack access to an employer-provided wellness program."

The national telephone survey – conducted March 19-29, among 583 adults working full- or part-time jobs – also found that workers with more formal education and those with above average incomes (over $70,000) are much more likely to report access to employer-based wellness programs.

Nearly half of college graduates (46 percent) report an employer wellness program, compared to just one-quarter of employees with a high school education or less (25 percent). Forty-five percent of salaried workers report access to a program, compared to 35 percent of hourly workers. Finally, about 4 in 10 workers (44 percent) with incomes of $70,000 or more said they have access to a wellness program, compared to just 2 in 10 (21 percent) of those making $35,000 or less.

"With public and private health spending predicted to reach $2.5 trillion in 2009 – a 17.6 percent share of the U.S. Gross Domestic Product – many policymakers are arguing that effective, evidence-based, preventive services such as smoking cessation programs not only promote health, but also offer high economic value," said Van Horn. "Workers are telling us that they want to participate in employer-based wellness programs, but many do not have access to them."

Still, wellness at the workplace has its boundaries. Most do not feel it is appropriate to give compensation in the form of increased salary or extra time off to those who participate in wellness programs. Many feel it is unfair for workers to pay higher premiums because of existing health conditions, such as being overweight or having emotional problems. And finally, workers express concern for the privacy of their healthcare records.

Employer Incentives and Penalties

Three-quarters of workers (74 percent) said employers should give lower healthcare premiums to employees who participate in wellness programs. Workers, however, do not support penalizing employees who engage in potentially unhealthy behavior:

• Just half (47 percent) of workers said employers should be allowed to charge smokers more for health insurance.
• Barely 4 in 10 workers (43 percent) supported higher rates for people who drink too much alcohol.
• Only one-quarter of workers (26 percent) thought people who are very overweight should pay more.

Workers overwhelmingly opposed higher health insurance rates for older workers, people with genetic conditions tied to major diseases, people with emotional problems, and others whose health conditions are beyond their control.

Worker Privacy

While wellness and disease management programs can work best through the sharing of health information, workers express concern about confidentiality of their health records.

About 1 in 4 workers is somewhat (13 percent) or very (13 percent) concerned that supervisors or managers in their company will have access to their health or medical insurance claims.

The advent of electronic health records causes unease for one-third (33 percent) of workers, who said they are very concerned about the protection of their medical privacy. Groups who expressed the most concern tend to be the most economically vulnerable, including those with less education and lower incomes.

The findings of "Healthy at Work?" suggest that worker attitudes about employer-based wellness options may be affected by the current economic slowdown. "Workers on the lower rungs of the economic ladder feel highly exposed and worry about anything that could jeopardize their job security," said Cliff Zukin, Ph.D., survey director and senior faculty fellow at the Heldrich Center and professor of public policy and political science at Rutgers University’s Eagleton Institute of Politics and Edward J. Bloustein School of Planning and Public Policy. "While federal and state laws should protect workers from discrimination due to health factors, the real uncertainty felt among workers is a clear message to lawmakers that these protections need to be enforced."

Address: J. Heldrich Center for Workforce Development, Edward Bloustein School of Planning and Public Policy, 30 Livingston Ave., New Brunswick, NJ 08901; (732) 932-1100, www.heldrich.rutgers.edu.