Association between health risks, consumer activation and measures of absenteeism and presenteeism

Measures of presenteeism are increasingly being added to the list of variables that guide the need for, and determine the economic benefits of, employee health programs. As an indicator of work impairment and lost productivity of those at work with health problems, presenteeism has been viewed as both a vital new measure of cost effectiveness but also as a construct lacking consistent theoretical and best practices guidelines. ACTIVATE is a randomized controlled trial of two companies with three arms in each company. One employer is a health care system with approximately 7,000 employees; the other is a national airline with approximately 20,000 employees in the Midwest. We used the absenteeism and presenteeism questions of the World Health Organization's Heath and Work Performance Questionnaire along with the Personal Wellness Profiles and the Patient Activation Measure. Bivariate and multivariate statistics were used to assess the interaction of independent health variables with absenteeism and relative or absolute presenteeism. Five health variables were significantly related to absenteeism and relative presenteeism while eight variables were significantly related to absenteeism and absolute presenteeism. Only two significant variables were shared in common with both of these scoring approaches indicating the most robust associations. Understanding the relationships between health conditions, absenteeism and presenteeism provides only partial insight into the economics of these interactions. Coming to work sick may be particularly associated with smoking and levels of patient activation.