Presenteeism is the phenomenon of employees coming into work when they are sick or injured, instead of staying at home. It has also been termed “sickness presence”, and it is thought that workers in ill-health are likely to be ineffective and unproductive, which can result in increased financial costs and stress-related absenteeism in the long run – it is estimated that presenteeism costs the UK economy up to £15.1 billion annually.
Therefore, addressing presenteeism in the workplace is something that should be taken seriously. There is some preliminary but promising evidence that workplace health promotion may be effective in improving presenteeism. By promoting a healthy workplace, and by being conscious of the factors that may contribute to presenteeism, organisations can target this phenomenon, enhance productivity, and improve overall employee well-being in the workplace.
Certain organisational policies may play a role in presenteeism. Policies regarding sick leave, sick pay, and attendance may lead to employees feeling like they cannot be absent from work. In particular, a lack of paid sick leave and disciplinary “trigger points” with regards to absent episodes are thought to foster presenteeism. It is important that employers review such policies to ensure that sickness presence is not encouraged over legitimate sick leave.
Job design features may also stimulate presenteeism. Employees in high-demand jobs may wish to maintain high levels of performance and may therefore engage in presenteeism when they are unwell. Job demands include the physical, cognitive, and social features of a role that require sustained physical and psychological effort – it is therefore imperative that the demands of a job are not so high that an employee feels under pressure to meet all of these demands, even when they are unwell.
Ease of replacement is another feature which impacts on presenteeism – if employees feel that sick leave will result in their work piling up, this will also trigger presenteeism. Reasons why other employees may not be able to assist with sick colleagues’ workloads include lean staffing, high specialisation, and a lack of cross-training. Furthermore, employees may be inclined to be present when they are unwell if they feel that it is unfair for colleagues to have to take on more work. All of these features influence whether or not an individual engages in presenteeism, and so management should provide opportunities for cross-training and should encourage communication among all staff regarding what is considered fair and reasonable with regards to the replacement of work.
Some studies have found that presenteeism cultures may contribute to sickness presence. In certain organisations, employees can experience presenteeism pressures, particularly when there exists “competitive presenteeism” cultures. Such cultures can demand long work hours, the foregoing of recuperation time after business trips, and working while sick. Management should ensure that competitive presenteeism is not encouraged.
Individual risk factors
It is also important to consider the individual factors which may put individuals at greater risk of presenteeism. It is thought that potential risk factors include a poor diet, a lack of exercise, high stress, certain health conditions, and poor relations with peers and management. It is therefore important that employers address these factors, by encouraging healthy food options, activity in the workplace, and open communication with all staff, as well as by educating employees on the importance of looking after their personal health and their workplace relationships.
Organisations face a challenge when it comes to actually measuring presenteeism, as there is currently no universal agreement on the most appropriate method for measuring the concept. However, several self-report measures have been developed, which may prove useful for organisations. These instruments require employees answering various questions with regards to the degree to which they believe that health issues hinder them in performing the tasks required of their roles. Examples of some of these measures which could be incorporated include the Work Limitations Questionnaire (WLQ), Work Productivity and Activity Impairment (WPAI), and the Stanford Presenteeism Scale (SPS).
A positive work environment
It is thought that creating a positive work environment can help to reduce health risks and improve productivity in the workplace. While being aware of the organisational and individual factors which may contribute to presenteeism is important, it is just as vital to encourage a healthy and positive work environment, to defend against sickness presence. Workplace health promotion can have a variety of benefits for employers and employees alike, such as increased satisfaction and productivity, improved morale, reduced costs and turnover, and improved company profile. Some examples of workplace health promotion activities include:
- Measures to improve the working environment, such as assessments and audits on manual handling, display screens, and stress
- Organisational policies that encourage a work-life balance and that discourage sickness presence
- Education for employees on health-related topics such as exercise, healthy eating, alcohol, smoking, stress, heart disease, and cancer
- Health screenings for employees
- Providing free or subsidised healthy food options
- Encouraging employees to engage in physical activity throughout the day, e.g. during their lunch break
- Providing health insurance and GP visits
Guest Author, Jennifer Fennell, Counseling Psychologist