Corporate Programs for the Promotion of Healthy Lifestyles and Their Health, Economic and Organizational Impact: A Critical Review of Evidence on Well-Being, Costs, Absenteeism, Presenteeism, Productivity and Return on Investment

Abstract

Corporate healthy lifestyle programs seek to improve physical activity, diet, and other health-related behaviors in the workplace. This structured critical review examined evidence on health, behavioral, and organizational effects, with emphasis on healthcare costs, absenteeism, presenteeism, productivity, and return on investment (ROI). Findings were more consistent for behavioral changes and some risk factors than for economic and organizational outcomes. In a randomized trial involving 32,974 workers across 160 sites, regular exercise increased by 8.3 percentage points and active weight management by 13.6 percentage points, without equivalent significant effects on clinical indicators, healthcare costs, or job performance. At three years, the estimated difference in medical spending was −US$297.90 per worker/year, but it was not statistically significant (95% CI: −US$1,201 to US$605; p=0.91). In 11 studies involving 60,020 participants, a review of physical activity-based corporate programs estimated a mean cost of €359, (≈US$388), and a mean net benefit of €1,095, (≈US$1,185), with a mean ROI of 3.6. Evidence on absenteeism was favorable in some analyses, whereas presenteeism and productivity showed less consistent results. Overall, these programs may contribute to well-being and modification of risk factors, but business profitability and healthcare savings have not been universally demonstrated. Evaluations with follow-up beyond three years and standardized outcome measurement are needed to distinguish sustained effects from short-term associations and financial estimates.