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Dr. Wendy Lynch notes that until recently, researchers “would most likely answer this question in terms of saved medical costs. A healthy employee with few health risks spends less money on medical care due to fewer chronic illnesses and avoided serious health events. This story alone is quite compelling—employees with multiple risk factors can cost thousands of dollars more than low-risk employees, on average. Furthermore, as our population ages, the difference will grow substantially.”

“Despite such evidence, many employers still consider poor employee health to be a fringe issue, not a true business issue. Health care costs are a single (though large) line item in a large benefits budget, inside the multifaceted human resources (HR) cost center. Although corporations recognize hiring, firing, providing benefits, and doing performance evaluations as necessary functions, HR is not usually considered part of a company’s core business. “Real” business is where the money gets made. HR is a necessary cost of doing business. In this context, medical costs are something to be controlled and managed, so benefits budgets stay reasonable. After all, medical coverage is an expense, like providing parking, vacation, and life insurance. In essence, following the same logic, employees are a necessary expense, too. They’re needed to get things done, but come with a large price tag.”

“Without realizing it, the medical cost focus of health promotion research may have perpetuated a perception of health as extrinsic to business. If high medical costs are the primary outcome of poor health, then businesses can restructure benefits (or stop providing health insurance) to make the problem go away. Besides, high health care costs may not occur for years, so decision-makers often avoid investments in good health (which just add to their expanding budget) in the short term in exchange for a potential return in the benefits budget later. But the decisionmakers are missing something.”