Presenteeism

The Invisible Cost to Organizations

H. Quazi

• Publisher: Palgrave Macmillan
• Year: 2013
• Print ISBN: 9781137275660
• eBook ISBN: 9781137275677
• Topic: Business
• Subtopic: Business Strategy
• Index: Business

Presenteeism presents the important issues related to the nature and extent of presenteeism and cited examples from different studies. The book discusses in depth why employees come to work despite being sick, strategies to manage presenteeism behavior and who should be taking the lead in managing such employee behavior.

1

Introduction

Absenteeism at work is one of the most-measured indicators to determine the health of an organization. This is based on an assumption that when employees are at work they are being productive. However, this assumption gives an inaccurate picture of employees’ health and workplace productivity. In fact, when employees come to work sick they are unable to work as productively as healthy workers. Experts in the field argue that to measure the health and workplace productivity of an organization both absenteeism and the lost productivity of employees who come to work sick (called as ‘presenteeism’) need to be included.

Sickness presenteeism is an emerging issue in organizations, as it entails one of the biggest drains on productivity. Proponents of this concept argue that, being present in the workplace while ill could be even costlier than being absent. This book explores the phenomenon of sickness presenteeism in different countries and its impact on employees’ productivity and work-related conditions.

In recent decades, studies have revealed a high incidence of sickness presenteeism among employees (Aronsson et al., 2000; Elstad and Vabo, 2008; Hansen and Andersen, 2008). It has become a prevalent phenomenon among employers and employees in today’s business world (Saarvala, 2006). This negatively affects output, quality of work-life and employee health (Lowe, 2002). Unlike absenteeism, sickness presenteeism among employees is not always noticeable, as one cannot easily tell whether the productivity of the employee who turns up for work is affected by his or her health conditions (Hemp, 2004).

U.S.-based studies have reported that sickness presenteeism costs U.S. companies over USD150 billion a year (Hemp 2004). Another study has shown that coming to work with migraine/headache and allergies, costs U.S. organizations USD12 and USD2.8 billion, respectively, through lost productivity (Burton et al., 2004). Some of the common health conditions that have been studied by these researchers are allergies, flu, asthma, diabetes, hypertension, arthritis, back and neck pain, migraine/headache and a few others. The reasons for coming to work despite being sick have been identified by the researchers as being ‘ill prepared’ to be absent due to sickness, fear of falling behind, reluctance to use sick leave and a misguided sense of duty.

Most such studies have been conducted in Western contexts that may not accurately reflect the prevalence of sickness presenteeism in other regions/countries in the world. In view of this, we undertook to carry out a series of empirical studies exploring different facets of sickness presenteeism issues in Singapore. During the period 2008 to 2012, the author with his final-year business students conducted three studies in Singapore. In the first study, conducted in 2008, 273 working adults responded to the survey. From this survey, it has been found that sickness presenteeism is prevalent among working adults in Singapore. The majority of the respondents cited ‘work commitments’ as the main reason for reporting to work despite being sick. In line with some other studies, this one also showed that female employees exhibited significantly higher levels of sickness presenteeism than do their male counterparts. Based on our estimate, approximately 4 per cent of an employee’s annual eligible work time is lost due to sickness presenteeism. This loss of productivity amounts to an average cost of SGD2,096 per annum to organizations for an employee earning a mean annual base salary of SGD36,000. This translates to a hidden loss of SGD210,000 per annum for businesses with only 100 employees, and SGD1.05 million for one with 500 employees.

The second study sought to: (a) understand the extent to which job-related factors such as job demand, job status, and employees’ awareness impact on presenteeism behaviour; (b) determine whether there were differences in sickness presenteeism between managerial and non-managerial level employees; (c) whether awareness of health-related programmes had any impact on sickness presenteeism; and (d) compute the detailed breakdown of costs of sickness presenteeism for selected medical conditions.

For this study, data was collected from 280 respondents, across various industries and diverse in age, gender, salary, and job status. The results showed that a job’s demands have a significant positive relationship with sickness presenteeism. It was also found that there were significant difference between sickness presenteeism as experienced by employees holding managerial positions and by those in non-managerial levels. Health-awareness programs were found to be inversely related to sickness presenteeism.

Our analyses on the cost of sickness presenteeism revealed that the most expensive health conditions were headache, cough and influenza. For instance, an employee who is 50 years old or under and earning a mean annual salary of SGD27,000 would cost the employer approximately SGD920 per year if he or she reports to work despite having a headache. This means that approximately 3.4 per cent of the employee’s annual salary will be unearned due to this health condition.

The third study was conducted between January and February 2012, examined the predictors of presenteeism, including ‘work context’ and ‘personal factors’. It also explored the effects of organizational culture and personality on presenteeism and examined in-depth why the Singaporean employees went to work despite being sick.

Figure 1.1   Conceptual framework

Source:  Developed by the author.

Literature indicates that reduction sickness presenteeism has become important from both public health and business organizations. Based on the findings of these and other similar studies conducted in other countries, employers may seriously consider ways to reduce sickness presenteeism in their own organizations. For example, health-awareness programs, subsidies for general health screening, and counselling for employees are some of the possible ways that the employers may pursue to reduce sickness presenteeism in their own organizations. This is to be noted that the benefits of reducing sickness presenteeism are mutual whereby employees can balance their health and work better and employers can reduce productivity losses and other related costs due to sickness presenteeism. Experts argue that if such an goals are achieved, this could ultimately result in the creation of a healthy and competitive workforce, and a healthy working environment which contributes to a strong foundation of organizational performances. This book has been organized around the theme of the three ‘W’s and one ‘H’ (that is. ‘What’ is presenteeism? ‘Why’ do employees go to work despite being sick? ‘How’ is presenteeism behaviour to be managed? ‘Who’ should be taking the lead in managing presenteeism behaviour?) shown in the conceptual framework below (Figure 1.1).

This book has been organized in ten chapters as listed below. Besides this introductory chapter, Chapter 2 explains what presenteeism is, its impact on employee productivity and the equivalent (but invisible) costs to the organization and the entire economy. In this chapter, research findings of a number of studies are presented. As the concepts of ‘absenteeism’ and ‘presenteeism’ are closely related, Chapter 3 explains the similarities, dissimilarities and the interrelationships of these two concepts. Some related research findings in this regard have also been presented. Chapter 4 addresses the issues of ‘Why’ employees go to work despite being sick. This chapter also cites examples and research findings from the literature.

Chapters 5 through 7 present the details of the three studies conducted in Singapore from 2008 through 2012. For example, in the first Singapore study, the focus was on understanding the nature and extent of sickness presenteeism (Chapter 5). In this study, using a customized questionnaire, data was collected from adult employees in Singapore. Based on the data collected, a composite (that is, including all sicknesses) ‘annual eligible work time lost’ figure was computed using a metric proposed by one of the experts in the field. This figure was then monetized using the pay- and benefits-related information of the employees (respondents of the survey) from the government and other published statistics. In addition, the study also separately computed the ‘annual eligible work time lost’ by male and female employees. Details of computations are also reported. Chapter 6 presents the study that investigated the costs of presenteeism in Singapore. In this chapter the impact of the impact of ‘chronic’ and ‘acute’ health conditions on presenteeism are computed. This study also compute the cost of presenteeism for each of 11 health conditions, of which 6 (conditions i.e., allergy, asthma, arthritis, anxiety, chronic back pain and hypertensions) belong to ‘chronic’ health conditions and rest 5 (i.e., cough, diarrhoea, fever, headache and influenza) belong to acute conditions. In addition, presenteeism costs for managerial and non-managerial employees were also computed and contrasted. The third study (reported in Chapter 7) specifically examined in-depth why Singaporean employees went to work despite being sick. This book has been organized in 10 chapters as shown below.

Chapter 1: Introduction

Chapter 2: Presenteeism: A Costly Affair for Employers

Chapter 3: Absenteeism and Presenteeism

Chapter 4: Why Do People Go to Work Even When Unwell?

Chapter 5: Nature and Extent of Presenteeism in Singapore

Chapter 6: Impact of Chronic and Non-chronic Health Conditions on Presenteeism: A Study in Singapore

Chapter 7: Why Do Employees Go to Work Despite Being Sick? An Exploratory Study in Singapore

Chapter 8: How Should Presenteeism Behaviour be Managed?

Chapter 9: Measuring the Costs of Presenteeism

Chapter 10: Summary and Discussions

References

G. Aronsson, K. Gustafsson and M. Dallner (2000) ‘Sick but yet at work: an empirical study of sickness presenteeism’, Journal of Epidemiology and Community Health, LIV (7), 502–509.

W.N. Burton, G. Pransky, D.J. Conti, C.Y. Chen and D.W. Edington (2004) ‘The association of medical conditions and presenteeism’, Journal of Occupational and Environmental Medicine, XLVI (6), S38–S45.

J.I. Elstad and M. Vabø (2008) ‘Job stress, sickness absence and sickness presenteeism in Nordic elderly care’, Scandinavian Journal of Public Health, 36 (5), 467–474.

C. Hansen and J. Andersen (2008) ‘Going ill to work – what personal circumstances, attitudes and work-related factors are associated with sickness presenteeism?’ Social Science and Medicine, LXVII, 956–964.

P. Hemp (2004) ‘Presenteeism: at work but out of it’, Harvard Business Review LXXXII (10), October, 49–59.

G. Lowe (2002) ‘Here is body, absent in productivity’, Canadian HR Reporter, XV (21), 5, 8.

E. Saarvala (2006) ‘Presenteeism: the latest attack on economic and human productivity’, Human Resources Management, SCS 0987–049, University of Toronto, Ontario, Canada.

2

Presenteeism: A Costly Affair for Employers

2.1 What is presenteeism?

The term presenteeism was coined by Cary Cooper, professor of Organizational Psychology and Health, Lancaster University. ‘Dictionary.com’ defines presenteeism from two different angles: ‘The practice of coming to work despite illness, injury, anxiety, etc., often resulting in reduced productivity’; and ‘The practice of working long hours at a job without the real need to do so’. In fact, various authors have described the nature and impact of presenteeism differently to reflect how they view this type of employee behaviour. Some of their definitions are presented in Box 2.1.

Box 2.1 ‘Presenteeism’ as defined by scholars

• ‘Going to work despite feeling unhealthy’ (Aronsson et al., 2000; Dew et al., 2005).

• ‘When employees attend work at times when sickness absence is justified and perform their w...

Table of contents

• Cover
• Title
• 1 Introduction
• 2 Presenteeism: A Costly Affair for Employers
• 3 Absenteeism and Presenteeism
• 4 Why Do People Go To Work Even When Unwell?
• 5 Nature and Extent of Presenteeism in Singapore
• 6 Impact of Chronic and Non-Chronic Health Conditions on Presenteeism: A Study in Singapore
• 7 Why Do Employees Go to Work Despite Being Sick? An Exploratory Study in Singapore
• 8 How Should Presenteeism Behaviour Be Managed?
• 9 Measuring the Costs of Presenteeism
• 10 Summary and Discussions
• Index