Unhealthy choices cost company health care plans billions of dollars


One out of every four dollars employers pay for health care is tied to unhealthy lifestyle choices or conditions like smoking, stress and obesity, despite the fact that most large employers have workplace wellness programs.

In the largest study of its kind, researchers from the University of Michigan looked at 10 modifiable health risks in roughly 223,500 people across seven industries, said Michael O’Donnell, first author on the study and director of the U-M Health Management Research Center at the School of Kinesiology.

Modifiable risks are conditions or behaviors that employees can improve or eliminate by making healthier choices. Obesity was most prevalent and cost employers the most money, followed by stress and use of mood-altering drugs. Other risks included seatbelt use, exercise, tobacco and alcohol use, blood pressure and cholesterol.

The results illustrate the substantial savings employers might realize by reducing or eliminating those risks through workplace wellness programs, O’Donnell said.

“There are hundreds of well-designed programs, but thousands of programs that are too superficial to have an impact,” O’Donnell said. “The best programs increase awareness about the link between lifestyle and health, motivate people to change and build the skills necessary to do so, and provide opportunities to practice a healthy lifestyle.”

The goal of wellness is to prevent disease from occurring in a way that saves money, O’Donnell said. Many previous studies have shown that successful wellness programs result in healthier employees and save more in medical care than they cost to design and implement.

“Employee wellness programs are a win-win for employers and employees. If employees improve their lifestyle, they feel better and reduce their chances of getting sick,” O’Donnell said. “Costs go down for employers and their employees, or at least costs do not increase as much as they would otherwise.”

The U.S. has worse health outcomes than most other developed nations, despite spending almost twice as much on health care.

“Medical care costs are out of control in the U.S. and also for employers,” O’Donnell said. “This makes it difficult for some businesses to compete globally.”

U-M researchers also found that the extra cost associated with modifiable risks was about the same for healthy employees and those with chronic conditions — which means employers can save money by helping those workers reduce existing health problems.

The average health care cost for a healthy employee was roughly $3,000, and roughly $10,000 for an employee with at least one medical condition, the study found. Modifiable behaviors and conditions accounted for about $750 for healthy employees, and about $2,600 for those with pre-existing health problems.

The study is scheduled to appear in a forthcoming issue of the Journal of Occupational and Environmental Medicine. Co-authors are Alyssa Schultz and Louis Yen of the Health Management Research Center.



  1. David Anderson
    on December 14, 2015 at 8:12 am

    An extra $1,000/year incentive to those who keep their weight in the healthy target range could provide the incentive needed to make better choices. For each percentage point above the target range you would lose $100 of the bonus, so those who are 10% or more above the range don’t receive the incentive money.

    • Erin S
      on December 14, 2015 at 10:04 am

      Would employees paid through grants and other fixed income amounts be excluded from the ability to receive this incentive, you think?

  2. Mary Roberts
    on December 14, 2015 at 8:43 am

    It amazes me how workers who smoke are allowed to take smoke breaks. They come back to their unit smelling if smoke. They should be discouraged not to smoke while at work. Patients comment about the smell. You would hunk a hospital wound say no smoking while at work.

  3. r m
    on December 14, 2015 at 8:57 am

    Not sure how stress is a lifestyle choice. Especially if it’s mostly related to your work at your employer. “unhealthy lifestyle choices or conditions like…stress…”

    • Michael O’Donnell
      on December 14, 2015 at 12:11 pm

      Good point. Stress is not a lifestyle choice; it is a health condition, as is weight or blood pressure. The lifestyle choices related to stress are making decisions to avoid stressful situations and learning methods to cope with stress. However, we need to recognize that some people do not have control over stressful aspects of their lives.

    • Doren Ripley
      on December 14, 2015 at 7:27 pm

      Not a lifestyle choice, a way of life , if you are a Nurse.

  4. George Woods
    on December 14, 2015 at 9:33 am

    Stress is caused many times by outside influences which people have no control over. Obesity many times is a result of other physical problems the medical profession refuses to recognize and just blows it off as a result of being obese.
    Many obese people are prejudged and denied proper care and diagnosis’s by many doctors. The obesity can be a result of pain causing a lack of mobility.
    Discrimination against the obese is all to common.

  5. Bonnie Krey
    on December 14, 2015 at 2:43 pm

    RM, Michael O’Donnell and George Woods are right on! Stress IS NOT a lifestyle choice.When you are too stressed out-exercise and eating right is the last thing on your mind. We all know why obesity is an epidemic. Eating and drinking “food like” substance and not real food, too much stress…we did not cause the obesity epidemic, our government and the FDA have the biggest hand in that. And then they call out against the rising costs of healthcare. Have the doctors forgotten what the sugar substitutes can do to a human body? “food like” sugar??? At least real sugar is “real”. Oxymorons…

  6. Anon ymous
    on December 17, 2015 at 10:15 am

    Meanwhile, my employer, the University of Michigan, is making more demands on my time every year. All the “unhealthy choices” as if they are a choice, take resources, support, and most importantly time to address. I’m exhausted from my work schedule, which I see happening to far too many colleagues on staff at U-M. MHealthy is just another guilt trip that rewards the marathoners and triathletes. How bout monitoring the workload? Stress is an unhealthy “choice?” Really? I understand how important these scientific studies are, but this slant of “coverage” in the daily employee newsletter just fuels more bias and resentment in the workplace.

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