The effects of behavioral risks on absenteeism and health-care costs in the workplace.

The impact of behavioral risk factors on absenteeism and health-care costs was analyzed among 45,976 employees in a large, diversified industrial work force. A cross-sectional design was used to evaluate health risk appraisal and physical-examination data collected from 1984 through 1988. Employees with any of six behavioral risks had significantly higher absenteeism (range = 10% to 32%) compared with those without risks. These differences led to significantly higher illness costs (defined as compensation, health care, and non-health care benefits) for those with risks compared with those without risks. Annual excess illness costs per person at risk were smoking, $960; overweight, $401; excess alcohol, $389; elevated cholesterol, $370; high blood pressure, $343; inadequate seatbelt use, $272; and lack of exercise, $130. Only one factor, lack of exercise, was not significant after adjusting for age, education, pay category, and the six other behavioral risks. The total cost to the company of excess illness was conservatively estimated at $70.8 million annually. These findings suggest that the cost of key behavioral risks provides an opportunity to manage health-care cost increases through health promotion, financial incentives for healthy lifestyle, and environmental changes that affect health behaviors.