Now more than ever, employee health and wellbeing is at the forefront of the organisational agenda. There are extensive human and organisational benefits to focusing on health and wellbeing, from improvements in productivity and engagement, to reductions in absenteeism and work-related disease. Employers are increasingly taking a proactive and preventative approach to health and wellbeing, and integrating wellbeing into the everyday employee experience. This involves considering the design of work itself, relationships at work, as well as specific health and wellbeing initiatives and support.

Peakon’s standard health and wellbeing question library includes:

  • 1 main health and wellbeing question
  • 2 health and wellbeing outcome questions
  • 4 driver questions
  • 11 sub-driver questions

This article will cover the theory behind the main health & wellbeing questions, as well as the 4 driver and 11 sub-driver questions. If you are part of the Business or Premier plan and do not yet have the health and wellbeing questions activated, please contact your customer success manager to add them to your account.

Main health and wellbeing driver

  • Main question: Employee health and wellbeing is a priority at [Company].

Health and wellbeing are closely interlinked: wellbeing has been shown to promote health (Howell et al., 2007). Similarly, the World Health Organization defines health as “a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”. In the workplace, wellbeing can be considered as the “positive and sustainable characteristics which enable individuals and organisations to thrive and flourish” (University of Cambridge Wellbeing Institute).

Health and wellbeing outcome questions

Additional health and wellbeing outcome questions that can be activated:

  • 'Productivity' outcome question: I have the necessary mental and physical health to perform effectively at work.
  • 'Balance' outcome question: I feel able to manage the impact of work on my personal life.

Health and wellbeing has a direct impact on productivity and performance at work (Miller 2016; Nielsen et al., 2017). Poor mental and physical health contributes to absences from work. At organisations where employees feel compelled to show up for work even when they’re ill, this can actually harm productivity. On the other hand, when employees feel their organisation cares about their wellbeing, they are likely to respond with increased efforts, based on the norms of reciprocity (Eisenberger & Stinglhamber, 2011). Health and wellbeing also increases productivity by increasing our “intrinsic motivation” to work. That’s when we feel motivated to do something because it’s fulfilling in itself. To be intrinsically motivated, we need to feel autonomous, competent, and a sense of relatedness to others in our jobs. An environment that supports health and wellbeing naturally helps fulfil these needs, boosting intrinsic motivation (Demerouti et al. 2001). Ultimately, wellbeing has been shown to strengthen the relationship between engagement and performance (Robertson & Cooper 2010).

People with higher levels of wellbeing are less likely to suffer from changes or disruption in their work or personal lives. They’re more likely to feel able to maintain a healthy work-life balance and to feel greater effectiveness in their job (Eisenberger & Stinglhamber, 2011). All these things help people feel more equipped to cope with the demands of work and personal life, reducing work-life conflict (Eisenberger & Stinglhamber, 2011).

Mental wellbeing driver

  • Driver question: I am able to look after my mental health, working at [Company].
  • 'Competing Demands' sub-driver question: I know how to balance any competing demands in my role.
  • 'Role-related Stress' sub-driver question: I am able to manage the stress of my role.
  • 'Involvement' sub-driver question: I am satisfied with my level of involvement in decisions that affect me.

Mental wellbeing at work assesses the psychological and emotional quality of an individual's life in relation to their work. This includes their ability to cope with work-related stress and realise their full potential and productivity. When an individual feels that they get sufficient support to help them cope with work-related stress and take care of their mental health, this can make all the difference. Organisations can significantly affect their employees' mental wellbeing by focusing on the psychological climate at work (Shuck & Reio, 2014).

An overall imbalance between the demands and resources associated with an employee’s role can lead to role-related stress. According to Job Demands-Resources theory (Demerouti et al., 2001), when an individual is subject to excessive job demands (such as workload or time pressure) or has insufficient resources to manage demands, this leads to stress. Over a sustained period, this can cause burnout. Burnout is associated with symptoms of exhaustion and withdrawal behaviour, and can lead to health problems such as depression. Bakker et al. (2003) observed that the impact of job demands on exhaustion was particularly strong if job resources were low.

When people have to juggle competing role demands — for example, when a person works on multiple teams and is faced with overlapping deadlines for each — this leads to a stressor known as “role conflict”. The clash of role expectations are thought to cause stress by reducing an individual’s sense of effectiveness in their role. If not managed, this role conflict can lead to mental strain (O’Driscoll & Beehr 1994). Another stressor is “role ambiguity”. This is the uncertainty that an individual experiences when there is a lack of information about what is expected of them in terms of responsibilities and performance. According to the Job Demands-Resources model, role conflict and role ambiguity acts as demands, which can lead to burnout, particularly when resources are low (Demerouti et al. 2001).

One way of preventing demands from becoming overwhelming is to involve people in decisions that affect them (Karasek, 1979). By allowing people more discretion in deciding how to meet demands, or “decision latitude”, this provides a sense of control and fairness that can reduce stress (Karasek, 1979). When people perceive that fairness is missing, particularly a sense of “procedural fairness” around decision-making processes and the distribution of resources, this can have a negative impact on health (Kivimäki et al., 2003).

Physical wellbeing driver

  • Driver question: [Company] cares about my physical health.
  • 'Taking Sick Leave' sub-driver question: I feel able to take time away from work when I am unwell.
  • 'Physical Environment' sub-driver question: My physical work environment supports my physical health.

Physical wellbeing concerns an individual’s ability to perform daily activities free of physical limitations, and having enough energy levels to function optimally. At work, an employee’s physical wellbeing can be directly affected by health promotion programmes, and more indirectly by the working environment. The working environment includes both the physical environment, as well as the culture and policies of the organisation, such as those surrounding sick leave. A healthy workplace is therefore not only free from hazards, but provides an environment that allows employees to thrive.

The physical working environment can have a negative impact on health if risks and hazards are not properly managed. Work hazards include physical hazards, such as falls, loud noises, and extreme temperatures, as well as chemical or biological hazards. Ergonomic hazards related to musculoskeletal problems are receiving increasing attention. Musculoskeletal injuries, including neck and back strain are recognised as some of the most common causes of short- and long-term illness in the workplace. In fact, a study revealed musculoskeletal disorders as responsible for 29% of all working days lost to work-related ill health (HSE, 2019). The occupational health literature is full of research on the impact of workplace hazards on health, and on the occurrence of occupational disease. Researchers have found that when employees are exposed to multiple hazards simultaneously, this has a bigger overall impact than the cumulative impact of individual hazards alone.

An organisation’s culture also impacts an employee’s physical well-being. In organisations where employees tend to show up to work when they’re ill, it’s been shown that this “presenteeism” results in greater productivity loss over time than employee absences (Johns, 2010). Presenteeism can also worsen health conditions and lead to longer recovery times. Psychologically, it lowers employee satisfaction and employees’ perceptions of their own effectiveness (Johns, 2010). In one study of workers with chronic health conditions at a US chemical company, it was found that the costs of presenteeism exceeded the combined costs of employee absence and medical treatment (Collins et al., 2005). This points to the importance of effective rehabilitation programmes for employees following illness or injury, including any appropriate adjustments to their role and a focus on the employee’s needs.

To combat these hazards, an organisation needs to have healthy policies around sick leave and encourage employees to take care of their physical health. Workplace health promotion programmes are designed to influence employee health practices and improve health indicators, such as weight, blood pressure and cardiovascular disease. Although the design of such programmes vary from organisation to organisation, researchers reviewing the evidence have found a positive impact on health outcomes (Hutchinson & Wilson, 2012; Conn et al., 2009; Shröer et al., 2014).

Social wellbeing driver

  • Driver question: I have mutually supportive relationships with people at work.
  • 'Change Support' sub-driver question: I feel I could speak to my manager about any changes happening at work.
  • 'Co-worker Support' sub-driver question: My co-workers provide me with personal support when I need it.
  • 'Personal Support' sub-driver question: I feel I could speak to my manager about challenges I am facing outside of work.

Social wellbeing relates to the social interactions and connections an individual has with others at work, including the depth of relationships as well as the availability of social support. According to Job Demands-Resources theory, social support from supervisors and co-workers can have a direct impact on wellbeing by providing a resource against stress (Demerouti et al. 2001). On the other hand, poor relationships at work increase stress, and bullying and abuse has been linked to burnout and lower levels of wellbeing (Yagil, 2006; Hackney & Perrewé, 2018).

There is evidence that particular leadership styles, such as “transformational leadership”, correlate with greater employee wellbeing. Leaders who display this style show social support, empower their employees, and are considerate of their needs (Skakon et al. 2010). Leaders can also extend social support for problems outside of work by showing empathy and care.

In addition to helping prevent stress, social support can also help people feel less stressed when they are facing too many demands or uncertainty (Viswesvaran et al., 1999; Karasek, 1982). The support offered by managers and leaders can help protect employees from the stress associated with organisational change (Mackay et al. 2004). It’s been shown that how managers coordinate these changes has a significant impact on the experience and perceptions of the people affected. Managers can help employees adapt by ensuring they understand the reasons and implications of the changes, and by giving them the opportunity to raise any questions or concerns.

Organisational support driver

  • Driver question: [Company] provides me with information and support to manage my health and wellbeing.
  • 'Role-modelling' sub-driver question: Senior leaders at [Company] show that employee wellbeing is important to them.
  • 'Benefits' sub-driver question: I am satisfied with the health and wellbeing benefits provided by [Company].
  • 'Financial Support' sub-driver question: [Company] would provide me with support to manage my personal finances, if I needed it.

Organisational support measures whether employees feel the organisation makes formal and informal efforts to support their wellbeing. Research shows that, as well as resources provided at the individual level, organisation-level resources have a significant impact on wellbeing (Nielsen et al. 2017). Organisational support is positively correlated to “perceived organisational support” (POS). This is an employee’s perception of the extent to which the organisation values their contribution and cares about their wellbeing (Eisenberger & Stinglhamber, 2011). High POS is linked to positive outcomes, such as higher employee engagement and performance, as well as higher self-reported levels of subjective wellbeing (Baran et al. 2012; Eisenberger & Stinglhamber, 2011).

As representatives of an organisation, senior leaders at an organisation play an important role in boosting POS. By providing information and support, and showing positive behaviours such as empowerment and feedback, leaders can also provide a resource against stress and improve affective wellbeing (Skakon et al., 2010). Leaders can also help foster trust that the organisation genuinely supports employee wellbeing by role-modelling healthy behaviours (Eisenberger & Stinglhamber, 2011). Examples of healthy behaviours include using health and wellbeing benefits and showing that they value maintaining a work-life balance. The evidence has shown that role-modelling increases healthy behaviours in employees. On the other hand, when employees perceive that leaders are stressed, this can increase their stress levels as well (Skakon et al., 2010).

Organisational support can also manifest itself through a holistic wellbeing strategy which includes benefits such as access to mental health programs, financial aid, or support from qualified mentors. Researchers reviewing the impact of health and wellbeing benefits have found that these can lead to improvements in health outcomes. Benefits also improve levels of employee satisfaction and organisational outcomes such as absenteeism and productivity (Grawitch et al., 2006). But simply offering benefits or health promotion programmes is not sufficient to ensure uptake. Rather, employees need to feel satisfied with the offerings and motivated and capable of using them. This points to the importance of aligning the benefits employees want with the ones that an organisation actually offers (Grawitch et al., 2006).

Financial support, such as pension advice and debt counselling, is increasingly recognised as a preferred and effective benefit to support financial wellbeing (CIPD 2017). Financial concerns can impact an employee’s mental and physical health (Selenko & Batinic 2011; Brüggen et al. 2017; Chou et al. 2016). By helping employees make informed decisions regarding their finances, and ensuring they feel fairly compensated for their contributions, this significantly helps reduce stress and ill health.

Article: Engagement question library and theory references

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