The economic impact of workplace physical activity interventions in Europe: a systematic review of available evidence

• DOI: https://doi.org/10.1108/IJWHM-04-2021-0105
• Published date: 08 April 2022
• Date: 08 April 2022
• Pages: 445-466
• Subject Matter: Health & social care,Healthcare management,HR & organizational behaviour,Human resource policy,Employee welfare
• Author: Alexander Braun,Arleta Anna Franczukowska,Irina Teufl,Eva Krczal

The economic impact of workplace

physical activity interventions

in Europe: a systematic review

of available evidence

Alexander Braun

Institute Health Management, IMC University of Applied Sciences Krems,

Krems, Austria, and

Arleta Anna Franczukowska, Irina Teufl and Eva Krczal

Department of Economy and Health, University for Continuing Education Krems,

Krems, Austria

Abstract

Purpose –There is growing interest in the economic impact of workplace physical activity interventions, but

the evidence is still lacking —especially in Europe. Although, some evidenceon the return on investment (ROI)

is found in literature, the included studies may not be applicable to the Europe situation. Therefore, the

objective of this study was to review current evidence on the economic impact of workplace physical activity

interventions in European countries.

Design/methodology/approach –A systematic review on the economic impact of worksite health

promotion programs aiming at increasing physical activity was conducted. Five electronic databases

(MEDLINE (Ovid), MEDLINE (PubMed), EMBASE, NHS-EED and Emerald Insights) were searched for

relevant studies published between 2000 and 2020.

Findings –A total of 953 abstracts were screened, and 28 were reviewed, 11 of which met all inclusion criteria.

The studies varied substantially in sample size, intervention type, duration and frequency of follow-up

measurements, valuation methods and assessed economic outcomes. There is inconclusive evidence for

decreasing absenteeism, positive net benefit (NB) and positive ROI. No evidence was found to indicate an effect

on self-assessed productivity or job satisfaction.

Originality/value –This study is the first try to take the different working conditions from Europe into

consideration. The authors found that working conditions could have some impact on the valuation of

absenteeism costs and thereof on the ROI. Further, this study provides insight into how to deploy effective and

efficient workplace physical activity interventions, based on a standardized and validated methodology and

program scope.

Keywords Health promotion, Productivity, Occupational health, Workplace health management

Paper type Research paper

Economics of

workplace

physical

interventions

445

© Alexander Braun, Arleta Anna Franczukowska, Irina Teufl and Eva Krczal. Published by Emerald

Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0)

licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both

commercial and non-commercial purposes), subject to full attribution to the original publication and

authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/

legalcode

All authors declare that they accept the submission of the paper: “The economic impact of workplace

physical activity interventions in Europe: a systematic review of available evidence”at the International

Journal of Workplace Health Management. The authors further declare that the listed tasks were

undertaken by the named authors, and the authors did not have any conflicts of interest.

Funding Statement: This research received no specific grant from any funding agency in the public,

commercial or not-for-profit

Conflict of Interest: We declare that there is no conflict of interest.

The current issue and full text archive of this journal is available on Emerald Insight at:

https://www.emerald.com/insight/1753-8351.htm

Received 4 May 2021

Revised 29 July 2021

3 December 2021

23 February 2022

Accepted 14 March 2022

InternationalJournal of Workplace

Health Management

Vol. 15 No. 4, 2022

pp. 445-466

Emerald Publishing Limited

1753-8351

DOI 10.1108/IJWHM-04-2021-0105

1. Background

There is incontrovertible evidence of the positive impact of physical activity on an

individual’s health and well-being. Regular physical activity has been shown to help prevent

the development of several chronic and non-communicable diseases (Reiner et al., 2013).

Physical exercise can also help with the management of musculoskeletal disorders and may

reduce the risk of premature death (Holth et al., 2008). Given these well-proven health benefits

and associated economic advantages (avoiding medical costs and productivity losses),

promoting physical activity has become an important human resource and business issue

(Malik et al., 2014). However, according to the most recent Eurobarometer on Sport and

Physical Activity, a large proportion of the European population is still physically inactive, a

trend that is increasing (2009: 39%; 2013: 42% and 2017: 46%) (European Union, 2017).

Current figures for the European Union show that 13% of physical activity already takes

place at work (European Union, 2017). There is also a growing evidence base on the

effectiveness of workplace physical activity interventions on behavioral changes that may

improve employees’health and worksite outcomes (Conn et al., 2009;Dugdill et al., 2008;

ECORYS, 2017;Jacobs et al., 2017;White et al., 2016). However, as employers are interested

not only in the effectiveness of health promotion interventions but also in their financial

returns, research on this issue is also increasingly gaining attention (van Dongen et al., 2011).

This means that from a financial perspective, cost–benefit margin (net benefit (NB)) and a

positive financial return on every monetary unit spent (return on investment (ROI)) are crucial

parts of the employer’s decisions and were prioritized in this study. In addition, other issues

like public image and good reputation could be an important piece for employers. This

specific economic perspective is considered in this review in order to contribute to the

evidence on this question.

2. Purpose or aim

There is already some evidence on the positive economic effects of workplace health

promotion programs, but high-quality evidence is mostly lacking (Aldana, 2001;ENWHP,

2004;Baicker et al., 2010;Lerner et al., 2013;White et al., 2016). A number of well-cited studies

report a positive ROI (Aldana, 2001;Baicker et al., 2010;Lerner et al., 2013), but they also note

that the results are difficult to compare since the programs undertaken either are unspecific,

lack an experimental design, have too broad a focus or focus only on people with pre-

conditions (Aldana, 2001;Baicker et al., 2010;Lerner et al., 2013;White et al., 2016).

Furthermore, a lack of evidence has been found on whether specific workplace physical

activity interventions may have an economic impact on enterprises for healthy workers

(ECORYS, 2017). This research gap was primarily identified in the European context, as

many well-cited systematic reviews have focused on studies from the United States or

Canada, which are limited in their comparability to other national worksite health promotion

strategies (Aldana, 2001;Pelletier, 2001;Baicker et al., 2010;van Dongen et al., 2011;Chapman,

2012;Lerner et al., 2013;Jacobs et al., 2017;Steel et al., 2018;Baid et al., 2021). For instance,

there is some difference in work absences between European countries with a strong scheme

of continuing payment in case of illness and the United States, which could, for instance,

influence the valuation of absenteeism (costs) (van Dongen et al., 2012). Further, it is crucial to

consider that besides the difference in valuation, it is also clear that the differences in labor

legislation, like that regulating minimum wage, working conditions and working cultures, are

also diverging from the European Union to the US. Also, the gap between income and

unemployment varies to a broad extent between North/South and post-communist/West and

Central member states of Europe.

Due to heterogeneity of working conditions between the different continents and

valuation methods, there is some lack of evidence on economic efficiency, and nearly all the

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