Associations between workplace health promotion, presenteeism, absenteeism and health behavior

Abstract Background Since 2015, workplace health promotion measures (WHPM) are implemented in the German Federal Armed Forces to promote the health of military and civilian employees and thus improve the ability to defend state interests. Here the aim is to evaluate associations between participation in WHPM and absenteeism, presenteeism and health behavior. Methods A longitudinal observational study (T0: 06-09/2022; T1: 06-09/2023; T2: 06-09/2024) was conducted. Each survey invitation was addressed to around 200.000 employees of the GFAF (full survey). Employees who participated in at least two out of the three surveys were included (first participation: baseline: BL, last participation: follow up: FU). Results In T0 23.568 (10.5%), T1 14.059 (6%), T2 13.551 (6%) employees participated. N = 7.183 participated in at least two surveys (military: 49%, women (w): 35.1%; mean age 43.42 ± SD 10.37 years). A proportion of 48.8% (BL vs. 54.1% FU) of employees participating in WHPM reported presenteeism (no WHPM: BL: 53.7%; FU: 58.2%) with a relative increase in both groups (WHPM: +10.9%, no WHPM: +8.4%; OR 0.96; 95% CI [0.85, 1.07]). The chance of male employees to report presenteeism was 26% lower than in female employees (OR 0.74; 95% CI [0.65, 0.85]). Employees reporting depressive thoughts had a significant higher chance to report presenteeism (OR 2.24; 95% CI [1.39, 3.73]). For employees participating in WHPM the chance of reporting absenteeism was 22% higher (OR 1.22; 95% CI [0.91, 1.64]), but employees participating in WHPM reported healthier nutrition behaviour (OR 1.27 (95% CI [1.10, 1.46]) as well as more regular physical activity (OR 1.62; 95% CI [1.40, 1.87]). Conclusions WHPM have not shown to have a significant effect on presenteeism and absenteeism. Sex/gender and further subgroups have to be taken into consideration to design adequate measures. Nevertheless, the reported improvement of health behavior may lead to better health and thus less days of incapacity to work. Key messages • Workplace health promotion measures have not shown to have a significant effect on presenteeism and absenteeism. • Workplace health promotion measures have shown to have a significant effect on healthy nutrition and physical activity.