25 June: The US could unlock a $36 billion per year productivity premium by employers taking steps to ensure employees feel confident to speak up about their health and wellbeing needs, new research shows.
Economic modelling by the Centre for Economics and Business Research (Cebr), commissioned by BSI, suggests that organisations can generate measurable productivity gains when employees feel comfortable discussing health challenges and believe employers will respond with meaningful support. This includes chronic illness, mental health conditions, and other workplace health needs that can affect someone’s ability to work effectively.
The study found that employees with lower confidence about raising health, safety, and wellbeing challenges with their employers experience reduced productivity. This manifests through more work absences, a greater propensity to work while unwell, a greater risk of taking extended periods of leave or leaving a job altogether.
Early intervention is critical, and, while implementing workplace adjustments, flexible working arrangements, or other support measures may involve upfront investment, the research indicates these can deliver substantial long-term benefits for both employers and the wider economy.
The findings identify a clear "confidence productivity premium," demonstrating that organizations that effectively support employees through health challenges can benefit from improved productivity, stronger retention, and a more resilient workforce.
In the US, this is calculated to be worth annually:
• $773 per employee annually for physical health challenges
• $1,041 per employee for psychological health challenges
Scaled across the US economy, this equates to a potential:
• $22 billion productivity gain linked to physical health
• $14 billion for psychological health
This represents a combined opportunity of $36 billion for US businesses at a time when more than 26 million Americans with disabilities are outside the labor force and health-related barriers continue to affect workforce participation, productivity and retention remain critical challenges for employers.
Kate Field, Global Head of Human and Social Sustainability, BSI said: “Workplace wellbeing starts with a culture of trust. When employees are facing health challenges, employers are not powerless. There are easy but meaningful steps they can take to support their people and sustain organizational performance and resilience. Our findings show that, where trust has not been cultivated and support feels difficult to access, employees’ health challenges are more likely to escalate and lead to time away from work.
“We know that everyone has moments where their physical or mental wellbeing are not optimal; the support an individual receives at these moments from their employer can make a big impact. Interventions like providing time to recuperate, or simple changes to the way people can work that keeps them in work, impacts not only the individual but the success of the organization and wider society.”
While the stigma surrounding many health and wellbeing issues has gradually diminished, many people still do not feel comfortable asking their employers for help and support. This is more pronounced for certain challenges. In the US, only 29% of employees were fully confident that their employer would provide support for a physical challenge, with less (16%) confident their employer would support a psychological challenge.
This may reflect limited awareness of the support available in workplaces and a lack of clear pathways for disclosure. Yet where they are confident about coming forward, the CEBR analysis identifies three areas of impact:
• Absenteeism: Employees with low confidence accumulate more days of absence over the year (an average of 1.7 additional days). While they may take leave less frequently, their absences tend to last longer, making them more disruptive and harder for employers to manage.
• Presenteeism: Rates of presenteeism are higher among employees with low confidence, reflecting a reduced ability or willingness to seek adjustments, take time off, or access support when needed. As a result, these employees are more likely to work while unwell, which can lower overall productivity. This effect is particularly pronounced for those experiencing physical challenges, where presenteeism is 13.9% higher compared with more confident colleagues.
• Job separation: Workers with low confidence are significantly more likely to leave roles or take extended leave. For example, 46.5% of low confidence employees experiencing psychological challenges reported leaving a job or taking extended time off, compared with 37.4% with greater confidence. Among those experiencing physical challenges, the gap is wider (44.6% versus 30.0%).
CEBR’s analysis sends a clear message that investing in employee wellbeing has moved from a peripheral cultural initiative to a commercial advantage for US businesses.
Liam Daly, Senior Economist, Centre for Economics and Business Research (CEBR) said: “Our analysis finds that the productivity premium unlocked when employees feel confident to raise health challenges with their employers is worth $36 billion. Critically, this reframes the employer's role from passive obligation to active opportunity. Fostering a culture of trust and openness is a tangible and achievable goal. Workplaces with stronger standards-based provisions are consistently associated with fewer workplace absences among employees facing health and wellbeing challenges. Health, safety and wellbeing standards give organizations a practical framework to move beyond good intentions, embedding the behaviors, systems, and accountability that build genuine employee confidence.”
BSI publishes clear, practical guidance to help organizations better support employees experiencing a range of health and wellbeing challenges. The research found that 78% globally, and 80.4% in the US viewed such guidance as a valuable tool. Adopting health and wellbeing standards can play a critical role in building employee confidence, signaling that workplace is both prepared and committed to providing support, and helping to create a more open, trusted culture.
Download the report here: The Value of Creating a Culture of Trust | BSI
