title: The Productivity Dilemma in Workplace Health Promotion.
abstract: BACKGROUND
  Worksite-based programs to improve workforce health and well-being (Workplace Health Promotion (WHP)) have been advanced as conduits for improved worker productivity and decreased health care costs. There has been a countervailing health economics contention that return on investment (ROI) does not merit preventive health investment. METHODS/PROCEDURES: Pertinent studies were reviewed and results reconsidered. A simple economic model is presented based on conventional and alternate assumptions used in cost benefit analysis (CBA), such as discounting and negative value. The issues are presented in the format of 3 conceptual dilemmas.
  
  
  RESULTS
  In some occupations such as nursing, the utility of patient survival and staff health is undervalued. WHP may miss important components of work related health risk. Altering assumptions on discounting and eliminating the drag of negative value radically change the CBA value.
  
  
  CONCLUSIONS
  Simple monetization of a work life and calculation of return on workforce health investment as a simple alternate opportunity involve highly selective interpretations of productivity and utility.
authors.affiliation: Department of Medicine, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-2017, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Cherniack
mesh_terms: D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data*; D004526:Efficiency / Q000941:ethics*; D017048:Health Care Costs; D006282:Health Personnel / Q000191:economics / Q000523:psychology; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D018803:Models, Economic; D016272:Occupational Health / Q000191:economics*; D017132:Workplace