1

CDC Worksite Health ScoreCard Scoring Methodology

CDC Worksite Health ScoreCard

Scoring Methodology

Evidence and Impact Ratings and Supporting Citations

Updated January 2019 
2

CDC Worksite Health ScoreCard Scoring Methodology

CDC Worksite Health ScoreCard Scoring Methodology

Evidence and Impact Ratings and Supporting Citations

Updated January 2019

U.S. Department of Health and Human Services

Centers for Disease Control and Prevention

National Center for Chronic Disease Prevention and Health Promotion

Division of Population Health

Web site addresses of nonfederal organizations are provided solely as a service to readers. Provision of an address does 

not constitute an endorsement of this organization by CDC or the federal government and none should be inferred. 

CDC is not responsible for the content of other organization’s Web pages.

See the 2019 CDC Worksite Health ScoreCard Manual’s acknowledgements page for the names and affiliations of all 

SMEs that contributed to the tool’s update.

Suggested Citation

Centers for Disease Control and Prevention. CDC Worksite Health ScoreCard Scoring Methodology, Evidence and Impact 

Ratings and Supporting Citations. Atlanta: U.S. Department of Health and Human Services; 2019.
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CDC Worksite Health ScoreCard Scoring Methodology

Foreword 

The purpose of this document is to help employers understand the methodology and scoring system in the 

Centers for Disease Control and Prevention (CDC) Worksite Health ScoreCard (CDC ScoreCard). CDC believes worksite 

health promotion and wellness programs are essential to maintaining a healthy workforce.

This document contains CDC guidance only. It does not establish or affect legal or administrative rights or 

obligations. References within this manual to any specific commercial products, processes, services by trade 

names, trademarks, or manufacturers do not constitute an endorsement or recommendation by CDC.

Both the CDC ScoreCard manual and tool, in their current forms, may be updated and revised at any time.

Jason E. Lang, MPH, MS

Team Lead

Workplace Health Programs

National Center for Chronic Disease Prevention and Health Promotion

Centers for Disease Control and Prevention

Dyann M. Matson-Koffman, DrPH, MPH, CHES

Health Scientist (Policy)

Guidelines and Recommendations Activity, Office of Science Quality

Office of the Associate Director for Science

Centers for Disease Control and Prevention

If you have any questions concerning the CDC ScoreCard, contact: 

1-800-CDC-INFO (1-800-232-4636)

TTY: 1-888-232-6348 

cdcinfo@cdc.gov
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CDC Worksite Health ScoreCard Scoring Methodology

Methodology and Citations Contents

Introduction .................................................................................................... 5

Overview of the Methodology for the 2019 CDC ScoreCard Update: 

Scoring Questions in the 2019 CDC ScoreCard .................................................................. 5

2019 CDC ScoreCard Questions by Module...................................................................... 8

References..................................................................................................... 32
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CDC Worksite Health ScoreCard Scoring Methodology

Introduction

This document describes the methods underlying the 2019 update to the CDC Worksite Health ScoreCard (CDC ScoreCard)

and provides the citations for the evidence-base underlying each item in the 154 question survey. 

An approach similar to the original method was followed to update the CDC ScoreCard. For the current version, the CDC 

Workplace Health Program in the National Center for Chronic Disease Prevention and Health Promotion office collaborated 

IBM Watson Health; the Johns Hopkins University Institute for Health and Productivity Studies (IHPS); and an expert panel 

of federal, state, academic, and private sector representatives. 

To update the CDC ScoreCard, the team conducted the following activities:

■ Held interviews with industry experts and surveyed the literature to identify new modules and questions on topics 

that were not included in previous versions of the CDC ScoreCard. This step was conducted to ensure that the tool 

remains timely and addresses the current and emerging needs of the American workforce.

■ Examined the literature base underlying all questions in the 2014 CDC ScoreCard; documented recommendations 

for modifying the text, evidence rating, and impact rating of existing questions and for adding new questions 

within the original modules.

■ Reviewed the questions for each module with a module-specific subject matter expert (SME) panel composed of 

federal, state, academic, and private sector representatives, and pretested the tool with nine employers.

■ Revised the tool on the basis of feedback from these groups.

■ Weighted each question on the basis of expert ratings of the level of scientific evidence and health impact of 

items on intended health behavior.

■ Field tested the tool with a new sample of 93 worksites of various sizes for validity and reliability and determined 

the feasibility of adopting the strategies highlighted in the tool.

■ Revised the tool again on the basis of feedback from the 14 worksites who participated in cognitive interviews 

and site visits to provide in-depth information.

■ Edited and submitted the final tool for public release.

The next section of this document describes the process for scoring each item in the survey tool. Finally, each question is 

listed in turn with its accompanying evidence base.

Overview of the Methodology 

for the 2019 CDC ScoreCard Update: 

Scoring Questions in the 2019 CDC ScoreCard

The evidence review process began by holding in-depth interviews with experts in workplace health promotion to identify 

new or emerging health topics and strategies for potential inclusion in the updated CDC ScoreCard. This process resulted in 

the identification of several potential new modules and questions reflecting emerging topics relevant to workplace health 

promotion and the creation of lists of key search terms to guide subsequent literature reviews. During this planning stage, 

relevant search terms were also identified for each of the existing CDC ScoreCard modules and original questions.

Team members from IBM Watson Health and the Johns Hopkins University Institute for Health and Productivity Studies (IHPS) 

conducted systematic literature reviews using databases such as PubMed, Web of Science, and Google Scholar to identify relevant 

peer-reviewed studies describing workplace health interventions and strategies. The team also leveraged Cochrane reports, 

Community Guide summaries, and U.S. Preventive Services Task Force Recommendations for additional supporting information. 
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CDC Worksite Health ScoreCard Scoring Methodology

The team created a summary of the literature for each of the 18 different health topics (modules) proposed for inclusion 

in the updated CDC ScoreCard. The module summaries included an annotated bibliography for each individual question, 

in addition to draft question text and proposed evidence and impact rating (see below for more detail). In August 2016 

module-specific panels of subject matter experts (SMEs) were convened to review the module summaries in detail.1

SMEs were asked to provide feedback on the draft questions, studies related to each individual strategy and program, and 

evidence and impact ratings. These recommendations were incorporated into a draft version of the tool which was then 

vetted by CDC and piloted with 93 employers.

Each question in the CDC ScoreCard is assigned an evidence and impact rating which are combined to create a weighted 

score for each recommended strategy in the tool. 

Step 1: Evidence Rating

To establish the evidence base for each of the strategies, researchers from IBM Watson Health and Johns Hopkins 

University’s Institute for Health and Productivity Studies (IHPS) conducted systematic literature reviews using databases 

such as PubMed, Web of Science, and Google Scholar to identify relevant peer-reviewed studies describing workplace 

health interventions and strategies. Additional information came from Cochrane reports, Community Guide summaries, 

and U.S. Preventive Services Task Force recommendations. 

During this phase, the team also developed new questions for existing modules, as well as entirely new modules, based 

on the recommendations from industry experts and the findings from the literature searches for existing questions. 

Preliminary evidence ratings were assigned by the project team based on the initial literature review.

Module-specific panels of subject matter experts (SMEs) were convened in 2016 to review the scientific evidence and 

preliminary evidence ratings for each item using a 4-point scale (from 1=Weak to 4=Strong). Evidence ratings were 

subsequently revised as appropriate. The definition of each rating category is provided in Table 1, below.

Table 1. Evidence Rating Categories and Definitions

Evidence 

Rating

Definition of the 

Rating Categories

Weak (1)

Research evidence supporting the relationship is fragmentary, non-experimental, or poorly 

operationalized. There is debate among experts in the field as to whether a causal impact is 

plausible or exists.

Suggestive (2)

Two or more studies (e.g., pre-post evaluations) support the relationship, but no studies reported using 

control groups (e.g., randomized control groups, quasi-experimental studies). Most experts believe that 

causal impact is plausible and consistent with knowledge in related areas, but some experts see the 

support as limited or acknowledge plausible alternative explanations.

Sufficient (3)

The relationship is supported by at least two well-designed, quasi-experimental studies containing 

comparison groups, but no randomized control groups. Experts believe that that the relationship is likely 

causal, and studies have eliminated most alternative confounding variables or alternative explanations.

Strong (4)

A cause-effect relationship is supported by at least one well-designed study with randomized control 

groups or three or more well-designed, quasi-experimental studies. There is little or no debate among 

experts regarding a causal relationship.

1

 Please see the 2019 CDC Worksite Health ScoreCard Manual’s acknowledgements page for the names and affiliations of all SMEs that contributed to 

the tool’s update.
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CDC Worksite Health ScoreCard Scoring Methodology

Step 2: Impact Score

Based on the evidence-base determined during Step 1, the project team assigned a preliminary impact score to each item 

reflecting the information identified during the literature review and in consideration of the impact ratings assigned by 

SMEs in prior versions of the CDC ScoreCard. Impact scores reflect the estimated impact on health outcomes or behaviors 

(i.e., effect size) using a 3-point scale: 1=Small, 2=Sufficient, and 3=Large. 

SMEs with health topic-specific expertise met to discuss the preliminary impact scores. The impact scores were 

subsequently revised as appropriate. The definition of each impact score category is provided in Table 2, below.

Table 2. Impact Score Categories and Definitions

Impact Rating Definition of the Rating Categories

Small (1) 0 to 1 percentage point improvement in 1 year

Sufficient (2) >1 to 2 percentage point improvement in 1 year

Large (3) >2 or more percentage point improvement in 1 year

Step 3: Assigning a Weighted Score to Each Survey Item

Once the evidence ratings and impact scores were finalized by the SMEs, the project team assigned a final weighed score 

to each item. The weighted score was calculated by adding the item’s Evidence Rating to the item’s Impact Score and 

adjusting the value based on the criteria in Table 3.

Table 3. Weighted Score Calculation

Evidence Base PLUS Impact Score EQUALS Adjusted Value Final Weighted Point Value

1=Weak Plus 1=Small Equals Total Pts.=2, 3 Value=1 1=Good

2=Suggestive Plus 2=Sufficient Equals Total Pts.=4, 5 Value=2 2=Better

3=Sufficient Plus 3=Large Equals Total Pts.=6, 7 Value=3 3=Best

4=Strong

Each item in the CDC ScoreCard was assigned a final weighted point value ranging between 1 and 3, where 1=Good, 

2-Better, and 3=Best. This point value reflects the level of impact (i.e., observable change elicited over 12 calendar months) 

that the strategy has on health outcomes or behaviors and the strength of the scientific evidence supporting this impact. 

The final weighted point values reflect the combination of efforts from the literature reviews, SME panels, and guidance 

from CDC. 

The following section contains the evidence ratings and impact scores and final weighted point values for each 

item in the updated 2019 CDC ScoreCard. The citations for the evidence underlying these values is provided in the 

References section.
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CDC Worksite Health ScoreCard Scoring Methodology

2019 CDC ScoreCard Questions by Module
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CDC Worksite Health ScoreCard Scoring Methodology

Organizational 

Supports

Leadership Commitment and Support

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Demonstrate organizational commitment and support of worksite health promotion at all 

levels of management? 1–14

Answer “yes” if, for example, all levels of management participate in activities, 

send communications to employees, or have performance objectives related to 

a healthy workforce.

2 3 5 2

2. Include references to improving or maintaining employee health and safety in the business 

objectives, core values, or organizational mission statement? 1, 3, 7, 15, 16 1 2 3 1

3. Have a strategic plan that includes goals and measurable organizational objectives for the 

health promotion program? 1, 3, 17

Answer “yes” if, for example, your organization identifies SMART (i.e., specific, 

measurable, achievable, realistic, time-bound) goals and objectives. 

2 2 4 2

4. Have an annual budget or receive dedicated funding for health 

promotion programs? 7, 12, 18 2 2 4 2

5. Have an active and diverse health promotion committee? 7, 12, 17–22

Answer “yes” if, for example, your health promotion committee is routinely engaged 

in planning and implementing programs, and includes workers from all levels of the 

organization, various departments, as well as representatives from special groups (e.g., 

remote workers, organized labor).

2 2 4 2

6. Have a paid health promotion coordinator whose job (either part-time or full-time) is to 

manage the worksite health promotion program? 2, 12, 18, 19, 23, 24

Answer “yes” if the staff member is located on or off site and has responsibility for 

health promotion as part of his or her job description or performance expectations. 

2 2 4 2

Measurement and Evaluation

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

7. Conduct an employee needs and interest survey for planning health promotion activities? 17, 19

Answer “yes” if, for example, your organization administers surveys or conducts focus 

groups to assess your employees’ readiness, motivation, or preferences for health 

promotion programs.

2 1 3 1

8. Conduct employee health risk appraisals (HRAs) or health assessments (HAs) and provide 

individual feedback plus health education resources for follow-up action? 1, 7, 17, 25–27

Answer “yes” if, for example, your organization conducts HRAs through vendors, on site 

staff, or health plans and provides individual feedback through written reports, letters, 

or one-on-one counseling. 

4 2 6 3

Continued
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CDC Worksite Health ScoreCard Scoring Methodology

Continued

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

9. Conduct ongoing evaluations of health promotion programming that use multiple data 

sources to inform decision-making? 3, 7, 17, 22, 28

Answer “yes” if, for example, your organization routinely measures the quality and 

impact of health promotion programs. This may be measured using data on employee 

health risks, medical claims, employee satisfaction, or organizational climate surveys.

3 2 5 2

Strategic Communications

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

10. Promote and market health promotion programs to employees? 2, 8, 11, 17, 18, 29–33

Answer “yes” if, for example, your worksite’s health promotion program has a brand 

name or logo or uses multiple channels of communication to inspire and connect 

employees to health promotion resources. These may include sharing employees’ 

health-related “success stories.” 

3 1 4 2

11. Use tailored health promotion communications to ensure that they are accessible and 

appealing to employees of different ages, genders, education levels, job categories, cultures, 

languages, or literacy levels? 2, 3, 7, 11, 18, 20, 26, 34–46

4 3 7 3

Participation and Engagement

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

12. Have an employee champion or network of champions who actively publicize health 

promotion programs? 17, 18, 20, 21, 47, 48 2 2 4 2

13. Use and combine incentives with other strategies to increase participation in health 

promotion programs? 2, 3, 7, 17, 29, 30, 49–65

Answer “yes” if, for example, your organization offers incentives such as gift certificates, 

cash, paid time off, product or service discounts, reduced health insurance premiums, 

employee recognition, or prizes. 

3 2 5 2

14. Use individual or team competitions or challenges in combination with additional 

interventions to support employees making behavior changes? 11, 60, 66, 67

Answer “yes” if, for example, your organization offers physical activity competitions. 

2 3 5 2

15. Promote and support employee volunteerism? 68–70

Answer “yes “if, for example, your organization encourages participation in volunteer 

activities, and allows employees the flexibility to participate during typical work hours. 

This may include time organizing food drives or participating in corporate walks or 

community clean-up days.

1 1 2 1

16. Provide a working environment that features healthy building design principles? 5, 48, 71–74

Answer “yes” if, for example, your workspaces have access to natural light, exposure 

to plants and nature, communal spaces, good ventilation and air quality, comfortable 

temperature, or no excessive noise.

2 1 3 1

17. Extend access to key components of the program to all workers, including hard to reach 

workers (e.g., telecommuters, contract workers, night shift workers, part-time workers)? 75, 76

Answer “yes” if, for example, your organization offers alternative options for 

participating in programs or services, such as 24-hour gym access or virtual 

access to lectures. 

1 2 3 1
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CDC Worksite Health ScoreCard Scoring Methodology

Programs, Policies, and Environmental Supports

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

18. Provide an employee assistance program (EAP)? 77–82

Answer “yes” if, for example, employees have access to an EAP that offers services 

addressing financial health, depression, stress management, grief counseling, 

substance use, and other mental and emotional health issues. 

3 2 5 2

19. Implement educational programming to improve health care consumerism? 83–88

Answer “yes” if, for example, your organization provides employees with written or 

interactive guidance on improving doctor-patient relationships, promoting patientcentered care, and appropriate use of medical resources.

2 1 3 1

20. Educate employees about preventive services and benefits covered by their health 

insurance plan on an ongoing basis, above and beyond what occurs during annual health 

insurance enrollment? 89–91

Answer “yes” if, for example, your worksite communicates information about benefits 

such as smoking cessation medication and counseling, weight management tools, 

or flu vaccinations through emails or newsletters that are distributed across the 

calendar year.

1 1 2 1

21. Provide and support flexible work scheduling policies? 33, 92–99

Answer “yes” if, for example, policies allow for flextime schedules, the option to 

work at home, or allowing time during the day for employees to engage in health 

promotion activities.

2 2 4 2

22. Provide work-life balance programming and resources? 100–103

Answer “yes” if, for example, your worksite provides resources related to elder care, child 

care, tuition reimbursement or financial counseling. 

4 2 6 3

23. Make some or all company-specific health promotion programs available to family 

members? 11, 33, 96, 104–108

Answer “yes” if your organization allows employees’ family members to access health 

promotion resources and programming, above and beyond what is provided by the 

health insurance plan. These resources may include fitness facilities, on site medical 

clinics, health fairs, or wellness competitions.

1 1 2 1

24. Offer all benefits-eligible employees paid time off for days or hours absent due to illness, 

vacation, or other personal reasons (including family illness or bereavement)? 109–114

Answer “yes” if, for example, paid time off, not including paid parental leave, is provided 

to all benefits-eligible employees.

1 2 3 1

25. Coordinate programs for occupational health and safety with programs for health 

promotion and wellness? 17, 24, 115–119

Answer “yes” if, for example, these departments have common strategies, routine 

data sharing, regular meetings across functions, 

or warm handoff referrals. 

2 2 4 2

Maximum Organizational Supports Score 44
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CDC Worksite Health ScoreCard Scoring Methodology

Tobacco 

Use

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Have and promote a written policy banning tobacco use at your worksite? 90, 120–130

Answer “yes” if, for example, your policy bans cigarettes and/or other tobacco products 

and is communicated to employees regularly through emails, newsletters, or signage in 

public places.

3 3 6 3

2. Provide educational materials that address tobacco cessation? 131–137

Answer “yes” if, for example, your worksite offers brochures, videos, posters, web-based 

programs, or newsletters on tobacco cessation, including referral to 1-800-QUIT-NOW 

or smokefree.gov, either as a single health topic or along with other health topics.

2 1 3 1

3. Provide and promote interactive educational programming on tobacco 

cessation? 45, 133, 134, 136, 138, 139

Answer “yes” if, for example, your worksite offers “lunch and learns,” seminars, 

workshops, or classes on tobacco cessation. These programs may be provided in group 

or individual settings; in-person or virtually (online, telephonically, mobile app); on or 

off site; through vendors, on site staff, health insurance plans/programs, community 

groups, or other practitioners.

3 2 5 2

4. Provide and promote free or subsidized lifestyle coaching/counseling or self-management 

programs that equip employees with skills and motivation to quit using tobacco? 132, 136, 140–143

Answer “yes” if these programs are provided in group or individual settings; in-person 

or virtually (online, telephonically, mobile app); on or off site; through vendors, on site 

staff, health insurance plans/programs, community groups, or other practitioners. This 

may include referral to 1-800-QUIT-NOW or smokefree.gov.

3 3 6 3

5. Prohibit the sale of tobacco products on worksite premises? 137, 144, 145 1 2 3 1

6. Provide financial incentives for being a current nonsmoker and for current smokers who 

are actively trying to quit tobacco by participating in a free or subsidized, evidence-based 

cessation program? 52, 60, 118, 146, 147

Answer “yes” if, for example, your organization provides discounts on health insurance, 

additional life insurance for nonsmokers, or other benefits for nonsmokers and smokers 

who are actively trying to quit.

4 2 6 3

7. Provide health insurance coverage with free or subsidized out-of-pocket costs for FDAapproved prescription tobacco cessation medications? 91, 127, 132, 136, 148

Answer “yes” if, for example, your organization provides coverage for inhalers, nasal 

sprays, bupropion (e.g., Zyban) or varenicline (e.g., Chantix). 

4 3 7 3

8. Provide health insurance coverage with free or subsidized out-of-pocket costs for FDAapproved over-the-counter nicotine replacement products? 132, 136, 140, 149 

Answer “yes” if, for example, your organization provides coverage for nicotine 

replacement gum, patches, or lozenges. 

3 2 5 2

Maximum Tobacco Use Score 18
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CDC Worksite Health ScoreCard Scoring Methodology

High Blood 

Pressure

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Provide free or subsidized blood pressure screening (beyond self-report) followed by 

directed feedback and clinical referral when appropriate? 25, 150–159 4 2 6 3

2. Provide educational materials on preventing and controlling high 

blood pressure? 21, 151, 153, 160–165

Answer “yes” if, for example, your worksite offers brochures, videos, posters, or 

newsletters that address high blood pressure/pre-hypertension, either as a single 

health topic or along with other health topics. 

2 1 3 1

3. Provide and promote interactive educational programming on preventing and controlling 

high blood pressure? 151, 153–156, 158, 163, 166–171

Answer “yes” if, for example, your worksite offers “lunch and learns,” seminars, 

workshops, or classes that address high blood pressure/pre-hypertension. These 

programs may be provided in group or individual settings; in-person or virtually 

(online, telephonically, mobile app); on or off site; through vendors, on site staff, 

health insurance plans/programs, community groups, or other practitioners. 

4 2 6 3

4. Provide and promote free or subsidized lifestyle coaching/counseling or self-management 

programs that equip employees with skills and motivation to set and meet their personal 

blood pressure management goals? 25, 150, 151, 157, 161–168, 170–176

Answer “yes” if these programs are provided in group or individual settings; in-person 

or virtually (online, telephonically, mobile app); on or off site; through vendors, on 

site staff, health insurance plans/programs, community groups, or other practitioners. 

4 3 7 3

5. Make blood pressure monitoring devices available with instructions for employees to 

conduct their own self assessments? 161, 174, 176–178 3 3 6 3

6. Provide health insurance coverage with free or subsidized out-of-pocket costs for blood 

pressure control medications? 152, 179–182 3 3 6 3

Maximum High Blood Pressure Score 16
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CDC Worksite Health ScoreCard Scoring Methodology

High 

Cholesterol

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Provide free or subsidized cholesterol screening (beyond self-report) followed by directed 

feedback and clinical referral when appropriate? 25, 155, 171, 183 4 2 6 3

2. Provide educational materials on preventing and controlling high cholesterol? 21, 184, 185

Answer “yes” if, for example, your worksite offers brochures, videos, posters, or 

newsletters that address high cholesterol, either as a single health topic or along with 

other health topics.

2 1 3 1

3. Provide and promote interactive educational programming on preventing and controlling 

high cholesterol? 25, 153–155, 163, 168, 171, 185–187

Answer “yes” if, for example, your worksite offers “lunch and learns,” seminars, 

workshops, or classes that address high cholesterol. These programs may be provided 

in group or individual settings; in-person or virtually (online, telephonically, mobile 

app); on or off site; through vendors, on site staff, health insurance plans/programs, 

community groups, or other practitioners. 

4 2 6 3

4. Provide and promote free or subsidized lifestyle coaching/counseling or self-management 

programs that equip employees with skills and motivation to set and meet their personal 

cholesterol management goals? 21, 25, 166, 171, 185, 186, 188–190

Answer “yes” if these programs are provided in group or individual settings; in-person 

or virtually (online, telephonically, mobile app); on or off site; through vendors, on 

site staff, health insurance plans/programs, community groups, or other practitioners. 

4 3 7 3

5. Provide health insurance coverage with free or subsidized out-of-pocket costs for cholesterol 

or lipid control medications? 179, 191–193 4 2 6 3

Maximum High Cholesterol Score 13
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CDC Worksite Health ScoreCard Scoring Methodology

Physical 

Activity

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Provide educational materials that address the benefits of physical activity? 194–196

Answer “yes” if, for example, your worksite offers brochures, videos, posters, or 

newsletters that address the benefits of physical activity, either as a single health topic 

or along with other health topics.

1 1 2 1

2. Provide and promote interactive educational programming on physical activity? 196–200

Answer “yes” if, for example, your worksite offers timely reminders/prompts to move, 

or “lunch and learns,” seminars, workshops, or classes that teach and promote physical 

activity. These programs may be provided in group or individual settings; in-person or 

virtually (online, telephonically, mobile app); on or off site; through vendors, on site 

staff, health insurance plans/programs, community groups, or other practitioners.

3 2 5 2

3. Provide and promote free or subsidized lifestyle coaching/counseling or self-management 

programs that equip employees with skills and motivation to set and meet their personal 

physical activity goals? 25, 199–204

Answer “yes” if these programs are provided in group or individual settings; in-person 

or virtually (online, telephonically, mobile app); on or off site; through vendors, on site 

staff, health insurance plans/programs, community groups, or other practitioners.

4 3 7 3

4. Provide an exercise facility on site? 174, 201 1 1 2 1

5. Subsidize or discount the cost of on or off site exercise facilities? 196, 201 2 1 3 1

6. Provide or promote other environmental supports for recreation or physical activity? 174, 201, 205–208

Answer “yes” if, for example, your worksite provides trails or a track for walking/jogging, 

maps of suitable walking routes, a basketball court, treadmill workstations, sit-stand 

workstations, lockers, a shower, or changing facility.

4 3 7 3

7. Encourage stair use by posting signs and making stairwells more inviting to use? 201, 209–214

Answer “yes” if, for example, signs encouraging stair use are posted at elevators, 

stairwells, and other key locations; enhancements such as artwork or music are 

available; and stairwells are kept clean and well-lit. 

4 3 7 3

8. Provide and promote organized physical activity programs for employees (other than the 

use of an exercise facility)? 201, 202, 215, 216

Answer “yes” if, for example, your worksite organizes walking groups, stretching 

programs, group exercise classes, recreational leagues, or buddy systems to create 

supportive social networks for physical activity.

4 2 6 3

9. Promote the use of activity trackers to support physical activity? 217–219

Answer “yes” if, for example, your worksite provides or subsidizes the cost of 

pedometers, wearable trackers, online tools, or mobile apps.

2 2 4 2

Continued
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CDC Worksite Health ScoreCard Scoring Methodology

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

10. Encourage active transportation to and from work? 220–227

Answer “yes” if, for example, your worksite subsidizes public transportation; 

subsidizes a bike share program; provides secure bicycle storage, lockers and shower 

facilities for employees; allows for a flexible dress code; and/or organizes workplace 

challenges, employee recognition programs, or community events to increase active 

transportation.

3 3 6 3

Maximum Physical Activity Score 22
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CDC Worksite Health ScoreCard Scoring Methodology

Weight 

Management

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Provide free or subsidized body composition measurement (beyond self-report) followed by 

directed feedback and clinical referral when appropriate? 25, 228, 229

Answer “yes” if, for example, your worksite offers periodic height and weight 

measurement, body mass index (BMI) scores, or other body fat assessments (beyond 

HRAs), plus follow-up recommendations. This may be offered as part of an occasional 

health fair or routine care at an on site clinic.

1 1 2 1

2. Provide educational materials that address the health risks of overweight or obesity? 194, 195, 230

Answer “yes” if, for example, your worksite offers brochures, videos, posters, or 

newsletters that address the risks of overweight or obesity, either as a single health 

topic or along with other health topics.

1 1 2 1

3. Provide and promote interactive educational programming on weight 

management? 194, 195, 199, 200, 228, 230–232

Answer “yes” if, for example, your worksite offers “lunch and learns,” seminars, 

workshops, or classes that teach and promote weight management. These programs 

may be provided in group or individual settings; in-person or virtually (online, 

telephonically, mobile app); on or off site; through vendors, on site staff, health 

insurance plans/programs, community groups, or other practitioners.

4 2 6 3

4. Provide and promote free or subsidized lifestyle coaching/counseling or self-management 

programs that equip employees with skills and motivation to set and meet their personal 

weight management goals? 194, 199, 200, 230, 231, 233–237

Answer “yes” if these programs are provided in group or individual settings; in-person 

or virtually (online, telephonically, mobile app); on or off site; through vendors, on 

site staff, health insurance plans/programs, community groups, or other practitioners. 

4 3 7 3

Maximum Weight Management Score 8
18

CDC Worksite Health ScoreCard Scoring Methodology

Nutrition

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Provide places to purchase food and beverages?

Answer “yes” if, for example, your worksite provides vending machines, cafeterias, snack 

bars, or other purchase points. 

IF NO, PLEASE SKIP TO QUESTION 8

N/A N/A N/A 0

2. Have and promote a written policy that makes healthier food and beverage choices 

available in cafeterias or snack bars? 238–245

Answer “yes” if, for example, your worksite has a policy or contract that makes 

vegetables, fruit, fish, whole grain items, nuts, and legumes available in cafeterias and 

limits sugary beverages, unhealthy fats (saturated or trans fats), and highly-processed 

or high-sodium foods. This policy can be promoted to employees regularly through 

emails, newsletters, or signage in public places. 

2 2 4 2

3. Have and promote a written policy that makes healthier food and beverage choices 

available in vending machines or other vending outlets? 238, 244–247

Answer “yes” if, for example, your worksite has a policy or contract that makes nuts, 

whole grain items, trans fat-free/low-sodium snacks, vegetables, fruit, or unsweetened 

beverages available in vending machines. This policy can be promoted to employees 

regularly through emails, newsletters, or signage in public places.

1 1 2 1

4. Make most (more than 50%) of the food and beverage choices available at the 

worksite (in vending machines, cafeterias, snack bars, or other purchase points) 

healthy food items? 174, 246, 248, 249

Answer “yes” if the healthy foods and beverages are items such as vegetables, fruit, 

unsweetened beverages, or low-sodium snacks. 

3 3 6 3

5. Provide visible nutritional information (beyond standard food labels) on sodium, calories, 

trans fats, or saturated fats for the food and beverages available at the worksite (in vending 

machines, cafeterias, snack bars, or other purchase points)? 250–253

3 3 6 3

6. Identify healthier (or less healthy) food and beverage choices with signs or symbols? 248, 252, 

254–257

Answer “yes” if, for example, your worksite puts a heart (❤) next to a healthy item or 

uses red-yellow-green color-coding to indicate the healthfulness of items in vending 

machines, cafeterias, snack bars, or other purchase points.

3 3 6 3

7. Subsidize or provide discounts on healthy food and beverage choices available at the 

worksite (in vending machines, cafeterias, snack bars, or other purchase points)? 249, 258–260 4 3 7 3

8. Have and promote a written policy making healthy food and beverage choices available 

in break rooms, during meetings, conferences, or company sponsored events when food is 

served? 244, 245, 261, 262

Answer “yes” if, for example, the policy makes vegetables, fruits, unsweetened 

beverages, whole grain items, or trans fat-free/low-sodium snacks available during 

meetings. This policy can be promoted to employees regularly through emails, 

newsletters, or signage in public places.

1 1 2 1

Continued
19

CDC Worksite Health ScoreCard Scoring Methodology

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

9. Offer or promote an on site or nearby farmers market or other arrangement where fresh 

fruits and vegetables are sold? 263–265

This may include coordinating Community Supported Agriculture (CSA) or vendors/

venues that are or are not operated by farmers. 

1 1 2 1

10. Provide educational materials that address healthy eating? 194, 266, 267

Answer “yes” if, for example, your worksite offers brochures, videos, posters, or 

newsletters that teach and promote healthy eating, either as a single health topic or 

along with other health topics.

1 1 2 1

11. Provide and promote interactive educational programming on nutrition? 194, 234, 266, 267

Answer “yes” if, for example, your worksite offers “lunch and learns,” seminars, 

workshops, or classes that teach and promote healthy eating. These sessions can be 

provided in-person or virtually (online, telephonically, mobile app); on or off site; in 

group or individual settings; through vendors, on site staff, health insurance plans/

programs, community groups, or other practitioners.

3 2 5 2

12. Provide and promote free or subsidized lifestyle coaching/counseling or self-management 

programs that equip employees with skills and motivation to set and meet their personal 

nutrition goals? 25, 166, 266–268

Answer “yes” if these programs are provided in group or individual settings; in-person 

or virtually (online, telephonically, mobile app); on or off site; in group or individual 

settings; through vendors, on site staff, health insurance plans/programs, community 

groups, or other practitioners. 

3 2 5 2

13. Provide employees with food preparation/storage facilities and a place to eat? 269, 270

Answer “yes” if, for example, your worksite provides a microwave oven, sink, refrigerator, 

and a place for employees to eat other than at their workstations.

1 1 2 1

14. Promote and provide access for increased water consumption? 271–273

Answer “yes” if, for example, your worksite uses promotional materials and provides 

easy access through water bottle filling stations, water fountains, break rooms, or 

vending machines. 

1 1 2 1

Maximum Nutrition Score 24
20

CDC Worksite Health ScoreCard Scoring Methodology

Heart Attack 

and Stroke

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Provide educational materials that address signs, symptoms, and emergency response to 

heart attack? 274–277

Answer “yes” if, for example, your worksite offers employees brochures, videos, or 

newsletters, or posts flyers in the common areas of your worksite that teach the signs 

and symptoms and appropriate response to heart attack. 

2 2 4 2

2. Provide educational materials that address signs, symptoms, and emergency response 

to stroke? 275–279

Answer “yes” if, for example, your worksite offers employees brochures, videos, or 

newsletters, or posts flyers in the common areas of your worksite that teach the signs 

and symptoms and appropriate response to stroke. 

2 2 4 2

3. Provide and promote interactive educational programming that addresses signs, symptoms, 

and emergency response to heart attack? 274–276

Answer “yes” if, for example, your worksite offers “lunch and learns,” seminars, 

workshops, or classes that teach the signs and symptoms and appropriate response 

to heart attack. These programs may be provided in group or individual settings; 

in-person or virtually (online, telephonically, mobile app); on or off site; through 

vendors, on site staff, health insurance plans/programs, community groups, or other 

practitioners.

2 2 4 2

4. Provide and promote interactive educational programming that addresses signs, symptoms, 

and emergency response to stroke? 275, 280, 281

Answer “yes” if, for example, your worksite offers “lunch and learns,” seminars, 

workshops, or classes that teach the signs and symptoms and appropriate response 

to stroke. These programs may be provided in group or individual settings; in-person 

or virtually (online, telephonically, mobile app); on or off site; through vendors, on site 

staff, health insurance plans/programs, community groups, or other practitioners.

2 1 3 1

5. Have an emergency response plan to address acute heart attack and stroke events? 282–285 1 2 3 1

6. Have an emergency response team trained to respond to acute heart attack and 

stroke events? 282–284

Answer “yes” if, for example, a formal or informal team is trained to respond.

2 2 4 2

7. Offer access to a nationally-recognized training course on Cardiopulmonary Resuscitation 

(CPR) that includes training on Automated External Defibrillator (AED) usage? 277, 282–284, 286, 287 3 2 5 2

8. Have and promote a written policy that requires an adequate number of employees per 

floor, work unit, or shift, in accordance with pertinent state and federal laws, to be certified 

in CPR/AED? 282–284

This policy can be promoted to employees regularly through emails, newsletters, or 

signage in public places.

2 2 4 2

9. Have one or more functioning AEDs in place? 282–285, 288

IF NO, PLEASE SKIP TO END OF MODULE 1 1 2 1

Continued
21

CDC Worksite Health ScoreCard Scoring Methodology

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

10. Have an adequate number of AED units so that a person can be reached within 3-5 minutes 

of collapse? 282–285 3 2 5 2

11. Identify the location of AEDs with posters, signs, markers, or other forms of communication 

other than on the AED itself? 282–284 1 1 2 1

12. Perform maintenance or testing on all AEDs in alignment with manufacturer 

recommendations? 282, 283 1 2 3 1

Maximum Heart Attack and Stroke Score 19
22

CDC Worksite Health ScoreCard Scoring Methodology

Prediabetes 

and Diabetes

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Provide free or subsidized prediabetes and diabetes health risk assessment (beyond selfreport) and feedback, followed by blood screening (fasting glucose or A1c) and clinical 

referral when appropriate? 289–295

4 3 7 3

2. Provide educational materials on prediabetes and diabetes? 296, 297 

Answer “yes” if, for example, your worksite offers brochures, videos, posters, or 

newsletters that address prediabetes and diabetes, including topics such as diet 

modification, physical activity, foot exams, and eye exams, either as a single health 

topic or along with other health topics.

1 1 2 1

3. Provide and promote interactive educational programming on preventing and 

controlling diabetes? 298–300

Answer “yes” if, for example, your worksite offers “lunch and learns,” seminars, 

workshops, or classes that address prediabetes and diabetes control and prevention. 

These programs may be provided in group or individual settings; in-person or virtually 

(online, telephonically, mobile app); on or off site; through vendors, on site staff, health 

insurance plans/programs, community groups, or other practitioners.

3 3 6 3

4. Provide and promote free or subsidized intensive lifestyle coaching/counseling and followup monitoring for employees with prediabetes or diabetes? 289, 290, 292, 293, 301–312

Answer “yes” if these programs are provided in group or individual settings; in-person 

or virtually (online, telephonically, mobile app); on or off site; through vendors, on 

site staff, health insurance plans/programs, community groups, or other practitioners.

4 3 7 3

5. Provide and promote self-management programs for diabetes control? 303, 304, 311

Answer “yes” if these programs are provided in group or individual settings; in-person 

or virtually (online, telephonically, mobile app); on or off site; through vendors, on 

site staff, health insurance plans/programs, community groups, or other practitioners. 

4 3 7 3

6. Provide health coverage with free or subsidized out-of-pocket costs for diabetes 

medications as well as supplies for diabetes management (e.g., glucose test strips, needles, 

monitoring kits)? 179, 191, 313–316

3 2 5 2

Maximum Prediabetes and Diabetes Score 15
23

CDC Worksite Health ScoreCard Scoring Methodology

Depression

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Provide free or subsidized clinical assessment for depression by a provider followed by 

directed feedback and clinical referral when appropriate? 79, 90, 295

Answer “yes” if these services are provided directly through your organization or 

indirectly through a health insurance plan.

4 3 7 3

2. Provide access to a self-administered depression screening tool that provides a feedback 

report with recommendations for clinical action as needed? 295, 317, 318

Answer “yes” if, for example, these services are provided through a health risk 

assessment (HRA), health insurance plan, or employee assistance program (EAP).

3 2 5 2

3. Provide educational materials on preventing, detecting, and treating depression? 319–321

Answer “yes” if, for example, your worksite offers brochures, videos, posters, or 

newsletters that address depression or depressive symptoms, either as a single health 

topic or along with other health topics.

2 1 3 1

4. Provide and promote interactive educational programming on preventing, detecting, and 

treating depression? 321–329

Answer “yes” if, for example, your worksite offers “lunch and learns,” seminars, 

workshops, or classes focused on reducing the risk factors for depression and reducing 

the stigma surrounding depression. These programs may be provided in group or 

individual settings; in-person or virtually (online, telephonically, mobile app); on or 

off site; through vendors, on site staff, health insurance plans/programs, community 

groups, or other practitioners.

3 2 5 2

5. Provide and promote free or subsidized lifestyle coaching/counseling or self-management 

programs that equip employees with skills and motivation to set and meet their personal 

goals for managing depression? 79, 154, 317, 330–334

Answer “yes” if these programs are provided in group or individual settings; in-person 

or virtually (online, telephonically, mobile app); on or off site; through vendors, on 

site staff, health insurance plans/programs, community groups, or other practitioners.

4 3 7 3

6. Provide training for managers that improves their ability to recognize depression and refer 

employees to company/community resources for managing depression? 335, 336

Note: Managers are not in a position to diagnosis depression, only to recognize 

depressive symptoms and encourage employee to seek professional assistance.

2 2 4 2

7. Provide health insurance coverage with free or subsidized out-of-pocket costs for depression 

medications? 90, 148, 191, 330, 337 4 3 7 3

Maximum Depression Score 16
24

CDC Worksite Health ScoreCard Scoring Methodology

Stress 

Management

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Provide educational materials on stress management? 322, 338, 339

Answer “yes” if, for example, your worksite offers brochures, videos, posters, or 

newsletters that address aspects of stress management, including coping skills and 

relaxation techniques, either as a single health topic or along with other health topics.

1 1 2 1

2. Provide and promote interactive educational programming on stress management? 322, 338, 339

Answer “yes” if, for example, your worksite offers “lunch and learns,” seminars, 

workshops, or classes on topics such as assertiveness, coping, and relaxation 

techniques. Answer “yes” if these programs are provided in group or individual 

settings; in-person or virtually (online, telephonically, mobile app); on or off site; 

through vendors, on site staff, health insurance plans/programs, community groups, 

or other practitioners. 

2 2 4 2

3. Provide and promote free or subsidized lifestyle coaching/counseling or self-management 

programs that equip employees with skills and motivation to set and meet their personal 

stress management goals? 154, 321, 340–342

Answer “yes” if these programs are provided in group or individual settings; in-person 

or virtually (online, telephonically, mobile app); on or off site; through vendors, on 

site staff, health insurance plans/programs, community groups, or other practitioners.

4 3 7 3

4. Provide dedicated space that is quiet where employees can engage in relaxation activities, 

such as deep breathing exercises? 343, 344 1 1 2 1

5. Sponsor or organize social activities designed to improve engagement with others, and 

provide opportunities for interaction and social support? 345–350

Answer “yes” if, for example, your worksite sponsors or organizes team building events, 

company picnics, holiday parties, or employee sports teams.

1 1 2 1

6. Provide training for managers that improves their ability to recognize and reduce workplace 

stress-related issues? 351–353

Answer “yes” if, for example, your worksite provides training on performance reviews, 

communication, personnel management, assertiveness, time management, or 

conflict resolution.

3 3 6 3

7. Provide opportunities for employee participation in organizational decisions regarding 

workplace issues that affect job stress? 354–359

Answer “yes” if, for example, your worksite provides opportunities for employees to 

participate in decisions about work processes and environment, work schedules, 

participative problem-solving, and management of work demands.

4 3 7 3

Maximum Stress Management Score 14
25

CDC Worksite Health ScoreCard Scoring Methodology

Alcohol 

and Other 

Substance Use

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Have and promote a written policy banning alcohol and other substance use at 

the worksite? 360–365

Answer “yes” if, for example, your worksite has a written policy that bans alcohol and 

other substance use (including opioids) at the worksite or while operating a motor 

vehicle, requires universal drug testing (in appropriate safety-sensitive industries), or 

indicates options offered for assistance and referral to behavioral health services. This 

policy can be communicated to employees regularly through emails, newsletters, or 

signage in public places. 

1 1 2 1

2. Provide access to alcohol and other substance use screening followed by brief intervention 

and referral for treatment when appropriate? 365–373

Answer “yes” if, for example, these services are provided through a health risk 

assessment (HRA), health insurance plan, and/or employee assistance program (EAP).

3 3 6 3

3. Provide educational materials that help workers understand the risks of alcohol and other 

substance use and guide them to receive help? 340, 374

Answer “yes” if, for example, your worksite offers brochures, videos, posters, or 

newsletters that address alcohol and other substance use such as prescription or illicit 

opioids, either as a single health topic or along with other health topics.

1 1 2 1

4. Provide and promote interactive educational programming that integrates health 

promotion with substance use prevention? 363, 375–382

Answer “yes” if, for example, your worksite offers health promotion “lunch and learns”, 

seminars, workshops, or classes. These may address alcohol and other substance 

use either directly or indirectly through topics such as stress management, conflict 

resolution, managing multiple priorities, personal finance planning, and team-building.

3 2 5 2

5. Discourage or limit access to alcohol or use of company funds for alcohol at worksponsored events? 360, 365, 383, 384

Answer “yes” if, for example, your worksite limits (e.g., through tickets) the consumption 

of alcohol at on and off site meetings and events.

1 1 2 1

6. Provide a health plan with insurance benefits that include substance use disorder prevention 

and treatment? 385–387

Answer “yes” if, for example, your worksite health plan offers coverage for medicationassisted treatment without prior authorization and lifetime limits, while preventing 

overuse of addictive substances such as use of prescription opioids, use of illicit 

opioids, and use of illicitly-manufactured fentanyl (e.g., reimbursement for non-drug 

treatments for pain relief as a results of an injury such as exercise, physical therapy, and 

psychological therapies, use of drug utilization review, and pharmacy lock-in). 

1 1 2 1

Maximum Alcohol and Other Substance Use Score 9
26

CDC Worksite Health ScoreCard Scoring Methodology

Sleep 

and Fatigue

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Have and promote a written policy related to the design of work schedules that aims to 

reduce employee fatigue? 388–391

Answer “yes” if, for example, your worksite has a policy related to self-scheduling, 

limiting the number of consecutive days or hours allowed to be worked, or specifying a 

minimum time interval between shifts. 

2 2 4 2

2. Provide access to a self-administered sleep screening tool that provides a feedback report 

with recommendations for clinical action, as needed? 392–395

Answer “yes” if, for example, these services are provided through a health risk assessment 

(HRA), health insurance plan, or employee assistance program (EAP).

2 2 4 2

3. Provide educational materials that address sleep habits and treatment of common 

sleep disorders? 396–399

Answer “yes” if, for example, your worksite offers brochures, videos, posters, or 

newsletters that address topics such as recommended sleep schedules, recognizing the 

signs and symptoms of fatigue or daytime sleepiness, and appropriate use of caffeine.

1 1 2 1

4. Provide and promote interactive educational programming that addresses sleep habits and 

treatment of common sleep disorders? 396–404

Answer “yes” if, for example, your worksite offers seminars, workshops, or classes that 

teach and promote appropriate sleep habits. These sessions can be provided in-person 

or online; on or off site; in group or individual settings; through vendors, on site staff, 

health insurance plans or programs, community groups, or other practitioners.

3 2 5 2

5. Provide training for managers to improve their understanding of the safety and health 

risks associated with poor sleep and their skills for organizing work to reduce the risk of 

employee fatigue? 400, 405

1 1 2 1

6. Offer solutions to discourage distracted or drowsy driving? 406–411

Answer “yes” if, for example, employees are given realistic expectations for mileage, 

adequate rest breaks, overnight stays after long trips, and limited distractions and work 

demands (e.g., phone calls/email) while driving.

1 1 2 1

Maximum Sleep and Fatigue Score 9
27

CDC Worksite Health ScoreCard Scoring Methodology

Musculoskeletal 

Disorders

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Have and promote a written policy that requires regular evaluation of the design of work 

spaces and job requirements? 412–416

Answer “yes” if, for example, the policy includes assessments of workstations, 

workloads, or repetitive tasks. This may be promoted to employees regularly through 

emails, newsletters, or signage in public places.

2 1 3 1

2. Conduct ergonomic assessments of work space design and equipment when problems 

are identified, or anticipated, to reduce the risk of musculoskeletal disorders? 413, 415–417

Answer “yes” if, for example, the policy includes assessments of workstations, 

equipment, tools, manually-handled loads, or repetitive tasks conducted either on a 

schedule or when requested on an as-needed basis.

2 1 3 1

3. Make organizational changes to job design, when appropriate, to reduce the risk of 

musculoskeletal disorders? 416, 418, 419

Answer “yes” if, for example, your worksite has adjusted work routines and 

workloads, implemented job rotation, or automated previously manual tasks that 

pose increased risk.

2 2 4 2

4. Provide educational materials on musculoskeletal disorders? 306, 419, 420

Answer “yes” if, for example, your worksite offers brochures, videos, posters, or 

newsletters that teach and promote strategies that minimize the incidence of 

musculoskeletal disorders such as ergonomic design, stretching, regular breaks, and 

weight management, either as a single health topic or along with other health topics.

1 1 2 1

5. Provide and promote interactive educational programming on musculoskeletal 

disorders? 412, 418, 421, 422

Answer “yes” if, for example, your worksite offers “lunch and learns,” seminars, workshops, 

or classes that teach strategies that minimize the risk of musculoskeletal disorders 

such as ergonomic design, stretching, regular breaks, and weight management. These 

programs may be provided in group or individual settings; in-person or virtually (online, 

telephonically, mobile app); on or off site; through vendors, on site staff, health insurance 

plans/programs, community groups, or other practitioners.

2 1 3 1

6. Provide training for managers that improves their ability to recognize potential risks for 

musculoskeletal disorders and refer employees to company/community resources? 306, 416, 423–425 2 1 3 1

7. Provide health insurance that includes appropriate access to therapies and treatment for 

musculoskeletal disorders? 426, 427

Answer “yes” if, for example, coverage options are aligned with best practices 

recommended by the Occupational Safety & Health Administration (OSHA), American 

College of Occupational & Environmental Medicine (ACOEM), or American College of 

Rheumatology.

2 2 4 2

Maximum Musculoskeletal Disorders Score 9
28

CDC Worksite Health ScoreCard Scoring Methodology

Occupational 

Health 

and Safety

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Have and promote a written policy on injury prevention and occupational health 

and safety? 7, 428–430

This policy could be promoted to employees regularly through emails, newsletters, or 

signage in public places.

2 2 4 2

2. Provide opportunities for employee input on hazards and solutions, and implement these 

solutions when appropriate? 7, 431–436

Answer “yes” if, for example, there were all-hands meetings, surveys, or focus groups for 

discovering and solving job health and/or safety issues.

4 3 7 3

3. Encourage employees to report uncomfortable, unsafe, or hazardous working conditions 

to a supervisor, occupational health and safety professional or through another reporting 

channel? 428, 433, 434, 436–440

Answer “yes” if, for example, employees are directed to report workplace injuries, 

bullying, or sexual harassment using a designated hotline. 

2 3 5 2

4. Carefully investigate the primary cause of any reported work-related illnesses or injuries and 

take specific actions to prevent similar events in the future? 7, 432, 434, 436, 441 4 3 7 3

5. Provide educational materials about health and safety at work? 428, 432

Answer “yes” if, for example, your worksite provides brochures, videos, posters, 

newsletters, or timely reminders for issues such as hand washing, taking breaks to 

reduce eye strain, or wearing personal protective equipment. 

1 1 2 1

6. Provide and promote interactive educational programming on how to avoid accidents or 

injury on the job? 115, 442–445

Answer “yes” if, for example, your worksite offers “lunch and learns,” seminars, 

workshops, or classes that address injury prevention. These sessions can be provided inperson or virtually (online, telephonically, mobile app); on or off site; through vendors, 

on site staff, or other practitioners.

1 2 3 2

7. Have a process in place for measuring and, if necessary, improving worksite air quality? 434, 446–449

Answer “yes” if, for example, your worksite routinely tests heating, ventilation, and air 

conditioning (HVAC) systems, vacuums carpets, and controls moisture levels to prevent 

mold growth.

3 2 5 2

8. Make adjustments or provide resources where necessary to reduce the risk of eye injury or 

vision impairment? 450–453

Answer “yes” if, for example, your worksite provides proper lighting to work areas, 

protective eyewear in hazardous environments (e.g., factories, construction sites) or 

ergonomic setup at work stations.

2 2 4 2

9. Proactively support employees returning to work after illness or injury? 454–460

Answer “yes” if, for example, your organization provides temporary job modifications or 

phased return-to-work options. 

2 1 3 1

Maximum Occupational Health and Safety Score 18
29

CDC Worksite Health ScoreCard Scoring Methodology

VaccinePreventable 

Diseases

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Provide health insurance coverage with free or subsidized influenza (flu) vaccinations? 461–465 4 3 7 3

2. Provide free or subsidized influenza vaccinations at your worksite? 464, 466–473

Answer “yes” if this is offered to employees on site, through a temporary 

vaccine clinic run by an outside organization, internal occupational health staff, 

or other arrangement. 

4 3 7 3

3. Conduct a seasonal influenza vaccination campaign that includes educational materials 

or programming? 464, 469, 473–477

Answer “yes” if, for example, your worksite offers brochures, videos, posters, newsletters, 

timely reminders, or sessions that address the benefits of flu vaccinations, either as a 

single health topic or along with other health topics.

1 1 2 1

4. Provide health insurance coverage with free or subsidized vaccinations for illnesses other 

than influenza? 461–463, 465, 478, 479

Answer “yes” if, for example, your worksite provides coverage for pneumococcal; 

tetanus, diphtheria, and pertussis (Tdap); or Zoster (shingles) vaccines.

4 3 7 3

5. Provide free or subsidized vaccinations at your worksite for illnesses other 

than influenza? 479–481

Answer “yes” if, for example, your worksite offers employees pneumococcal; tetanus, 

diphtheria, and pertussis (Tdap); or Zoster (shingles) vaccines through a temporary 

vaccine clinic run by an outside organization, internal occupational health staff, or other 

arrangement. 

2 2 4 2

6. Promote vaccinations other than influenza with educational materials or educational 

programming? 479, 482

Answer “yes” if, for example, your worksite offers brochures, videos, posters, newsletters, 

timely reminders, or sessions that provide information on adult vaccine requirements 

and benefits, either as a single health topic or along with other health topics. 

1 1 2 1

7. Promote good hand hygiene in the worksite? 483–486

Answer “yes” if, for example, your worksite provides soap, water, hand sanitizer, and 

educational materials in strategic workplace locations such as bathrooms, breakrooms, 

doors, elevators, or other strategic workplace locations.

2 1 3 1

Maximum Vaccine-Preventable Diseases Score 14
30

CDC Worksite Health ScoreCard Scoring Methodology

Maternal 

Health and 

Lactation 

Support

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Have and promote a written policy on breastfeeding for employees? 487–490

Answer “yes” if, for example, this policy is communicated at the time of hiring and/or at 

the time of maternity leave planning.

2 1 3 1

2. Provide a private space (other than a restroom) that may be used by employees to express 

breast milk? 488, 489, 491–494

Answer “yes” if, for example, your worksite has a private space with an electrical outlet, 

comfortable chair, and sink. 

2 2 4 2

3. Provide flexible break times to allow employees to pump breast milk? 488, 493, 494 2 1 3 1

4. Provide access to a breast pump at the worksite? 489–491, 495

Answer “yes” if, for example, your worksite provides on site access to a breast pump or 

offers insurance coverage that subsidizes the purchase of a pump for personal use. 

2 2 4 2

5. Provide and promote maternal health and breastfeeding support groups, educational 

classes, or consultations? 490, 495–501

Answer “yes” if these programs are provided in-person or virtually (online, 

telephonically, mobile app); on or off site; through vendors, peer and/or professional 

consultants, on site staff, or health insurance plans/programs. 

4 3 7 3

6. Offer paid parental leave, separate from any accrued sick leave, annual leave, 

or vacation time? 502–506 3 3 6 3

7. Offer health insurance coverage with no or subsidized out-of-pocket costs for pre- and 

postnatal care? 507, 508 3 3 6 3

Maximum Maternal Health and Lactation Support Score 15
31

CDC Worksite Health ScoreCard Scoring Methodology

Cancer

During the past 12 months, did your worksite:

Evidence 

Base 

1-4

Item 

Impact 

1-3

Total Adjusted 

Value

1. Offer free or subsidized cancer screenings on site? 509–511

Answer “yes” if, for example, your worksite offered cancer screenings (e.g., stool test kits, 

mobile mammography vans, or skin cancer screenings) as part of a health campaign or 

as part of routine care at an on site clinic.

2 2 4 2

2. Provide educational materials that address skin, breast, cervical, or colorectal 

cancer prevention? 512–517

Answer “yes” if, for example, your worksite offers brochures, videos, posters, 

reminders, or newsletters that promote sun protection, evidence-based vaccinations, 

or evidence-based cancer screenings, either as a single health topic or along with 

other health topics.

3 1 4 2

3. Provide and promote interactive educational programming on cancer prevention? 509, 518, 519

Answer “yes” if, for example, your worksite offers “lunch and learns,” seminars, 

workshops, or classes that address prevention, early identification, and survivorship. 

These programs may be provided in group or individual settings; in-person or virtually 

(online, telephonically, mobile app); on or off site; through vendors, on site staff, health 

insurance plans/programs, community groups, or other practitioners.

3 1 4 2

4. Monitor and take action to reduce employee exposure to known carcinogens within 

the workplace? 520, 521

Answer “yes” if, for example, your worksite takes action to limit exposures to radon, 

asbestos, and other carcinogens that may exist at the worksite, and uses alternative 

materials (i.e., “green chemistry”) wherever possible.

1 2 3 1

5. Provide health insurance coverage with free or subsidized evidence-based cancer screenings 

and vaccinations? 522–524

Answer “yes” if, for example, your insurance covers the cost of breast, cervical, and 

colorectal cancer screening, and HPV and Hepatitis B vaccines.

2 3 5 2

6. Do you have outdoor workers?

IF NO, PLEASE SKIP TO THE END OF THE MODULE. N/A N/A N/A 0

7. Have and promote a written policy that includes measures to reduce sun exposure for 

outdoor workers? 517, 525

Answer “yes” if, for example, the policy encourages rotation of workers in ultraviolet 

(UV) intense positions, scheduling of tasks to avoid high-exposure periods, and the 

use of sun protective clothing, hats, and sunscreen. This policy can be promoted to 

employees regularly through emails, newsletters, or signage in public places.

1 2 3 1

8. Provide employees working outdoors with supports for sun protection, such as shade, hats, 

or sunscreen? 518, 526–528 1 2 3 1

Maximum Cancer Score 11
32

CDC Worksite Health ScoreCard Scoring Methodology

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CS# 301832-A