Workplace 

Health 

in America

2017
Explanations of figures for accessibility is found in the 

Appendix: Accessible Explanation of Figures on page 68. 

Workplace Health in America 2017

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

Suggested Citation

Centers for Disease Control and Prevention. Workplace Health in America 2017. Atlanta, GA: Centers for Disease 

Control and Prevention, U.S. Department of Health and Human Services, 2018.

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

an address does not constitute an endorsement by the Centers for Disease Control and Prevention (CDC) 

or the federal government, and none should be inferred. CDC is not responsible for the content of other 

organizations’ Web pages.
Foreword

As the first government-sponsored national survey 

of worksite health programs since 2004, Workplace 

Health in America 2017 has been highly anticipated 

by many researchers and practitioners in the 

field of workplace health promotion. The data are 

unique for two reasons. First, the sample includes 

representation from worksites often excluded from 

national worksite surveys: federal, state and local 

government worksites and worksites with fewer 

than 50 employees. Second, the survey covered a 

broad set of topics to shed light not only on what 

types of health programming worksites offer, but 

how they offer them. The 2017 survey included 

questions on emerging issues, as well as questions 

that will allow comparisons with previous surveys.

Workplace Health in America 2017 products, 

including this report, public use data files, and an 

interactive online data dashboard (https://www.cdc.

gov/workplacehealthpromotion/data-surveillance/

index.html) are available tools that employers, 

practitioners, and researchers can use to explore the 

results, and design and implement successful and 

sustainable programs using a broad spectrum of 

evidence-based strategies. This summary report serves 

as a snapshot of the current state of workplace health 

promotion in the United States, a benchmark for 

emerging topics not previously measured, and a report 

card identifying opportunities for improvement.
Contents

Overview .................................................................................................... 8

Section 1: Survey Development and Data Collection....................................... 9

Methods ................................................................................................... 10

Survey instrument development process .............................................................. 10

Sampling and data collection........................................................................... 11

Weighting and estimation methods to produce nationally representative results..................... 11

Description of Worksite Respondents .................................................................... 11

Worksite size, industry, and regional distributions ..................................................... 13

Worksite demographic characteristics ................................................................. 15

Limitations ................................................................................................. 15

Section 2: Promoting Health at Work............................................................ 16

Health Insurance Coverage ............................................................................... 17

Health Risk Assessments ................................................................................. 17

Presence of Any Health Promotion Program ............................................................. 19

Length of Time Health Promotion Program in Place ..................................................... 21

Management of the Program ............................................................................. 22

Program Support, Planning, and Evaluation.............................................................. 24

Incentives.................................................................................................. 27

Comprehensive Health Promotion Programs ............................................................. 28

Barriers to Offering Health Promotion Programs......................................................... 30

Key Partners for Worksites Offering Health Promotion Programs....................................... 32

Section 3: Health Promotion Programming to Address Specific Health Topics . . 33

Workplace Efforts to Increase Physical Activity ......................................................... 35

Addressing Healthy Eating in the Workplace ............................................................ 39

Helping Employees Manage Their Weight................................................................ 42

Workplace Efforts to Reduce Tobacco, Excess Alcohol, and Drug Use................................. 45

Tobacco ................................................................................................. 45

Alcohol and other drugs ................................................................................ 48

Providing Lactation Support to Employees............................................................... 49

Workplace Efforts to Address Other Health Topics ...................................................... 50

Section 4: Health Screenings and Disease Management ................................ 51

Health Screenings ......................................................................................... 52

Disease or Risk Management............................................................................. 54

Section 5: Occupational Safety and Health ................................................... 56

Section 6: Worklife...................................................................................... 59

Conclusion ................................................................................................. 61
References................................................................................................ 63

Acknowledgments...................................................................................... 66

Appendix................................................................................................... 68

Explanation of Figures for Accessibility .................................................................. 68

Figures

Figure 1. The number of cases sampled, ineligible and complete ......................................... 12

Figure 2. Percentage of U.S. worksites offering full, partial, or no payment of 

premiums for full-time employees’ health insurance ............................................. 17

Figure 3. Percentage of U.S. worksites that offered employees a health risk assessment ............... 18

Figure 4. Level of employee participation in health risk assessments..................................... 18

Figure 5. Action taken after employees completed a health risk assessment............................. 19

Figure 6. Percentage of U.S. worksites offering any type of health promotion program, by worksite size. 20

Figure 7. Percentage of U.S. worksites offering any type of health promotion program, by industry group20

Figure 8. Percentage of U.S. worksites with a health promotion program in place for less than 

1 through more than 10 years .................................................................... 21

Figure 9. Organization with primary responsibility for managing worksite health promotion programs.... 22

Figure 10. Percentage of U.S. worksites with at least one person assigned responsibility for 

health promotion at the worksite, by worksite size............................................... 23

Figure 11. Percentage of U.S. worksites with committees that address health promotion, 

safety, or both ..................................................................................... 23

Figure 12. Percentage of U.S. worksites with visible support for employee health ......................... 24

Figure 13. Percentage of U.S. worksites with an annual budget for health promotion...................... 24

Figure 14. Percentage of U.S. worksites with annual health promotion planning and plan features ....... 25

Figure 15. Percentage of U.S. worksites using data to evaluate programs and the 

types of measurement performed ................................................................ 26

Figure 16. Percentages of U.S. worksites using incentives and how they are used ........................ 27

Figure 17. Type of incentives offered by U.S. worksites ..................................................... 27

Figure 18. Employers’ ratings of the effectiveness of incentives for achieving intended outcomes ........ 28

Figure 19. Percentage of U.S. worksites with each element of a comprehensive health promotion program . . 29

Figure 20. Percentage of U.S. worksites with all five elements of a comprehensive health 

promotion program, by worksite size ............................................................. 30

Figure 21. Barriers to offering health promotion program among U.S. worksites ........................... 31

Figure 22. Percentage of U.S. worksites that partnered with different types of 

organizations to offer employee health programs ................................................ 32
Figure 23. Percentage of U.S. worksites that offered specific health programs ............................ 34

Figure 24. Percentage of U.S. worksites that offered a physical activity program, by worksite size ........ 36

Figure 25. Percentage of U.S. worksites that offered a physical activity program, by industry group....... 36

Figure 26. Type of worksite physical activity programs offered to employees ............................... 37

Figure 27. Level of employee participation in worksite physical activity programs .......................... 37

Figure 28. Percentage of worksites offering evidence-based strategies to encourage physical activity .... 38

Figure 29. Percentage of U.S. worksites that offered a nutrition program, by worksite size ................ 39

Figure 30. Percentage of U.S. worksites that offered a nutrition program, by industry group............... 40

Figure 31. Type of worksite nutrition programs offered to employees ....................................... 40

Figure 32. Level of employee participation in worksite nutrition programs.................................. 41

Figure 33. Percentage of U.S. worksites offering evidence-based strategies to encourage healthy eating. 41

Figure 34. Percentage of U.S. worksites that offered an obesity/weight management 

program, by worksite size ......................................................................... 42

Figure 35. Percentage of U.S. worksites that offered an obesity/weight management 

program, by industry group........................................................................ 43

Figure 36. Type of worksite obesity/weight management programs offered to employees ................. 44

Figure 37. Percentage of U.S. worksites that offered a tobacco cessation program, by worksite size ..... 45

Figure 38. Percentage of U.S. worksites that offered a tobacco cessation program, by industry group.... 45

Figure 39. Percentage of U.S. worksites offering evidence-based strategies to help 

employees stop using tobacco.................................................................... 46

Figure 40. Percentage of U.S. worksites that offered programs to address excessive alcohol 

and/or excessive drug misuse, by worksite size ................................................. 48

Figure 41. Percentage of U.S. worksites that offered lactation support programs, by worksite size ....... 49

Figure 42. Percentage of U.S. worksites offering evidence-based strategies to support lactation ......... 50

Figure 43. Percentage of U.S. worksites addressing other health topics ................................... 50

Figure 44. Percentage of U.S. worksites offering health screenings and referral to 

treatment/follow-up education for high-risk employees, by health condition .................... 52

Figure 45. Usual location where health screenings were offered to employees............................. 53

Figure 46. Estimated usual employee participation in health screenings offered by U.S. worksites ....... 53

Figure 47. Percentage of U.S. worksites with disease management programs, by health condition ....... 54

Figure 48. Usual method for disease management program delivery to employees ........................ 55

Figure 49. Percentage of U.S. worksites offering occupational safety and health strategies ............... 57

Figure 50. Percentage of U.S. worksites with at least one person responsible for 

employee safety, by worksite size................................................................. 57

Figure 51. Percentage of U.S. worksites integrating health promotion with occupational 

safety and health efforts.......................................................................... 58

Figure 52. Percentage of U.S. worksites offering employee assistance programs (EAPs) .................. 60

Figure 53. Percentage of U.S. worksites with work-life policies and benefits ............................... 61
Tables

Table 1. Survey respondent job department.................................................................. 13

Table 2. Unweighted worksite size distribution ............................................................... 13

Table 3. Unweighted worksite industry group distribution.................................................... 14

Table 4. Unweighted worksite CDC region distribution ....................................................... 14

Table 5. Questions asked about each of the nine health topics ............................................. 35
Workplace Health In America 2017

8

Overview

The Workplace Health in America 2017 survey is a 

nationally representative survey of U.S. employers 

describing the current state of U.S. workplace health 

promotion and protection programs and practices 

in worksites of all sizes, industries, and regions. This 

summary report serves as a snapshot of the current 

state of workplace health promotion in the U.S., 

a benchmark for emerging topics not previously 

measured, and an opportunity to highlight areas 

for improvement.

The summary report highlights emerging or key 

issues; a brief overview of the survey development, 

data collection, and analysis methods; opportunities 

for employers and practitioners; and a special focus 

on results related to physical activity, nutrition, 

obesity, and lactation.

The report summarizes results related to:

■ Survey methods

■ Promoting health at work

■ Health promotion programming to 

address specific health topics

■ Health screenings and disease 

management

■ Occupational safety and health

■ Work-life policies and benefits
Workplace Health In America 2017

9

Section 1: 

Survey Development and 

Data Collection
Workplace Health In America 2017

10

The success of a workplace and the health and safety of 

its employees are interdependent. Ideally, workplaces not 

only protect the safety of employees, but also provide 

them opportunities for better long-term health and 

enhanced quality of life. Effective workplace programs, 

policies, and environments that are health-focused and 

worker-centered have the potential to significantly benefit 

employers, employees, their families, and communities. 

As the nation’s premier public health agency, the Centers 

for Disease Control and Prevention (CDC) helps protect 

the health and safety of all people in our schools, 

communities, homes, and workplaces through prevention. 

The workplace can specifically protect and promote health 

through programs, policies, and practices that have the 

potential of reaching millions of workers and their families.

Increasing health care costs; workers’ compensation 

claims and costs; and health-related decreases in worker 

productivity have led American businesses to examine 

strategies to improve employee health and contain health 

costs that are largely driven by chronic diseases. Employers 

are recognizing the role they can play in creating a 

healthy and safe work environment and providing their 

employees with opportunities to make healthy lifestyle 

choices and sustain them over time. They increasingly look 

to CDC and other public health experts for guidance and 

solutions to combat the effects of chronic diseases on their 

employees and businesses. Workplace health programs 

not only benefit individual employees, but also make good 

business sense.

CDC conducted the Workplace Health in America 2017 

survey to describe the current state of U.S. workplace 

health promotion and protection programs and practices 

in worksites of all sizes, industries, and regions. A key 

objective for the survey was to provide free and accessible 

data for employers to benchmark their practices against 

other employers of similar size and type. The Workplace 

Health in America 2017 survey was designed to build an 

infrastructure capable of supporting ongoing surveillance 

to evaluate national workplace health priorities (e.g., 

Healthy People), monitor trends, and address emerging 

issues. Another objective was to provide a better 

understanding of promising practices to inform the 

development of tools and resources to support the design, 

implementation, and evaluation of employer-based 

workplace health programs.

To meet these objectives, we used an inclusive 

process to develop a survey instrument that covered a 

wide range of health promotion and protection topics, 

including some emerging areas and details about program 

implementation practices. We collected data from a 

nationally representative sample of worksites, including 

worksites with fewer than 50 employees, which are 

often not represented in other national surveys. We have 

produced products to allow employers and others to easily 

access the results and provided a publicly available data 

file to allow researchers to conduct their own analyses.

Methods

Survey instrument development process

We convened external advisory groups to identify 

high-priority content areas for the survey and specific 

survey questions. For a list of the external groups, please 

see the Acknowledgments section. Survey development 

started with the questions in the 2004 national survey 

and included a review of questions from 15 other 

surveys, including those by national employer groups 

(e.g., the National Business Group on Health), on work/

family balance, and the integration of safety and 

health promotion.

CDC and other subject matter experts recommended 

questions about specific evidence-based or promising 

strategies for each health topic covered in the survey. 

These strategies were identified through the literature as 

having been developed, implemented, and evaluated for 

their effectiveness through the application of principles of 

scientific reasoning, including systematic uses of data and 

information systems, and appropriate use of behavioral 

science theory and program planning models. To reduce 

the burden on respondents, we included questions 

deemed most fundamental to the survey’s objectives in 

the “core” section of the survey, and included questions 

deemed less critical in a short “supplemental” section 

that followed the core section. We invited all survey 

respondents to continue and complete the supplemental 

section after completing the core section.

The survey topic areas (both core and supplemental) include:

■ Worksite characteristics and demographics

■ Health insurance

■ Health risk assessments

■ Workplace health program characteristics

■ Nine health promotion program areas and use 

of evidence-based strategies

■ Health screenings

■ Disease management programs

■ Key partners and incentives

■ Work-life benefits and policies

■ Occupational health and safety

■ Barriers to health promotion program 

implementation

■ Emerging issues.
Workplace Health In America 2017

11

Sampling and data collection

The Workplace Health in America 2017 survey gathered 

information from a cross-sectional, nationally 

representative sample of U.S. worksites. We defined 

a worksite as a building, unique location, or business 

unit within an organization where work occurs, or that 

serves as a primary work address for field-based or 

telecommuting employees. A worksite could include a 

group of buildings that are part of the same organization 

and within close proximity, like hospitals or university 

campuses. Multiple worksites from the same organization 

(e.g., franchises) could participate separately if they 

were sampled. The sample was drawn from the Dun 

& Bradstreet (D&B) database of all private and public 

employers in the United States with at least 10 employees. 

The survey questions addressed specific worksite locations 

rather than the organizations to which the worksites 

belonged. We selected worksites using a stratified simple 

random sample design, where the primary strata were 

10 geographic regions (based on the regions used by the 

U.S. Department of Health and Human Services), plus an 

additional stratum containing all hospital worksites. We 

included a separate stratum for hospitals because CDC’s 

Division of Nutrition, Physical Activity and Obesity focuses 

on hospital worksites. Within each region stratum, we 

further stratified by worksite size (Table 2) and industry 

group, where groups were defined by combining North 

American Industry Classification System (NAICS) sectors 

(Table 3). We grouped NAICS sectors to be as similar as 

possible to the 2004 national worksite health survey. We 

selected the number of worksites per size and industry 

group based on proportional allocation to the population.

Trained interviewers contacted each sampled 

worksite by telephone. They attempted to identify and 

recruit the respondent at each site who was “most 

knowledgeable about employee health and safety at the 

worksite.” Interviewers also confirmed each worksite met 

eligibility criteria of having at least 10 employees and 

being in operation for at least 12 months. Respondents 

were invited to complete the survey using one of three 

modes: the most popular being the Web (86.6%), followed 

by telephone interview (8.6%), and mailed paper survey 

(4.9%). The survey was estimated to take about 40 

minutes. Our data collection protocol included reminder 

emails to worksites that requested, but did not complete 

the Web survey, and follow-up phone calls to all worksites 

that had not completed the survey. To improve response 

to the survey, we mailed postcards, alerting worksites we 

would be contacting them about the survey. As a benefit 

for completing the survey, we also offered respondents 

free access to expert webinars designed to help employers 

implement low-cost health promotion strategies.

Weighting and estimation methods to 

produce nationally representative results

We computed analysis weights as the inverse of selection 

probabilities, and adjusted for both nonresponse and 

coverage. The weights represent the D&B total number 

of worksites in each region, size, and industry category, 

representing approximately 2.5 million worksites. 

We estimated variances using first-order Taylor series 

approximations of deviations of estimates from their 

expected values, and properly accounted for the 

combined effects of stratification and unequal weighting. 

In the results presented in this report, we excluded 

respondents with missing or nondeterminant (e.g., don’t 

know, refused) item data from analyses for that item. When 

comparing estimates between groups of interest, we used 

the standard t-test to determine statistically significant 

differences between groups of interest and the Wald X2

statistic to compare logistic models’ fit to groups with 

and without a comprehensive program. We set the level 

of statistical significance at P<0.05. To preserve statistical 

reliability, we suppressed any estimates with a sample size 

of less than 50 or a relative standard error above 30%.

Only those worksites with health promotion programs 

were asked about the topics and types of programs, 

health screenings, and disease management services they 

offered. In the results reported in this summary report, we 

coded worksites that did not have any health promotion 

program in place as not having the more specific type 

of health promotion, screening, or disease management 

program or service.

Description of 

Worksite Respondents

We sampled 35,584 worksites and eliminated 4,721 

as ineligible, usually because they had fewer than 10 

employees at the time of the survey. Ineligibility was 

determined based on information obtained from a contact 

at the worksite through a screening call. We were able 

to complete a screening call with 10,350 sites to obtain 

information about worksite sector (public, private) and 

to ask whether the worksite representative would agree 

to participate in the survey by web, mail, or phone 

interview. A total 6,209 worksites agreed to participate 

and 3,109 of these worksites completed some portion of 

the survey (10.1% of the eligible cases) (Figure 1). For the 

final sample, we retained 2,843 cases that met completion 

criteria. For the survey to be considered complete, 

respondents had to answer the question about having a 

health promotion program or they had to answer at least 

50% of the core survey questions. 

From among the complete cases, 1,255 respondents 

also completed the supplemental survey questions. We 

compared the cases that answered the supplemental 
Workplace Health In America 2017

12

survey to the overall sample of cases that completed the 

core survey to look for potential bias based on differences 

in size, region, industry, or presence of health promotion 

programs. The worksites that completed the supplemental 

sample had no significant differences from the larger 

core sample in their size (P = 0.81), regional (P = 0.29), or 

industry group (P = 0.15) distributions. The worksites that 

answered the supplemental survey questions were no 

more likely to have a health promotion program in place 

than the overall core sample (P = 0.23).

Figure 1. The number of cases sampled, ineligible and complete

CASES RELEASED FOR DATA 

COLLECTION

35,584

2,843 

CASES COMPLETED

1,255 

SUPPLEMENTAL SURVEY 

CASES COMPLETED

3,109 

CASES RETURNED

(10.1% RESPONSE RATE)

4,721

CASES INELIGIBLE;

27,754

NONRESPONDENTS
Workplace Health In America 2017

13

Table 1 presents the percentage of respondents’ job 

department describing the type of individuals who 

completed the survey and their general occupation. 

The survey interviewers did request that the person most 

knowledgeable about employee health or wellness at the 

worksite complete the survey. This may be different from 

the type of individual(s) who managed the workplace 

health promotion programs, which the survey did not ask. 

Table 1. Survey respondent job department

Survey Respondent Job Department Percentages

Total Sample 100.0

Human Resources and/or Benefits 32.4

Finance/Marketing 5.1

Health Promotion/Fitness/Wellness 4.0

Safety 3.1

Other 54.1

Don’t Know/Blank 1.3

Note: “Other” department most commonly included: office administrators/managers; general managers/management; owners; presidents/principals.

Worksite size, industry, and regional distributions

Table 2 presents the unweighted number and percentage 

of worksites with completed surveys in each of the 

size categories. The Workplace Health in America 2017

sample is unique because of the strong representation 

of worksites with fewer than 50 employees. The national 

level results of the survey are heavily influenced by 

these smaller worksites. Table 3 presents the unweighted 

number and percentage of worksites in each of the 

industry groups and Table 4 presents the number and 

percentage in each of the 10 CDC regions. We did not 

have resources to obtain enough cases to produce 

separate estimates for each of the 10 regions; however, 

the online dashboard includes estimates for five larger 

regional groups.

Table 2. Unweighted worksite size distribution

Worksite Size (number of employees) Unweighted Frequencies Unweighted Percentages

Total Sample 2843 100.0

10–24 1175 41.3

25–49 655 23.0

50–99 365 12.8

100–249 263 9.3

250–499 131 4.6

500+ 254 8.9
Workplace Health In America 2017

14

Table 3. Unweighted worksite industry group distribution

Industry Category Unweighted 

Frequencies

Unweighted 

Percentages

Total Sample 2843 100.0

Agriculture, Forestry, Fishing; Mining; Utilities; 

Construction; Manufacturing 525 18.5

Wholesale/Retail Trade; Transportation; Warehousing 311 10.9

Arts, Entertainment, Recreation; Accommodations and Food 

Service; Other Services 433 15.2

Information; Finance; Insurance; Real Estate and Leasing; 

Professional, Scientific, Technical Services; Management; 

Administration Support; Waste Management

429 15.1

Education Services; Health Care & Social Assistance 551 19.4

Local, State, and Federal Public Administration 256 9.0

Hospitals 338 11.9

Table 4. Unweighted worksite CDC region distribution

CDC Region (states in each region) Unweighted 

Frequencies

Unweighted 

Percentages

Total Sample 2843 100.0

Connecticut, Maine, Massachusetts, New Hampshire, 

Rhode Island, Vermont 215 7.6

New Jersey, New York 166 5.8

Delaware, District of Columbia, Maryland, Pennsylvania, 

Virginia, West Virginia 251 8.8

Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, 

South Carolina, Tennessee 340 12.0

Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin 322 11.3

Arkansas, Louisiana, New Mexico, Oklahoma, Texas 273 9.6

Iowa, Kansas, Missouri, Nebraska 413 14.5

Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming 311 10.9

Arizona, California, Hawaii, Nevada 216 7.6

Alaska, Idaho, Oregon, Washington 336 11.8
Workplace Health In America 2017

15

Worksite demographic characteristics

The survey asked about basic workforce demographic 

characteristics of each participating worksite. At the 

national level, worksites reported having an average 

of 46.4% female employees. However, the average 

percentage of female employees was higher for worksites 

in the Education, Health Care, and Social Assistance 

industry group (81.5%), and in the Hospital group (76.4%). 

We also asked about younger and older workers. At the 

national level, worksites reported having an average of 

27.7% of the workforce under age 30 and 12.2% over 

age 60. An average of 39.8% of employees in the Arts, 

Entertainment, Recreation; Accommodations and Food 

Service; and Other Services group were under 30.

Worksites reported that over half of the workforce 

(61.1%) was hourly or nonexempt and an average of 7.4% 

of the workforce was unionized. The average percentage 

of workers who were unionized among the public 

administration employers was 38.0%. At the national level, 

an average of 24.2% of workers work something other 

than a typical daytime (e.g., 9 a.m.–5 p.m., 7 a.m.–3 p.m.) 

schedule; this average was 42.2% for hospitals and 41.7% 

for worksites in the Public Administration industry group.

Limitations

The sample was drawn to be proportionally allocated 

across size and industry strata within each CDC region, 

and final analysis weights accounted for nonresponse 

and matched the frame-based distribution of eligible 

U.S. worksites by region, size, and industry. If additional 

characteristics correlated with the survey outcomes of 

interest are unobservable for both the respondents and 

nonrespondents, and hence cannot be accounted for in 

the weighting adjustments, the inferential properties of 

these estimates may be limited. 
Workplace Health In America 2017

16

Section 2: 

Promoting Health 

at Work
Workplace Health In America 2017

17

FIG 2

Full

Payment

39.1%

Partial

Payment

45.6%

No Insurance

Coverage

Offered

15.4%

Note: Percentages based on weighted estimates.

Percentages do not equal 100% due to rounding. 

84.7% of employers offered either full or partial health insurance.

Health Insurance Coverage

Employer-based health insurance covers a larger portion 

of the U.S. population than any other source of health 

insurance.1 Health insurance is critical for disease 

management and early detection, and as the results 

throughout this report will indicate, it is also important 

for primary prevention efforts because insurers play 

a role in delivering some worksites’ health promotion 

programs. Most of the worksites offered partial or full 

payment of personal health insurance premiums for fulltime employees, with just 15.4% offering no coverage 

(Figure 2). During our data collection period, employee 

insurance costs remained fairly level. Two-thirds (67.0%) 

of respondents indicated full-time employees paid the 

same proportion of their insurance premiums in the past 

year as they had paid the year before, 28.0% said that 

employees paid a larger proportion, and 5.1% answered 

that employees paid a smaller proportion.

Health insurance coverage extended beyond fulltime employees. Most worksites offered family coverage 

(79.6%), and 20.2% offered health insurance for part-time 

employees.

Figure 2. Percentage of U.S. worksites offering full, partial, or no payment of premiums for full-time 

employees’ health insurance

Health Risk Assessments

Health Risk Assessments (HRAs) are questionnaires 

employees answer about their health status, healthrelated behaviors, and how ready they are to improve 

those behaviors. This information can help employees 

recognize areas for improvement. It can also be 

aggregated and used for health promotion program 

planning, by identifying the health promotion needs 

most relevant for a worksite’s population.

Respondents reported whether they had offered 

employees at their worksites an HRA in the past 12 

months. At the national level, only 25.5% of the worksites 

offered HRAs, although this percentage increased 

to 68.7% among the worksites with more than 500 

employees (Figure 3).
Workplace Health In America 2017

18

23.4% 23.3%

31.5%

21.8%

1-25% 26-50% 51-75% 76-100%

% Employee Participation

Among U.S.worksitesthatoffered a health riskassessment

Number of Employees

25.5%

21.6% 23.1%

31.1%

43.9%

52.0%

68.7%

National 10-24 25-49 50-99 100-249 250-499 500+

Note: Percentages based on weighted estimates.

Note: Percentages based on weighted estimates.

Figure 3. Percentage of U.S. worksites that offered employees a health risk assessment

Some employees may be concerned about the privacy 

of the health data they provide. HRA aggregate results 

are less useful for program planning when employee 

participation is low. The Workplace Health in America 2017 

survey results indicated relatively high participation 

among half of the worksites that offered HRAs. Just over 

half of the worksites estimated that more than 50% of the 

employees completed HRAs in the past year (Figure 4). 

The level of employee participation in HRAs was higher 

than the reported levels of employee participation in other 

programs and screenings.

HRAs can be important tools at the employee level 

too. There is strong evidence for the effectiveness of 

assessment of health risks with feedback plus education 

for improving worker health behaviors.2 The majority 

of worksites (79.4%) reported that after employees 

completed an HRA they were given their results and 

provided feedback and education for identified health risks 

or conditions (Figure 5). However, 20.6% of the worksites 

that offer HRAs do not follow the evidence-based 

recommendations to provide feedback or education.

Figure 4. Level of employee participation in health risk assessments
Workplace Health In America 2017

19

FIG 5

Employees

given their

results

15.6%

Employees

given

their results

and provided

feedback and

education for

health risks

79.4%

Neither

5.0%

AmongU.S. worksitesthatofferedahealthrisk assessment

Note: Percentages based on weighted estimates.

Figure 5. Action taken after employees completed a health risk assessment 

Presence of Any Health Promotion Program

Respondents reported whether they had any type of 

health promotion or wellness program, defined very 

broadly as any education materials, activities, classes, 

screenings, services, environmental supports, or policies 

that encourage employees to be healthy. Almost half of 

all worksites offered some type of health promotion or 

wellness program (46.1%) (Figure 6). This could include 

a range of program types, from worksites that just 

provide brochures about health topics to worksites that 

have onsite facilities for physical activity to worksites 

that offer different activities to address multiple 

health topics. Fewer worksites in the two smallest size 

categories offered programs than worksites in the four 

larger size categories. Small employers may have fewer 

resources to spend on health promotion or lack the 

skill, expertise, and capacity to put health promotion 

programs in place.3,4 Given the broad description of 

health promotion program that was used in the survey, 

there is room for improvement, especially for smaller 

worksites to find strategies they can implement.
Workplace Health In America 2017

20

46.1%

39.1%

43.9%

59.6%

69.4%

83.0%

91.8%

National 10-24 25-49 50-99 100-249 250-499 500+

Number of Employees

FIG 7

Industry Sector

46.1%

25.1% 28.8%

17.1% 19.8%

29.0%

47.8%

62.2%

Note: Percentages based on weighted estimates.

Note: Ag/For/Const/Manf = Agriculture, Forestry, Fishing; Mining; Utilities; Construction; Manufacturing

Trade/Trans/Wrhs = Wholesale/Retail Trade; Transportation; Warehousing

Arts,Rec/Acc,Food,Svc = Arts, Entertainment, Recreation; Accommodations and Food Service; Other Services

Info/Fin/Ins/Real Est = Information; Finance; Insurance; Real Estate and Leasing; Professional, Scientific, Technical Services; Management; 

Administration Support; Waste Management

Educ/Hlth, Soc Asst = Education Services; Health Care & Social Assistance

Pub Admin = Local, State, and Federal Public Administration

Percentages based on weighted estimates.

Figure 6. Percentage of U.S. worksites offering any type of health promotion program, by worksite size

The percentages of worksites from the Public 

Administration and Hospital industry groups offering 

programs were larger than the percentages of worksites 

from the other five industry groups (Figure 7). Hospitals 

were primarily found in the two largest size categories. 

They accounted for 31.3% of the worksites with 500 or 

more employees, so findings related to the largest size 

group and hospitals are often similar. Relative to other 

types of worksites, we expect hospitals to have more inhouse health promotion expertise. Public Administration 

worksites, on the other hand, were more concentrated in 

the three smallest size groups.

Figure 7. Percentage of U.S. worksites offering any type of health promotion program, by industry group
Workplace Health In America 2017

21

FIG 8

Number of Years

10.1%

20.6%

32.9%

16.5%

19.8%

<1 year 1-2 years 3-5 years 6-9 years 10+ years

Note: Percentages based on weighted estimates.

Percentages do not equal 100% due to rounding. 

Length of Time Health Promotion Program in Place

The length of time the program had been in place varied 

among worksites with a health promotion program. 

Most of the worksites had at least a few years of program 

experience (Figure 8). About one-third of the worksites 

reported having their programs in place for more than 

five years. Programs that have been in place for more 

than five years are more likely to be comprehensive 

programs.3 About one-third of the worksites with at least 

250 employees had programs in place for at least 10 

years, compared to 18.1–21.0% of the worksites in the 

smaller categories. Thirty percent of public administration 

worksites had programs in place for at least 10 years. 

Figure 8. Percentage of U.S. worksites with a health promotion program in place for less than 1 through more than 10 years
Workplace Health In America 2017

22

FIG 9

Organizations' 

own employees

62.3%

Health

insurance

provider

16.2%

Vendor or

third party

21.5%

Among U.S. worksites with a health promotion program

Note: Percentages based on weighted estimates.

Management of the Program

Most worksites with health promotion programs reported 

managing them with their own internal staff (Figure 9). 

This was particularly true in hospitals, with 79% reporting 

their programs were managed by their own employees. 

The Workplace Health in America 2017 survey did not ask 

what type of employees managed the programs, but 

the survey interviewers requested that the person most 

knowledgeable about employee health or wellness at 

the worksite complete the survey. About one-third of 

the respondents reported their department as human 

resources or benefits, 7.1% were from wellness or 

safety, 5.1% were from finance or marketing, and 54.1% 

reported some other department; most commonly office 

administrators or managers. Although worksites rely on 

their internal staff to manage their programs, about onethird of the worksites overall indicated that lack of staff 

experience was a significant barrier to offering 

health promotion programs.

Figure 9. Organization with primary responsibility for managing worksite health promotion programs

Even at the smallest worksites, most worksites with a 

program had at least one person who was assigned 

responsibility for health promotion (Figure 10). As with 

any worksite initiative, it is important to have at least one 

person accountable for implementation and monitoring. 

Worksite health promotion is unlikely to be a one-person 

job and may have a better chance of success with input 

from multiple individuals.5 They can share the workload and 

represent a variety of employee perspectives and needs. 

Most worksites (59.0%) had some type of committee. 

Twice as many of the smallest worksites (43.9%) had no 

committee, compared to the largest worksites (18.0%). 

The Workplace Health in America 2017 survey assessed 

the extent to which committees combined or separated 

employee health promotion and employee safety concerns 

as the committee’s focus (Figure 11). Similar percentages of 

worksites had health promotion and safety integrated into a 

single committee as had separate committees. Respondents 

who reported having a worksite committee rated how well 

the committee(s) represented a wide variety of employees 

from the worksite, including different departments and 

health interests. Most (79.4%) indicated that the committee 

was mostly or entirely representative of a variety of 

employees at their worksite.
Workplace Health In America 2017

23

Number of Employees

Among U.S. worksites with a health promotion program

72.2% 69.2% 69.7% 74.3%

82.3% 83.4%

90.1%

National 10-24 25-49 50-99 100-249 250-499 500+

Combined

wellness

and safety,

17.5%

Safety

only

12.5%

Wellness

only

7.9%

Separate

wellness

and safety

21.2%

No

committee

41.0%

AmongU.S.worksites witha health promotionprogram 

Note: Percentages based on weighted estimates.

Note: Percentages based on weighted estimates.

Percentages do not equal 100% due to rounding. 

Figure 10. Percentage of U.S. worksites with at least one person assigned responsibility for health promotion at the 

worksite, by worksite size

Figure 11. Percentage of U.S. worksites with committees that address health promotion, safety, or both 
Workplace Health In America 2017

24

FIG 12

Among U.S. worksites with a health promotion program

46.1%

84.2%

83.4%

62.0%

Reference employee health in

organization objectives/mission

Senior leadership committed to employee

health and safe work environments

Middle management committed to employee

health and safe work environments

Has champion who is a strong advocate

% of Worksites

FIG 13

Among U.S. worksites with a health promotion program

35.6%

11.0%

17.6%

7.4% 10.4%

18.1%

No

Budget

≤$1,000 $1,001–

$10,000

$10,001–

$20,000

$20,001–

$100,000

$100,001 

or more

Total Number of Dollars

Note: Percentages based on weighted estimates.

Note: Percentages based on weighted estimates.

Percentages do not equal 100% due to rounding.

Program Support, Planning, and Evaluation

The survey asked about the level of support the program 

received (i.e., organizational and leadership backing, 

financial resources) and what type of program planning 

and evaluation were done. Among worksites with a health 

promotion program, 46.1% agreed that their organization 

includes references to employee health in its business 

objectives or the mission statement (Figure 12). Regardless 

of size or industry, most worksites with programs agreed 

that senior leadership (84.2%) and middle management 

(83.4%) were visibly committed to employee health and 

safe work environments.

The survey asked how much worksites had annually 

to spend on employee health promotion at their worksite 

location. The question noted that it was fine to include 

salaries of employees who have responsibility for 

employee health as part of their job. A notable finding was 

that 35.6% of the worksites that reported having some 

type of health promotion program reported having no 

annual budget for the program (Figure 13). Even among 

sites with more than 500 employees, 16.1% reported 

having no annual budget for health promotion. Most 

worksites (58.1%) report having less than $5,000 to spend 

annually on health promotion. Most of these worksites 

(79.4%) reported planning to spend about the same 

amount on health promotion in the coming year, 17.5% 

planned to spend more, and 3.1% planned to spend less.

Figure 12. Percentage of U.S. worksites with visible support for employee health 

Figure 13. Percentage of U.S. worksites with an annual budget for health promotion
Workplace Health In America 2017

25

FIG 14

Among U.S. worksites with a health promotion program

% of Worksites

53.3%

58.9%

88.8%

77.8%

65.3%

Program uses data to help

decide what to offer

Has annual health

promotion plan

Among U.S. worksites with an

annual health promotion plan:

Plan includes strategies to

promote the program

Plan includes clear

implementation responsibilities

Plan has specific

measurable goals

Note: Percentages based on weighted estimates.

The Workplace Health in America 2017 survey included 

a question that asked respondents to rate the extent to 

which they believed that employees at their worksite 

worked within a “culture of health.”6,7 The survey defined 

a workplace culture of health as one in which leadership 

creates a work environment that values and supports 

employee health and provides healthy work conditions 

as the normal way of doing business. Respondents rated 

this item on a scale of 1, “not at all” a culture of health, 

to 10, “completely” a culture of health. Overall, the mean 

rating was 6.8 on the scale of 1 to 10, suggesting that 

most respondents believed their work environments 

and conditions were on the healthy side, but had room 

for improvement. Across the different worksite size 

categories, the mean rating only varied from a low of 6.3 

in the 250–499 employees size group, to 6.9 in the 10–24 

employees size group, and there was also little variation in 

the mean across the industry groups. 

Just over half (58.9%) of the worksites with programs 

had an annual health promotion plan, leaving 41.1% with 

no plan. The percentage with plans ranged from 49.3% of 

worksites with 25–49 employees, to 79.4% of worksites 

with at least 500 employees. Most of those with plans 

include important elements like goals, clear responsibilities 

for staff involved in management of the program, and 

strategies to promote and communicate the program to 

employees (Figure 14). The percentages of worksites with 

these plan elements were similar across size categories.

Figure 14. Percentage of U.S. worksites with annual health promotion planning and plan features

Among worksites with programs, 53.3% use data to 

help decide what to offer. This ranged from 41.3% of 

worksites with 25–49 employees, to 79.3% of worksites 

with at least 500 employees. Forty percent of the 

worksites that use data for planning reported using 

some type of organizational level assessment tool 

(e.g., CDC Worksite Health ScoreCard) to benchmark 

changes, or to plan and/or evaluate health-related 

organizational changes made over time.

Half of the worksites reported using data to evaluate 

their health promotion program. While 47.5% of the 

smallest worksites used data for evaluation, 77.3% of the 

largest sites did. This may be related to lack of expertise 

or low perceived need for data-driven evaluation among 

the smaller sites. Nearly all worksites that used data used 

employee participation data (Figure 15). Worksites were 

less likely to use absenteeism or presenteeism data for 

program evaluation than other types of data.
Workplace Health In America 2017

26

FIG 15

Among U.S. worksites with a health promotion program

50.2%

98.3%

89.7%

78.1%

73.1%

60.7%

57.2%

56.9%

51.6%

38.7%

Uses data to evaluate program

Among U.S. worksites who use

data, they are measuring:

Employee participation

Employee feedback

Changes in employee

health risk behaviors

Health care claim costs

Workers compensation claims

Return on investment

Employee satisfaction

Changes in employee

disease rates

Absenteeism

% of Worksites

Note: Percentages based on weighted estimates.

Figure 15. Percentage of U.S. worksites using data to evaluate programs and the types of measurement performed

Opportunity The Workplace Health in America 2017

findings—that just 50.2% of the worksites with 

a health promotion program have a plan, use data to decide what to offer, and 

use data to evaluate how successful their programs are—suggest that employers 

may need guidance on (1) the importance of planning, using data, and evaluation; 

and (2) how to accomplish these activities. Additionally, respondents were asked 

about their training and technical assistance (TA) needs. Just under half (45.9%) of 

worksites indicated training in program planning, implementation, and evaluation 

would be helpful as would training and TA on best practices for employee safety 

and health (75.5%); laws, regulations, and standards (55.6%); and conducting health 

and safety assessments (53.2%). Templates and practical technical assistance can 

save employers time and money that might be wasted on poorly implemented 

programming that doesn’t address the needs or interests of the target employee 

population. Free resources are available to help employers: https://www.cdc.gov/

workplacehealthpromotion/initiatives/resource-center/index.html
Workplace Health In America 2017

27

82.3%

30.6%

30.8%

Offered incentivestied

to participation

Offered incentivestied to

a health standard

Offered incentivestied to

participation and a

health standard

% of Worksites

53.0% of U.S. worksites with a health promotion program offered incentives. Of those:

FIG 16

FIG 17

5.7%

8.2%

10.5%

52.6%

53.1%

64.4%

Additional paid

time off

Health insurance

copay differences

Add money to flexible

spending accounts

Health insurance

premium discounts

Cash rewards

Gifts or prizes

Note: Percentages based on weighted estimates.

Note: Percentages based on weighted estimates.

Incentives

Just over half (53.0%) of worksites with a program 

reported that they had offered some type of incentive 

related to the health promotion program. The percentage 

was 78.0% for the worksites with at least 500 employees. 

The survey described incentives broadly to include those 

used to reward participation or behavior change, or to 

penalize employees for not improving health behaviors. 

Among the worksites that offered some type of incentive, 

82.3% reported that incentives were tied primarily to 

participation or attendance in a health program (Figure 

16). Worksites used multiple strategies with incentives 

because 30.6% reported that incentives were tied to 

meeting some health standard (e.g., meeting a weight 

loss goal, quitting smoking) and 30.8% also report they 

provided incentives tied to both participation and meeting 

a health standard.

Figure 16. Percentages of U.S. worksites using incentives and how they are used

Respondents also reported what types of incentives they 

had used in the past 12 months. The most commonly 

used incentives are shown in Figure 17. The other types 

of incentives included in the survey (e.g., additional paid 

time off ) were much less commonly used by respondents. 

The survey asked respondents to rate how effective they 

considered the incentives they offered for achieving their 

intended outcomes. The largest percentage (48.1%) of 

respondents rated their incentives as just “somewhat 

effective” (Figure 18).

Figure 17. Type of incentives offered by U.S. worksites
Workplace Health In America 2017

28

Not at all

effective

6.5%

Somewhat

effective

48.1%

Effective

34.2%

Extremely

effective

11.2%

Among U.S. worksites with a health promotion program offering incentives

Note: Percentages based on weighted estimates.

Figure 18. Employers’ ratings of the effectiveness of incentives for achieving intended outcomes

Comprehensive Health Promotion Programs

Comprehensive health promotion programs are 

considered a best practice for worksite health promotion 

and have demonstrated effectiveness in improving 

employee health, morale, and productivity.4 The Workplace 

Health in America 2017 survey included questions 

assessing whether worksites offered the five elements of 

a comprehensive workplace health promotion program as 

defined by Healthy People 2010.8

■ Health education programs that focus on skill 

development and lifestyle behavior change 

along with information dissemination and 

awareness building, preferably tailored to 

employees’ interests and needs

■ A supportive social and physical environment 

that includes an organization’s expectations 

regarding healthy behaviors, and 

implementation policies that promote health 

and reduce risk of disease (e.g., policies 

restricting smoking, increasing access to 

healthy foods at work)

■ Integration of the health promotion program 

into the organization’s structure that includes 

allocating dedicated resources, budget, and/or 

alignment with the business plan

■ Linkage to related programs like employee 

assistance programs and programs to help 

employees balance work and family

■ Worksite health screening programs ideally 

linked to medical care to ensure follow-up and 

appropriate treatment as necessary.

Overall, fewer than half of the worksites reported having 

any individual element in place (Figure 19). However, more 

than half of the worksites with at least 250 employees 

had any one of the five elements. For example, just under 

one-quarter of worksites with fewer than 50 employees 

offered health screening programs, compared to 63.4% of 

worksites with at least 250 employees.
Workplace Health In America 2017

29

% of Worksites

47.8%

46.0%

33.7%

28.4%

26.6%

Supportive social and

physical environment

Linkage to related programs

Health education programs

Integration of health promotion

into organizational structure

Health screening programs

Note: 5 elements of a comprehensive health promotion program as defined by Healthy People 2010.

Percentages based on weighted estimates.

Figure 19. Percentage of U.S. worksites with each element of a comprehensive health promotion program

At the national level, 11.8% of worksites offered a 

comprehensive worksite health promotion program that 

incorporated all five key elements. Higher percentages 

of worksites with more than 100 employees had 

comprehensive programs compared to the worksites 

with fewer than 100 employees (Figure 20). The highest 

percentage of worksites with comprehensive programs 

were in the Hospital industry (35.7%). Using the Workplace 

Health in America 2017 data, we analyzed the factors 

that predicted whether worksites had a comprehensive 

health promotion program using logistic regression. 

We tested several possible predictor variables including 

employer size, industry group, presence of an annual 

health promotion budget, having a person responsible 

for the health promotion program, and having the 

health promotion program in place for at least five years. 

When we statistically analyzed the effects of each of 

these possible predictors at the same time, we found 

that employer size and industry group were no longer 

important predictors. Instead, we found worksites that had 

health promotion programs in place for at least five years 

were three times more likely to have a comprehensive 

program compared to worksites that had programs in 

place for less than three years (P < .0001); worksites with 

an annual budget for health promotion were seven times 

more likely to have a comprehensive program compared 

to worksites with no annual budget (P < .0001); and 

worksites with a person assigned responsibility for the 

health promotion program were eight times more likely to 

have a comprehensive program compared to those who 

did not have a responsible person (P < .0001).

Opportunity The Workplace Health in America 2017 results suggest 

that no worksite size category or industry group is 

at an inherent disadvantage for having a comprehensive health promotion program. 

The key factors are tied to putting financial and trained personnel resources behind 

the program and maintaining the program over several years, allowing it to develop 

and become more comprehensive. Wider dissemination of this message and data may 

empower more employers who seek to develop or implement more comprehensive 

health promotion programs.

3
Workplace Health In America 2017

30

Number of Employees

National

11.8% 11.0%

8.3%

12.2%

21.3%

33.6%

39.5%

10-24 25-49 50-99 100-249 250-499 500+

Note: Elements of a Comprehensive Workplace Health Program as defined by Healthy People 2010: 1) Health education; 2) Links to related 

employee services; 3) Supportive physical and social environment for health improvement; 4) Integration of health promotion into the 

organizational culture; 5) Employee screenings with adequate treatment and follow-up.

Percentages based on weighted estimates.

Figure 20. Percentage of U.S. worksites with all five elements of a comprehensive health promotion program, by 

worksite size 

Barriers to Offering Health Promotion Programs

All worksites were asked about a set of potential barriers 

to offering health promotion programs. Cost was rated 

as challenging or extremely challenging by the largest 

percentage of worksites, followed by competing business 

demands, lack of employee interest, lack of experienced 

staff, lack of physical space, and demonstrating program 

results (Figure 21). These six questions were rated by the 

largest percentages of worksites as challenging, whether 

the worksites had a health promotion program in place 

or not. The percentages of worksites that rated costs and 

competing business demands as challenging did not vary 

based on worksite size. However, just 21.7% of the largest 

worksites rated lack of experienced staff as a high barrier 

to their efforts to implement health promotion programs, 

compared to 37.1% of worksites with 2–9 employees.

The Workplace Health in America 2017 survey findings 

indicate that 62.3% of worksites with programs manage 

those programs with their own staff. Nationally, 32.9% of 

worksites reported lack of experience as a high barrier. 

Providing additional training to staff and linking them to 

credible tools and resources to assist with program planning, 

implementation, and evaluation could give decision-makers 

at worksites without programs more confidence in their 

capacity to implement a program. Small percentages of 

respondents from worksites in the smallest size category 

rated confidentiality concerns (12.7%) or employee distrust 

of employer-sponsored programs (9.2%) as high barriers, 

which suggests these are probably not big factors in these 

worksites’ low rates of offering interventions that collect 

employee level data like HRAs.
Workplace Health In America 2017

31

% of Worksites

57.5%

41.7%

37.5%

32.9%

30.4%

24.7%

Cost

Competing business demands

Lack of employee interest

Lack of experienced staff

Lack of physical space

Demonstrating results

Note: Percentages include U.S. worksites who responded “challenging” or “extremely challenging“ on a 5 point Likert scale. 

Percentages based on weighted estimates.

Figure 21. Barriers to offering health promotion program among U.S. worksites 

Opportunity Barriers to offering workplace health promotion 

programs are common to all types of worksites, 

and fortunately many can be overcome. Programs that do not follow best practices 

and have not taken steps to integrate their activities into the broader workplace 

culture often have low engagement and participation. Setting clear, reasonable 

expectations that can be measured while starting with smaller successes and 

growing over time can keep employees interested as will keeping programming 

fun and flexible. Many low or no cost resources including training on program 

planning, implementation, and evaluation as well as turnkey programs; policy 

templates; and survey tools are available to worksites. If a lack of space is a barrier, 

creative and innovative solutions such as using conference or meeting rooms for 

dual purposes or mapping walking routes to the surrounding area may be a viable 

option. Developing partnerships with community organizations such as state 

health departments that have expertise in data and evaluation, and population 

health programming can bring a capacity to the workplace health program to 

fill a gap. Free resources are available to help employers: https://www.cdc.gov/

workplacehealthpromotion/initiatives/resource-center/index.html.
Workplace Health In America 2017

32

% of Worksites

FIG 22

5.7%

7.3%

7.5%

9.7%

11.5%

15.2%

Community organization (e.g., YMCA,

Area Agencies on Aging)

Hospital

Business group (e.g., Chamber of Commerce,

Small Business Majority)

State/local public health agency

Health-related organization (e.g., American

Heart Association, American Cancer Society)

Workers compensation provider

AmongU.S. worksiteswithahealthpromotionprogram

Note: Percentages based on weighted estimates.

Key Partners for Worksites Offering Health Promotion Programs

Most worksites didn’t partner with other organizations to 

offer employee health promotion programs. In fact, about 

three-quarters of worksites (72.4%) had no partnerships 

at all. Of the 27.6% of worksites that did have a partner 

for their health promotion programs, 10.4% had a single 

partner and 17.2% had multiple partnerships which 

varied among community groups, business groups, 

health agencies, and non-profits (Figure 22). Employers, 

especially smaller ones, may not be aware of partnership 

opportunities in their communities. Employers are missing 

out on free and low-cost resources that in some cases 

may require minimal effort to provide to their workers. 

Organizations that want to increase their impact could do 

more to tailor their messages to small employers (business 

case or value proposition) and market their services and 

collaboration opportunities to local employers.9-11

Figure 22. Percentage of U.S. worksites that partnered with different types of organizations to offer employee 

health programs
Workplace Health In America 2017

33

Section 3: 

Health Promotion Programming 

to Address Specific Health Topics
Workplace Health In America 2017

34

FIG 23

% of Worksites

28.5%

23.1%

17.4%

18.5%

14.4%

7.6%

19.6%

12.1%

9.9%

Physical activity

Nutrition/healthy eating

Obesity/weight management

Tobacco cessation

Excessive alcohol and/or

drug misuse

Lactation support

Stress management

Musculoskeletal disorders,

back pain, arthritis

Healthy sleep

Note: Percentages based on weighted estimates.

Almost half of all worksites offered some type of health 

promotion or wellness program (46.1%) (Figure 6). 

Worksites reported whether they offered health promotion 

programs to address nine specific health-related behaviors 

and conditions that are major contributors to lost 

productivity and costs to employers and the country:

■ Physical activity

■ Nutrition and healthy eating

■ Obesity and weight management

■ Tobacco use

■ Drug misuse and excessive alcohol

■ Musculoskeletal disorders, back pain, 

and arthritis

■ Lactation support

■ Stress management

■ Healthy sleep.

Worksite health promotion/wellness programs were 

defined as any educational materials, activities, classes, 

screenings, services, environmental supports, or policies 

that encourage employees to be healthy. These strategies 

and interventions were evidence-based, meaning that 

they had been developed, implemented, and evaluated for 

their effectiveness through the application of principles of 

scientific reasoning, including systematic uses of data and 

information systems, and appropriate use of behavioral 

science theory and program planning models.

In this section, we focus on worksite activities 

addressing physical activity; healthy eating; weight 

management; tobacco, alcohol and drugs; and lactation. We 

also present results for musculoskeletal, stress management, 

and healthy sleep programs at the national level.

Less than one-third of the worksites offered 

programs addressing any of the nine topics (Figure 23). 

The most common types of programs offered focused on 

physical activity, nutrition, and stress. Higher percentages 

of larger worksites (>250 employees) offered programs 

addressing any of the health topics than small worksites 

(<50 employees). Hospitals, most of which had more 

than 250 employees, were consistently the industry 

group with the highest percentage of worksites offering 

a program across all topics, followed by the Public 

Administration industry group.

For each of the topic areas, respondents also 

answered questions about the types of programs 

offered, the entity that typically offered the programs to 

employees, the estimated level of employee participation 

in programs (Table 5), and whether the worksite offered 

specific evidence-based strategies.

Figure 23. Percentage of U.S. worksites that offered specific health programs 
Workplace Health In America 2017

35

Table 5. Questions asked about each of the nine health topics

Question asked Response 

Choices

Response 

Choices

Response 

Choices

Response 

Choices

What types of programs have you 

offered? Informational Skill-building Informational and 

skill-building

Who typically offered these 

programs to employees? Employer Health Plan Vendor Combined efforts

Thinking about all the programs 

offered here in the past 12 months, 

approximately what percentage 

of employees from this location 

participate?

1–25% 26–50% 51–75% More than 75%

The Workplace Health in America 2017 survey defined 

awareness or informational programs as those including 

print or online materials, posters, flyers, brochures, 

educational materials, or one-time presentations. 

Informational programs are characteristically passive 

and low intensity. The survey defined skill-building 

programs as including onsite, online, or offsite classes 

in the community; one-on-one coaching; contests or 

competitions. Skill-building programs are generally more 

active and intense than information-only programs. Across 

the topic areas, between 87% and 98% of worksites that 

had programs reported offering programs that were either 

information only or a combination of information and 

skill-building. Only small percentages of worksites had 

programs they characterized as exclusively skill-building 

for any topic.

For most health topics, respondents reported that 

it was the employers themselves who typically offered 

the programs, rather than the health plan or a different 

outsourced vendor. Or they reported that the program was 

offered through the combined efforts of the employer, 

health plan, and/or vendors. Across nearly all health 

topics, the largest percentages of respondents reported 

that between 1 and 25% of employees participated in 

programs related to that topic within the past year. About 

half of all worksites indicated that more than 25% of 

employees participated in physical activity, nutrition, and 

musculoskeletal disorder prevention programs—topics 

that could be relevant to all employees.

Less than 25% of worksites at the national level 

offered any of the evidence-based strategies included on 

the survey, except having a tobacco policy and providing 

food storage facilities. Consistently higher percentages of 

large worksites offered the evidence-based strategies than 

the smaller worksites.

Workplace Efforts to Increase 

Physical Activity

Engaging in regular physical activity is one of the 

most important behaviors influencing health, including 

heart disease, stroke, diabetes, depression, and some 

cancers. Despite its importance, the results of the 2016 

National Health Interview Survey indicated that 39.5% of 

employed adults did not meet the 2008 federal physical 

activity guidelines.12 Full-time employees spend one-third 

of most days working, making worksites an opportune 

setting to encourage physical activity by providing 

information, establishing policies to encourage movement 

at work, and providing programs and environmental 

supports such as exercise classes and walking paths.

Physical activity programs were the most common 

type of health promotion program offered by worksites 

of all sizes and industry groups (Figures 24 and 25). 

Nationally, 28.5% of worksites reported offering some type 

of program to address physical activity, fitness, and/or 

sedentary behavior.
Workplace Health In America 2017

36

Number of Employees

National

28.5%

24.7% 23.7%

35.7%

48.0%

63.9%

75.8%

10-24 25-49 50-99 100-249 250-499 500+

28.5%

18.9%

34.5%

20.7% 22.8%

33.3%

55.9%

63.7%

IndustrySector

Note: Percentages based on weighted estimates.

Note: Ag/For/Const/Manf = Agriculture, Forestry, Fishing; Mining; Utilities; Construction; Manufacturing

Trade/Trans/Wrhs = Wholesale/Retail Trade; Transportation; Warehousing

Arts,Rec/Acc,Food,Svc = Arts, Entertainment, Recreation; Accommodations and Food Service; Other Services

Info/Fin/Ins/Real Est = Information; Finance; Insurance; Real Estate and Leasing; Professional, Scientific, Technical Services; Management; Administration 

Support; Waste Management

Educ/Hlth, Soc Asst = Education Services; Health Care & Social Assistance

Pub Admin = Local, State, and Federal Public Administration.

Percentages based on weighted estimates.

Figure 24. Percentage of U.S. worksites that offered a physical activity program, by worksite size 

Figure 25. Percentage of U.S. worksites that offered a physical activity program, by industry group 

Most worksites (57.9%) offered a combination of 

informational and skill-building programs (Figure 

26). Compared to most other health topics, a lower 

percentage of worksites offered physical activity 

programs that were informational only. Worksites relied 

on their own staff or their staff in combination with 

others to offer physical activity programs. Over a third 

(37.6%) reported that their physical activity programs 

were typically offered mostly by the employer, 11.9% 

were offered by the health plan, 8.1% were offered by a 

vendor, and 42.4% were offered by the combined efforts 

of the employer, health plan, or a vendor.
Workplace Health In America 2017

37

FIG 27

% Employee Participation

Among U.S. worksites with a physical activity program

49.2%

35.1%

10.1%

5.7%

1-25% 26-50% 51-75% >75%

Among U.S. worksites with a physical activity program

Both

Informational

and

Skill-Building

57.9%

Informational

29.2%

Skill-Building

12.9%

Note: Percentages based on weighted estimates.

Percentages do not equal 100% due to rounding.

Note: Percentages based on weighted estimates.

Figure 26. Type of worksite physical activity programs offered to employees 

Respondents indicated that employee participation 

in physical activity programs was relatively low, with 

84.3% estimating that less than 50% of employees took 

advantage of these programs (Figure 27). Only 8.2% of 

worksites offered paid time to be physically active and 

less than 20% had any evidence-based strategies in place, 

which may help to explain low participation.

Figure 27. Level of employee participation in worksite physical activity programs 
Workplace Health In America 2017

38

FIG 28

% of Worksites

17.6%

17.2%

16.3%

15.3%

13.9%

12.4%

9.9%

8.8%

8.7%

8.2%

Subsidized/discounted exercise facilities

Provided organized physical activity programs

Provided environmental supports for physical activity

Provided lifestyle self-management program

with advice on physical activity

Provided active work stations

Provided onsite exercise facility

Encouraged active transportation

Provided physical fitness assessments

Provided physical activity tracking device

Offered paid time to be physically active during work hours,

for fitness breaks, walking meetings, or other options

Note: Percentages based on weighted estimates.

Environmental supports for physical activity include: walking trails or tracks, maps of measured walking/jogging routes, bicycle racks, showers and 

changing rooms, open space for recreation, weight rooms

The survey asked whether employers offered several 

different evidence-based environmental supports, 

policies, and programs for physical activity. Although 

physical activity programs were the most common type 

of specific health programming offered (Figure 23), less 

than 20% of the worksites had any of the evidence-based 

strategies on the survey in place (Figure 28). Among all 

the strategies the survey asked about, the most common 

was subsidizing or discounting the cost of onsite or 

offsite exercise facilities (17.6% of worksites). This ranged 

from just 11.6% of the worksites with 24–49 employees 

to 55.3% of the worksites with at least 500 employees. 

Similarly, 17.2% of the worksites provided organized 

individual or group physical activity programs such 

as walking programs or group exercise classes. These 

organized programs were reported by 12.6% of worksites 

with 24–49 employees and 51.0% of worksites with at 

least 500 employees. Worksites in the Agriculture, Forestry, 

Fishing; Mining; Utilities; Construction; and Manufacturing 

industry group had the lowest percentage (9.4%), while 

hospital worksites had the highest percentage (46.8%) 

of organized programs. Only 8.2% of all worksites offered 

employees paid time to be physically active during work 

hours, for fitness breaks, walking meetings, or other 

options. This policy, which could be more expensive than 

some of the other strategies, was relatively uncommon 

even among the largest worksites. It was offered by 19.5% 

of worksites with more than 500 employees.

Figure 28. Percentage of worksites offering evidence-based strategies to encourage physical activity 

Opportunity Only 16.3% of all worksites provide environmental 

supports for physical activity such as walking 

trails, bicycle racks, showers or changing rooms, or open space for recreation. These 

environmental interventions may require more initial planning and, in some cases, 

initial capital investment than an educational opportunity or policy for example. 

However, once in place they provide inexpensive, lower maintenance strategies for 

increasing employees’ opportunities to engage in physical activity while at work.
Workplace Health In America 2017

39

FIG 29

Number of Employees

National

23.1% 19.8% 20.0%

27.1%

39.9%

59.5%

75.6%

10-24 25-49 50-99 100-249 250-499 500+

Note: Percentages based on weighted estimates.

Addressing Healthy Eating in the Workplace

Americans eat out frequently and spent more money on 

food away from home than they spent on food at home 

for the first time in 2014.13 Food may be available through 

many channels at the workplace including cafeterias, 

snack bars, vending machines, onsite or nearby farmers 

markets, food served at company meetings and events, 

coworkers bringing food to share, and employees bringing 

in their own food. A recent study found that 22% of U.S. 

employees obtained food from the workplace during the 

week; it was more common for employees to obtain free 

food than to purchase food; and the food people obtained 

at work was generally high in empty calories and low in 

whole grains and fruit.14

Some employers are learning that they can help 

steer employees toward healthier food choices at work 

by making sure healthier options are available, affordable, 

convenient, and appealing. Programs focused on healthy 

eating were the second most common type of health 

promotion program offered by worksites of all sizes. 

Nationally, 23.1% of worksites reported offering some 

type of program to address nutrition and/or healthy 

eating (Figure 29). Hospitals and worksites in the Public 

Administration group had the highest percentages of 

worksites offering these programs (Figure 30). Larger 

worksites, including hospitals, are the most likely to have 

food available for purchase at the site and may see more 

opportunities to address healthy eating with a program.

Among the worksites offering nutrition programs, 

almost all were informational and skill-building, or just 

informational (Figure 31). Although most worksites 

estimated that no more than 50% of the employees 

participated, 21.0% estimated that more than 75% of 

employees participated (Figure 32). 

Figure 29. Percentage of U.S. worksites that offered a nutrition program, by worksite size 
Workplace Health In America 2017

40

23.1%

14.6%

28.8%

17.9% 17.8%

27.1%

44.0%

59.7%

IndustrySector

Among U.S. worksites with a nutrition program

Informational

43.0%

Skill-Building

4.6%

Both

Informational

and

Skill-Building

52.5%

Note: Ag/For/Const/Manf = Agriculture, Forestry, Fishing; Mining; Utilities; Construction; Manufacturing

Trade/Trans/Wrhs = Wholesale/Retail Trade; Transportation; Warehousing

Arts,Rec/Acc,Food,Svc = Arts, Entertainment, Recreation; Accommodations and Food Service; Other Services

Info/Fin/Ins/Real Est = Information; Finance; Insurance; Real Estate and Leasing; Professional, Scientific, Technical Services; Management; 

Administration Support; Waste Management

Educ/Hlth, Soc Asst = Education Services; Health Care & Social Assistance

Pub Admin = Local, State, and Federal Public Administration.

Percentages based on weighted estimates.

Note: Percentages based on weighted estimates.

Percentages do not equal 100% due to rounding. 

Figure 30. Percentage of U.S. worksites that offered a nutrition program, by industry group 

Figure 31. Type of worksite nutrition programs offered to employees 
Workplace Health In America 2017

41

% Employee Participation

Among U.S. worksites with a nutrition program 50.7%

20.4%

7.9%

21.0%

1-25% 26-50% 51-75% >75%

FIG 33

15.2%

10.1%

8.5%

Provided lifestyle self-management

program with advice on nutrition

Have written policy making healthier

food/beverages available at meetings

Offered/promoted onsite

or nearby farmers market

% of Worksites

Note: Percentages based on weighted estimates.

Note: Percentages based on weighted estimates.

Figure 32. Level of employee participation in worksite nutrition programs 

Worksite respondents answered questions about evidencebased environmental supports, policies, and programs 

supporting healthy eating. Higher percentages of larger 

worksites offered them to their employees compared to 

smaller worksites. For example, 12.1% of the smallest 

worksites offered lifestyle self-management programs, 

compared to 58.5% of the largest sites. Policies that 

make healthier food and beverages available during 

meetings when food is served have not yet become the 

norm, ranging from 5.8% of the smallest sites to 26.0% of 

the largest sites reporting having this policy (Figure 33).

Figure 33. Percentage of U.S. worksites offering evidence-based strategies to encourage healthy eating 
Workplace Health In America 2017

42

Number of Employees

National

17.4%

14.0% 14.4%

23.4%

33.9%

45.3%

66.3%

10-24 25-49 50-99 100-249 250-499 500+

Note: Percentages based on weighted estimates.

Helping Employees Manage Their Weight

Individuals who have obesity are at increased risk 

for chronic diseases and health conditions including 

diabetes, heart disease, hypertension, high cholesterol, 

osteoarthritis, and sleep apnea.15 Obesity is associated with 

lower productivity at work, more sick days, and higher 

health care costs.16 The 2016 National Health Interview 

Survey estimated that 37.1% of employed adults were 

classified as overweight based on their body mass index, 

and another 28.5% were classified as obese.17

Overall, 17.4% of the worksites offered some type of 

program to address obesity or weight management for 

employees. The Community Preventive Services Task Force 

recommends worksite programs to improve healthy eating 

and physical activity to address weight management.18

The Workplace Health in America 2017 survey included 

these topics in separate sections, understanding that the 

programs might have shared outcomes. Worksites in the 

largest size category had the highest percentage offering 

weight management programs (Figure 34), and hospitals 

had the highest percentage with weight management 

programs among the industry groups (Figure 35).

Figure 34. Percentage of U.S. worksites that offered an obesity/weight management program, by worksite size 
Workplace Health In America 2017

43

17.4%

10.9%

26.9%

9.0% 12.8%

20.8%

30.8%

52.9%

Industry Sector

Note: Ag/For/Const/Manf = Agriculture, Forestry, Fishing; Mining; Utilities; Construction; Manufacturing

Trade/Trans/Wrhs = Wholesale/Retail Trade; Transportation; Warehousing

Arts,Rec/Acc,Food,Svc = Arts, Entertainment, Recreation; Accommodations and Food Service; Other Services

Info/Fin/Ins/Real Est = Information; Finance; Insurance; Real Estate and Leasing; Professional, Scientific, Technical Services; Management; 

Administration Support; Waste Management

Educ/Hlth, Soc Asst = Education Services; Health Care & Social Assistance

Pub Admin = Local, State, and Federal Public Administration.

Percentages based on weighted estimates.

Figure 35. Percentage of U.S. worksites that offered an obesity/weight management program, by industry group 

Among the 17.4% of worksites offering weight 

management programs, most (64.2%) offered a 

combination of informational and skill-building programs 

(Figure 36). The percentage of worksites offering only 

informational programs (27.4%) was the lowest of all 

the nine health topics on the survey and an additional 

8.4% of worksites offered skill-building program only, 

suggesting that worksites tried more activity or skillbased programming, like weight loss challenges with or 

without information (72.6%) compared to just offering 

information to employees (27.4%).

Eighty percent of worksite respondents estimated 

that just 1–25% of their employees participated in weight 

management programs and this was consistent across 

worksite sizes. Participation in weight management 

programs would vary based on the workforce needs and 

would not be expected to be high in all worksites, but it 

is worth noting again that 66% of employed adults are 

classified as overweight or having obesity.

The Workplace Health in America 2017 survey asked 

about one specific weight management intervention: 

bariatric, or weight loss, surgery. Overall, 5.6% of worksites 

reported that they provide full or partial insurance 

coverage for bariatric surgery. While less than 5% of 

the smallest worksites provided this benefit, 27.3% of 

worksites with 250–499 employees and 49.5% of worksites 

with more than 500 employees covered at least some of 

the cost for weight loss surgery.
Workplace Health In America 2017

44

Among U.S. worksites with an obesity/weight management program

Informational

27.4%

Skill-Building

8.4%

Both

Informational

and

Skill-Building

64.2%

Note: Percentages based on weighted estimates.

Figure 36. Type of worksite obesity/weight management programs offered to employees 

Opportunity Evidence suggests that physical activity 

interventions in adults who are overweight or 

have obesity may be more effective in increasing physical activity if they have a 

physical activity component that includes activity monitors to provide regular 

feedback (i.e., number of steps, calories used) along with instruction, such as 

counseling or Web-based education.19 Workplace Health in America 2017 results 

showed that less than 10% of all worksites provide activity tracking devices, even 

though there are inexpensive options available. Worksites may want to consider 

their nutrition and physical activity initiatives when they are planning weight 

management programs.
Workplace Health In America 2017

45

Number of Employees

National

18.5% 16.1% 14.2%

21.4%

35.0%

46.1%

73.5%

10-24 25-49 50-99 100-249 250-499 500+

FIG 38

Industry Sector

18.5% 13.9%

28.1%

14.3% 10.3%

18.3%

35.9%

59.5%

Note: Percentages based on weighted estimates.

Note: Ag/For/Const/Manf = Agriculture, Forestry, Fishing; Mining; Utilities; Construction; Manufacturing

Trade/Trans/Wrhs = Wholesale/Retail Trade; Transportation; Warehousing

Arts,Rec/Acc,Food,Svc = Arts, Entertainment, Recreation; Accommodations and Food Service; Other Services

Info/Fin/Ins/Real Est = Information; Finance; Insurance; Real Estate and Leasing; Professional, Scientific, Technical Services; Management; Administration 

Support; Waste Management

Educ/Hlth, Soc Asst = Education Services; Health Care & Social Assistance

Pub Admin = Local, State, and Federal Public Administration.

Percentages based on weighted estimates.

Workplace Efforts to Reduce Tobacco, Excess Alcohol, and Drug Use

Tobacco

In 2016, the National Health Interview Survey 

estimated 14% of employed adults were current 

smokers.20 While smoking is at an all-time low, it 

remains the leading cause of preventable death. 

National survey data indicate rates of smoking are 

highest in certain industry groups including Mining; 

Accommodations and Food Service; and Construction.21

Nationally, 18.5% of worksites reported offering 

some type of program to help employees stop using 

tobacco products. The percentage of worksites with more 

than 100 employees offering these programs was higher 

than the percentage of worksites with fewer than 100 

employees (Figure 37). The percentage of public sector 

worksites offering tobacco programs was higher than 

other industry groups, except Hospitals and those in the 

Trade, Transportation, and Warehousing group (Figure 38). 

The industry groups with higher rates of smoking (those 

including Mining, Construction, and Accommodations 

and Food Service) had some of the lowest percentages of 

worksites with programs to help employees stop smoking.

Figure 37. Percentage of U.S. worksites that offered a tobacco cessation program, by worksite size 

Figure 38. Percentage of U.S. worksites that offered a tobacco cessation program, by industry group 
Workplace Health In America 2017

46

FIG 39

% of Worksites

7.5%

12.3%

15.9%

17.5%

20.8%

28.9%

19.4%

31.2%

Removed barriers to accessing tobacco

treatments (e.g., copays)

Referred tobacco users to cessation quitline

Provided/subsidized tobacco

cessation counseling

Provided insurance coverage for cessation meds

Informed employees about tobacco cessation

medication and counseling coverage/programs

Displayed "no smoking" and other signs

Policy banning all tobacco use at worksite

Written policy to restrict smoking

Note: Percentages based on weighted estimates.

About half of the worksites with tobacco cessation 

programs (49.3%) only offered employees information on 

quitting. The other half (46.3%) offered a combination of 

informational and skill-building programs. Nearly onethird (30.2%) of worksites reported that their tobacco 

cessation programs were offered mostly by the employer, 

25.5% percent reported that these programs were offered 

by the health plan, 15.5% reported that these programs 

were offered by a vendor, and 28.8% percent were offered 

through the combined efforts of the employer, health 

plan, or a vendor.

Worksite respondents answered questions about 

evidence-based environmental supports, policies, and 

programs to help employees stop using tobacco (Figure 

39). The most common strategy was having a policy to 

restrict smoking, reported by 31.2% of the worksites, and 

19.4% completely banning tobacco use at the worksite 

(indoors and outdoors). Nationally, 17.5% of the worksites 

provided insurance coverage with low or no out-of-pocket 

costs for U.S. Food and Drug Administration-approved 

prescription and/or over-the-counter tobacco cessation 

medications. The percentage of worksites offering such 

coverage to employees ranged from about 15.1% of 

the smallest worksites to 72.8% of the largest worksites. 

Similarly, at the national level, just 15.9% of the worksites 

provided or subsidized the cost of tobacco cessation 

counseling (including onsite or offsite; in group or 

individual settings; through vendors, on-site staff, health 

insurance plans or programs, community groups, or other 

practitioners). This counseling was offered to employees in 

14.6% of the smallest worksites, compared to employees 

at 65.6% of the largest worksites. At the national level, just 

7.5% of worksites removed barriers like copays and prior 

approval requirements for employees seeking tobacco 

cessation medication; however, 44.0% of worksites with 

500 or more employees reported removing such barriers.

Figure 39. Percentage of U.S. worksites offering evidence-based strategies to help employees stop using tobacco 
Workplace Health In America 2017

47

Opportunity About 70% of adult smokers want to quit, and 

more than half try to quit each year. Quitting 

smoking is difficult; smokers often try to quit multiple times before succeeding. 

However, about three in five U.S. adults who ever smoked have quit. While the 

optimal approach is to use cessation medications and counseling to quit, fewer 

than one in 20 smokers use both.22–24 Combining environmental changes (e.g., 

smoke-free or tobacco-free policies) with barrier-free access to free cessation 

assistance (e.g., quitlines, in-person counseling, and cessation medications) is an 

especially effective approach to help employees quit smoking. The environmental 

changes motivate employees to try to quit and provide them with a supportive 

environment for quitting. Ensuring employees’ access to proven cessation 

treatments maximizes their chances of quitting successfully. In addition to being 

clinically effective, smoking cessation treatments are highly cost-effective; in fact, 

they have been referred to as the gold standard of health care cost effectiveness. 

This is especially true from the perspective of employers, who stand to realize 

productivity gains as well as reduced health care costs.24 Employers in industries 

with higher than average rates of tobacco use may consider targeting their efforts 

to help employees quit smoking by using this type of comprehensive approach.
Workplace Health In America 2017

48

FIG 40

Number of Employees

National

14.4% 14.0% 10.8% 12.4%

26.2%

33.5%

52.3%

10-24 25-49 50-99 100-249 250-499 500+

Note: Percentages based on weighted estimates.

Alcohol and Other Drugs

In 2016, the National Health Interview Survey estimated 

62% of employed adults drank alcohol regularly.25

Excessive alcohol use is associated with short- and longterm health risks, including motor vehicle crashes, alcohol 

poisoning, liver disease, high blood pressure, and various 

cancers.26 It is estimated that alcohol use contributed to 

one in 10 deaths of working-age adults.27 Illicit drug use, 

including illegal drugs and the misuse of prescription 

drugs, is another risk for employers. Of the approximately 

44 million adults who used illicit drugs in 2016, about 69% 

were employed.28

Nationally, 14.4% of worksites reported offering some 

type of program to address excessive alcohol use or drug 

misuse. Higher percentages of worksites with more than 

100 employees offered these programs than did worksites 

with fewer than 100 employees (Figure 40).

Figure 40. Percentage of U.S. worksites that offered programs to address excessive alcohol and/or excessive drug 

misuse, by worksite size 

Among the 14.4% of worksites offering programs to 

address excessive alcohol and other drug misuse, about 

half (48.9%) offered only information. The other half 

(48.8%) offered a combination of informational and 

skill-building programs. Compared to other health 

issues, a smaller percentage of worksites tried to address 

this topic on their own. Just 18.5% reported that these 

programs were typically offered mostly by the employer, 

20.3% percent were offered by the health plan, 15.6% 

were offered by a vendor, and 45.6% percent were 

offered by combined efforts of the employer, health plan, 

or a vendor.

Opportunity Employee substance misuse is costly to 

businesses. Addressing substance misuse will 

support the health, safety, and well-being of employees, and protect company 

performance and stability. Employers can include resources like self-screening 

tools to address excessive alcohol use and drug misuse as part of the overall health 

promotion program. Employers can also follow guidance from the Substance Abuse 

and Mental Health Services Administration to develop a substance use policy to 

reflect the needs of their own workplace. https://www.samhsa.gov/workplace/

toolkit/develop-policy
Workplace Health In America 2017

49

7.6% 4.8% 6.7%

11.8%

18.0% 16.8%

58.6%

FIG 41

Number of Employees

National 10-24 25-49 50-99 100-249 250-499 500+

Note: Percentages based on weighted estimates.

Providing Lactation Support to Employees

The health benefits of breastfeeding to infants include 

reduced risk of asthma, obesity, type 2 diabetes, and 

sudden infant death syndrome. The American Academy 

of Pediatrics and the World Health Organization 

recommend infants be breastfed exclusively for the first 

six months of life, with continued breastfeeding and 

complementary foods for one year or longer, which 

CDC also supports.29–31 Despite the evidence supporting 

these recommendations, CDC reports that only one in 

four infants are breastfed exclusively through the first six 

months of life.32 Policies and supports in the workplace 

are factors influencing whether working mothers stop 

breastfeeding sooner than planned. Effective March 

2010, the Patient Protection and Affordable Care Act 

amended the Fair Labor Standards Act to require most 

employers to support breastfeeding mothers in certain 

employment categories for one year after their child’s 

birth by providing mothers with reasonable break 

time and a private space, other than a restroom, to use 

to express their breast milk. This provision applies to 

“nonexempt” employees who are required by federal 

law to be paid time and one-half for overtime hours. 

(State laws may require employers to provide such 

breaks for breastfeeding mothers who are exempt from 

federal overtime pay requirements). An employer that 

employs fewer than 50 employees is not subject to these 

requirements if they impose undue hardship.33

Lactation support programs were the least common 

type of health promotion program reported by worksites 

at the national level (7.6%), although more than half of 

worksites (58.6%) with more than 500 employees reported 

having them (Figure 41).

Figure 41. Percentage of U.S. worksites that offered lactation support programs, by worksite size 

Most of the lactation support programs offered 

were informational only (51.6%) or a combination of 

information and skill-building programs (41.0%). These 

programs were most commonly offered by the employers 

themselves (54.8%), followed by the health plan (22.2%), 

or the combined efforts of the employer, the health plan, 

or a vendor (19.8%).

Although only 7.6% of worksites reported having 

a lactation support program, a larger percentage had 

strategies in place to support breastfeeding. We asked 

whether employers offered several different evidencebased facilities, policies, and programs to support 

lactation. We asked these questions regardless of whether 

the worksite reported having a lactation support program 

in place (Figure 42).
Workplace Health In America 2017

50

% of Worksites

3.0%

3.1%

9.2%

21.8%

26.8%

Provided breastfeeding support

groups or classes

Provided access to a breast pump

Written breastfeeding policy for employees

Provided private space (other than

restroom) to pump breast milk

Provided flexible times to allow mothers

to pump breast milk at work

Note: Percentages based on weighted estimates.

FIG 43

% of Worksites

9.9%

12.1%

19.6%

Provided any programs to promote healthy sleep

Provided any programs to educate about

musculoskeletal disorders, arthritis, or back pain

Provided any programs to address stress management

Note: Percentages based on weighted estimates.

Figure 42. Percentage of U.S. worksites offering evidence-based strategies to support lactation 

Workplace Efforts to Address Other Health Topics

We included questions about worksite programs 

addressing stress, musculoskeletal disorders, and 

insufficient sleep and fatigue because these health risks are 

common worker issues, they are costly to employers, and 

they may be affected by working conditions (Figure 43).

Twenty percent of workers report experiencing 

a great deal of stress at work.34 Work-related stress is 

associated with absenteeism and lower productivity. Stress 

management was the third-most common type of health 

promotion program reported by Workplace Health in 

America 2017 respondents, with 19.6% reporting they offer 

some type of program to address stress.

Musculoskeletal disorders are injuries or disorders of 

the muscles, nerves, joints, cartilage, and spinal discs. The 

2016 National Health Interview Survey estimated 24.8% 

of employed adults had lower back pain and 17.8% had 

arthritis.35,36 Only 12.1% of Workplace Health in America 

2017 respondents reported offering programs to educate 

employees about the prevention of musculoskeletal 

disorders, arthritis, and back pain.

Results from the 2014 Behavioral Risk Factor 

Surveillance System (BRFSS) indicate that 35% of U.S. 

adults reported short sleep duration (less than seven hours 

of sleep in a typical 24-hour period).37 The 2014 BRFSS 

data also showed that people who did not get enough 

sleep were more likely to report having obesity, being 

physically inactive, and being current smokers compared 

to people who usually slept at least seven hours each day. 

In addition, insufficient sleep and insomnia are associated 

with decreased worker productivity.38 On an annual basis, 

the U.S. loses 1.23 million work days to insufficient sleep of 

less than six hours per night.39 And sleep disorders increase 

the risk of being injured at work.40 Programs designed to 

promote healthy sleep or reduce fatigue were among the 

least common type reported by employers, with 9.9% of 

worksites offering these to employees.

Figure 43. Percentage of U.S. worksites addressing other health topics 
Workplace Health In America 2017

51

Section 4: 

Health Screenings and 

Disease Management
Workplace Health In America 2017

52

FIG 44

% of Worksites

3.2%

3.5%

4.8%

4.8%

6.2%

9.4%

11.5%

12.1%

14.4%

5.4%

5.5%

7.3%

7.7%

11.3%

18.2%

19.0%

19.7%

22.5%

Depression

Arthritis/musculoskeletal

disorders

Cervical cancer

Colorectal cancer

Breast cancer with

mammography

Obesity

Diabetes

Blood cholesterol

Blood pressure

Screening only

Screening with referral to treatment and follow-up education

Note: Percentages based on weighted estimates.

The Workplace Health in America 2017 survey focused on 

worksites’ efforts to improve conditions and behaviors to 

reduce the risk of developing health problems, but the 

survey also included questions about health screenings to 

assess worksites’ secondary prevention efforts. Secondary 

prevention efforts try to reduce the negative effects of a 

condition or disease that has already occurred by detecting 

it as soon as possible. The Workplace Health in America 2017

survey also included questions about disease management 

to assess worksites’ tertiary prevention efforts, which aim to 

manage the impact of an ongoing, chronic disease or injury.

The survey included questions about conditions 

related to some of the leading causes of death including 

heart disease, cancer, high blood pressure (related to 

stroke), diabetes, and depression (related to suicide).

Health Screenings

Worksites indicated whether nine types of health 

screening tests were available to their employees in the 

past 12 months and, if so, whether high-risk employees 

were referred to a health professional for treatment and 

provided follow-up education. Less than 25% of the 

worksites offered any of the listed screenings (Figure 

44). Across all the health risk areas, just over half of 

the worksites that offered the screening also referred 

high-risk employees to treatment. As with all the 

health promotion programming, higher percentages 

of the largest employers than the smallest offered the 

screenings and the referrals to treatment.

Figure 44. Percentage of U.S. worksites offering health screenings and referral to treatment/follow-up education for 

high-risk employees, by health condition 
Workplace Health In America 2017

53

Among U.S. worksites that offer some type of health screening

Onsite

42.2%

Offsite

24.1%

Both Onsite

and Offsite

33.6%

45.8%

21.1%

16.4% 16.6%

1-25% 26-50% 51-75% >75%

% Employee Participation

Among U.S. worksites that offer some type of health screening

Note: Percentages based on weighted estimates.

Percentages do not equal 100% due to rounding.

Note: Percentages based on weighted estimates.

Percentages do not equal 100% due to rounding.

Three-quarters of the worksites reported they offered 

screenings onsite, or onsite and offsite (Figure 45), 

making it convenient for employees to be screened. The 

largest percentage of respondents estimated between 

1 and 25% of employees usually participate in 

screenings, but 33.0% estimated that more than 50% of 

employees participate (Figure 46).

Figure 45. Usual location where health screenings were offered to employees 

Figure 46. Estimated usual employee participation in health screenings offered by U.S. worksites 
Workplace Health In America 2017

54

FIG 47

% of Worksites

84.9%

83.4%

81.4%

81.4%

81.1%

80.5%

80.3%

4.3%

3.4%

4.1%

4.1%

4.2%

4.9%

4.4%

2.9%

2.9%

6.6%

4.3%

3.0%

4.5%

3.9%

12.5%

14.5%

16.4%

16.0%

16.3%

16.6%

17.3%

Depression

Cancer

Cardiovascular disease

Obesity

High cholesterol

Diabetes/pre-diabetes

Hypertension/high blood pressure

Nothing provided

Provided one-on-one counseling

Provided seminars, workshops, classes

Provided Information

Note: Percentages based on weighted estimates.

Respondents could select multiple disease management program delivery types (counseling; seminars/workshops/classes; and/or information).

Disease or Risk Management

For each of the 10 diseases or risks included in the 

Workplace Health in America 2017 survey, respondents 

were asked whether they offered any of three types of 

disease management programming to employees in the 

last 12 months: 1) information such as brochures, posters, 

newsletters; 2) educational seminars, workshops, or 

classes on the condition; or 3) one-on-one counseling or 

coaching and follow-up monitoring. The programs could 

have been offered through the health plan, a vendor, 

or directly by the employer. At the national level, most 

worksites offered nothing on disease management topics 

(Figure 47). Very small percentages of worksites offered the 

one-on-one counseling and monitoring, which has more 

potential to help employees manage their conditions than 

just providing information. Although the percentages of 

worksites in the smallest size categories that offered 

one-on-one counseling for any condition did not reach 

5%, the percentages of worksites in the largest size 

category that offered one-on-one counseling ranged from 

12.3% (for migraines/headaches) to 40.8% (for diabetes).

Of those offering disease management programs, 

two-thirds of worksites offered disease management 

programs using multiple modes of delivery (Figure 48). 

This was true across worksite size categories. Overall, 

12.8% of worksites offered disease management 

exclusively onsite in person. However, 29.1% of hospitals 

used this strategy, which is practical given onsite expertise 

available in hospitals.

Figure 47. Percentage of U.S. worksites with disease management programs, by health condition 
Workplace Health In America 2017

55

Among U.S. worksites with a disease management program

Onsite

in-person

12.8%

Phone

Counseling

7.1%

Online

12.6%

Multiple

ways

67.6%

Note: Percentages based on weighted estimates.

Percentages do not equal 100% due to rounding. 

Figure 48. Usual method for disease management program delivery to employees 
Workplace Health In America 2017

56

Section 5: 

Occupational Safety 

and Health
Workplace Health In America 2017

57

FIG 49

69.4%

91.3%

87.8%

76.4%

Written injury and illness prevention program

Had policy requiring/encouraging reporting

of injuries, near misses, and illnesses

Provided opportunities for employee

input on hazards and solutions

Provided new employees formal safety training

% of Worksites

IG 50

Number of Employees

National

83.5% 81.2% 86.0% 83.0%

91.9% 93.9% 93.9%

33.4% 34.6% 34.5% 29.6% 30.2% 29.1% 23.2%

10-24 25-49 50-99 100-249 250-499 500+

At least one person responsible for employee safety

Safety person also responsible for health promotion

Note: Percentages based on weighted estimates.

Note: Percentages based on weighted estimates.

In general, higher percentages of worksites reported 

having occupational safety and health programs and 

policies in place, compared to the percentages of 

worksites with employee health promotion programs and 

policies (Figure 49). For example, 91.0% reported having 

a policy requiring or encouraging employees to report 

worksite injuries and illnesses. The Occupational Safety 

and Health Act applies to most private-sector employers 

and requires employers to comply with the standards of 

the act and to provide a workplace free from recognized 

safety and health hazards. The two industry groups with 

the largest percentages of worksites with written injury 

and illness prevention programs were Hospitals (89.8%) 

and the Agriculture, Forestry, Fishing; Mining; Utilities; 

Construction; and Manufacturing group (86.7%). These 

industry groups have higher injury rates than other 

industry groups. The Information; Finance; Insurance; Real 

Estate; Professional Services; Management; Administration 

Support; and Waste Management industry group had 

the lowest percentage of worksites with an injury and 

illness prevention program (54.6%), possibly because 

many of these include white collar occupations with lower 

perceived risk of physical injury. This broad industry group 

also had the lowest percentage of worksites (58.2%) that 

provided new employees formal training on how to avoid 

on-the-job accidents, injuries, and illnesses.

Figure 49. Percentage of U.S. worksites offering occupational safety and health strategies 

Across all size categories, over 80% of worksites reported 

having at least one person responsible for employee 

safety (Figure 50). These percentages were higher than the 

percentages of worksites with health promotion programs 

that had at least one person responsible for the health 

promotion program (72.2%, nationally).

Figure 50. Percentage of U.S. worksites with at least one person responsible for employee safety, by worksite size 
Workplace Health In America 2017

58

FIG 51

% of Worksites

86.9%

65.3%

60.2%

64.2%

Senior leadership demonstrates commitment to

both safe work design and worker well-being

Plan for initiatives that jointly protect

worker health, safety, and well-being

Efforts to protect and promote worker

health include training of supervisors

Communication/programs that protect worker

health included with efforts to promote well-being

Note: Percentages based on weighted estimates.

The Workplace Health in America 2017 survey also assessed 

the extent to which worksites were implementing Total 

Worker Health® (https://www.cdc.gov/niosh/twh/). The 

National Institute for Occupational Safety and Health 

defines Total Worker Health® as “policies, programs, and 

practices that integrate protection from work-related 

safety and health hazards with promotion of injury and 

illness prevention efforts to advance worker well-being.” 

The results in Figure 50 show that nationally, a third of 

worksites have the same person responsible for health 

promotion and employee safety at the worksite. Even in 

the largest size category where staff might be less likely to 

have multiple roles, 23.2% of worksites have an individual 

who is responsible for both health promotion and safety. 

This suggests there is some level of integration and 

coordination between health promotion and safety efforts 

across those worksites. In addition to staffing, evidence 

of integration can be seen in the percentage of U.S. 

worksites with visible support for employee health (Figure 

12) by referencing employee health in the organizational 

objectives and/or mission statement (46.1%), senior 

(84.2%) and middle management’s (83.4%) commitment 

to a healthy and safe work environment, and respondents’ 

overall mean rating of 6.8 on the scale of 1 to 10 for the 

degree to which employees work within a culture of health 

at the worksite. 

The results in Figure 51 suggest more than half of 

the worksites reported practices that were consistent 

with Total Worker Health®. Notably, almost two-thirds 

reported having communication and programming that 

protects worker health included with efforts to promote 

employee well-being; and planning for initiatives that 

jointly protect worker health, safety, and well-being. 

Because an occupational safety and health program 

is required and already well-established at most 

worksites, integrating evidence-based health promotion 

strategies with safety programs is a promising approach 

for increasing the percentage of worksites adopting 

programs to improve employee well-being.41,42 There 

is currently little nationally representative data on the 

presence of Total Worker Health® policies and practices; 

the Workplace Health in America 2017 data provide a 

useful benchmark to assess progress on the adoption of 

Total Worker Health® over time.

Figure 51. Percentage of U.S. worksites integrating health promotion with occupational safety and health efforts 
Workplace Health In America 2017

59

Section 6: 

Worklife
Workplace Health In America 2017

60

Offered an 

EAP to 

Employees

13.4%

Offered

an EAP to

Employees

and Families

31.7%

Did not offer

an EAP

55.0%

% ofWorksites Note: Percentages based on weighted estimates.

Percentages do not equal 100% due to rounding. 

The Workplace Health in America 2017 survey included 

questions about a range of benefits and policies supporting 

employees with their own and their family obligations. 

Employee assistance programs (EAPs) are workplace 

programs designed to help employees identify and resolve 

issues including mental or physical health, family, financial, 

substance use, emotional, or other issues that may affect job 

performance. At the national level, only 45.0% of employers 

offered any type of EAP (Figure 52). The percentage with 

EAPs increased as the worksite size increased, from 38.0% of 

worksites with 10–24 employees up to 91.3% of worksites 

with at least 500 employees. The Arts, Entertainment, 

Recreation; Accommodations and Food Service; and Other 

Services industry group had the lowest percent of worksites 

with EAPs (33.7%). Most worksites that offered EAPs made 

them available to employees and their families.

Figure 52. Percentage of U.S. worksites offering employee assistance programs (EAPs) 
Workplace Health In America 2017

61

FIG 53

% of Worksites

76.5%

69.6%

55.3%

42.8%

35.8%

27.1%

6.0%

4.5%

1.1%

Allowed unpaid parental leave

Offered disability leave or insurance

Offered flexible work schedules

Offered paid family leave for new parents

Allowed employees to work from home

Helped cover child care costs

Offered onsite or offsite child care

Covered any costs ofeldercare

Offered onsite or offsite elder care

Note: Percentages based on weighted estimates.

The large majority (94.5%) of worksites provided some 

form of paid time off for employees. Respondents reported 

all paid time off categories the worksite offered: 73.9% 

offered paid sick time, 59.6% offered paid personal 

time, and 87.6% offered paid vacation time. The most 

common work-life policy was unpaid parental leave, 

which is a federal requirement for worksites with at least 

50 employees (Figure 53). Paid leave for new parents was 

offered by 41.2% of the smallest worksites compared to 

76.4% of the employers with at least 500 employees. Small 

percentages of worksites offered more expensive benefits 

like child care or elder care.

Figure 53. Percentage of U.S. worksites with work-life policies and benefits 

Work-life policies that offer employees flexibility about 

when and where they do their work were most common 

in the worksites with at least 500 employees. At the 

national level, 55.3% of worksites allow employees to 

work flexible schedules that could include choosing their 

own starting and quitting times within a range of hours, 

compressed work weeks, teleworking, and job sharing. 

There was little variation in the percentage among 

employers with fewer than 500 employees, but 68.1% of 

the largest worksites offered employees this flexibility. 

Similarly, at the national level, 35.8% of all worksites allow 

employees to work from home, but this percentage was 

69.8% among the largest employers. Large employers 

may be better equipped with technology needed to allow 

employees to work from home and have the staffing 

available for onsite coverage as needed.

Conclusion

Approximately 156 million full-time workers in the 

United States spend a majority of their waking hours at 

work, providing an opportunity for workplace health 

programs to reach segments of the population who 

otherwise might not be exposed to and engaged in public 

health promotion programs, campaigns and messages 

(Accessed U.S. Bureau of Labor Statistics October 17, 2018). 

Acknowledging the economic incentive to support healthy 

and productive employees, employers have increased their 

wellness program offerings in the past decade. 

During this same period, public health has 

increasingly incorporated and integrated policies, 

systems, and environmental (PSE) approaches into 

health promotion programs as a means of initiating and 

sustaining healthy behavior change.43–45 PSEs target 

the whole population. When combined with traditional 

individual education and skill-building interventions, 

they create synergy to provide access and opportunity 

for participants to apply health knowledge and improve 

the chances of successful and sustained behavior change. 
Workplace Health In America 2017

62

This comprehensive approach has been incorporated 

into workplace health program design and captured in 

national health priorities such as Healthy People.8,46–49

However, PSEs often are less prevalent when compared to 

individual level interventions such as passive information 

dissemination strategies and more intensive lifestyle 

coaching and counseling.3,50,51

Nearly half of U.S. worksites have put in place 

strategies to improve the social or physical environment 

(47.8%) indicating progress made by U.S. employers. 

However, many individual strategies such as providing 

onsite exercise facilities (12.4%) or a written policy to 

restrict smoking in the workplace (31.2%) that contribute 

to a comprehensive program approach remain low. 

And overall, fewer than one out of five worksites offer 

comprehensive health promotion programs (11.8%), 

providing many opportunities for practitioners to continue 

to educate and build skill among U.S. employers to make 

their programs more robust, successful, and sustainable. 

Practitioners also have opportunities to focus on small 

employers. Workplace Health in America 2017 provides a 

spotlight on small employers, which represent over 99% 

of all employers (less than 500 employees). Additionally, 

small businesses employ 58.9 million people, about 

47.5% of the U.S. workforce.52 By nearly every measure, 

small worksites offer fewer programs and services (e.g., 

education, health screening), have fewer policies and 

environmental supports, and less infrastructure (e.g., 

annual program plans, budgets, and staff ) than larger 

employers. Small employers are a key audience for 

workplace health programs. They not only represent the 

vast majority of all employers, but they also often make 

up a significant population in areas that are priorities 

for population health such as small towns and rural 

communities. Rural Americans face numerous health 

disparities compared to their urban counterparts.53 In 

engaging small worksites, practitioners should be mindful 

of the need to tailor interventions that meet their needs, 

maximize their organizational strengths, and address their 

unique challenges.

Although a number of surveys of workplace health 

programs have been conducted over the past 25 years, 

there has not been a systematic, ongoing effort to 

document evidenced-based and promising strategies that 

comprise a comprehensive workplace health program 

from a representative sample of U.S. employers. In fact, 

the last time the federal government funded a national 

survey of employers’ workplace health promotion offerings 

was in 2004.3 Workplace Health in America 2017 is the first 

national survey to capture the status of workplace health 

and safety programming, implementation of evidencebased strategies, barriers employers have experienced 

in implementing these programs, and description of 

key components of a comprehensive workplace health 

promotion program. Regular monitoring of changes over 

time in offering comprehensive employer-sponsored 

health and safety programs, policies, and environmental 

supports will continue to be a need. 
Workplace Health In America 2017

63

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Acknowledgments

Workplace Health in America 2017 Contributors

Steering Committee

Member Organization

Jason Lang, MPH, MS (Core Team, Lead) Centers for Disease Control and Prevention, National Center for Chronic 

Disease Prevention and Health Promotion, Division of Population Health

Laura Linnan, ScD (Core Team) University of North Carolina

Laurie Cluff, PhD (Core Team, Principal Writer) RTI International

Michael Penne, MPH (Core Team) RTI International

Casey Chosewood, MD, MPH Centers for Disease Control and Prevention, National Institute for 

Occupational Safety and Health

Dyann Matson Koffman, DrPH, MPH Centers for Disease Control and Prevention, Office of the Director, Office of the 

Associate Director for Science

Pam Allweiss, MD, MSPH Centers for Disease Control and Prevention, National Center for Chronic 

Disease Prevention and Health Promotion, Division of Diabetes Translation

Ron Goetzel, PhD Truven Health Analytics/Institute for Health and Productivity Studies at Johns 

Hopkins

Brian Klepper, PhD National Business Coalition on Health

Elizabeth Walker Romero, MS Association of State and Territorial Health Officials

Carter Blakey U.S. Department of Health and Human Services

Paul Terry, PhD The Health Enhancement Research Organization (HERO)

Eduardo Sanchez, MD, MPH American Heart Association

Data User Group

Member Organization

Heather Healy, LCSW Association of Flight Attendants

David Chase Small Business Majority

Meg Molloy, PhD Prevention Partners

Karen Moseley Population Health Alliance

Ken Anderson, DO, MS American Hospital Association
Workplace Health In America 2017

67

Member Organization

Michael O’Donnell, PhD American Journal of Health Promotion

Dan McKenna, MA Colorado Department for Public Health

Sue Polis Trust for America’s Health

Jan Price Employee Assistance Professionals Association

Dave Schweppe, MPH Kaiser Permanente

Teresa Lovely Kentucky Department for Public Health

Steve Bush McDowell County, North Carolina Chamber of Commerce

Doris Konicki, MHS American College of Occupational and Environmental Medicine (ACOEM)

Brian Caveney, MD, JD, MPH Blue Cross Blue Shield of North Carolina

Dawn Wiatrek, PhD American Cancer Society

Kate Kowalsky Quality Bicycle Products (small employer)

Survey Development Group

Member Organization

Deborah Galuska, PhD, MPH Centers for Disease Control and Prevention, National Center for Chronic 

Disease Prevention and Health Promotion, Division of Nutrition, Physical 

Activity & Obesity

Jeff Harris, MD, MPH University of Washington School of Public Health

Mark Wilson, PhD University of Georgia College of Public Health

Jeannie Nigam, MS Centers for Disease Control and Prevention, National Institute for 

Occupational Safety and Health

Jim Newhall, PhD Centers for Disease Control and Prevention

Christina Lee Society for Human Resource Management

Deborah McLellan, PhD, MHS Harvard School of Public Health

Nico Pronk, PhD HealthPartners

Catherine Heaney, PhD, MPH Stanford Department of Psychology
Workplace Health In America 2017

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Appendix

Explanation of Figures for Accessibility

Figure 1. Title: The number of cases sampled, ineligible 

and complete. This figure shows the number of employer 

cases that were initially sampled (n=35,584). Of those, 

4,721 cases were ineligible and 27,754 did not respond 

to the initial survey inquiry. 3,109 surveys were returned. 

Of those, 2,843 were complete core surveys that would 

be included in the final analysis. Also among the 2,843 

surveys that were returned, 1,255 respondents also 

completed the supplemental survey questions. 

Figure 2. Title: Percentage of U.S. worksites offering 

full, partial, or no payment of premiums for full-time 

employees’ health insurance. This figure shows among 

U.S. worksites, 84.7% offered either full or partial health 

insurance to employees. Within this group, almost half 

(45.6%) offered partial payment for insurance and 39.1% 

paid employee premiums in full. 15.4% of U.S. worksites 

offered no insurance coverage to employees. The vast 

majority of U.S. employer offered their employees either 

full or partial payment of premiums for full-time employee 

health insurance. Note: Percentages based on weighted 

estimates. Percentages do not equal 100% due to 

rounding. 84.7% of employers offered either full or partial 

health insurance.

Figure 3. Title: Percentage of U.S. worksites that offered 

employees a health risk assessment. This figure shows 

that nationally, about a quarter of U.S. worksites offer 

employees a health risk assessment (HRA) which can be 

used to provide health promotion programs and services 

based on employees’ health needs. The figure breaks down 

the percentage by employer size. As employers grown in 

size, the percentage that offer HRAs increases with 21.6% 

of the smallest employers (10–24 employees) offering an 

HRA, 23.1% of employers with 25–49 employees, 31.1% 

of employers with 50–99 employees, 43.9% of employers 

with 100–249 employees, 52.0% of employers with 

250–499 employees, and 68.7% of the largest employers 

(500 or more employees) offering HRAs. Note: Percentages 

based on weighted estimates.

Figure 4. Title: Level of employee participation in health 

risk assessments. This figure shows the percentage of 

employees who participate in health risk assessments 

among U.S. worksites that offer them. The majority of 

U.S. worksites have 50% or more of their employees 

participating. Overall, 23.4% of U.S. worksites have 25% or 

less employee participation, 23.3% of U.S. worksites have 

26–50% employee participation, 31.5% of U.S. worksites 

have 51–75% employee participation, and 21.8% of U.S. 

worksites have 76–100% employee participation. Note: 

Percentages based on weighted estimates.

Figure 5. Title: Action taken after employees completed 

health risk assessment. This figure shows among U.S. 

worksites that offered employees a health risk assessment, 

nearly 4 out of 5 (79.4%) provide their employees the 

results of the assessment as well as additional feedback 

and education on their health risks which align with 

Community Guide recommendations. 15.6% of U.S. 

worksites only provide their employees the results of the 

assessment, and 5.0% do not share any results or provide 

feedback. Note: Percentages based on weighted estimates.

Figure 6. Title: Percentage of U.S. worksites offering any 

type of health promotion program, by worksite size. This 

figure shows that nationally, 46.1% of U.S. worksites offer 

some type of workplace health promotion program. The 

figure breaks down the percentage by employer size. 

As employers grown in size, the percentage who offer 

workplace health promotion programs increases with 

the 39.1% of the smallest employers (10–24 employees) 

offering a program, 43.9% of employers with 25–49 

employees, 59.6% of employers with 50–99 employees, 

69.4% of employers with 100–249 employees, 83.0% 

of employers with 250–499 employees, and 91.8% of 

the largest employers (500 or more employees) offering 

workplace health promotion programs to employees. 

Note: Percentages based on weighted estimates.

Figure 7. Title: Percentage of U.S. worksites offering any 

type of health promotion program, by industry group. 

This figure shows that nationally, 46.1% of U.S. worksites 

offer some type of workplace health promotion program. 

The figure breaks down the percentage by employer 

industry sector. Hospitals (62.2%) are the leading industry 

sector to provide programs to staff. Public Administration 

is next at 47.8%. Among the remaining industry groups, 

25.1% of Agriculture, Forestry, Fishing; Mining; Utilities; 

Construction; and Manufacturing provide workplace 
Workplace Health In America 2017

69

health promotion programs; 28.8% of Wholesale/Retail 

Trade; Transportation; Warehousing employers; 17.1% of 

Arts, Entertainment, Recreation; Accommodations and 

Food Service; and Other Services; 19.8% of Information; 

Finance; Insurance; Real Estate and Leasing; Professional, 

Scientific, Technical Services; Management; Administration 

Support; and Waste Management; and 29.0% of Education 

Services; and Health Care & Social Assistance employers 

provide some type of workplace health promotion 

programs to employees. Note: Percentages based on 

weighted estimates.

Figure 8. Title: Percentage of U.S. worksites with health 

promotion program in place for less than 1 through more 

than 10 years. This figure shows the length of time a 

workplace health promotion program has been offered 

to employees among U.S. worksites who have a program. 

The majority of workplace health promotion programs 

have been in place for 3 years or longer. Overall, 10.1% of 

programs have been in place for less than 1 year; 20.6% 

have been in place for 1–2 years; 32.9% of programs have 

been in place for 3–5 years; 16.5% have been in place 

for 6–9 years; and almost 1 in 5 (19.8%) of U.S. worksites 

have had a workplace health promotion program in 

place for a decade or longer. Note: Percentages based on 

weighted estimates. Percentages do not equal 100% due 

to rounding.

Figure 9. Title: Organization with primary responsibility 

for managing worksite health promotion programs. 

This figure shows who is managing workplace health 

promotion programs among U.S. worksites who have a 

program. The majority of workplace health promotion 

programs are managed internally with 62.3% of U.S. 

worksites reporting their own employees run the 

program. 21.5% of U.S. worksites say that a vendor or 

other third party manages the program, and 16.2% use 

their health insurance provider to manage the workplace 

health promotion program. Note: Percentages based on 

weighted estimates.

Figure 10. Title: Percentage of U.S. worksites with at least 

one person assigned responsibility for health promotion 

at the worksite, by worksite size. This figure shows that 

nationally, about three-quarters of U.S. worksites (72.2%) 

with a health promotion program have at least one person 

responsible for managing the program. The figure breaks 

down the percentage by employer size. As employers 

grown in size, the percentage who have staff responsible 

for health promotion at the worksite increases with 69.2% 

of the smallest employers (10–24 employees) reporting 

staff, 69.7% of employers with 25–49 employees, 74.3% 

of employers with 50–99 employees, 82.3% of employers 

with 100–249 employees, 83.4% of employers with 

250–499 employees, and 90.1% of the largest employers 

(500 or more employees) reporting at least one person 

responsible for health promotion at the worksite. Note: 

Percentages based on weighted estimates.

Figure 11. Title: Percentage of U.S. worksites with 

committees that address health promotion, safety, or both. 

This figure shows if worksites have additional support for 

managing workplace health promotion programs through 

committees. The figure examines the percentage of 

worksites with committees among U.S. worksites that have 

a health promotion program and how the committees are 

structured. 41.0% of U.S. worksites do not have any type of 

committee. Among those that do, 21.2% separate wellness 

(health promotion) activities from safety activities; 17.5% 

combine wellness and safety; 12.5% are focused on 

safety only; and 7.9% are focused on wellness only. Note: 

Percentages based on weighted estimates. Percentages do 

not equal 100% due to rounding.

Figure 12. Title: Percentage of U.S. worksites with visible 

support for employee health. This figure shows how U.S 

worksites with a health promotion program are receiving 

organizational and leadership support. More than 8 in 10 

(84.2%) U.S. worksites have senior leadership committed 

to employee health and safe work environments. Similarly, 

83.4% of U.S. worksites have middle management 

commitment. 62.0% of U.S. worksites have a champion 

who is a strong advocate for the program, and 46.1% of 

U.S. worksites have referenced employee health in their 

organizational objectives or mission statement. Note: 

Percentages based on weighted estimates.

Figure 13. Title: Percentage of U.S. worksites with an 

annual budget for health promotion. This figure shows 

the amount of spending on health promotion among U.S. 

worksites with a health promotion program. Nationally, 

35.6% of U.S. worksites have no dedicated budget to 

health promotion. Among those worksites with a budget, 

11.0% spend $1,000 or less annually; 17.6% spend 

between $1,001 - $10,000 annually; 7.4% spend between 

$10,001 - $20,000 annually; 10.4% spend between $20,001 

- $100,000 annually; and 18.1% spend more than $100,000 

annually. Note: Percentages based on weighted estimates. 

Percentages do not equal 100% due to rounding.

Figure 14. Title: Percentage of U.S. worksites with annual 

health promotion planning and plan features. This figure 

shows the type of health promotion plans among U.S. 

worksites with health promotion program. Overall, 58.9% 

of U.S. worksites have an annual health promotion plan 

and 53.3% use data to decide what to offer to employees. 

Among U.S. worksites with an annual health promotion 

plan, 88.8% include strategies to promote the program; 

77.8% include clear implementation responsibilities for 

plan activities; and 65.3% have specific measurable goals. 

Note: Percentages based on weighted estimates.
Workplace Health In America 2017

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Figure 15. Title: Percentage of U.S. worksites using data 

to evaluate programs and the types of measurement 

performed. This figure shows the type of health 

promotion program evaluation among U.S. worksites 

with health promotion programs. Overall, 50.2% of U.S. 

worksites use data to evaluate their programs. Among 

U.S. worksites that use data, 98.3% are measuring 

employee participation; 89.7% are measuring employee 

feedback; 78.1% are measuring changes in employee 

health risk behaviors; 73.1% are measuring health care 

claims costs; 60.7% are measuring workers compensation 

claims; 57.2% are measuring return on investment; 

56.9% are measuring employee satisfaction; 51.6% are 

measuring changes in employee disease rates; and 38.7% 

are measuring absenteeism. Note: Percentages based on 

weighted estimates.

Figure 16. Title: Percentages of U.S. worksites using 

incentives and how they are used. This figure shows the 

structure of incentives. Nationally, 53% of U.S. worksites 

with a health promotion program offer incentives. 

Of these: 82.3% offered incentives tied to employee 

participation; 30.6% offered incentives tied to employees 

meeting a health standard; and 30.8% offered incentives 

tied to both participation and meeting a health standard. 

Note: Percentages based on weighted estimates.

Figure 17. Title: Type of incentives offered by U.S. 

worksites. This figure shows gifts or prizes are the most 

common incentive offered (64.4%) followed by cash 

rewards (53.1%); health insurance premium discounts 

(52.6%); adding money to flexible spending accounts 

(10.5%); health insurance copay differences (8.2%); and 

additional time off (5.7%). Note: Percentages based on 

weighted estimates.

Figure 18. Title: Employers’ ratings of the effectiveness 

of incentives for achieving intended outcomes. This 

figure shows how effective employers feel their 

incentives are among U.S. worksites with a health 

promotion program offering incentives. 11.2% of U.S. 

worksites feel their incentives are “extremely effective”; 

34.2% feel their incentives are “effective”; 48.1% feel their 

incentives are “somewhat effective”; and 6.5% feel their 

incentives are “not at all effective”. Note: Percentages 

based on weighted estimates.

Figure 19. Title: Percentage of U.S. worksites with each 

element of a comprehensive health promotion program. 

This figure shows the level to which U.S. worksites have 

the five elements of a comprehensive workplace health 

promotion program as defined by Healthy People 2010. 

Nearly half of U.S. worksites (47.8%) have supportive social 

and physical work environments; 46.0% link their health 

promotion programs to related programs; 33.7% include 

health education programming as a component of their 

overall health promotion program; 28.4% integrate health 

promotion into their organizational structure; and 26.6% 

include health screening programs as a component of the 

their overall health promotion program. Note: Percentages 

based on weighted estimates.

Figure 20. Title: Percentage of U.S. worksites with all five 

elements of a comprehensive health promotion program, 

by worksite size. This figure shows that nationally, 11.8% 

of U.S worksites have a comprehensive workplace 

health promotion program. The figure breaks down the 

percentage by employer size. As employers grown in 

size, the percentage that have comprehensive health 

promotion programs increases with 11.0% of the smallest 

employers (10–24 employees) having comprehensive 

programs, 8.3% of employers with 25–49 employees, 

12.2% of employers with 50–99 employees, 21.3% of 

employers with 100–249 employees, 33.6% of employers 

with 250–499 employees, and 39.5% of the largest 

employers (500 or more employees) reporting having a 

comprehensive workplace health promotion program. 

The elements of a Comprehensive Workplace Health 

Program as defined by Healthy People 2010 include: 1) 

Health education; 2) Links to related employee services; 

3) Supportive physical and social environment for health 

improvement; 4) Integration of health promotion into 

the organizational culture; 5) Employee screenings with 

adequate treatment and follow-up. Note: Percentages 

based on weighted estimates.

Figure 21. Title: Barriers to offering health promotion 

program among U.S. worksites. This figure shows cost is 

the most common barrier among U.S. worksites (57.5%) 

followed by competing business demands (41.7%); lack 

of employee interest (37.5%); lack of experienced staff 

(32.9%); lack of physical space (30.4%); and demonstrating 

results (24.7%). Note: Percentages include U.S. worksites 

who responded “challenging” or “extremely challenging“ on 

a 5 point Likert scale.

Figure 22. Title: Percentage of U.S. worksites that 

partnered with different types of organizations to offer 

employee health programs. This figure shows the type 

of partners U.S. worksites with a health promotion 

program have. The most common partners are workers 

compensation providers (15.2%) followed by healthrelated organization such as the American Heart 

Association or American Cancer Society (11.5%); state/

local public health agencies (9.7%); business groups such 

as the Chamber of Commerce or Small Business Majority 

(7.5%); hospitals (7.3%); and community organization 

such as YMCAs or Area Agencies on Aging (5.7%). Note: 

Percentages based on weighted estimates.

Figure 23. Title: Percentage of U.S. worksites that offered 

specific health programs. This figure shows the most 
Workplace Health In America 2017

71

common types of health promotion programs offered to 

employees. The most common type of health programs are 

physical activity programs (28.5%) followed by nutrition/

healthy eating (23.1%); stress management (19.6%); 

tobacco cessation (18.5%); obesity/weight management 

(17.4%); excessive alcohol and/or drug misuse (14.4%); 

musculoskeletal disorders, back pain, and arthritis (12.1%); 

healthy sleep (9.9%); and lactation support (7.6%). Note: 

Percentages based on weighted estimates.

Figure 24. Title: Percentage of U.S. worksites that offered 

a physical activity program, by worksite size. This figure 

shows that nationally, 28.5% of U.S. worksites offer a 

physical activity program to employees. The figure breaks 

down the percentage by employer size. As employers 

grown in size, the percentage that offer physical activity 

programs increases with the 24.7% of the smallest 

employers (10–24 employees) reporting physical activity 

programs, 23.7% of employers with 25–49 employees, 

35.7% of employers with 50–99 employees, 48.0% of 

employers with 100–249 employees, 63.9% of employers 

with 250–499 employees, and 75.8% of the largest 

employers (500 or more employees) reporting offering 

physical activity programs. Note: Percentages based on 

weighted estimates.

Figure 25. Title: Percentage of U.S. worksites that 

offered a physical activity program, by industry group. 

This figure shows that nationally, 28.5% of U.S. worksites 

offer a physical activity program to employees. The 

figure breaks down the percentage by employer industry 

sector. Hospitals (63.7%) are the leading industry sector 

to offer physical activity programs. Public Administration 

is next at 55.9%. Among the remaining industry groups, 

18.9% of Agriculture, Forestry, Fishing; Mining; Utilities; 

Construction; and Manufacturing provide workplace 

physical activity programs; 34.5% of Wholesale/Retail 

Trade; Transportation; Warehousing employers; 20.7% of 

Arts, Entertainment, Recreation; Accommodations and 

Food Service; and Other Services; 22.8% of Information; 

Finance; Insurance; Real Estate and Leasing; Professional, 

Scientific, Technical Services; Management; Administration 

Support; and Waste Management; and 33.3% of Education 

Services; and Health Care & Social Assistance employers 

offer physical activity programs to employees. Note: 

Percentages based on weighted estimates.

Figure 26. Title: Type of worksite physical activity 

programs offered to employees. This figure shows the 

type of physical activity programs offered to employees 

among U.S. worksites with a physical activity program. 

The majority of U.S worksites (57.9%) offer a combination 

of both informational and skill-building physical activity 

programming to employees. 29.2% offer informational only 

programs and 12.9% offer skill-building only programs. 

Note: Percentages based on weighted estimates.

Figure 27. Title: Level of employee participation in 

worksite physical activity programs. This figure shows 

the percentage of employees who participate in physical 

activity programs among U.S. worksites that offer them. 

Nearly half of U.S. worksites (49.2%) have 25% or less 

employee participation. 35.1% have 26–50% employee 

participation, 10.1% of U.S. worksites have 51–75% 

employee participation, and 5.7% of U.S. worksites receive 

76–100% employee participation in physical activity 

programs. Note: Percentages based on weighted estimates. 

Percentages do not equal 100% due to rounding.

Figure 28. Title: Percentage of worksites offering 

evidence-based strategies to encourage physical activity. 

This figure shows the percentages of U.S worksites with 

other interventions to encourage employee physical 

activity. The most common intervention strategy is 

subsidized/discounted exercise facilities (17.6%) followed 

by organized physical activity programs (17.2%); 

environmental supports for physical activity (16.3%) such 

as walking trails or tracks, maps of measured walking/

jogging routes, bicycle racks, showers and changing 

rooms, open space for recreation, weight rooms; 

lifestyle self-management programs with advice on 

physical activity (15.3%); active work stations (13.9%); 

onsite exercise facilities (12.4%); encouraged active 

transportation (9.9%); physical fitness assessments (8.8%); 

providing physical activity tracking devices (8.7%); and 

offering paid time to be physically active during work 

hours, for fitness breaks, walking meetings, or other 

options (8.2%). Note: Percentages based on weighted 

estimates.

Figure 29. Title: Percentage of U.S. worksites that offered 

a nutrition program, by worksite size. This figure shows 

that nationally, 23.1% of U.S. worksites offer a nutrition 

program to employees. The figure breaks down the 

percentage by employer size. As employers grow in size, 

the percentage that offer nutrition programs increases 

with 19.8% of the smallest employers (10–24 employees) 

reporting nutrition programs, 20.0% of employers with 

25–49 employees, 27.1% of employers with 50–99 

employees, 39.9% of employers with 100–249 employees, 

59.5% of employers with 250–499 employees, and 

75.6% of the largest employers (500 or more employees) 

reporting offering nutrition programs. Note: Percentages 

based on weighted estimates.

Figure 30. Title: Percentage of U.S. worksites that offered 

a nutrition program, by industry group. This figure 

shows that nationally, 23.1% of U.S. worksites offer a 

nutrition program to employees. The figure breaks down 

the percentage by employer industry sector. Hospitals 

(59.7%) are the leading industry sector to offer nutrition 

programs. Public Administration is next at 44.0%. Among 

the remaining industry groups, 14.6% of Agriculture, 
Workplace Health In America 2017

72

Forestry, Fishing; Mining; Utilities; Construction; and 

Manufacturing provide workplace nutrition programs; 

28.8% of Wholesale/Retail Trade; Transportation; 

Warehousing employers; 17.9% of Arts, Entertainment, 

Recreation; Accommodations and Food Service; and 

Other Services; 17.8% of Information; Finance; Insurance; 

Real Estate and Leasing; Professional, Scientific, Technical 

Services; Management; Administration Support; and 

Waste Management; and 27.1% of Education Services; and 

Health Care & Social Assistance employers offer nutrition 

programs to employees. Note: Percentages based on 

weighted estimates.

Figure 31. Title: Type of worksite nutrition programs 

offered to employees. This figure shows the type of 

nutrition programs offered to employees among U.S. 

worksites with a nutrition program. The majority of 

U.S worksites (52.5%) offer a combination of both 

informational and skill-building nutrition programming to 

employees. 43.0% offer informational only programs and 

4.6% offer skill-building only programs. Note: Percentages 

based on weighted estimates. Percentages do not equal 

100% due to rounding.

Figure 32. Title: Level of employee participation in 

worksite nutrition programs. This figure shows the 

percentage of employees who participate in nutrition 

programs among U.S. worksites that offer them. More 

than half of U.S. worksites (50.7%) have 25% or less 

employee participation. 20.4% have 26–50% employee 

participation, 7.9% of U.S. worksites have 51–75% 

employee participation, and 21.0% of U.S. worksites have 

76–100% employee participation in nutrition programs. 

Note: Percentages based on weighted estimates.

Figure 33. Title: Percentage of U.S. worksites offering 

evidence-based strategies to encourage healthy eating. 

This figure shows the percentages of U.S worksites with 

other interventions to encourage employee healthy eating. 

The most common intervention strategy is providing 

food prep and storage facilities (40.3%) followed by 

providing lifestyle self-management programs with advice 

on nutrition (15.2%); having a written policy making 

healthier food/beverages available at meetings (10.1%); 

and offering/promoting onsite or nearby farmers markets 

(8.5%). Note: Percentages based on weighted estimates.

Figure 34. Title: Percentage of U.S. worksites that offered 

an obesity/weight management program, by worksite 

size. This figure shows that nationally, 17.4% of U.S. 

worksites offer an obesity/weight management program 

to employees. The figure breaks down the percentage by 

employer size. As employers grown in size, the percentage 

who offer obesity/weight management programs 

increases with 14.0% of the smallest employers (10–24 

employees) reporting obesity/weight management 

programs, 14.4% of employers with 25–49 employees, 

23.4% of employers with 50–99 employees, 33.9% of 

employers with 100–249 employees, 45.3% of employers 

with 250–499 employees, and 66.3% of the largest 

employers (500 or more employees) reporting offering 

obesity/weight management programs. Note: Percentages 

based on weighted estimates.

Figure 35. Title: Percentage of U.S. worksites that offered 

an obesity/weight management program, by industry 

group. This figure shows that nationally, 17.4% of U.S. 

worksites offer an obesity/weight management program 

to employees. The figure breaks down the percentage by 

employer industry sector. Hospitals (52.9%) are the leading 

industry sector to offer obesity/weight management 

programs. Public Administration is next at 30.8%. Among 

the remaining industry groups, 10.9% of Agriculture, 

Forestry, Fishing; Mining; Utilities; Construction; and 

Manufacturing provide workplace obesity/weight 

management programs; 26.9% of Wholesale/Retail Trade; 

Transportation; Warehousing employers; 9.0% of Arts, 

Entertainment, Recreation; Accommodations and Food 

Service; and Other Services; 12.8% of Information; Finance; 

Insurance; Real Estate and Leasing; Professional, Scientific, 

Technical Services; Management; Administration Support; 

and Waste Management; and 20.8% of Education Services; 

and Health Care & Social Assistance employers offer 

obesity/weight management programs to employees. 

Note: Percentages based on weighted estimates.

Figure 36. Title: Type of worksite obesity/weight 

management programs offered to employees. This figure 

shows the type of obesity/weight management programs 

offered to employees among U.S. worksites with an 

obesity/weight management program. The majority of U.S 

worksites (64.2%) offer a combination of both informational 

and skill-building obesity/weight management 

programming to employees. 27.4% offer informational only 

programs and 8.4% offer skill-building only programs. Note: 

Percentages based on weighted estimates.

Figure 37. Title: Percentage of U.S. worksites that 

offered a tobacco cessation program, by worksite size. 

This figure shows that nationally, 18.5% of U.S. worksites 

offer a tobacco cessation program to employees. The 

figure breaks down the percentage by employer size. 

As employers grown in size, the percentage who offer 

tobacco cessation programs increases with 16.1% of the 

smallest employers (10–24 employees) reporting tobacco 

cessation programs, 14.2% of employers with 25–49 

employees, 21.4% of employers with 50–99 employees, 

35.0% of employers with 100–249 employees, 46.1% of 

employers with 250–499 employees, and 73.5% of the 

largest employers (500 or more employees) reporting 

offering tobacco cessation programs. Note: Percentages 

based on weighted estimates.
Workplace Health In America 2017

73

Figure 38. Title: Percentage of U.S. worksites that offered 

a tobacco cessation program, by industry group. This 

figure shows that nationally, 18.5% of U.S. worksites offer 

a tobacco cessation program to employees. The figure 

breaks down the percentage by employer industry sector. 

Hospitals (59.5%) are the leading industry sector to offer 

tobacco cessation programs. Public Administration is 

next at 35.9%. Among the remaining industry groups, 

13.9% of Agriculture, Forestry, Fishing; Mining; Utilities; 

Construction; and Manufacturing provide workplace 

tobacco cessation programs; 28.1% of Wholesale/Retail 

Trade; Transportation; Warehousing employers; 14.3% of 

Arts, Entertainment, Recreation; Accommodations and 

Food Service; and Other Services; 10.3% of Information; 

Finance; Insurance; Real Estate and Leasing; Professional, 

Scientific, Technical Services; Management; Administration 

Support; and Waste Management; and 18.3% of Education 

Services; and Health Care & Social Assistance employers 

offer tobacco cessation programs to employees. Note: 

Percentages based on weighted estimates.

Figure 39. Title: Percentage of U.S. worksites offering 

evidence-based strategies to help employees stop 

using tobacco. This figure shows the percentages of U.S 

worksites with other interventions to help employees stop 

using tobacco. The most common intervention strategy 

is a written policy to restrict smoking (31.2%) followed by 

displayed “no smoking” and other signs (28.9%); informing 

employees about tobacco medication and counseling 

coverage/programs (20.8%); a policy banning all tobacco 

use at worksite (19.4%); providing insurance coverage for 

cessation meds (17.5%); providing/subsidizing tobacco 

cessation counseling (15.9%); referring tobacco users to 

a cessation quitline (12.3%); and removing barriers to 

accessing tobacco treatments such as copays (7.5%). Note: 

Percentages based on weighted estimates.

Figure 40. Title: Percentage of U.S. worksites that offered 

programs to address excessive alcohol and/or excessive 

drug misuse, by worksite size. This figure shows that 

nationally, 14.4% of U.S. worksites offer a program to 

employees for excessive alcohol and/or excessive drug 

misuse. The figure breaks down the percentage by 

employer size. As employers grown in size, the percentage 

who offer excessive alcohol and/or drug misuse programs 

increases with the 14.0% of the smallest employers (10–24 

employees) reporting these programs, 10.8% of employers 

with 25–49 employees, 12.4% of employers with 50–99 

employees, 26.2% of employers with 100–249 employees, 

33.5% of employers with 250–499 employees, and 

52.3% of the largest employers (500 or more employees) 

reporting offering excessive alcohol and/or excessive drug 

misuse programs. Note: Percentages based on weighted 

estimates.

Figure 41. Title: Percentage of U.S. worksites that offer 

lactation support programs, by worksite size. This figure 

shows that nationally, 7.6% of U.S. worksites offer lactation 

support programs to employees. The figure breaks down 

the percentage by employer size. As employers grown in 

size, the percentage who offer lactation support programs 

generally increases with 4.8% of the smallest employers 

(10–24 employees) reporting lactation support programs, 

6.7% of employers with 25–49 employees, 11.8% of 

employers with 50–99 employees, 18.0% of employers 

with 100–249 employees, 16.8% of employers with 

250–499 employees, and 58.6% of the largest employers 

(500 or more employees) reporting offering lactation 

support programs. Note: Percentages based on weighted 

estimates.

Figure 42. Title: Percentage of U.S. worksites offering 

evidence-based strategies to support lactation. This 

figure shows the percentages of U.S worksites with 

other interventions to support lactating mothers in the 

workplace. The most common intervention strategy is 

providing flexible times to allow mothers to pump breast 

milk at work (26.8%) followed by providing private space 

other than a restroom to pump breast milk (21.8%); having 

a written breastfeeding policy for employees (9.2%); 

providing access to a breast pump (3.1%); and providing 

breastfeeding support groups or classes (3.0%). 

Note: Percentages based on weighted estimates.

Figure 43. Title: Percentage of U.S. worksites addressing 

other health topics. This figure shows that among U.S. 

worksites 19.6% provided stress management programs 

for employees; 12.1% provided programs to educate 

employees about musculoskeletal disorders, arthritis, 

or back pain; and 9.9% provided programs to promote 

healthy sleep. Note: Percentages based on weighted 

estimates.

Figure 44. Title: Percentage of U.S. worksites offering 

health screenings and referral to treatment/follow-up 

education for high-risk employees, by health condition. 

This figure shows whether nine types of health screening 

tests were available to their employees in the past 12 

months and, if so, whether high-risk employees were 

referred to a health professional for treatment and 

provided follow-up education. The most common 

screening test available was for blood pressure with 

22.5% of U.S. worksites providing the screening, but only 

14.4% providing blood pressure screening with referral 

to treatment and follow-up education. Next was blood 

cholesterol screening at 19.7% with only 12.1% of U.S. 

worksites providing blood cholesterol screening with 

referral to treatment and follow-up education followed by 

diabetes at 19.0% screening and 11.5% of U.S. worksites 

with diabetes screening and referral to treatment and 

follow-up education; obesity at 18.2% screening and 

9.4% of U.S. worksites with obesity screening and referral 
Workplace Health In America 2017

74

to treatment and follow-up education; mammography 

at 11.3% screening and 6.2% of U.S. worksites with 

mammography screening and referral to treatment and 

follow-up education; colorectal cancer at 7.7% screening 

and 4.8% of U.S. worksites with colorectal cancer screening 

and referral to treatment and follow-up education; cervical 

cancer at 7.3% screening and 4.8% of U.S. worksites 

with cervical cancer screening and referral to treatment 

and follow-up education; arthritis and musculoskeletal 

disorders at 5.5% screening and 3.5% of U.S. worksites 

with arthritis and musculoskeletal disorders screening 

and referral to treatment and follow-up education; and 

depression at 5.4% screening and 3.2% of U.S. worksites 

with depression screening and referral to treatment 

and follow-up education. Note: Percentages based on 

weighted estimates.

Figure 45. Title: Usual location where health screenings 

were offered to employees. This figure shows the places 

where U.S. worksites who offer some type of health 

screening conduct the screenings. 42.2% of U.S. worksites 

offer health screenings onsite, 24.1% offer health 

screenings offsite, and 33.6% of U.S. worksites offer their 

health screening both onsite and offsite. Note: Percentages 

based on weighted estimates. Percentages do not equal 

100% due to rounding.

Figure 46. Title: Estimated usual employee participation 

in health screenings offered by U.S. worksites. This figure 

shows the percentage of employees who participate in 

health screenings among U.S. worksites that offer some 

type of health screening. A little less than half of U.S. 

worksites (45.8%) have 25% or less employee participation. 

21.1% have 26–50% employee participation, 16.4% of 

U.S. worksites have 51–75% employee participation, 

and 16.6% of U.S. worksites have 76–100% employee 

participation in health screening programs. Note: 

Percentages based on weighted estimates. Percentages do 

not equal 100% due to rounding.

Figure 47. Title: Percentage of U.S. worksites with disease 

management programs, by health condition. This figure 

shows that most U.S. worksites do not provide any type of 

disease management program. If a disease management 

program is available it can be delivered through seminars, 

workshops, or classes; through information; and/or 

through one-on-one counseling. The figure shows how 

these programs are delivered for seven separate health 

conditions. Respondents could select multiple disease 

management program delivery types (counseling; 

seminars/workshops/classes; and/or information). 80.3% 

of U.S. worksites did not provide a disease management 

program on hypertension/high blood pressure. Of those 

that did 17.3% provided information; 3.9% provided 

seminars, workshops, or classes; and 4.4% provided 

one-on-one counseling. 80.5% of U.S. worksites did not 

provide a disease management program on diabetes/

prediabetes. Of those that did 16.6% provided information; 

4.5% provided seminars, workshops, or classes; and 4.9% 

provided one-on-one counseling. 81.1% of U.S. worksites 

did not provide a disease management program on high 

cholesterol. Of those that did 16.3% provided information; 

3.0% provided seminars, workshops, or classes; and 4.2% 

provided one-on-one counseling. 81.4% of U.S. worksites 

did not provide a disease management program on 

obesity. Of those that did 16.0% provided information; 

4.3% provided seminars, workshops, or classes; and 4.1% 

provided one-on-one counseling. 81.4% of U.S. worksites 

did not provide a disease management program on 

cardiovascular disease. Of those that did 16.4% provided 

information; 6.6% provided seminars, workshops, or 

classes; and 4.1% provided one-on-one counseling. 83.4% 

of U.S. worksites did not provide a disease management 

program on cancer. Of those that did 14.5% provided 

information; 2.9% provided seminars, workshops, or 

classes; and 3.4% provided one-on-one counseling. 84.9% 

of U.S. worksites did not provide a disease management 

program on depression. Of those that did 12.5% provided 

information; 2.9% provided seminars, workshops, or 

classes; and 4.3% provided one-on-one counseling. Note: 

Percentages based on weighted estimates.

Figure 48. Title: Usual method for disease management 

program delivery to employees. This figure shows 

how disease management programs are delivered 

to employees among U.S. worksites with a disease 

management program. Most U.S. worksites use multiple 

delivery methods (67.6%). 12.8% of U.S. worksites deliver 

disease management programs onsite and in-person; 

12.6% deliver programs online; and 7.1% use telephonic 

counseling to deliver disease management programs. 

Note: Percentages based on weighted estimates. 

Percentages do not equal 100% due to rounding.

Figure 49. Title: Percentage of U.S. worksites offering 

occupational safety and health strategies. This figure shows 

the percentages of U.S worksites with evidence-based 

interventions to support occupational safety and health. 

The most common intervention strategy is having a policy 

requiring/encouraging reporting of injuries, near misses and 

illnesses (91.3%) followed by providing opportunities for 

employee input on hazards and solutions (87.8%); provided 

new employees formal safety training (76.4%); and having a 

written injury and illness prevention program (69.4%). Note: 

Percentages based on weighted estimates.

Figure 50. Title: Percentage of U.S. worksites with at 

least one person responsible for employee safety, by 

worksite size. This figure shows that nationally, 83.5% of 

U.S. worksites have at least one person responsible for 

employee safety and 33.4% report that the safety person 

is also responsible for health promotion at the worksite. 
Workplace Health In America 2017

75

The figure breaks down the percentage by employer 

size. Employers of all sizes report high levels of having 

at least one person responsible for employee safety and 

report fewer staff with dual responsibilities for safety 

and health promotion. 81.2% of the smallest employers 

(10–24 employees) reported having at least one person 

responsible for employee safety and 34.6% report having 

safety personnel also responsible for health promotion, 

86.0% of employers with 25–49 employees reported 

having at least one person responsible for employee 

safety and 34.5% report having safety personnel also 

responsible for health promotion, 83.0% of employers with 

50–99 employees reported having at least one person 

responsible for employee safety and 29.6% report having 

safety personnel also responsible for health promotion, 

91.9% of employers with 100–249 employees reported 

having at least one person responsible for employee 

safety and 30.2% report having safety personnel also 

responsible for health promotion, 93.9% of employers 

with 250–499 employees reported having at least one 

person responsible for employee safety and 29.1% report 

having safety personnel also responsible for health 

promotion, and 93.9% of the largest employers (500 or 

more employees) reported having at least one person 

responsible for employee safety and 23.2% report having 

safety personnel also responsible for health promotion. 

Note: Percentages based on weighted estimates.

Figure 51. Title: Percentage of U.S. worksites integrating 

health promotion with occupational safety and health 

efforts. This figure shows the degree to which U.S. 

worksites are combining occupational safety and health. 

Among U.S. worksites, 86.9% report senior leadership 

demonstrates commitment to both safe work design and 

worker well-being; 65.3% plan for initiatives that jointly 

protect worker health, safety, and well-being; 64.2% have 

communication/programs that protect worker health 

included with efforts to promote well-being; and 60.2% 

make efforts to protect and promote worker health include 

training of supervisors. Note: Percentages based on 

weighted estimates.

Figure 52. Title: Percentage of U.S. worksites offering 

employee assistance programs (EAPs). This figure shows 

that nationally 55.0% of employers did not offer any type 

of EAP. Of the 45% of U.S. worksites that do offer an EAP, 

31.7% offered an EAP to employees and families and 13.4% 

offered an EAP to only employees. Note: Percentages 

based on weighted estimates. Percentages do not equal 

100% due to rounding.

Figure 53. Title: Percentage of U.S. worksites with work-life 

policies and benefits. This figure shows the types of work-life 

policies and benefits U.S. worksites report making available 

to employees. 76.5% of U.S worksites allowed unpaid 

parental leave; 69.6% offered disability leave or insurance; 

55.3% offered flexible work schedules; 42.8% offered paid 

family leave for new parents; 35.8% allowed employees to 

work from home; 27.1% helped cover child care costs; 6.0% 

offered onsite or offsite child care; 4.5% covered any costs of 

elder care; and 1.1% offered onsite or offsite elder care. Note: 

Percentages based on weighted estimates.
For more information please contact 

Centers for Disease Control and Prevention

1600 Clifton Road NE, Atlanta, GA 33029-4027

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

TTY: 1-888-232-6348

E-mail: cdcinfo@cdc.gov

Web: www.cdc.gov

Publication date: December 2018

CS 299094-A