aspects of health to look fully at health-related productivity. Employers are finding that not only is it important to affect the overall health of a population to manage health care costs and sustain productivity (e.g., by minimizing the effect of absenteeism) but that advancing health also reduces presenteeism (the effect of diminished health on an employee’s ability to engage and function to full capacity while at work), reflecting the realization that not all employees present are fully engaged and optimally productive. Isolating the components of absenteeism, disability, workers’ compensation, and presenteeism has enabled employers to more closely examine the effect of health risks on overall productivity (Edington, 2001).

In recent years, employers and relevant federal agencies have demonstrated that multifactor determinants of health and productivity must be addressed using new perspectives, metrics, and models. Table 3-1 outlines current trends toward achieving a healthy and productive workforce based on determinants of health and productivity.

Global competition and systems analyses of productivity of the workforce has led to more holistic thinking about productivity at the workplace. Whereas absenteeism was the metric of choice for many years, the current metric has been expanded and evolved into the measurement of performance or presenteeism. Productivity at the workplace now includes two components: time away from work (absenteeism and disability) and presenteeism (job performance).