Presenteeism: the One Thing Worse than Absenteeism

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Absenteeism occurs when an employee misses work intentionally, creating a habit of taking unscheduled time-off for a variety of reasons, legitimate and otherwise.

Common Causes of Absenteeism

  • Bullying and harassment – Employees who are bullied or harassed by coworkers and/or bosses are more likely to call in sick to avoid the situation.
  • Burnout, stress and low morale – Heavy workloads, stressful meetings/presentations and feelings of being unappreciated can cause employees to avoid going into work. Personal stress (outside of work) can lead to absenteeism.
  • Childcare and eldercare – Employees may be forced to miss work in order to stay home and take care of a child/elder when normal arrangements have fallen through (for example, a sick caregiver or a snow day at school) or if a child/elder is sick.
  • Depression – According to the National Institute of Mental Health, the leading cause of absenteeism in the United States is depression. This finding is supported by recent research by Gallup. Depression can lead to substance abuse if people turn to drugs or alcohol to self-medicate their pain or anxiety.
  • Disengagement – Employees who are not committed to their jobs, coworkers and/or the company are more likely to miss work simply because they have no motivation to go.
  • Injury & Illness – Injuries, illness and medical appointments are the most commonly reported reasons for missing work (though not always the actual reason). Not surprisingly, each year during the cold and flu season, there is a dramatic spike in absenteeism rates for both full-time and part-time employees. Accidents can occur on the job or outside of work, resulting in absences. In addition to acute injuries, chronic injuries such as back and neck problems are a common cause of absenteeism.
  • Job hunting – Employees may call in sick to attend a job interview, visit with a headhunter or work on their résumés/CVs.
  • Partial shifts – Arriving late, leaving early and taking longer breaks than allowed are considered forms of absenteeism and can affect productivity and workplace morale.[1]

According to a recent Gallup poll, absenteeism is a growing problem that is costing American businesses as much as $84 billion every year in lost productivity. Given the many reasons for absenteeism, its growing prevalence and the impact it has on businesses and the economy, it’s hard to imagine a more potentially destructive workplace challenge.

The Presenteeism Epidemic

That is, until you begin to delve into the impact and cost of presenteeism. Although primarily defined as “the act of attending work while sick,”[2] the word presenteeism is also used to describe a broader range of circumstances that occur when employees are physically present, but due to a physical or emotional issue, are distracted to the point of reduced productivity.[3]

Just as people stay away from work for a variety of reasons, people also choose to come to work sick (or distracted) for a variety of reasons, ranging from economic necessity to exuberance for the job. Although substantive research on the impact of presenteeism is only recently beginning to emerge, early evidence suggests that the health related component of presenteeism (i.e. those who are working while suffering the effects of ill health or injury) could be even more costly to businesses than absenteeism[4]. In fact, according to one director at Sunlife Financial, “It’s about four times bigger than absenteeism in terms of hours lost.”  When we add this fact to recent figures indicating that up to 24% of workers are actively disengaged (which equates to non-medical presenteeism), a disturbing picture begins to form.

Tackling Presenteeism in the Workplace

The challenge, of course, is what to do about it. As with any problem, acknowledging that it exists is the first step toward resolution. There are a number of survey tools available to measure both absenteeism and presenteeism in the workplace. Two of the most commonly used are the World Health Organization (WHO) Health and Work Performance Questionnaire (HPQ) and the Work Limitations Questionnaire (WLQ). The HPQ is more suitable for smaller employers. These surveys will help you determine whether a problem exists and establish a baseline that you can then improve upon.

When the issue is absence, there are a range of responses available to employers, from strict monitoring and enforcement of time-off policies to offering “unlimited vacation” with performance tied to defined outcomes rather than time spent at work.

Due to its silent nature, presenteeism can be both harder to monitor and harder to address than absenteeism. It’s not always obvious that someone has mentally checked out until performance and productivity suffer significantly. There are three things you can do to help prevent an epidemic of presenteeism from developing in your workplace:

  1. Focus on policy, culture and engagement. People are less likely to mentally check out of an environment that supports their life challenges and strives to engage them. For example;

  2. Avoid an absence management policy that encourages employees with medical conditions to come to work to avoid disciplinary measures.
  3. Offer work-from-home options when employees ought to stay home, but have deadlines to meet.
  4. Provide flexible work hours to help employees manage doctor’s appointments, specialized treatment, or symptoms that interfere with their ability to work.
  5. Get to know your people on a more personal level so you’ll know if they’re dealing with chronic health or personal issues that might lead to presenteeism.
  6. Create a comprehensive workplace wellness program. Elements of such a program might include, for example: a benefits plan with employee assistance services, health risk appraisals, health fairs, lunch and learn seminars on a broad range of health topics. This Workplace Wellbeing Tool created by the UK Government offers one template to help you get started.
  7. Presenteeism is a complex issue and its impact in the workplace is only just beginning to be recognized.  As we work toward creating work environments where all employees are valued, engaged and able to realize their potential; challenges like absenteeism and its silent partner, presenteeism, will become less pervasive and less damaging.


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    [1] List of causes excerpted from The Causes and Costs of Absenteeism in the Workplace


    [3] Benefits Canada

    [4] Klachefsky, M. Understanding Presenteeism.

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