The Case for Including Spouses in Employee Health Management 

There is evidence that comprehensive communications, the use of incentives, and a strong culture of health can all help drive increased participation in employee health management (EHM) programs. An often overlooked element that also contributes to the long-term success of EHM programs, however, is the role of family support — specifically spouses. Health behavior research has found that other individuals and groups have a profound impact on an individual’s behavior, with spouses being a key influencer. Social support is not only a predictor of initial engagement, but also of long-term success, including higher quit rates for tobacco users and weight-loss program adherence.

Mercer’s ongoing collaboration with the Health Enhancement Research Organization (HERO) on the HERO Employee Health Management Best Practices Scorecard — a free, online assessment tool for employers — has yielded a rich database that is being used by industry experts to learn more about what makes employee health management work. A study conducted by my Mercer colleague Dan Gold looked at the impact of including spouses in an EHM program on employee engagement and the program’s likelihood to reduce health risks and demonstrate savings.

The analysis was limited to 228 employers offering, at a minimum, a health assessment (HA) and lifestyle management programs. About three-fourths of these respondents indicated that they include spouses in key components of their EHM program. Spouse involvement had a minimal effect on average employee HA participation rates (52% in programs that included spouses and 50% in those that didn’t) but a dramatic impact on participation in behavior change programs, where the average employee participation rate was twice as high in programs including spouse (28% vs. 14%). As other research also suggests, these findings imply that social support likely has a greater impact on engagement in specific interventions than on initial participation.

Among employers that measured outcomes, 70% of respondents that included spouses reported at least some improvement in medical trend vs. 64% of respondents that did not include spouses, and 88% reported at least some improvement in health risks vs. 81% of respondents that did not include spouses.

While factors not controlled for in the analysis also likely influence the results, the data support, at least directionally, that those organizations that include spouses in their overall EHM strategy have higher employee participation, especially in the interventions that matter, as well as a greater likelihood of health improvement and medical cost savings. In addition to the positive influence on employees, including spouses in EHM also addresses dependent medical expense. Given that reducing medical plan cost is a primary objective for most EHM programs, it seems only logical to include a group of members that typically drives nearly a third of an organization’s health care costs.

While this best practice is on the way to becoming the norm, there are many programs that still do not include spouses; until they do, they may be limiting their potential impact.

A new version of the HERO Employee Health Management Best Practices Scorecard in Collaboration with Mercer© has just been released and can be accessed here.