The Science of Staying on the Job

by Jon Scaccia March 24, 2025

Every year, millions of workers call out sick, leading to lost productivity, increased stress on coworkers, and financial strain on businesses and economies. The numbers are staggering—a 44% increase in sick leave between 2006 and 2020 in Europe alone. And yet, despite decades of research, we still struggle to find effective ways to keep workers healthy and on the job.

A recent scoping review of 28 studies set out to answer a critical question: What actually works to prevent sick leave? The findings were both revealing and frustrating. While some interventions show promise, the research highlights a troubling reality—most of the interventions studied simply don’t work as well as we’d hope. But there are bright spots that offer a roadmap for moving forward.

What We Know: The Three Most Promising Approaches

The review identified three types of interventions that appear to reduce sick leave in certain situations:

1. Multi-Component Workplace Interventions
   • Combining individual efforts (like stress management or exercise) with workplace-level changes (such as better supervision or improved policies) shows the most promise.
   • Workplace health promotion programs that address both mental and physical health were particularly effective, especially when they included leadership training and environmental changes.
2. Targeted Health Interventions for High-Risk Workers
   • One-size-fits-all solutions rarely work, but interventions aimed at workers with specific health risks—such as cognitive behavioral therapy (CBT) for employees with anxiety and depression or consultations with occupational health staff—proved effective in reducing sick leave.
   • These programs succeed because they address individual needs rather than attempting broad, generalized fixes.
3. Exercise Programs to Prevent Physical Health-Related Sick Leave
   • Physical health problems, particularly musculoskeletal issues like back pain, are major drivers of sick leave.
   • Exercise programs, particularly those tailored to workplace needs, consistently demonstrated a reduction in sick leave rates.

What We Keep Getting Wrong

While these interventions offer hope, the broader picture remains frustrating. Many strategies aimed at reducing sick leave are either ineffective or implemented poorly. Here’s why:

• Ignoring the Workplace Environment: Too many interventions focus only on individual behavior rather than workplace conditions. A worker can be given stress management training, but if their workplace is toxic, they’ll still burn out.
• Short-Term Thinking: Many studies on sick leave interventions don’t follow workers long enough to see if the benefits last. Habits, workplace cultures, and policy changes take time to influence sick leave rates.
• Low Participation Rates: Even when effective programs exist, many employees don’t take advantage of them, often due to workplace culture, stigma, or lack of awareness.
• Insufficient Research on What Actually Works: Many interventions lack robust scientific backing, and studies often fail to include sick leave as a primary outcome. If we don’t measure it, we can’t improve it.

The Future of Sick Leave Prevention

So, where do we go from here? The research suggests that future efforts should focus on:

• Long-Term Studies: We need more randomized controlled trials with extended follow-up periods to truly understand what interventions have lasting impacts.
• Better Workplace Integration: Rather than placing the burden solely on workers, future interventions should involve company leadership, policies, and workplace culture shifts.
• Custom-Tailored Interventions: Workers in different industries and risk groups need solutions that are specific to their environments and challenges.
• Higher Participation Rates: Employers need to focus on reducing barriers to participation, whether through incentives, workplace encouragement, or policy changes that make engagement easier.

Join the Conversation

The research is clear: while some interventions work, most still fall short of keeping workers healthy and on the job. What has your workplace tried to reduce sick leave? Have you participated in any workplace health programs, and if so, did they make a difference?

• What workplace health programs have you found effective or ineffective?
• What do you think employers should do to improve worker health and reduce sick leave?
• Do you think workplace policies or personal health behaviors play a bigger role in preventing sick leave?

Let’s discuss—share your thoughts in the comments or on social media!

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