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Resolving Presenteeism in the Workplace

Big Picture:

Many working Americans engage in presenteeism — they arrive to work despite acute and chronic health conditions that require medical care or at-home recovery. Often, these sick employees come to work due to economic and job-related anxieties, such as fear of unemployment, lack of paid sick leave or conflicting directions from their bosses (e.g., being pushed to work instead of taking time off). Specific government and workplace policies should be implemented to reduce presenteeism because it limits workplace health, spreads disease and reduces efficiency.

Operative Definitions:

  1. Presenteeism: The event of employees attending work despite health conditions that may require treatment, often leading to low efficiency, worse health and disease spread.

  2. Absenteeism: The event of employees failing to attend work as scheduled.

  3. Sick Leave: Paid absence from work, allowing workers to postpone work and recover from illness.

Important Facts and Statistics:

  1. Literature reviews cautiously estimate that presenteeism costs U.S. businesses $150 to $260 billion annually.

  2. Many researchers believe presenteeism should be assessed as a qualitative measure, such as quality of life, rather than a dollar amount. Presenteeism’s direct impact on the economy is difficult to measure; there is currently no standard method to calculate the economic effects of illness-associated productivity losses.

  3. The dangerous loop of presenteeism leading to more significant cycles of presenteeism and absenteeism is hazardous in the healthcare industry. Researchers find presenteeism is more common among workers with valuable, high-demand, high-commitment jobs, such as physicians, nurses and other healthcare workers. Presenteeism is particularly unsafe in healthcare environments because sick workers are likely to infect immunocompromised patients or fellow healthcare workers.

Three-Point Plan:

(1) Ensure all employees have a certain amount of paid sick days annually and have access to paid sick leave even if they have taken time off separately (e.g., family leave, caretaker leave, medical recovery, etc.). Many Americans attend work while ill because they have run out of paid sick leave days. By giving employees enough leave of different types, those who have already used their allotted “leave days” for absences unrelated to illness will still be able to take time off and rest when they are ill. Furthermore, it is crucial not only to give workers access to paid sick leave but also other leave types, such as maternity and family leave.

(2) Ensure that unrestricted paid sick leave is available to employees in healthcare settings. Healthcare workers with little to no paid sick leave are likely to engage in presenteeism because of their essential and demanding jobs, which can lead to them spreading diseases. Ensuring access to paid sick leave will help reduce the spread of contagious diseases and allow medical staff to recuperate or seek care for chronic conditions.

(3) Ensure adequate staffing and coverage of workers’ roles if policies mandate back-to-work rules. Many sick employees come to work because they fear work will accumulate or the team will suffer in their absence. Adequate staffing and scheduling can prevent presenteeism by ensuring that employee tasks are taken care of when they are ill and cannot work.

Why This Initiative Is Important:

Presenteeism carries direct and indirect financial losses; researchers estimate these costs could be as high as $260 billion annually. By delaying rest and arriving at work as scheduled, presentee workers are at higher risk for a longer-term cycle of absenteeism and presenteeism. This occurs because minor health problems tend to worsen and become more challenging to treat when people attend work rather than tending to their health. Delaying healthcare and recovery can worsen individuals’ and workplaces’ health and productivity as employees who return to work before fully recovering are often tired and inefficient. They also spread diseases and reduce team cohesion and productivity. Changing workplace, state and federal policies to provide sick leave and reduce employees’ burden can improve workplace wellness and efficiency in the long run.


The following student(s) worked on this nonpartisan proposal: Diane Bao, University of Texas Health Science Center School of Public Health at Austin.


Homrich, Paulo Henrique Poti, et al. “Presenteeism Among Health Care Workers: Literature Review.” Revista Brasileira de Medicina do Trabalho, vol. 18, no. 1, 2020, pp. 97-102. doi:10.5327%2FZ1679443520200478. Accessed 19 May 2022.

Johns, Gary. “Presenteeism in the Workplace: A Review and Research Agenda.” Journal of Organizational Behavior, vol. 31, no. 4, 2009, pp. 519-42. Wiley Online Libraries, doi:10.1002/job.630. Accessed 8 May 2022.

Lohaus, Daniela, and Wolfgang Habermann. “Presenteeism: A Review and Research Directions.” Human Resource Management Review, vol. 29, no. 1, 2019, pp. 43-58. ScienceDirect, doi:10.1016/j.hrmr.2018.02.010. Accessed 10 May 2022.

Schultz, Alyssa, et al. “The Cost and Impact of Health Conditions on Presenteeism to Employers: A Review of the Literature.” Pharmacoeconomics, vol. 27, no. 1, 2009, pp. 365-78. doi:10.2165/00019053-200927050-00002. Accessed 16 May 2022.

Widera, Eric, et al. “Presenteeism: A Public Health Hazard.” Journal of General Internal Medicine, vol. 25, no. 11, 2010, pp. 1244-7, doi:10.1007%2Fs11606-010-1422-x. Accessed 15 May 2022.

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