第1章
Beyond Health Programs: Reimagining Workplace Wellness
What if the key to transforming workplace wellness isn't another expensive program but a movement that captures hearts and minds? Laura Putnam's groundbreaking approach has revolutionized how organizations approach employee well-being, earning praise from wellness pioneers like Dr. Dean Ornish who calls it "a must-read for all workplace leaders." As a former public school teacher turned wellness innovator, Putnam brings a refreshing educational perspective to a field dominated by medical models. Her book has become required reading at companies like Google and LinkedIn, where wellness leaders have implemented her strategies to dramatically increase engagement rates from the typical 20% to over 80%. The traditional wellness model simply isn't working-despite 75% of U.S. employees having access to wellness programs, participation remains dismally low and outcomes disappointing. Putnam's solution? Stop treating workplace wellness as a clinical intervention and start treating it as a movement that inspires genuine engagement.
第2章
The Billion-Dollar Dilemma: Why Traditional Wellness Fails
We're facing a health crisis of epic proportions. More than two-thirds of American adults are overweight or obese, nearly half have at least one chronic condition, and healthcare costs for largely preventable diseases consume about 75% of national health expenditures. Yet despite knowing what we need to do-move more, eat better, and quit smoking-most of us fail to make these changes stick.
The problem isn't knowledge; it's implementation. Even healthcare professionals struggle with the same health challenges as everyone else. The "knowing-doing gap" exists because our brains are hardwired to resist change. Research by Roy Baumeister and Baba Shiv shows that willpower is a limited resource drawing from the same mental reserves as focus and decision-making. When our prefrontal cortex is overloaded with cognitive tasks, we have less capacity for self-regulation.
This explains why the classic workplace wellness model-assessment, feedback, programs, and incentives-often fails. It places the entire burden of change on individual willpower without addressing the larger environment and culture that shape our choices. Johnson & Johnson pioneered this approach in 1979 with their "Live for Life" program and documented impressive results: improved health outcomes and cost savings of $565 per employee with an ROI of up to $3.92 for every dollar invested. But most companies haven't achieved similar success.
Despite widespread adoption, most wellness initiatives struggle with abysmal participation rates. Less than half of eligible employees participate in initial assessments, and program participation drops below 20%. Without sufficient participation, programs can't deliver expected health outcomes or cost savings. The "build it and they will come" approach simply doesn't work.
Moreover, recent studies challenge the notion that lifestyle management programs significantly reduce healthcare costs. While disease management programs do reduce hospital visits, the broader promise of wellness ROI remains largely unfulfilled for most organizations.
To create workplace wellness that works, we need to shift from isolated programs to movements that infuse well-being into every aspect of organizational life. This means embracing a holistic approach that addresses physical, emotional, financial, social, career, community, environmental, creative, and spiritual dimensions of well-being. The solution requires a ten-step framework divided into three phases: Start It, Build It, and Make It Last.
第3章
Becoming a Changemaker: From Expert to Movement Leader
The first step in creating effective workplace wellness is shifting your mindset from being merely an expert to becoming an agent of change. Like Tom Rath, who wrote "Eat Move Sleep" without claiming to be a health expert, successful wellness leaders connect through personal stories rather than credentials.
Effective changemakers share six critical traits: First, they know their deep personal "why" that drives their conviction, like Shane Valentine whose heart program for kids is fueled by alarming heart health statistics. Second, they speak to emotions rather than just intellect, recognizing that emotional competencies matter twice as much as IQ in leadership effectiveness. Third, they master storytelling, creating "brain to brain coupling" that statistics alone cannot achieve. Fourth, they personally embody their wellness message, like Arianna Huffington who committed to proper sleep after her collapse. Fifth, they do whatever it takes-even unconventional actions-to inspire others. Finally, they don't wait for permission to start making changes.
Leading a wellness movement requires overcoming numerous challenges: securing buy-in from decision makers, engaging management beyond mere support to active participation, inspiring authentic employee commitment, building a supportive culture, and ultimately changing behaviors. To navigate these challenges, wellness leaders should form a "core action team" of like-minded colleagues who can help launch the movement.
When advocating for workplace wellness, focus on costs beneath the surface-presenteeism accounts for 63% of health-related costs while direct medical costs are only 24%. Emphasize value on investment (VOI) rather than just ROI, highlighting broader benefits like improved morale and talent retention. Tailor your business case to organizational needs using the Value Creation Framework-efficiency, risk management, marketing creation, or leadership quality. Most importantly, make an emotional case through compelling stories that connect wellness to a higher purpose beyond cost savings.
第4章
Imagining What's Possible: Beyond Physical Health
Like Seattle Seahawks' sports psychologist Mike Gervais who inspired the team to their first Super Bowl by asking "What's possible?", change agents must envision and paint a compelling picture of a desired future state. This vision should look beyond mere "health" toward a workplace where everyone reaches their full potential.
Abraham Maslow revolutionized psychology by shifting focus from what's wrong with people to what's right-or what's possible. While psychology traditionally studied pathology, Maslow explored optimal psychological states, convinced we're all born with the desire and ability to reach our full potential. His famous hierarchy of needs provides a roadmap for achieving our highest potential that can be applied to workplace wellness.
Disease prevention rarely inspires those in good health, but fully thriving in life appeals to most people. While our immediate health concerns may not be priorities, higher-order needs like career success, meaningful relationships, and making a difference are actually vital to our overall well-being. The "Imagine What's Possible Pyramid" builds on Maslow's hierarchy to encompass multiple dimensions of health and vitality.
Health extends far beyond the absence of disease or eating vegetables and exercising. Surprising factors like zip code (which can create life expectancy differences of up to 25 years between neighborhoods), education level (which can impact lifespan by 10 years), social connections (which can reduce mortality risk by 50%), and "unmentionables" (like relationship quality, financial stress, and caregiving responsibilities) profoundly affect our health.
Gallup researchers identified five essential elements of well-being: career, social, physical, financial, and community. People excelling in all five areas aren't just happier and more productive-they have 40% lower medical costs than those doing well in two or fewer areas. Unfortunately, only 7% of people thrive in all five areas.
The most powerful approach is recognizing how these elements of well-being interact and reinforce each other. Each dimension feeds the others in an interdependent system. Those with high social well-being are almost 50% more likely to thrive in their careers. Beethoven exemplified these connections-his morning walks (physical well-being) generated creative thinking, which he recorded in a notebook before returning to compose (creative well-being).
第5章
Uncovering Hidden Factors: The Culture Imperative
Culture shapes our behaviors in ways we don't even recognize-like water to fish. While we often think we're creatures of habit, we're more accurately creatures of culture. To create meaningful change, we must shift from changing a few behaviors in individuals to changing entire cultures.
Culture is the ethos of an organization-how employees work together, the leaders' vision, shared values, social norms, and "what happens when the boss is not around." Great cultures prioritize humans first, which fosters engagement and high performance. Companies with engaged employees outperform competitors by 20-28%, while disengaged employees actively create toxic environments.
Before launching any wellness program, you must first assess whether your culture will support it. John Thiel at Merrill Lynch learned this lesson the hard way when his well-intended meditation and wellness initiative backfired among hard-charging financial advisors, resulting in a reactionary consumption of "meat, potatoes, and booze." As David Hunnicutt from WELCOA emphasizes: "Assess culture first, health second."
If employees are disengaged at work, they'll likely remain disengaged from wellness programs regardless of how well-designed they are. The key factor is "perceived organizational support"-employees who don't feel supported by their organization, managers or coworkers are unlikely to trust wellness initiatives.
Building a "culture of health" requires more than superficial changes like leader modeling or environmental modifications. True culture encompasses behaviors, values, and underlying assumptions. Wellness efforts that contradict the underlying culture breed resentment-employees become cynical when told to be healthy while simultaneously expected to work 60-hour weeks.
The Maslow Meets Mallory Culture Audit maps organizational needs to Maslow's hierarchy, using a mountain climbing metaphor. Organizations, like individuals, must satisfy lower-order needs before reaching higher levels. The audit examines five levels: the Functioning Factor (basic job needs), Feelings Factor (appreciation and respect), Friendship Factor (connection), Forward Factor (growth opportunities), and Fulfillment Factor (inspiration and purpose).
第6章
Starting with What's Right: The Power of Positive Approaches
Traditional workplace wellness typically starts with what's wrong-using health risk assessments (HRAs) and biometric screenings to identify problems. This negative-first approach may contribute to low engagement levels. Fear tactics don't work, even with heart attack survivors who rarely maintain lifestyle changes when approached with negative messaging.
In contrast, Dean Ornish's heart disease reversal program demonstrates the power of positive framing, achieving 85-90% compliance rates (versus 10% with traditional approaches) by emphasizing optimism and hope rather than fear. His approach-encouraging patients to "embrace life" and "love your life" while eliminating judgmental language-maintains 77% adherence after three years, saving nearly $30,000 per patient in follow-up procedures.
As wellness manager at Stanford Health Care and Lucile Packard Children's Hospital, Patty de Vries demonstrates the power of positive approaches. By starting with what's right, she increased health fair attendance from 1,500 to 4,000 in one year and expanded wellness champions from 32 to 1,075 in two years. Her secret is approaching situations "with love," building trust through unconventional practices like opening meetings with "The Four Agreements" and integrating gratitude and breathing exercises into team development. She tells employees "You're perfect where you are" before offering wellness support, creating a foundation of trust that drives engagement.
Research by Martin Seligman and colleagues has evolved into "positive health," shifting focus from reducing suffering to achieving optimal well-being. Harvard studies show cheerful people develop less heart disease, optimistic men have lower hypertension rates, and positive outlooks protect against common colds. Happy employees are 12% more productive, gaining what Shaun Achor calls a "happiness advantage." Barbara Fredrickson's research shows positive emotions "light the path to lifestyle change" by improving brain function and enabling systemic problem-solving.
Research shows that naming three good things daily can be more effective and longer-lasting than antidepressants. Though humans are "hardwired to remember the negative," this practice can develop a positive mindset that boosts health. To build successful wellness initiatives, focus first on creating a positive spirit that leverages strengths, happiness, and well-being advantages.
第7章
Taking a da Vinci Approach: Breaking Down Silos
Leonardo da Vinci embodied the interdisciplinary "Renaissance man" approach by uniting diverse fields. Similarly, workplace wellness needs to break out of its compartmentalized approach and tear down organizational silos. While 98% of large employers and 73% of smaller organizations offer some wellness benefits, many programs are merely disjointed screenings and weight loss challenges. The da Vinci approach creates synergy through integration across multiple departments and disciplines, ensuring greater organizational impact.
Marianne Jackson led Blue Shield's Wellvolution initiative by recruiting senior leaders as active participants, not just passive supporters. She created a two-day immersion retreat for executives to personally experience wellness across mind, body, and spiritual dimensions. Following this kickoff, Wellvolution was deployed company-wide with programs, resources and online communities, using rapid prototyping to continuously improve. Participation rates increased from 20% to 80%, with remarkable outcomes: 50% of smokers quit, physical inactivity dropped by half, and 33% of employees became physically active. Health metrics improved significantly, with 27% of at-risk employees becoming healthy and high blood pressure rates dropping from 25% to 10%.
Brocade's "WellFit" council exemplifies the da Vinci approach, bringing together representatives from corporate benefits, corporate affairs, facilities, internal communications, and global wellness champions. By housing WellFit under corporate affairs rather than HR, they've integrated wellness with other initiatives like their "B-Involved" community outreach program, which gives employees 40 paid hours to volunteer with nonprofits. This structure connects community, social, physical and financial well-being through activities like community gardens and fundraising bike events.
A successful wellness movement requires collaboration across departments. Human Resources typically houses wellness but shouldn't solely own it. Compensation and Benefits must align plan design, incentives, eligibility, premium structures, and help employees become better healthcare consumers while ensuring legal compliance. Facilities managers are essential partners for events, fitness spaces, and wellness signage. Information Technology supports tech solutions like gamification and mobile apps. Marketing helps brand your wellness movement with an evocative name and communication strategy.
Creating a distinctive brand for your wellness movement requires collaboration with your marketing team. Blue Shield's "Wellvolution" name perfectly captured their wellness revolution and became embedded in company language-used as a verb, noun, and adjective-creating lasting cultural impact.
第8章
Going Stealth: The Sneakiness Imperative
The hard sell for wellness rarely works. A more effective approach is to "go stealth" by sneaking wellness in under the cover of more popular initiatives-like using a Trojan Horse. The resource disparity between workplace wellness and learning and development is enormous. While critics question wellness program expenses, workplace wellness is a $6-10 billion industry compared to learning and development's $164 billion. The average large company spends $17.4 million annually on learning and development ($976 per employee per year across all company sizes). In contrast, 36% of organizations have no defined wellness budget, 17% spend $150+ per employee annually, 13% spend $25 or less, and 34% spend between $26-149 per employee annually-a fraction of learning and development investments.
Stanford researchers discovered that stealth approaches to health behavior change are more effective than traditional methods. When comparing two student groups-one learning about nutrition through traditional health education and another studying "Food and Society" focusing on environmental and social justice aspects of food-the second group made significantly better dietary improvements. This research demonstrates that connecting wellness to higher purposes and social movements creates more lasting change than explicit health-focused approaches.
According to Bersin by Deloitte research, the "Top Global Talent Priorities" for business leaders are: (1) addressing leadership gaps, (2) retention and engagement, (3) increasing HR skills, (4) talent acquisition, and (5) learning and development. Wellness doesn't make the list, but this presents an opportunity to embed wellness into these existing priorities rather than pushing wellness as a separate initiative.
To effectively integrate wellness into other initiatives, avoid traditional terminology. Instead of "wellness" or "well-being," use terms like "sustainable engagement," "energy management," or "leadership and resilience." Position yourself as a "human performance improvement leader" rather than a "wellness specialist" to increase senior leader buy-in and employee engagement.
Jim Loehr and Tony Schwartz masterfully reframed wellness as performance enhancement in their book "The Power of Full Engagement," proposing "managing your energy, not your time." Their approach resonates with business leaders because energy directly impacts current performance, unlike health which seems abstract and distant. Their organizations-The Human Performance Institute (using terms like "Corporate Athlete") and The Energy Project ("Discover a Better Way of Working")-market themselves as performance training programs rather than wellness initiatives. This strategic positioning allows them to command 1-2 days of work time, often off-site, while typical wellness programs struggle to get an hour of attention.
第9章
Creating Meaning: Beyond Carrots and Sticks
This step explores how to move beyond short-term incentives to foster intrinsic motivation for wellness. Just as the author discovered with her history students that meaningful engagement comes from collaborative inquiry rather than external rewards, sustainable behavior change requires finding each person's "right why." The chapter distinguishes between extrinsic motivation (doing something for rewards or to avoid penalties) and intrinsic motivation (enjoying the activity itself), arguing that while incentives may boost initial participation, they rarely lead to lasting engagement.
Despite scientific evidence favoring intrinsic motivation, workplace wellness programs increasingly rely on incentives and penalties. The National Business Group on Health reports 74% of employers with wellness programs used incentives in 2014 (up from 57% in 2009), with average payments rising to $693 per employee. Penalties have doubled in two years and are expected to double again. These incentives range from gift cards to health premium reductions, while penalties include surcharges or even termination for smokers at companies like Scott's Miracle Gro.
While incentives effectively drive participation in one-time activities like health assessments or flu shots, they fail to create sustainable habits. University of Oxford researchers found no significant long-term improvement in smoking cessation rates from incentive programs. Incentives and penalties create numerous unintended consequences. They often feel punitive to employees, with surveys showing most workers resent participation and outcomes tied to rewards. These approaches have sparked lawsuits, including one against Honeywell by the Equal Employment Opportunity Commission. They also oversimplify complex lifestyle changes, shift focus away from the activity itself to the reward, and encourage cheating (like putting pedometers on dryers to fake steps).
Rather than relying on incentives, wellness leaders should focus on building intrinsic motivation. This means emphasizing immediate benefits (like increased energy) rather than long-term outcomes (like weight loss). Research shows women who exercise for "energy" rather than "weight management" are 34% more likely to maintain their routines.
Lasting motivation comes from addressing five universal human needs: competency (feeling capable), autonomy (feeling in control), relatedness (connecting with others), purpose (finding meaning), and play (having fun). When wellness programs tap into these intrinsic motivators rather than external rewards, they create sustainable engagement that drives authentic behavior change.
第10章
Designing Nudges and Cues: Making Healthy Choices Easy
Building on motivation strategies, creating environments that naturally support healthy choices through nudges and cues is essential. Nudges are environmental prompts that make healthy choices easier, like signage or healthy vending machine options. Cues are cultural prompts that normalize certain behaviors, including policies, organizational values, and leadership modeling. Research shows employees in companies with strong cultures of health are three times more likely to engage in their wellbeing, yet only 26% of employees believe their company has such a culture.
Organizations worldwide are implementing nudges to promote wellness without relying solely on individual motivation. MD Anderson Cancer Center created "BeWell Stations" with exercise equipment throughout campus for stress relief. The CDC's "StairWELL to Better Health" campaign enhanced stairwells with music and artwork. Brocade designed its headquarters with wide, attractive stairs and strategically placed salad bars. IDEO and Google reduced soda consumption by moving healthier drinks to eye level. Nintendo earned a Gold LEED rating with its sustainable headquarters featuring subsidized "Green Arrow" healthy meal options, specialized bike storage with ventilation systems for wet gear, and gaming zones that promote playfulness.
Cultural cues normalize healthy behaviors within organizations. In Japan, "asa taisou" morning exercises are standard practice in workplaces nationwide, with Honda expanding this into a two-week fitness program for new hires. American companies are adopting similar practices: Chevron brings fitness trainers into workspaces for stretch breaks, while L.L. Bean's manufacturing employees take three five-minute stretch breaks daily, yielding 100% ROI through increased productivity. LinkedIn's CEO Jeff Weiner conducts walking meetings on nearby trails, signaling to employees that this practice is normal while freeing conference room space and enabling more direct, distraction-free communication.
Organizations should first assess existing nudges (environmental factors) and cues (cultural elements) before developing action plans. Key cultural cues include policies, rituals, recognition systems, leadership modeling, peer encouragement, and wellness integration into business decisions. For physical wellness, movement nudges might include prominent stairs, bike facilities, on-site fitness options, walking meetings, and stand-up workstations. Healthy eating nudges include nutritious vending options, water stations, employee refrigerators, and replacing candy bowls with fruit. By focusing on environment and culture rather than individual willpower, organizations create "oases of vitality" where healthy choices become both easy and normal.
第11章
Launching and Iterating: The Experimentation Imperative
Thomas Edison's approach to inventing the lightbulb exemplifies the experimentation mindset needed for workplace wellness-seeing failure not as defeat but as steps toward success. Like Silicon Valley's iterative process, wellness initiatives should embrace a "launch and iterate" approach: implementing activities before they're perfect, evaluating results, making adjustments, and launching again. This experimental spirit moves workplace wellness from "check the box" to "out of the box" while demonstrating management's commitment to finding effective solutions through collaboration with employees.
Traditional workplace wellness has favored scientific, evidence-based approaches that identify problems (health risks) and offer solutions. Design thinking complements this with a creative, solutions-focused methodology that's active and participatory, drawing on imagination and systems thinking. The ideal approach combines evidence-based practices with experimentation, collecting your own data while incorporating best practices from fields beyond wellness-management, education, architecture, and advertising-to create a more holistic approach.
IDEO embodies the "Fail faster!" philosophy, encouraging employees to "try early and often" through constant prototyping and experimentation. Their approach to wellness reflects this playful, experimental mindset, defining well-being as "bringing your whole self to work" and supporting multiple dimensions: physical (bike storage systems, pop-up yoga classes), social (creative workspace redesigns like the VW camper), financial (opt-out 401(k) system), career (guided mastery approach), and creative (interactive spaces like bathroom chalkboards for big questions).
Carol Dweck's research distinguishes between fixed mindset (believing capabilities cannot change) and growth mindset (believing change is always possible). A growth mindset encourages action, progress, possibility, and creativity-exactly what's needed for wellness initiatives. Michelle Segar and Winifred Gebhardt suggest teaching people to view setbacks as learning opportunities rather than failures, building resilience toward challenges and fostering ongoing behavior change.
To implement an iterative approach to wellness programs, organizations can establish "learning labs" where departments experiment with wellness initiatives. For example, HealthySteps at Lucile Packard Children's Hospital awarded grants for innovative ideas, including adapting a weight-control curriculum from children to adults. Organizations can also form ad hoc teams to use design thinking for testing new approaches. The program development process follows three phases: "get ready" (analyze, ideate, design, develop), "go" (implement with bias for action), and "keep going" (evaluate and iterate). This approach emphasizes learning through doing rather than endless planning.
第12章
Going Global: Wellness Without Borders
The wellness movement must expand globally as health challenges shift worldwide. In less than four decades, obesity rates have doubled or tripled across countries, with emerging economies seeing the fastest growth. What was once primarily an American issue has spread globally-Mexico, Saudi Arabia, and South Africa now have obesity rates rivaling the United States. This "perfect storm" combines lifestyle factors with genetic predispositions, particularly affecting urban areas in rapidly developing countries like China and India.
Global health has dramatically shifted from infectious diseases to chronic conditions. Obesity rates have increased 82% worldwide since 1990, with the Middle East seeing a startling 100% rise. According to McKinsey, 30% of the world's population is now overweight, projected to reach 40% by 2030. Fast economic growth correlates directly with rapid obesity growth, creating alarming health changes driven by reduced food prices, less physical activity, and increased fast food availability-with KFC expanding aggressively across Asia, particularly in China.
Beyond physical health concerns, global stress levels are skyrocketing, particularly in rapidly growing economies. A Regus Group survey of 11,000 companies found workplace stress doubled in large organizations, with Chinese workers reporting the highest increase (86%). Overall, 58% of workers report job stress, primarily from poor work-life balance. These rising stress rates coincide with increasing social isolation as traditional family structures change.
Despite troubling global health trends, there are encouraging developments in well-being awareness internationally. Bhutan pioneered this shift in 1972 when King Wanchuk declared his country would focus on gross national happiness (GNH) rather than gross national product. This noble focus led to remarkable improvements: per-capita income now exceeds India's, life expectancy rose from 43 to 66 years, infant mortality dropped from 163 to 40 per 100,000 births, and literacy increased from 10% to 66%. The world's "Blue Zones" of longevity-like Okinawa, Sardinia, and Loma Linda-offer additional insights beyond diet and exercise, highlighting the importance of life purpose, restoration time, spiritual community, family prioritization, and uplifting social connections.
Organizations with global offices need to adapt wellness strategies to local cultures while maintaining international cohesion. OzForex Group uses "Good Vibes" committees across global locations, giving each office autonomy to create region-specific wellness activities while maintaining connections through shared initiatives like global races. For effective global wellness, organizations must acknowledge lifestyle issues are global, adapt to local cultures, address region-specific health concerns, focus on productivity rather than cost containment, avoid relying on financial incentives, account for varying resource levels, and continue emphasizing leadership at all levels.
Remote parts of the world remind us of simpler living where wellness is naturally infused into daily life-walking instead of driving, manual tasks instead of electronic ones, locally grown food, natural sleep cycles, and tight-knit communities. These traditional practices offer valuable insights as we navigate our technology-driven world. Our challenge is finding ways to integrate these time-tested approaches into modern workplaces, creating wellness strategies that honor our biological programming while functioning within our cultural mandates.
