This paper aims to explore the added value of healthy workplaces for employees and organizations, in particular regarding employee satisfaction, labour productivity and facility cost.
The paper is based on a narrative review of journal papers and other sources covering the fields of building research, corporate real estate management, facilities management, environmental psychology and ergonomics.
The review supports the assumption of positive impacts of appropriate building characteristics on health, satisfaction and productivity. Correlations between these impacts are still underexposed. Data on cost and economic benefits of healthy workplace characteristics is limited, and mainly regard reduced sickness absence. The discussed papers indicate that investing in healthy work environments is cost-effective.
The findings contribute to a better understanding of the complex relationships between physical characteristics of the environment and health, satisfaction, productivity and costs. These insights can be used to assess work environments on these topics, and to identify appropriate interventions in value-adding management of buildings and facilities.
Voordt, T.v.d. and Jensen, P.A. (2023), "The impact of healthy workplaces on employee satisfaction, productivity and costs", Journal of Corporate Real Estate, Vol. 25 No. 1, pp. 29-49. https://doi.org/10.1108/JCRE-03-2021-0012
Emerald Publishing Limited
Copyright © 2021, Theo van der Voordt and Per Anker Jensen.
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The WHO defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. As such, a healthy workplace can be defined as a workplace that contributes to the physical, mental and social well-being of its users. Health is the result of a complex interaction between the physiological, psychological, personal and organizational resources available to individuals and the stress placed upon them by their physical and social environment at work and home (Clements-Croome, 2018). Well-being reflects one’s feelings about oneself in relation to the world, personal feelings about motivation, competence, aspirations and degree of personal control.
The past decades show a growing awareness of the impact of the physical environment on peoples’ health and well-being, both in academic research and in professional publications. This may be because of the shift from a one-sided focus on cost reduction to a more holistic and integrated value-based approach and an optimal balance between costs and benefits of interventions in buildings, facilities and services (Jensen and Van der Voordt, 2017). Besides, people have become more aware of the impact of health and well-being on our quality of life and the risk of health complaints, illness or – in worst cases – burnout (Appel-Meulenbroek et al., 2020). The relationship between physical workplace characteristics and health and well-being has been explored by a variety of studies, using reviews of the literature (Forooraghi et al., 2020; Van der Voordt, 2021), surveys (Cordero et al., 2020), case studies (Bauer, 2020) and conducting short-term experiments using mobile devices (Nelson and Holzer, 2017).
It appears that in particular a poor indoor climate, noise and distraction have a negative impact on employees’ health and well-being, whereas appropriate opportunities to communicate and to concentrate and contact with nature contribute to a healthy workplace. In a survey of 2,000 office workers, occupants reported preferences for lots of natural light, access to outdoor spaces, contemplation spaces, support from colleagues and private as well as collaborative spaces, whereas the main irritants were noise in open-plan areas, lack of natural light, lack of colour, lack of greenery, lack of artwork, lack of fresh air, no personal control of temperature, lack of privacy, clutter and inflexible space (British Council for Offices, 2018).
Another frequently assessed factor is office type. A literature review by Colenberg et al. (2020) on the relationship between interior office space (layout, furniture, light, greenery, controls and noise) and employees’ physical, psychological and social well-being showed that open-plan offices, shared rooms and higher background noise are negatively related to health. Positive relationships were found between physical well-being and aspects that encourage physical activity; between physical/psychological well-being and (day)light, individual control and real/artificial greenery; and between social well-being and small shared rooms.
Other influencing factors on health and well-being are important as well, such as the context (cultural, social, economic, political), personal characteristics (age, gender, lifestyle), organizational issues (leadership, personal support) and job characteristics (work load, (mis)fit between demands and resources). The European Agency for Safety and Health at Work (2014) warns for a disbalance between high job demands and available job resources. Too little time, too much work and tight deadlines are the most widely recognized risk factors, resulting in sleep disturbance, changes in mood, fatigue, headaches and stomach irritability.
Healthy workplaces that support employees’ health and well-being can be a goal in itself, but may also have intended or unintended effects on other values, such as employee satisfaction, productivity, costs, corporate image and risk. Vice versa, values such as sustainability may contribute to health and well-being. For instance, green buildings are supposed to be healthier than non-green buildings, because of its focus on the triple P of people, planet and profit. Interrelationships between healthy workplaces and other values are much less studied. This paper aims to reduce this gap in our knowledge, and to answer two research questions: What is the relationship between healthy workplaces and employee satisfaction, productivity and costs? And which evidence is available for these relationships?
These three values turned out to be most frequently prioritized in interviews with corporate real estate and facility managers (Van der Voordt and Jensen, 2014). It is hypothesized that health, satisfaction and productivity go hand in hand. Furthermore, because of the high staff costs compared to facility costs, it is hypothesized that health-supportive interventions are cost-effective. Figure 1 visualizes the key topics of this paper in blue.
Because of a limited number of available publications, it was decided to select a number of leading journals in the field and to conduct a narrative review (Green et al., 2006; Ferrari, 2015). In our earlier review of environmental impact factors on healthy workplaces (Jensen and Van der Voordt, 2020), we checked four facilities management and corporate real estate management oriented journals in a 10-year period, covering 2008–2017: Journal of Corporate Real Estate, Corporate Real Estate Journal, Facilities and the Journal of Facilities Management. For the current paper, we extended our search to the period 2018–2021 and to other journals, based on paper citations and journal titles. We also screened the last six volumes of Applied Ergonomics, Building and Environment, Building Research and Information, Environment and Behavior, Ergonomics, Intelligent Buildings International and Journal of Environmental Psychology on the keywords workplace, health, well-being, satisfaction, productivity and cost.
All papers from the screened journals that discuss health in connection to workplace characteristics and satisfaction, productivity and/or cost were included in this review. This has resulted in a selection of 45 papers on health and satisfaction and/or productivity. Because very few scientific papers related to facility cost were found, we have included relevant industry reports and other publications. Papers that discuss the relationship between the physical environment and either health, satisfaction, productivity or cost, without discussing any interrelationships between these variables, have been excluded.
Table 1 summarizes the research topics, methods and findings of eight papers that discuss relationships between physical characteristics of the built environment, health and satisfaction, ranked by year and per year in alphabetical order of the first author. Five out of eight studies investigate the impact of office type and workspaces. The other studies focus on environmental conditions, sense of coherence or green buildings. The findings show positive but also contradictory connections between office type; health and well-being; and employee satisfaction. Open-plan seems to have a negative impact, which can be partly compensated by improved environmental conditions. High density and poor acoustics affect health and satisfaction in a negative way. The green building study showed mixed results. Personal characteristics make a difference as well. Employees with high need for concentration report more distraction in all office types, except in cell, and more cognitive stress in all office types except cell and flex-offices. People suffering from claustrophobia perceive stronger effects.
The findings on relationships between health and well-being and labour productivity are summarized in Table 2. Four studies focus on office type and workplace concept (open-plan, work pattern–office type fit, high-performance hub, variety of workplaces). Five studies investigated the impact of indoor air quality (IAQ) and related issues such as thermal comfort and look-and-feel. Four studies focus on sit-stand/adjustable workstations. The other studies show a variety of research topics, i.e. the influence of a healing office design concept, wind-inducing motion of tall buildings, green buildings, workplace safety, biophilia, plants and time spent in the office. The findings show significant positive but also mixed impacts of IAQ, “green” buildings and sit–stand work on both health and productivity. Health and productivity are usually discussed separately; correlations between health and productivity were only explored in two studies. Interrelationships are affected by job demands and job stress
Table 3 summarizes the findings from 17 studies on health and well-being and both satisfaction and productivity. Independent variables include office types, non-territorial workspaces, proximity, impact of break out areas, storage space, adopting the WELL criteria, indoor environmental quality (IEQ), shading conditions, sit–stand workstations and plants. Here, too, health, satisfaction and productivity are mainly discussed separately and less regarding possible correlations. In general, activity-based workplaces are perceived to have a positive impact on satisfaction, partly because of better technical qualities regarding IEQ. Searching for a workplace needs time and reduces productivity. Personal control, easiness of interaction and communication, availability of break out areas, windows, sit–stand workstations, comfort of furnishing, attractive IEQ, modern shading systems and applying to the WELL standard show to have a positive impact on both health and satisfaction, whereas distraction and lack of privacy are important predictors of productivity loss.
All presented studies on health in connection to satisfaction and/or productivity originate from Europe, USA, Australia and New Zealand.
The discussed papers on health and satisfaction and/or productivity show a variety of research designs and research methods (Table 4). Ten studies conducted a before–after study; four studies used an experiment in a lab setting. About 80% of the presented studies used a questionnaire survey, some of them as part of a mixed-methods approach with interviews and observations, identifying healthy or unhealthy office design qualities, scores on the WELL standard and data about toxic substances in the air. Measuring physical conditions such as the heart rate or skin temperature is rather rare.
Clements-Croome (2018) mentions a return on investment of €5.7 for every euro invested in well-being. However, not much quantitative data was found about the financial impact of changing the spatial layout, supporting new ways of working, providing more contact with nature or the introduction of sit–stand desks. This may be because of the difficulties to quantify the results of healthy workplaces. Various papers discuss the monetary costs and benefits of health-promoting programs such as stop-smoking programs or providing sports facilities and healthier nutrition. However, these topics are not related to physical characteristics of workplaces and are beyond the scope of this paper. Table 5 summarizes the findings from 11 publications. Different research methods are used, such as literature reviews, surveys and analysis of sickness absence data (8 out of 11 studies) and costs. Some studies focus on the impact of stress, without clear links to physical characteristics. Not all project data on financial costs and benefits has been tested scientifically on reliability and validity.
The discussed studies show a huge variety in environmental characteristics that influence health and well-being, employee satisfaction and labour productivity, such as office type, proximity, density, IEQ of IAQ, furniture (ergonomics, sit–stand desks), plants and personal control. Some studies focus on specific building types such as certified green buildings, WELL-certified buildings and tall wind-excited building, specific building components such as shading systems or specific interior elements such as sit–stand desks and furniture comfort. Research methods range from questionnaire surveys to before–after studies and laboratory experiments. Measuring physical conditions such as heart rates and skin temperature is still underexposed. Remarkably, most discussed papers present findings on health and satisfaction and/or productivity without discussing correlations between health, satisfaction and productivity.
The reviewed studies indicate positive but also mixed and contradictory effects of healthy workplaces on satisfaction and productivity. Overall, a healthy IAQ, opportunities for communication, concentration and privacy, availability of break-out rooms, an attractive look-and-feel, ergonomic furniture, contact with nature and plants go hand-in-hand with higher employee satisfaction and perceived productivity. Large open-plan offices and centrally controlled air condition show a negative effect on health, satisfaction and productivity. There is some evidence that workplaces in green buildings are healthier than workplaces in conventional buildings. Adjustable workstations with sit–stand desks show to have beneficial effects for comfort and labour productivity. Practitioners should take these findings into account in their design and management activities.
What constitutes a healthy workplace is much dependent on the workstyles and the preferences of the users. The degree to which the workplace has impact on satisfaction is in particular dependent on user preferences in relation to privacy versus social contact. The impact on productivity is in particular dependent on the specific workstyle and how well the workplace supports the work activities. Involving the users in the planning process and change management during implementation is crucial.
Scientific research on monetary cost and benefits of healthy workplaces is limited. Overall, the data indicate a positive impact of healthy workplaces on the reduction of sickness absence.
Because of the impact of many interrelated variables, it is difficult to trace cause–effect relationships between characteristics of healthy work environments and support of other value dimensions. Usually, various interventions are conducted simultaneously. Furthermore, employees’ health not only depends on what the workplace does to employees, but also on what workers bring with them to the workplace.
The mixed findings make it hard to provide a sound business case for physical interventions to improve health and well-being. On the one hand, taking care of healthy work environments is a matter of moral responsibility and has in general a positive effect on employee satisfaction and labour productivity and on society as a whole. These advantages have to be balanced with the costs of interventions to provide more healthy environments. An obstacle for a more integrated, holistic business case may be that the cost of interventions and its resulting output and outcomes are not always easy to measure in a quantitative way. Another difficulty is that some outcomes might be experienced in the short term and perhaps only temporarily, while others might be sustained, reduced or only experienced in the long term. One solution is to base business cases not only on quantitative data but to take into account well-argued qualitative considerations as well. As such, we plea for a so-called value based business case or “value case”.
Additional research is needed to get a deeper, holistic and evidence-based knowledge of the added value of healthy workplaces and interrelationships between health, satisfaction and productivity and financial impacts that integrate different research topics and research methods. A next step can be to use the research findings as input to follow-up transdisciplinary research by academics from different fields, including corporate real estate management, facilities management, human resource management, environmental psychology and work and organizational psychology. Reflections on data by an interdisciplinary team and experimenting with particular interventions may be helpful as well.
Other topics for future research are extension of this literature review with papers from other journals and databases such as Scopus and PubMed, and to conduct additional empirical research with before–after studies of particular interventions and data-collecting techniques such as workshops, group interviews, pilot projects and self-measurement of health and health-supportive behaviour, e.g. by using wearables and apps. Cost studies should not only focus on data analysis of sickness absence, but extend their scope to self-reported health risks and health conditions, to get a better understanding of what drives health costs and lost productivity (Jinnett et al., 2017). Besides, more studies are needed into the costs of particular interventions and return on investment.
A particular topic for further research is the use and experience of offices in the post Covid-19 period. Increased “infection risk mitigation” will affect the presence in the office, number of people per m 2 , need for fresh air access, etc. The Covid-19 crisis has resulted in a drastic increase in home working and this experience is likely to have profound implications for office work in the future.