Employee well-being programmes have become a hallmark of modern employment, with many companies offering ‘perks’ that extend beyond monthly massages in an unused meeting room, or the occasional yoga session during lunch breaks. Increasingly, companies are encouraging their employees to participate in activities that promote health through programmes ranging from gym memberships and health screenings, to smoking cessation initiatives and mental health support.

‘Employee wellness is increasingly recognised as a critical component of business success. This trend is particularly pronounced in South Africa, where several listed companies are leading the way in fostering comprehensive wellness programmes,’ according to business consultancy Emergent Africa. ‘South African companies like Naspers, Standard Bank and Shoprite exemplify their commitment to employee wellness.’

However, in a world where the lines between employees’ personal and professional lives are increasingly blurred, a provocative question arises – can employers mandate their staff members to be healthy?

Few employees would be disgruntled if ‘forced to endure’ a massage, but what if your employer enforced a strict no-smoking policy that extended beyond the workplace? That was the situation that employees of Weyco – an insurance benefits administrator based in Michigan, in the US – found themselves in way back in 2005.

Weyco had a strict policy against the smoking of cigarettes – even when employees were not at work. In January of that year, the company began implementing mandatory breathalyser tests on its 200 employees. The company line was clear. Pass the test or pack your bags. Four of those staff members refused to take the test and resigned from the company.

It may sound like an old-school rule that belongs in the era of Y2K, but it’s not. Michigan is one of around 20 US states that do not have laws preventing employers from firing workers who smoke – even if it’s only a sneaky drag in the privacy of their home.

No one would argue against the rationale of deterring employees from smoking. Even the most dedicated nicotine puffer knows what the associated health risks are. And for employers, it’s a no-brainer – healthier employees are more productive, have fewer absences and incur lower healthcare costs.

However, the shift from encouraging wellness to mandating health is where the issue becomes contentious. It’s generally accepted that employers can – and should – offer health-related benefits, but the idea of compelling employees to adhere to certain health standards raises ethical and legal questions.

From a practical standpoint, the enforcement of health mandates is also fraught with challenges. Tracking and verifying compliance with health standards can be invasive and costly. Moreover, such mandates can lead to resentment and decreased morale among employees, counteracting any potential productivity gains. After all, trust and a positive workplace culture are considered essential for employee engagement and retention; over-reaching health mandates can undermine these crucial elements.

At the heart of the ethical debate is the concept of autonomy. Employees, as individuals, have the right to make their own health decisions. Mandating health behaviours can be seen as an infringement on personal freedom. For instance, requiring employees to quit smoking or lose a certain amount of weight intrudes into their personal lives and decisions.

Yet what happens when an employee’s so-called ‘wellness’ level has an impact on their productivity? A rotund office worker, for example, will in all likelihood conduct their work as well as their more svelte counterpart, making their weight a moot point. However, the same can’t be said of, for example, a police officer whose portly size could potentially impact their job performance.

‘Police officers should be able to walk with their head held high, their stomach in and chest out – not the other way around.’ Those were the words of then national police commissioner Bheki Cele, a comment made in 2010 during the lead-up to the FIFA World Cup.

According to a BBC report, Cele added that ‘new recruits should fit into the same size uniform for their whole careers. Officers needing a larger size will be given a year to slim down or face being kicked off the force’. It was a somewhat comical statement, and certainly not one followed through with. It has to be said, however, that Cele made a valid point, and at the time, SAPS recruits – and senior managers – were sent on mandatory fitness programmes.

Was it a fair move, considering that not all police officers – or any employee, for that matter – have the same starting point when it comes to health? The definition of ‘healthy’ is, after all, subjective and can vary widely among individuals and cultures. What one person considers a healthy diet might not be suitable or acceptable to another due to cultural, ethical or personal reasons.

It’s this subjectivity that makes it difficult for employers to set universal health standards that are fair and inclusive. Forcing employees to meet certain health criteria can disproportionately affect those who face greater health challenges, potentially leading to discrimination and inequity in the workplace.

Of course, employee well-being extends beyond physical wellness. Mental health has a particularly large impact on productivity.

In an online article, law firm Webber Wentzel explains that depression is one of the most prevalent mental health issues suffered by employees in the workplace. ‘Around 27% of South Africans suffer from depression. It is also estimated that employee absenteeism on account of depression costs the South African economy approximately R19 billion annually. From a labour law perspective, the Labour Appeal Court in the Jansen judgment accepted that depression should be looked at as a form of ill health within the workplace environment.’

The law firm goes on to explain that the employer is legally bound to attempt to reasonably accommodate the employee’s ‘disability’ – be it alternative work or reduced remuneration. ‘In addition, procedural fairness will entail that the employee has been properly counselled and the impact of their mental health issues on their performance or conduct has been discussed with them. An employee must also be provided with a fair opportunity to contest the employer’s conclusions about their mental health issues.’

In short, an employer – if aware of an employee’s mental health struggles – should offer support options, such as counselling, but they certainly cannot force their staff member to attend therapy.

Rather than mandating health, a more balanced approach might be to create a supportive environment that encourages healthy behaviours without being coercive. Employers can focus on education, providing resources and creating a culture that values and supports health and well-being. This can include offering flexible work hours to allow time for exercise, providing healthy food options in the workplace and promoting mental health awareness and support.

Moreover, personalisation of wellness programmes can make them more effective and inclusive. Tailoring programmes to meet the diverse needs of employees, rather than imposing one-size-fits-all mandates, can lead to better engagement and outcomes. For instance, offering a range of wellness activities and allowing employees to choose those that best fit their lifestyles and health goals can respect individual autonomy while promoting overall health.

The benefits of having a healthy workforce are undeniable, but the approach to achieving this goal must be carefully considered. While employers have a role in supporting the health of their employees, it’s a role that should be balanced with respect for personal autonomy and fairness.

Creating a workplace culture that values health and provides resources and support, without crossing into coercion, is likely the most effective and ethical path forward. Ultimately, health is a personal matter, and the best outcomes are achieved when individuals are empowered to make their own health decisions within a supportive and respectful environment.

Image: iStock