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Employee engagement · 

4 minutes

Cormac O'SullivanPiggy

Navigating Presenteeism: Understand, Measure & Overcome

Far from being a sign of commitment, presenteeism – employees feeling compelled to work while sick – can have detrimental impacts on organizational productivity, mental wellbeing, and job satisfaction. In this article, we’ll delve into what presenteeism is, how it differs from absenteeism, how it can be measured, and most importantly, how it can be reduced.

What is presenteeism?

Presenteeism, unlike its better-known cousin absenteeism, is the practice of attending work despite illness, injury, anxiety, or other health problems that can interfere with one's productivity. It is a hidden productivity loss that can cost businesses up to 10 times more than the more visible cost of absenteeism. The Harvard Business Review notes that presenteeism costs American businesses over $150 billion per year, significantly more than the cost of absenteeism.

Presenteeism vs absenteeism

Absenteeism and presenteeism are two sides of the same coin, representing the issues that can arise when an employee's health, both mental and physical, is not at its optimum. Absenteeism is often easier to detect and manage since it involves the physical absence of an employee from work. This could be due to various reasons including illness, personal reasons, or burnout.

Absenteeism can lead to workflow disruptions and increased workload for other employees, impacting overall productivity. However, it also allows employees the necessary time to recover, leading to increased productivity upon their return.

Presenteeism, on the other hand, represents a more insidious problem. Here, employees, despite experiencing health issues or personal challenges, continue to show up to work. This could be due to job insecurity, lack of paid sick leave, pressure from management, or a work culture that rewards constant presence.

The key issue with presenteeism is that while an employee might be physically present, their productivity, creativity, and engagement levels are likely to be lower than usual. Unlike absenteeism, presenteeism is harder to detect and measure, but its impact on long-term productivity and employee health can be significant.

How to measure presenteeism

Measurement is complex because it's not about whether an employee is physically present but about their level of productivity and engagement while at work. Employers can measure presenteeism through anonymous surveys asking employees about their health and productivity. Stanford University’s Work Limitations Questionnaire and the World Health Organization Health and Work Performance Questionnaire are commonly used tools to assess this issue.

How to reduce presenteeism

Reducing presenteeism involves addressing its root causes and creating a work culture that values the health and wellbeing of employees. Here are more detailed strategies to address presenteeism:

Foster a Supportive Work Culture

The role of a supportive and understanding work culture can't be underestimated in the fight against presenteeism. Encourage open conversations about health and well-being and establish a culture where taking sick leave is not frowned upon but viewed as necessary for long-term productivity and wellness.

Mental Health Initiatives

Mental health issues are a significant contributor to presenteeism. Establish mental health initiatives that provide support and resources for employees dealing with mental health challenges. This can include on-site counseling, mental health days, workshops on stress management, and training for managers to detect and support team members who may be struggling.

Flexible Work Arrangements

Embrace flexible work arrangements that allow employees to adjust their schedules or work from home when necessary. This can help employees balance their health needs with their work commitments, reducing the need to work while sick.

Clear Policies on Sick Leave

Ensure clear and fair policies on sick leave. Employees should not fear job loss, missed opportunities for advancement, or stigma because of taking sick leave.

Regular Health Check-ups

Offer regular health check-ups to employees. Early detection and treatment of health issues can help prevent presenteeism.

Ergonomic Workplaces

Physical discomfort or injury at the workplace can contribute to presenteeism. Providing ergonomic furniture and promoting regular breaks can ensure employees are comfortable and reduce the risk of chronic physical ailments.

Reasons for Presenteeism

Presenteeism is driven by various factors, often deeply embedded in the work culture or personal fears of the employees. Below are more elaborated reasons:

Job Insecurity

In an unstable economic environment or competitive industries, employees may fear losing their job or missing out on opportunities for advancement. This can compel them to work even when they are unwell, leading to presenteeism.

Work Culture

In certain work cultures, long working hours and being always available are seen as indicators of commitment and dedication. Such environments can pressure employees to work despite illness, exacerbating presenteeism.

Insufficient Paid Sick Leave

If employees have limited or no access to paid sick leave, they are more likely to come to work while ill. In such cases, policy changes are needed to support the health needs of employees.

Mental Health Challenges

Untreated or unrecognized mental health issues, such as anxiety or depression, can significantly contribute to presenteeism. Employees might continue working while their productivity and mental health deteriorate. In such cases, mental health support and understanding from management can help address the issue.

Lack of Autonomy Over Work

When employees have little control over their work demands or schedules, they may feel unable to take time off when needed. This lack of flexibility can lead to a rise in presenteeism, particularly among employees juggling personal responsibilities and high-pressure jobs.


Presenteeism is a multifaceted problem with deep-rooted causes and wide-ranging impacts on productivity, employee health, and company culture. By recognizing the causes and implications of presenteeism, organizations can take proactive steps to reduce it, fostering a healthier, more engaged, and more productive workforce in the process.

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