The UK is in a presenteeism crisis but before taking action, HR must understand exactly what presenteeism is. This article will give you a mature understanding of presenteeism and why it’s important.
A follow-up article tells you how to tackle presenteeism and why your current approach might be exacerbating the problem.
Presenteeism definition: its early days as a sign of excellence
Presenteeism has negative connotations but this hasn’t always been the case.
Stolz (1993) defined it as “exhibiting excellent attendance,” while Smith (1970) called it “attending work, as opposed to being absent.”
These definitions are reflective of the view – still prevalent in the workplace – that ‘face time’ is an important part of being a good worker. Organisations are increasingly tackling this view through flexible working and policies of managing by outcomes, not presence.
Medicalisation: linking presenteeism with illness
Over time the term was linked more clearly with illness and contrasted with absenteeism: it was medicalised, in effect.
For example, Kivimäki et al (2005) defined presenteeism as “being unhealthy but exhibiting no sickness absenteeism.”
Scholarly interest grows: linking presenteeism with productivity
As organisational scholars became more interested in presenteeism, it was linked to its effects on productivity and – because wellbeing is aligned with productivity – with the broader employee wellbeing agenda.
To illustrate, Turpin et al (2004) defined presenteeism as “reduced productivity due to health problems.” Note that the link with medical illness, as mentioned in the previous section, is still there.
The problem with defining presenteeism by its link to productivity is that it begs several questions: is anyone fully productive at any time? Don’t we all have things going on in our lives that distract us, but which don’t qualify as medical issues? And when does being human (and therefore experiencing natural dips in productivity) cross into presenteeism?
Also, productivity is such a personal thing that without a baseline for each individual it’s very hard to measure changes.
Miraglia and Johns (2015) make the point that presentees vary in how productive they are due to many personal and contextual circumstances, such as the degree of impairment caused by illness.
One person, for example, may be so affected by illness that coming to work is a clear case of presenteeism, whereas someone else could be totally unimpaired by the same illness, come to work, and exhibit no signs of presenteeism.
A broader definition of illness: focusing on ‘other events’
As the presenteeism debate matured, scholars increasingly took a broader overview of the reasons people display presenteeism.
Whitehouse (2005) called presenteeism “reduced productivity at work due to health problems or other events that distract one from full productivity.”
The key phrase here is ‘other events.’ This is important because it recognises that reasonable reasons for staying off work are not always clinically significant or even medically-related.
This brings presenteeism in line with the diversity movement, which is about viewing everyone as individuals with unique needs, including the reasons that lead that person to seek absence from work.
However, the problem with this definition is that it links presenteeism to a fall in productivity, which is not always the case.
Presenteeism definition: a good choice for HR
Evans (2004) uses the phrase ‘other events’ too, but crucially his definition does not make any judgements on productivity:
“Going to work despite feeling unhealthy or experiencing other events that might normally compel absence (e.g. childcare problems).”
This definition makes sense for HR to use for a few reasons:
- It does not ascribe automatic consequences to presenteeism: this is important because we need to remember presenteeism can produce positive consequences as well as negative and we mustn’t assume it will always go one way or the other
- It doesn’t make judgements on productivity: presenteeism may reduce productivity but productivity is relative: if someone is at work rather than absent, their productivity may naturally be higher, but their long-term health may suffer. Or it may not. We need to be careful not to generalise the productivity consequences of presenteeism because it’s a very individual formula.
- It doesn’t presume what ‘unhealthy’ or ‘other events’ actually means: taking a broad view is very important here. People’s physical and especially mental health are unique and so are their reasons for why they need to be absent from work. In fact, a common cause of presenteeism is employees thinking their reason for absence would not be considered appropriate by the organisation.
- It doesn’t exclude positive reasons for presenteeism: we must not assume why people go to work when ill. This is important because people often attend work when ill for positive reasons. Police officers, for example, will go to work when ill because “they don’t want to let colleagues down.”
Adopting a definition of presenteeism as suggested by Evans above, we are naturally led onto a very important question when trying to solve presenteeism: what do we mean as an organisation when we say unhealthy and other events? What do employees mean? Are there mismatched expectations?
The next questions then become: what makes people feel like they have to come to work when feeling unhealthy or experiencing other events? Are there policies forcing employees into ‘face time?’ Is their line manager putting pressure on them to come in when ill? Are there cultural issues? Do they feel too emotionally committed to the organisation?
Following this path, you can move from a concrete definition of presenteeism to a strategy for addressing it in your organisation.