What Are Wellness and Well-Being?

After our January summit in Chicago, we looked for basic grounding in wellness and this new relationship between building science and medicine. We scheduled our next summit at the Mayo Clinic and specifically for the WELL Living Lab.

I drove in from the Rochester, Minnesota, airport to the Mayo Clinic in mid-March to prepare our first summit for this book. I passed several closed office buildings. Except for the Mayo Clinic, dominating downtown Rochester, the rest of the city looked like a lot of declining Midwestern towns. Rochester is, in fact, a “factory town”: it produces health like few other places in the world. Their unique approach to team-based medicine attracts patients with complex medical needs. Speaking of his Walmart days, Tom Emerick said it was far better, and more cost-effective, to fly employees requiring expensive and complex treatment—and their families—to the Mayo or Cleveland Clinic than use local hospitals.

A decade ago, the mention of well-being in the boardroom would have been met with a round of blank stares, rolling eyes, or hushed giggles. While progress has been achingly slow, the concept is finally making its way into executive suites and workplaces around the world.³

—Kate Lister

The Mayo Clinic pays its doctors salaries instead of fees per procedure. That philosophy and practice stand opposite the traditional assembly line approach of seeing as many patients as possible and then quickly passing them on down the line. The Mayo doctors, instead, focus on whole care and outcomes. Of the 34,000 employees on its Rochester campus, about 4,000 are doctors. Rochester's next largest employer, the public school district, employs just under 3,000 people.

Mayo, ground zero for health in America, was the ideal place to begin our series of summits. And that is where we started with the ground zero of questions: What is wellness?

Webster's 1828 dictionary did not even include the word “wellness.” Apparently, the earliest use of the word simply conveyed the opposite of being ill.⁴ Webster now defines wellness as: “the quality or state of being in good health especially as an actively sought goal.” And HealthCare.gov defines wellness through programs “intended to improve and promote health and fitness.”⁵

The plot thickens when we turn to the Society for Human Resource Management (SHRM), the self-described “leading provider of resources to serve the needs of HR professionals and advance the professional practice of human resource management.” It describes the means or tools a company may use for achieving wellness. Typical benefits in a wellness program include smoking cessation, weight loss, stress management, company gym/workout rooms, recreational programs such as company-sponsored sports teams, medical screenings, and immunizations/flu shots. Also included are educational safety and accident prevention programs that provide information and guidance on topics such as back care, cancer prevention, and AIDS awareness, as well as proper eating and exercise habits. All these benefits can be administered within an employer's employee assistance program or could be stand-alone programs.⁶

A lot of companies talk about wanting to improve work-life balance, but then only solve for “Work.” It's time to make “Life” a factor in creating great workplace experiences with support that help individuals renew and stay energized throughout the day…“Work” will improve exponentially if we were to just focus on “Life.”

Bryan Berthold, managing director, Workplace Strategy & Workplace Experience, Cushman & Wakefield

But ask any person how they define wellness, and you will hear definitions as varied as the people responding. And that is where our problems begin. If we don't have a common understanding of what we hope to achieve, it's impossible to set a course.

Fuzzy Wellness

Because the definitions of wellness often have no context, they have no meaning. They are static, technical, and focused on means without anyone really asking, “To what end?” After the first few months of diving into the research, I felt a degree of vertigo about any attempt to understand or define wellness. Everyone uses the same or similar words, but each with different meanings, priorities, mixes, and intents.

I found that a few companies had an origin story, some form of epiphany or “aha” moment that set them on a search for wellness—not a wellness program. Those leaders talk about their journeys. They and their companies—GoDaddy, Barry-Wehmiller, Tuthill, Cummins, NextJump, Google, Idibri, MeTEOR, DPR, and others—knew their starting point, why they were on their unique journey, and they knew the distance to (and carried good pictures of) their destination.

Naturally, I also found some companies that had robust programs, but no story. They measured their success not by some image of a better future for their employees but in cold metrics like participation or health costs. It is hard to convey just how distinct those two camps were. With the first group, our conversations lasted several hours and included stories, authentic discoveries, failures, and lessons. Those leaders were open, comfortable, and not defensive.

My conversations with the second group seldom lasted an hour. Questions traveled well-paved roads. When I asked an off-road question, the conversation hit a wall of abrupt silence. Of course; my questions took them off script. So, they could only respond with, “How will you be using this information?” Or, “I have to check with our Communications department and get back to you.” Before my conversation with one senior HR executive, I had to submit all my questions and allow five weeks for them to “research” the answers. I understand those responses, especially with an unknown outsider. I'm simply trying to describe the stark contrast between companies with healthy cultures and those trying to implement programs.

High Touch

We spent the first part of our Mayo Clinic time examining the terrain of health and wellness definitions, the differences between wellness and well-being, the meaning of “holistic,” and other conceptual landscapes. Words fluttered about the room like butterflies. But then I watched them all settle around the need to humanize our approaches to humans.

That led to an observation that programs, in general, strip away the human experience and are too often delivered as a one-size-fits-all approach. What surprised us was that no one, even our wellness experts, considered corporate wellness programs and other efforts as helping or enhancing wellness or a sense of well-being (except some employee assistance programs).

We discussed corporate cultures—known to us—that did express genuine employee care through a myriad of workplace initiatives, such as flexible work policies, paid time off, personal development opportunities, engaging workplaces, e-mail–free zones, and kid-friendly (and even pet-friendly) environments. We also learned that the efforts most valued by employees were inexpensive, creating connection, encouraging community, designing convenience, simplifying processes, providing coaches, and feeling valued in a time of need.

Thirty-five years ago, John Naisbitt captured the same tension between cold efficiency and the human touch: “Whenever a new technology is introduced into society, there must be a counterbalancing human response—that is, high touch—or the technology is rejected…We must learn to balance the material wonders of technology with the spiritual demands of our human nature.”⁷

Our summary question became, “How do companies create that human touch?” You will read about the best of those in Chapter 14, Courageous Leaders and a Culture of Care, and Chapter 15, Emily's Story: Creating a Movement from the Second Chair.

What Does It Mean to Be Human at Work?

Corporate wellness was designed in the 1970s to detect and prevent the rise of chronic disease. As employee health-related costs began to double, wellness became a means for reducing cost and improving the return on investment. When that didn't happen, the rationale for wellness shifted to improving the attraction of talent. That didn't happen either. The most recent claim for wellness credibility is improving engagement, which it doesn't. Wellness is still in search of a clear identity and value proposition, with “well-being” as the latest addition to the conversation.

Steve Carter, a member of this MindShift project, raised the question, “What does it mean to be human at work?” Steve, who had recently completed his doctorate in virtues-based leadership, explained (over drinks and meals with the team) the relevance of ancient Greek thinking by describing human “well-being” as (eudaemonia). The modern English translation of the word comes down to human flourishing. If we peel this back one more layer, we arrive at the prefix eu-, “good” or “the good.” The word “being” refers to soul or spirit. Thus, the roots of well-being literally mean: good + spirit.

The Greek concept of good is excellence, mastery, or virtue. Mastery is an intrinsic pursuit. Martin Seligman describes moral virtues as something we seek more of, not less. For example, we want more justice, honesty, wisdom, courage, and knowledge—not less. And these all have intrinsic worth and, therefore, do not require outside pressure, motivation, or manipulation.

Seligman's pioneering research examines the traits of those who flourish. One of his studies compared soldiers returning with PTSD. He found, however, a group with a different kind of PTSD, post-traumatic strength syndrome. These were soldiers whose traumatic exposures to death and violence proved to make them stronger and “more human.” He found five attributes that they possessed. As summarized in his book, Flourish: A Visionary New Understanding of Health and Well-Being, the attributes create the acronym PERMA; positive emotion, engagement, relationships, meaning, and accomplishment.⁸

Aristotle defined happiness as human flourishing. If being human at work is the opportunity to grow and flourish through mastery, we must have completely different conversations about workplace wellness or well-being. We must realize that the workplace provides an opportunity for all the elements in flourishing: PERMA. This truth really does flip our assumptions about workplace health. It may also flip our strategies.

Intrinsic desires more naturally succeed. Anything that relies on external levers will need to be continually propped, pumped, and hyped to stay alive. They may serve as a starting point but quickly fade. Employees instinctively feel the difference. One feels like it is provided for me, while the other feels like it is done to me.

So, What Is the Point?

As I told you in Chapter 3, a Japanese survey revealed that more than a million poll respondents named “spiritual aridity,” or dryness, as the biggest threat to their country. You and I see some versions of that every day in America. Many in our workplaces seem to have lost a sense of why (purpose) and to what end. But that sense of futility starts well before work.

In catching up with an old friend over lunch recently, he surprised me by probing below the surface, “So Rex, how are you doing? What are your long-term plans?”

I paused, took a breath, and thought about his question. If a true friend digs that deep, I will try to answer from the same depth.

“Mark, right now I have a book deadline and three kids who are all freshmen in college. My mother-in-law just died, and my father-in-law moved in with us. We are temporarily taking care of a homeless person, and we have four dogs. I'm doing the best I can to keep up. I'm not sure I can see past these next several months let alone the next few years.”

Mark understood, responded graciously, and shifted to a story of his cab driver, an immigrant from Congo who would love to have our problems. I nodded; sure, I got it. But his questions made me wonder if I'm among the multitude on a treadmill or on a journey heading toward PERMA.

Workplace wellness has too often become a means-driven conversation, focusing on the how, and not the why or the who. It has become a convoluted and complex hairball of competing constituencies, too many vendors, and big bandwagons. But, it seems that very few leaders or managers operate out of any vision of human flourishing.

But we must and can rise to that higher ground of leadership. We can discover, enhance, and increase the value of “being human at work.”

Ed Strouth, who along with Laurie Ferrendelli runs Barry-Wehmiller's wellness and education programs, told me about getting “reschooled” by Bob Chapman when he was promoted to director of health and well-being. Bob's predecessor was a more traditional HR person, who focused on cost and risk. Ed naturally prepared for his first budget meeting with Bob as he would have prepared for Bob's predecessor; multiple spreadsheets, program justifications, comparisons to the previous year's spending, etc.

Then, Bob asked him one question: “Is this the right thing to do for our employees?”

“Yes.”

“Then I don't want to see a spreadsheet brought to a future meeting.”

Bob's message was clear. Barry-Wehmiller's justification, or WHY—”Is it the right thing to do?”—said that the numbers, while important, should not drive any wellness decisions. Josh Glynn from Google relies on extensive data but is equally clear on WHY. He said Google's mission is “We help Googlers lead full lives in order to sustain a culture that can change the world.”

Our team built a “ladder” during our Mayo summit. It has proven useful to some leaders as an assessment of where a company is on its journey to wellness. The ladder begins with tactical challenges. The next rungs move into strategic goals. The higher rungs, transformational opportunities, require greater leadership participation, coalitions between departments, deeper stakeholder voices, and a reshaping of cultural norms.

The Bottom Rungs—Tactical Goals

• Repackaging current benefits
• Reducing cost and risk

The Next Rungs—Strategic Goals

• Attract and retain talent
• Gain a competitive advantage
• Enhance the brand

The Higher Rungs—Transformational Opportunities

• The rude awakening
• Transforming the business
• Alignment to our values and culture
• Changing the industry

Each rung requires higher and broader commitment and more resources. The calculus also shifts from budget line-item cost controls over to more complex relationships, influencing organizational performance. When you evaluate your company's current location on the ladder, you may find the program, messaging, resources and systems, leadership, and employee experience all on different rungs. That is more common than clean alignment, and it also offers an immediate opportunity for increased effectiveness.

The work of aligning these can be messy like cleaning out an attic. You may need an outsider to lift the process above the understandable emotions of the process.

Finding that common starting point with a “ladder” was, perhaps, the most valuable work we accomplished together at the Mayo Clinic summit. Our collection of leaders from different companies was probably like leaders inside any company. We came with different experiences, expectations, biases, and assumptions, and our first instincts were to bolt those onto existing frameworks and fuzzy notions of wellness. The ladder concept helped us to find the same sheet of music.

The ladder also helps companies ask, “Do we start with designing a better program?” Or “Can we use our program to build a better company?”