Organizational Wellness

How to Reduce Presenteeism in the Workplace

Dec 23, 2023
Last Updated May 24, 2024

Coming to work when sick or struggling often feels non-negotiable. Employees often think pushing through shows dedication, but it actually hampers productivity. This phenomenon is called "presenteeism." 

While the impulse is understandable, the impacts are far-reaching. Presenteeism decreases productivity, spreads illness, diminishes inclusion efforts, and costs companies billions each year. And, when chronic, it can morph into quiet quitting.

As an HR leader, addressing presenteeism is foundational to nurturing a productive work environment. Let’s dive into effective strategies you can use to tackle this $1.5 trillion issue.


What Is Presenteeism in the Workplace?

Presenteeism is when your employees  show up to work, but they’re not fully focused. This can be caused by a variety of distractions, from stress to health complications, or injury. Essentially, someone does come into the office (or signs in on Zoom), even though they aren’t able to do their best work. . 

Presenteeism vs. Absenteeism

Absenteeism and presenteeism are  close cousins, but they’re not exactly the same. Absenteeism is when an employee consistently does not show up to work. Presenteeism is when they do show up, but they don’t get much done. Both situations decrease productivity, but presenteeism is much harder to spot.

The Underlying Causes of Presenteeism

There can be a lot of factors that play into the prevalence of presenteeism at your organization. They fall into two major buckets: workplace and psychological. 

Workplace Factors

Sometimes structures within a company lead to presenteeism, like:

  • Modeled behavior. What does your leadership team do when they’re sick or feeling unwell? If they continue to show up and “push through,” that can create a culture where that’s expected for everyone. On the flip side, if leadership takes sick days and mental health days, they help normalize that for everyone. 
  • Job insecurity. If your team members are worried about their jobs, they’re going to be reluctant to take a day off. People worried about that could choose to come to work distracted, not getting anything done. 
  • Lack of sick leave. If your company simply doesn’t offer enough sick days (or offer mental health days at all), people are going to have to show up. They don’t have another option. 
  • Heavy workloads. When employees have heavy workloads where deadlines are tight, they may not feel comfortable taking a sick day. They’re worried about letting their teams down and missing deadlines, so they “push through” when they should be resting. 

Psychological Factors

Norms and culture in a workplace can also foster presenteeism, including:

  • Stigma surrounding sick days. There’s a prevalent stigma around using sick days, even when someone is actually sick. Researchers found that two-thirds of them felt their bosses didn’t believe them when they called in sick. On top of that, it’s women of color who feel this stigma more than anyone. Black and Hispanic women are more likely to work while sick because they fear repercussions at work. 
  • Fear of falling behind. Intertwined with that thought is the fear of falling behind. When work piles up on a good day, it can be hard to justify taking a day off without falling behind. 
  • Quiet quitting. This mindset is where employees don’t quit their jobs but quit the idea of going above and beyond. Long-term quiet quitting can develop into chronic presenteeism. 
  • Pressure to appear dedicated. One of the most mentioned characteristics of a dedicated employee is high attendance. While attendance is highly valuable (hence why absenteeism is also a problem), there’s this cultural idea that pushing through on the bad days means you’re somehow more dedicated than everyone else. Hence why too many people come to work unwell. 

Consequences of Presenteeism

What happens when people come to work but aren’t really there? Here are three big outcomes: 

Lost Productivity

It might seem, in theory, to be better for someone to show up sick than not show up at all. Unfortunately, that’s not true.

There’s a large productivity gap between an employee who can be fully present and one who is just physically there. Those who are fully present get more done than those who just show up or sign on. On top of that, unwell employees who are still at work are more likely to make errors — and mistakes can be dangerous in industries like healthcare and construction. 

Health Implications

Within a few hours, a sick employee can infect 50% of high-touch surfaces in the office. That means a single ill employee can get several coworkers sick, creating a major absenteeism issue within a department or company. Plus, when employees are pushing themselves early in their illness, they can extend the time they’re sick

Impact on Workplace Morale and Inclusion

When an employee comes in sick, it can affect the workplace morale. Often, their lower mood can drag down the mood of their teammates—leaving everyone feeling worse. 

Plus you have the considerations from earlier. POC are more likely to feel the impacts of the sick day stigma, so when you’re letting presenteeism fester, you’re not creating a fully inclusive environment. 


Absenteeism might cost your company, but presenteeism could potentially cost you more. It’s estimated that presenteeism costs 10 times more than that of absenteeism. Absent workers cost employers around the US about $150 billion per year, while the sticker price of presenteeism is an estimated $1.5 trillion per year.

Measuring Presenteeism

How can you tell if presenteeism is rampant in your workplace? It can be hard to tell. Presenteeism is difficult to measure. That’s why most companies will look for signs that there could be a problem. 

Recognizing the Signs

If you are trying to identify if your company has an issue with presenteeism, signals you can look for include: 

  • Low productivity. Presenteeism contributes to lower productivity. So if you’re finding you have low productivity in your workplace, there are probably a variety of factors that are causing that, but one might be presenteeism. 
  • Lowered quality. When sick employees are more likely to make more mistakes, you could also notice lower quality work.
  • Illness runs rampant. If your employees are sick often, that may be because they’re getting each other ill because they’re all coming to work feeling poorly. 
  • Few sick days are used. If your employees aren’t using sick days, it’s probably not because they’re all magically never ill or feeling down. It might be because they’re simply not using their allotted time off. 

Gathering Feedback

One of the best ways to know if something is happening is to simply ask your employees. If you’re unsure if your workplace is experiencing a problem with presenteeism, consider gathering feedback to see. You could run an anonymous survey to see how many of your employees are working sick or avoiding taking a mental health day. 

Strategies to Reduce Presenteeism

So presenteeism is bad news, but what can you actually do about it? While there’s no silver bullet, there are steps you can take to tackle this issue.  

Reevaluating Leave Policies

Step one is to consider your leave policies. In general, if employees can’t take sick time, they’re going to come in sick. So why not consider adjusting leave policies, so everyone can take sick days and mental health days when they need? 

Here are just a few of the ways your team could consider updating your leave policies: 

  • Offer mental health days. One way to consider updating your policies is to include mental health days as a part of your benefits package. Mental health days are an appropriate use of sick time, but creating special mental health days could let employees take a day off for their mental health when they need to without eating away at their sick time. They may need that later for the flu.
  • Don’t make employees earn time. Having your employees put in hours to receive sick days could make those days feel like a reward. Instead, you might consider allocating all of your employees a reasonable amount of sick days. 
  • Offer paid sick days. Seventy percent of employees said they couldn’t financially afford to take an unpaid sick day off, according to a Theraflu survey. So to counter this problem, your company could offer your employees paid sick leave where they can rest without the financial strain. 

Modeling Wellness

An effective way to combat presenteeism can be encouraging leaders, managers and CEOs to use their sick time and to avoid presenteeism. Encouraging leaders to model wellness to their teams can help workers with less seniority feel justified in taking a sick day when needed. After all, the CEO does it too! 

Educating Employees

Your employees might not understand presenteeism and its potential consequences. They’re focused on the task at hand, they might not know that they’re lowering productivity and morale, or getting colleagues ill.

Educate your employees on presenteeism and its negative effects may help curb the issue. You might consider workshops where you outline the problem and thoroughly explain the leave policies, so everyone knows exactly how to take a sick day or a mental health day. 

Wellness Programs at Work

Why not just nip the problem in the bud? Wellness programs are a way to help improve the overall wellness of your employees to keep them healthy and reduce the number of sick days they need in the first place. In fact, 52% of employees say that employee wellness programs have reduced their number of sick days.  

Embracing Flexibility

Your employees are all unique individuals with a variety of needs. It’s hard to create a universal policy that will appropriately accommodate for every need. So why not embrace flexibility? When your company utilizes flexibility, you’re allowing employees to adjust their schedules when needed and maybe their work environment if necessary. For example, maybe someone needs a morning off for their mental health, but they’re happy to hop on some Zoom calls in the afternoon. Allowing for flexibility can empower your employees to take care of themselves in the way that works best for them. 

Leverage Wellbeing to Boost Productivity

Presenteeism is a complex issue, but all of the solutions have a simple through line: Employees are more productive when they feel good

Your company can cut presenteeism off at the root with an employee wellbeing program. When nine out of 10 workers say their physical wellbeing impacts their productivity, helping employees get up and move helps boost your bottom line.

More than 15,000 companies trust Wellhub with their workforce wellness. Talk to a Wellbeing Specialist today to start taking advantage of employee wellness!

Company healthcare costs drop by up to 35% with Wellhub! (* Based on proprietary research comparing healthcare costs of active Wellhub users to non-users.) Talk to a Wellbeing Specialist to see how we can help reduce your healthcare spending!



Wellhub Editorial Team

The Wellhub Editorial Team empowers HR leaders to support worker wellbeing. Our original research, trend analyses, and helpful how-tos provide the tools they need to improve workforce wellness in today's fast-shifting professional landscape.


Our weekly newsletter is your source of education and inspiration to help you create a corporate wellness program that actually matters.

By subscribing you agree Wellhub may use the information to contact you regarding relevant products and services. Questions? See our Privacy Policy.