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Wellness Isn't Such a Foreign Concept to American Express Employees Overseas

The New York-based financial-services company has taken on such issues as food safety and prenatal care as part of a broader global wellness effort it launched in 2009.

May 16, 2012
Related Topics: Top Stories - Frontpage, Health and Wellness, Health Care Benefits, Benefits
CARE@Amex onsite clinic in Gurgaon, India

American Express workers seeking medical care at the company's on-site health clinic in Mexico City had two primary complaints: breathing-related problems including asthma and stomach ailments.

Benefits leaders for the New York-based financial services company couldn't do much about Mexico City's smoggy air. But they tackled food safety head-on as part of a broader global wellness effort the company launched in 2009. Since then, they've educated employees about which foods are more likely to cause stomach upset, installed more refrigerators at work and opened a cafeteria in 2010.

The investment already is paying off, says Dr. Wayne Burton, the company's chief medical officer. "For 2011, the absences and health care costs have been trending down month by month," he says, although company officials declined to provide specific data, saying it was proprietary.

Increasingly, multinational companies like American Express are looking beyond U.S. borders as they try to address sometimes long-entrenched health issues. As of early 2011, just one-third of 149 multinational companies—employing 5.2 million people in 37 countries—had implemented a global wellness strategy, a Towers Watson & Co. survey shows. But an additional 47 percent of the companies planned to do so within the next two years.

The global wellness efforts aren't spawned by fears of rising health costs, since non-U.S. countries typically have nationalized health systems, says Thomas Parry, president and CEO of the Integrated Benefits Institute, a nonprofit organization based in San Francisco.

Instead, he says, "They're really focused on workplace performance. And two of the pieces are absence from work and presenteeism while at work. And that's where wellness really comes in as an investment."

Leaders at American Express, which employs slightly more than half of its 60,000 workers outside the United States, decided to pair improved health and productivity assessments with locally tailored wellness initiatives.

Since 2009, they've beefed up some existing on-site clinics to treat more than just workplace injuries and they've rolled out education programs, including food safety in Mexico and a maternity coaching program in India. All overseas employees also can now access employee assistance programs, which is an uncommon benefit outside the United States, says Robert Holdom, the company's vice president of global compensation, health and benefits.

To collect data, health risk appraisals have been introduced in 10 countries with possibly more to follow. The appraisals also include eight questions from the licensed Work Limitations Questionnaire, or WLQ, which measures the effect of employee health on workplace productivity. "If you have healthier employees, they are going to be on-site more, they are going to be better engaged and they are going to hopefully have greater retention," Holdom says.

In research involving the banking industry published in 2005 in the Journal of Occupational and Environmental Medicine, Burton used the WLQ to help demonstrate the health-productivity link. Information was collected from employees regarding a dozen risk factors, including smoking, weight and high stress levels. Each risk factor translated to a 2.4 percent decline in on-the-job productivity. Annually, that productivity drain adds up, costing a company between $1,392 and $2,592 per employee, the researchers found.

Holdom says that American Express officials conducted an early analysis in 2010, looking at risk factors and productivity data from its call centers near New Delhi, India. "Basically the higher the number of risk factors that an employee had on average, the worse that their customer service scores were," he says, declining to release data pending possible publication.

American Express officials are striving to customize their global wellness effort country by country. Questions about eating or exercise habits are sometimes changed, depending upon the country being surveyed, Holdom says. The focus of wellness initiatives also can vary.

In India, where American Express officials identified a high employee cesarean section rate of 63 percent, a maternity coaching program was started in 2009 to emphasize prenatal care and the potential risks of abdominal delivery. By the following year, the c-section rate was 43 percent among those women who had completed the program, Holdom says.

The health clinics in India and Mexico also have been revamped and expanded to provide preventive screenings and treat minor health issues along with worksite injuries.

In both countries, the crowded streets and health clinics can make it difficult to get medical treatment elsewhere without missing an entire work day, Holdom says.

The on-site clinics "ensure that employees get access because some people are going to forgo it [seeking care elsewhere], and then the disease gets worse," he says. This sort of proactive effort, American Express officials hope, will demonstrably pay off in healthier and more productive employees at sites thousands of miles from the company's U.S. headquarters.

Charlotte Huff is a writer based in Fort Worth, Texas. To comment, email

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