Workplace Productivity Cost Associated with Psychological Distress in the United States

Details

• Journal Article:
  American Journal of Industrial Medicine
• Personal Author:
  Asfaw, Abay ; Alterman, Toni ; Pana-Cryan, Regina
• Description:
  Introduction: Psychological distress (PD) is negatively associated with workplace productivity. Objective: To estimate the potential workplace productivity cost of PD related to absenteeism and presenteeism in the United States, and to break down this cost by broad industry sector. Method: We used data from the 2021 National Health Interview Survey, which included questions on absenteeism and presenteeism, and applied a human capital approach to quantify absenteeism and presenteeism cost associated with PD. We measured PD using the Kessler Psychological Distress Scale (K6) and categorized the presence or severity of PD as: no (K6 = 0), mild (K6 = 1-4), moderate (K6 = 5-12), and severe (K6 ≥ 13) PD. We used workers reporting no PD as the reference group. Our regression models included sociodemographic, economic, health, and workplace covariates. Results: In 2021, 16,356 sampled adults represented 151 million US workers. Among these workers, 3.8 million (2.5%) reported experiencing severe, 24.0 million (15.9%) moderate, and 57.4 million (38.0%) mild PD. Our regression estimates suggest that the total PD-related absenteeism and presenteeism cost that year was between United States Dollars (USD) 90.1 and 118.2 billion, excluding additional costs related to injury, turnover, disability claims, and early retirement. We also observed statistically significant differences in estimated total and per-worker cost of PD across seven broad industry sectors. Total PD-related cost was highest in the services sector (USD 53.9 billion), followed by healthcare and social assistance (USD 19.7 billion) and wholesale and retail trade (USD 12.4 billion). On a per-worker basis, we observed the highest cost in healthcare and social assistance (USD 950), services (USD 732), and wholesale and retail trade (USD 731). Conclusion: Our findings showed large and uneven burden of PD across different industries manifested through absenteeism and presenteeism. This burden may be reduced, and productivity enhanced, through improvement in work organization, the implementation of psychosocial risk management strategies, and the expansion of mental health interventions. Investments in workplace mental health may generate returns comparable to other capital investments largely through lowering absenteeism and presenteeism costs. Description provided by NIOSH
• Subjects:
  • Mental Health
  • Occupational Health
  • Occupational Stress
  • Safety
  • Stress, Psychological
  • Working Conditions
• Keywords:
  • Work performance; Absenteeism; Psychological reactions; Psychosocial factors; Mental health; Work organization; Cost estimates; Economic impact; National Health Interview Survey; NHIS;
  • Author Keywords: absenteeism; human capital approach; NHIS; presenteeism; psychological distress; surveillance; workplace cost
• Source:
  Am J Ind Med 2026 May; :Epub ahead of print
• ISSN:
  0271-3586
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Chicago Region OSHA ; District of Columbia ; Ohio ; Philadelphia Region OSHA
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OD - Office of the Director ; DFSE - Division of Field Science and Engineering
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  15 pdf pages
• NIOSHTIC Number:
  nn:20071599
• Contact Point Address:
  Abay Asfaw, Centers for Disease Control and Prevention (CDC)-National Institute for Occupational Safety and Health (NIOSH), Washington, DC, USA
• Email:
  AAsfaw@cdc.gov
• Federal Fiscal Year:
  2026
• Peer Reviewed:
  True
• Download URL:
  https://stacks.cdc.gov/view/cdc/259374/cdc_259374_DS1.pdf
• File Type:
  [PDF - 654.18 KB]
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:87a94ac6c5644d853dbf949ac196aacef07dec56cdcd4b29276196497c391abbecdce7080ec47f1b5fad307ec83581e76e2632131f3209b04f7a4cf2cd6b2d73