Research for the Real World |

There Ain’t No Rest for the Wellness Algorithms

It’s summertime. Time to bike, hike, swim, run, take long walks. Time for vacations, picnics, long weekends — generally recharging and feeling well.

It’s also time for wellness data collection platforms to register any uptick in physical exercise, weight reduction and utilization of days off. As those concerned with total rewards and employee well-being, we can all cheer summertime-induced, wellness- promoting activity. But how do we — or should we — consider the year-round algorithm-feeding data collection on such behaviors? Academic researchers are increasingly answering, “with great care.”

Near Historic Low-Cost Increases
For the past two years, employers have benefited from almost record-low increases in employer costs for employee health benefits. Throughout 2017 and 2018, U.S. employers have consistently experienced a 12-month percentage change (reported quarterly) in employer costs for health benefits of less than 2%. The mid-1990s are the only other time in the survey’s 35-year history when a lower inflation rate was recorded, according to the U.S. Bureau of Labor Statistics’ “Employment Cost Index Health Benefits.” (

Wellness Programs Doing Well
For their part, employers — especially large employers — have been embracing and expanding wellness programs. During the past five years, more businesses offering health benefits have included weight-loss programs, lifestyle/behavioral coaching and health-risk assessments as part of their wellness programs, while the frequency of companies offering incentives to employees who participate in wellness programs has remained stable. (See Figure 1.)

Adding Ethics into the Mix
Leveraging risk assessments, incentivizing behaviors and measuring progress requires collecting data, “big data.” A colleague of mine at Cornell University’s ILR School, Ifeoma Ajunwa, a sociologist and lawyer, has been studying employers’ collection and use of big data. With co-authors Kate Crawford and Joel S. Ford, she has published an “ethical framework” and 10 core “promises” to address three concerns regarding employers’ collection of employees’ health data. The three concerns of their focus are (i) informed consent in the data collection; (ii) handling of data; and (iii) risks for employment discrimination. (Ajunwa, et al. 2016. “Health and Big Data: An Ethical Framework for Health Information Collection by Corporate Wellness Programs,” Journal of Law, Medicine and Ethics 44: 474-480.)

The authors point out that prior to consenting to the collection of their wellness data, individual employees should be fully informed of:

  • Privacy risks from sharing data along with any health effects from joining a wellness program
  • The evidence underpinning wellness program directives
  • The limitations in accuracy of the data collection methods, such as wearable technologies.

Data breaches and cases of data resale by wellness vendors have been documented. Furthermore, the authors note, the law has few, if any, limitations on wellness programs trawling for nonvolunteered information on individuals. Against this backdrop, two policies are key to crafting an ethical wellness program: transparency with employees about the collection, storage and ownership of data; and ensuring the employee the right to review and correct collected data, as well as deleting personal health records from the vendor if that employee leaves the company.

The third concern the authors raise is the need for “an impenetrable barrier between the information [the wellness program] gathers and the employer” (p. 478). It would clearly be unethical for a wellness program to share data with a present or future employer that could affect an individual’s employment opportunities. Picking just one characteristic, pay gaps and other forms of discrimination against obese individuals, have been documented in the research. (Shinall, Jennifer Bennett. 2016. “Distaste or Disability: Evaluating the Legal Framework for Protecting Obese Workers.” Berkeley Journal of Employment and Labor Law 37: 101-142.)

Ajunwa, et al. detail 10 “promises” that a workplace wellness program should include as an ethical basis. They conclude that workplace-based wellness programs “can safely navigate the ethical quagmires” presented by collecting employees’ health data if they commit to “well-settled ethical principles of informed consent, accountability, and fair use of person health information data” (p. 479).

Greater Reflection Along with Data Collection
Wellness, in its broadest definition, is often described as being healthy, through some deliberate effort, in mind (and/or “spirit”) as well as body. As employers, more of us are encouraging our employees to make that deliberate effort to be well. Perhaps in turn, we need to consider adding ethical considerations into our own organizational wellness and make the deliberate effort to ensure we are ethically healthy in our collection and use of big data. At a minimum, we should make some time to ponder such big challenges and deep thoughts during our wellness-promoting summertime activities. 


About the Author 

Linda Barrington Bio Image

Linda Barrington is the executive director at Institute for Compensation Studies, ILR School — Cornell University

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