Key points:
More than half of employees in the U.S. (58%) report having physical chronic health conditions, such as hypertension, heart disease, diabetes, and asthma, according to a new nationally representative survey.
Three-fourths of U.S. employees with chronic conditions (76%) need to manage their conditions during work hours, yet a majority (60%) have not formally disclosed their conditions to their employer.
More than one-third of U.S. employees with chronic conditions (36%) say they have skipped medical appointments or delayed getting care to avoid interfering with work in the past year.
Boston, MA—Chronic health conditions are taking a major, hidden toll on the U.S. workforce’s lives and productivity, according to a new national poll by Harvard T.H. Chan School of Public Health and the de Beaumont Foundation. The poll, conducted among a national sample of U.S. employees, found that three-fourths (76%) of those with chronic conditions—such as hypertension, heart disease, diabetes, and asthma—need to manage their conditions during work hours. Yet a majority (60%) have not formally disclosed their conditions to their employer.
The poll, U.S. Employee Perspectives on Managing Chronic Conditions in the Workplace, was conducted October 2–16, 2024, among a probability-based, nationally representative sample of the U.S. workforce, composed of 1,010 part-time and full-time working adults ages 18+ who are not self-employed and work at organizations with 50 or more employees.
The poll found that more than half of employees in the U.S. (58%) report having physical chronic health conditions, with many structuring their health care to account for their jobs or going without. Notably, more than one-third of employees with chronic conditions (36%) say they have skipped medical appointments or delayed getting care to avoid interfering with work in the past year. And about half of those with chronic conditions say, in the past year, they felt they could not take time off work (49%) or take a break while at work (49%), even though they needed to because of their conditions.
Missed opportunities and stigma
In addition, one-third of employees with chronic health conditions (33%) say in the past year they have missed out on opportunities for more hours or projects because of their conditions, while 25% report missing out on opportunities for promotion and 21% report receiving bad reviews or negative feedback as a result of their chronic health conditions.
“Though employers may think they know their employees’ needs, poll results suggest there are widespread and frequently hidden challenges facing workers with chronic conditions,” said survey lead Gillian SteelFisher, director of the Harvard Opinion Research Program and principal research scientist at Harvard Chan School. “Workers commonly feel stigmatized by their conditions, and this can have a profound effect on both their work and their health. To help retain employees in a tight job market, employers may want to have more conversations with employees about ways that they can make work ‘work’ for everyone.”
Challenges managing family members’ conditions
The poll also found that a significant share of the U.S. workforce faces additional challenges caring for family members with chronic conditions. One-third of all employees (33%) say they have helped family members with their chronic conditions in the past year, and nearly half of those helping family members (45%) frequently needed to do so during working hours. More than a third of those helping family members (37%) say it has been difficult to take time off work, and among those helping family members or managing chronic conditions themselves, a quarter (25%) have needed to reduce work hours to manage this.
Concerningly, one in four employees who have chronic conditions themselves or help family members with theirs say they don’t have any paid leave (12%) or have run out of paid leave in the past year (14%) because they were trying to take care of their or their family’s chronic conditions.
“There is a major opportunity for employers to play a greater role in supporting employees who are managing their own or their family’s chronic conditions,” said Brian Castrucci, president and CEO of the de Beaumont Foundation. “Not only will this improve the health of employees and their families, but it will also provide employers a way to distinguish themselves, as well as improve retention and reduce absenteeism.”
Less than half of all U.S. workers say their current employer is very supportive of key measures that allow employees to manage their conditions, including allowing employees to take breaks when they feel they need it (44%) or take paid leave (44%). Fewer than four in ten say their employer is very supportive of flexible schedules or working remotely more often if the work can be done offsite (37% and 27%, respectively).
Methodology
Results are based on survey research conducted by the Harvard Opinion Research Program (HORP) based at Harvard T.H. Chan School of Public Health, in partnership with the de Beaumont Foundation. Representatives from each organization worked closely to develop the survey questionnaire, while analyses were conducted by researchers from Harvard Chan School and the fielding team at SSRS of Glen Mills, Pennsylvania.
The HORP project team included Gillian SteelFisher, director of HORP and principal research scientist at Harvard Chan School; Mary Gorski Findling, managing director; and Hannah Caporello, senior research projects manager.
The de Beaumont Foundation project team included Brian Castrucci, president and CEO of the de Beaumont Foundation; Katy Evans, senior program officer; Emma Dewhurst, program and research associate; Mark Miller, vice president of communications; and Nalini Padmanabhan, communications director.
Interviews were conducted with a representative sample of 1,010 part-time and full-time working adults ages 18 and older, who work at organizations with 50 or more employees. Self-employed individuals were excluded. The sample included a subset of 594 adults with physical chronic health conditions. Interviews were conducted in English and Spanish online and by telephone. Respondents were reached online and by phone through the SSRS Opinion Panel, a nationally representative, probability-based panel. Panelists were randomly recruited via an Address Based Sampling (ABS) frame and from random-digit dial (RDD) samples on SSRS surveys. Most panelists completed the survey online, with a small subset who do not access the internet completing by phone. The interview period was October 2–16, 2024.
When interpreting findings, one should recognize that all surveys are subject to sampling error. Results may differ from what would be obtained if the whole U.S. adult population had been interviewed. The margin of error for the full sample is ±3.8 percentage points.
Possible sources of non-sampling error include non-response bias, as well as question wording and ordering effects. Non-response in web and telephone surveys produces some known biases in survey-derived estimates because participation tends to vary for different subgroups of the population. To compensate for these known biases and for variations in the probability of selection within and across households, sample data are weighted in a multi-step process by probability of selection and recruitment, response rates by survey type, and demographic variables (gender, age, education, race/ethnicity, region, the frequency of internet use, civic engagement, population density, registered voter, party ID, religious affiliation, number of adults in household, and home tenure) to reflect the true population of employed adults in the U.S. working at organizations with 50 or more employees. Other techniques, including random sampling, multiple contact attempts, replicate subsamples, and systematic respondent selection within households, are used to ensure that the sample is representative.
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Harvard T.H. Chan School of Public Health is a community of innovative scientists, practitioners, educators, and students dedicated to improving health and advancing equity so all people can thrive. We research the many factors influencing health and collaborate widely to translate those insights into policies, programs, and practices that prevent disease and promote well-being for people around the world. We also educate thousands of public health leaders a year through our degree programs, postdoctoral training, fellowships, and continuing education courses. Founded in 1913 as America’s first professional training program in public health, the School continues to have an extraordinary impact in fields ranging from infectious disease to environmental justice to health systems and beyond.
The de Beaumont Foundation creates and invests in bold solutions that improve the health of communities across the country. Its mission is to advance policy, build partnerships, and strengthen public health to create communities where everyone can achieve their best possible health. For more information, visit www.debeaumont.org.
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