An Overview of Employee Wellness Programs (EWPs) in Large U.S. Cities: Does Geography Matter?

Although Employee Wellness Programs (EWPs) have been around for decades, initiatives in government organizations typically lag behind initiatives developed in the private sector in both magnitude and diversity. While city managers may invest in EWPs with the intent of saving on health care costs and of enhancing employee productivity, internal characteristics and incentive structures as well as the organizational culture within each individual bureaucracy ultimately shape the nature and direction of EWP management. Drawing upon the logic of geographic individuality of administrative regions, the authors argue that organizations in different cities are likely to develop and incorporate wellness services that reflect unique regional settings. By assessing EWPs across the county, it is evident that the decision to implement certain wellness services within a city unit are based, in part, on geography rather than technical characteristics of the organization or wellness program. This means that geographical attributes can be translated into the provision of services. Pressure to establish a program likely comes from many arenas, and this assessment posits that geography plays an important role in program adoption alongside the service distribution argument of need and ability to pay.