Newsroom | 28 August 2017

Employees in Developing Countries Have More Health Risks and Higher ‘Presenteeism’ Than Those in Developed Countries

Global Cigna Study Shows Clear Relationship Between Country of Employment and Employee Health Risks and Productivity


For further information, please contact:
Cigna Global Health Benefits
Robyn R. Ray, +1 302-746-3338

WILMINGTON, Del., 28 August, 2017 - Cigna Corporation (NYSE: CI), a global health services company, announces publication of its research results which show that there is a clear difference in health risks for employees from developed countries and those from developing countries that employers can address through well-being programs for their global workforces.

“Where a person lives is a key predictor of his or her productivity,” said lead researcher, Dr. Jose Quesada, Cigna GHB Chief Medical Officer. “Overall, employees in developing countries report having more health risks than those in developed countries – 82.1% of these employees reported having more than one health risk, such as smoking or existing medical conditions, versus 72.7% of employees from developed countries.”

The developing country group, however, fared better than the developed country group on obesity, with one-sixth (15.2%) of the developing group classified as obese (i.e., BMI of 30 or over) compared to almost a quarter of the developed group (24.3%). That said, there is a growing trend of lifestyle-related illness in developing countries. In this study, the developing country group reported slightly higher rates of anxiety and/or depression (18.8%) than in developed countries (14%), as well as slightly higher heart risk factors.

Conducted by Cigna GHB Chief Medical Officer, Dr. Jose Quesada; Dr. Peter Mills, Associate Medical Director; and Ana Howarth, Research Scientist, the study fills an important information gap for global employers who use western-centric health risk assessment (HRA ) to predict employee health and behavior around the world.

“The Cigna GHB study found that there are significant geographical differences between HRA scores and performance,” said Dr. Quesada. “We learned that place of residence was the biggest predictor of presenteeism (where an employee is physically present at work but not productive or engaged) and poor pain management was the biggest predictor of absenteeism.”

“These findings are particularly valuable to employers, as health risks highlighted by HRA can be improved with the support of effective well-being programs,” said Dr. Quesada.

These are some of the key findings of a global, cross-cultural study by Cigna Global Health Benefits (GHB), published in The Annals of Occupational and Environmental Medicine, Springer Nature, June 12, 2017. The study analyzed HRA data collected from 117,000 employees of 254 multinational companies over a four-year period.

The research confirms there is a large body of evidence supporting the effectiveness of well-being programs on improving numerous aspects of employee health – positively impacting employee productivity and lowering employee absenteeism.

“Research like this helps Cigna design health and wellness services and solutions for its customers that are rooted in scientific evidence,” said Dr. Quesada.

The full article can be found here.

About the Study

This study used a cross-sectional design to summarize and compare findings from online HRA completed by multinational organizations taken over four years from the period 2013 to 2016. The HRA was administered as an online questionnaire to 254 companies from 120 countries. The final sample consisted of 117,274 employees, aged 18 to 64 years.

About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to helping people improve their health, well-being and sense of security. All products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, Life Insurance Company of North America and Cigna Life Insurance Company of New York. Such products and services include an integrated suite of health services, such as medical, dental, behavioural health, pharmacy, vision, supplemental benefits, and other related products including group life, accident and disability insurance. Cigna maintains sales capability in 30 countries and jurisdictions, and has more than 95 million customer relationships throughout the world. To learn more about Cigna ® , including links to follow us on Facebook or Twitter, visit