Financial and physical health intertwined. Some of the statistics offered are surprising and disturbing:

• 59% of people who assess their medical health as fair or poor say they live paycheck to paycheck, compared to 34% of people in very good or excellent health.
• 70% of people who rate their health as fair or poor are very concerned about making ends meet, compared to 52% of people whose health is very good or excellent.
• 76% of people who see their health as fair or poor are very concerned about affording health care in retirement, compared to 57% of those in very good or excellent health.

We asked Ronald Leopold, M.D., MetLife’s vice president of U.S. business, to comment on those statistics, as well as others in the study. Which comes first, our query went, poor medical health or poor financial health?

“It’s really a chicken-and-egg relationship between the two,” Leopold responded. If someone loses his or her job or a lot of income, it’s tempting to delay or avoid needed health care. “The premiums and co-pays are seen as too expensive.” Worse still, says Leopold, a family with tight finances may seek cheaper food, which is often less nutritious (in fact, prices for many corn- and grain-based products have fallen while the cost of fresh fruits and vegetables has risen significantly over the years). And, it works the other way around. If an individual’s health deteriorates, his or her expenses rise and productivity at work declines, he added. “I’ve seen reports that 50% of personal bankruptcies are caused by medical expenses.”

Interestingly, however, the employees who assess their health as fair or poor have healthcare coverage through their employers at nearly the same rate as those who say their health is very good or excellent. So the connection between poor health and tight finances is in no way limited to people without healthcare insurance.

How well are wellness programs? Given that 94% of surveyed employers agree that wellness programs can be at least somewhat effective in reducing medical costs, MetLife researchers expressed some disappointment that the number of employers offering such programs is growing so slowly. Only one-third (33%) of respondents offered wellness programs in late 2008, up from about one-fourth (27%) in late 2005. And, even among organizations employing more than 500 people, the portion offering such programs is only 57%, up from 46% in 2005.

What makes a wellness program? We asked Leopold, is it as little as a fitness reimbursement, or are certain components required for qualification? “We let employers tell us whether, in their view, they offer a wellness program,” He answered. “It’s a simple yes or no question on our survey.” So what are the typical components? “The low-hanging fruit—the offerings that are the easiest to provide and that have the biggest impact—are smoking cessation and weight-loss programs.”

And, you don’t need to gather a lot of demographic and other health-related information on your employees: “All you need to do, especially in smaller organizations,” Leopold points out, “is look around you to see who’s ducking out for a smoke break and who’s overweight.” Further, organizations like Weight Watchers will hold classes at your worksite if enough employees sign up, at their own expense; all you need to do is provide the space. The next level of program components involves either greater data-gathering on employee claims—so that disease management can be offered for diabetes or heart or lung disease—or considerable expenses, such as those for creating in-house fitness centers.

Why offer wellness programs? Leopold understands that such offerings are often promoted based on the idea that they can dramatically reduce healthcare expenditures, saving money for both employees and employers. For example, Johnson & Johnson, which introduced its programs in 1995 for its 100,000 employees, now reports savings of $225 per year per employee as a result. But, Leopold cautions, “the actual results of programs, in terms of saving money, are difficult to capture, and they tend to be all over the lot. Implementing wellness programs is always a leap of faith, and I caution small and mid-sized companies not to obsess over the return on investment or cost-saving metrics.”

So why do it at all? Two huge reasons: Such offerings are very popular with employees, so you’re likely to see retention gains and higher morale. And, the better the overall health of your workforce, the better your workers’ productivity will be. “Remember the value of your human capital,” advises Leopold.

The MetLife study showed that nearly half of employees participate in programs offered by their employers. But here’s the payoff: They don’t do so primarily to earn incentives or avoid penalties but simply to maintain good health. The older they are, the more likely they value the health benefits, while incentives are more important to the youngest workers. Here’s to wellness!