US employees lose an average of 63.4 productive workdays each year due to poor physical and mental health, with most of that productivity loss occurring while they are still at work, according to the Global Health and Productivity Index 2026, published by Vitality.
The findings, published in Vitality's Global Health and Productivity Index 2026, show that 53.9 days, or approximately 85% of the total productivity loss, are attributable to presenteeism. This occurs when employees continue working despite physical or mental health problems that affect their ability to perform effectively.
By comparison, employees lose an estimated 9.5 productive days annually through absenteeism.
The research was conducted in partnership with RAND Europe and highlights a gap in how employers assess the relationship between workforce health and productivity. Traditional absence records capture time employees spend away from work but do not account for the larger productivity losses experienced by those who remain at work while unwell.
Poor Health Creates a Significant Productivity Burden
The report estimates that poor workforce health costs the US economy approximately $2.33 trillion annually in lost productivity.
Around 32% of surveyed US employees said their health had a moderate or significant impact on their productivity while working. Additionally, 14% reported missing more than four hours of work during the week preceding the survey because of health problems.
The US recorded the second-highest number of productive days lost among the five markets examined, behind Germany, where employees lose an estimated 69.3 days annually. The average across the five markets was 54.8 days.
For the research, productive days lost include both time missed through absence and estimated reductions in performance while employees are at work. The figures therefore represent equivalent full working days rather than the number of days employees were actually absent.
Limited Access to Preventive Health Support
The findings also point to gaps in employer-provided health support and early intervention.
Approximately 49% of surveyed US employees said their employers offered medical or health insurance, while only 18% reported having access to employer-organised health screenings.
Vitality's research suggests that employer support remains more focused on treating and managing existing health conditions than identifying potential health risks early.
The report also identifies mental wellbeing, physical health, work-related strain and lifestyle factors as contributors to workforce productivity loss. These factors can overlap, increasing the impact on employees and organisations.
What the Findings Mean for HR
The findings highlight why HR teams may need to look beyond sickness absence when assessing workforce health and productivity.
A low absence rate does not necessarily indicate that employees are healthy or able to perform at their best. Employees who continue working through illness, stress or other health challenges may still experience significant productivity losses.
For employers, the research raises questions about access to preventive healthcare, employee wellbeing support, workplace pressures and whether managers are equipped to recognise when employees need assistance.
The study also found that employees who feel their managers genuinely care about their wellbeing experience nine fewer productive days lost annually than those who do not.
As organisations continue to monitor workforce performance, the findings suggest that employee health and productivity need to be considered together rather than treating attendance as the primary indicator of workforce effectiveness.
