Striking a balance between physical and mental well-being for employees

Workplace wellness has evolved in recent years to focus increasingly on mental health. But how much value does it hold for expat employees compared to physical well-being? And how have the events of 2020 changed these views?

In summer 2021, Aetna International surveyed 1,000 expats from Germany, UAE, Singapore and Mexico to find out how the pandemic and the growing awareness around mental health have impacted the type of health care benefits they expect from their employers.

Changing attitudes

Awareness of mental health conditions and stigma has grown steadily over the past five years but reached new heights during the pandemic. Not only have individuals placed more importance on their mental health, but there has also been a growing need for more open conversations in the workplace. Employers have been compelled to reconsider the benefits they offer their staff, aiming to better protect the health and well-being of a workforce coming to terms with a global crisis.

In 2016, Aetna International’s ‘Pioneering Change’ research found that only 6% of globally mobile individuals were concerned with issues related to mental well-being. This has now changed significantly; our research shows that:

• 41% of our survey respondents said that workplace health care benefits should be focused towards supporting mental well-being.
• This rate differs only slightly between the countries we surveyed, suggesting how much attitudes have changed on a global scale. Interestingly, countries that recorded a lower rate of COVID-19 infections had a slightly lower figure (UAE 40%, Singapore 36%) than those who were more widely affected by the pandemic (Germany 43%, Mexico 43%).

Key findings also show expats’ concerns about access to quality health care:

• 30% said ensuring access to quality health care was one of the biggest challenges of living as an expatriate – significantly more than finding appropriate accommodation (20%) or dealing with language barriers (22%).
• 38% considered moving back to their country of origin to ensure they could access quality health care.

Refocus on physical health

Despite the growing demand for improved mental health provisions, 59% of the expats we surveyed want employers to prioritise physical well-being when constructing or choosing health care packages and benefits.

While there are many possible reasons for this, it could be that there remains a stigma around mental health at work. Employees may feel as though they could be perceived negatively for having mental health issues and decide to keep them private, perhaps believing that emotional well-being is a more personal consideration.

Thankfully, many employers are taking steps to address these perceptions, often in partnership with their health care benefits provider. For example, Aetna Mind is part of Aetna International’s holistic approach to health and wellness. It provides members with resources and services designed to maintain positive mental health – tools to help employers adopt a culture of openness and reduced stigma.

The impact of the pandemic is a likely trigger for expats wanting physical health to be prioritised – expats wanting reassurance about the level of care available should they or their family become ill:

• Those with dependent children (under 16) favoured employers focusing on physical well-being more than those without – 65% versus 55% respectively.

To demonstrate how consistent this opinion is, the table below breaks down by country the responses of those with dependent children (under 16) in answer to the question: “Considering the effects of the global pandemic, do you think the priority of employers health care should be to support physical or mental well-being of their employees?”

Family support

Whether physical health, mental health or both, expat workers agree that employee health and wellness benefits should be for their whole family and that this key consideration when relocating for work:

• 83% of those surveyed said they expected their employer to provide full health care for either themselves (39%) or both themselves and their partner/family (44%).
• 87% said employment benefits related to family health care were an important factor when considering a job opportunity abroad.

The global pandemic has underlined the expectations of expat workers: employers should support not only the mental and physical well-being of their expat employees, but also that of their families. You can learn more about the impact of COVID-19 on expat health care in our Expat Family Wellness Survey 2020.

Connections and comorbidities

Comorbidities are a major consideration when it comes to maintaining and improving well-being. The term refers to the existence of more than one condition at the same time in the same person and the potential impact these conditions could have on each other. In the context of the pandemic, this can be seen in how a patient with COVID-19 who also has diabetes, heart disease or asthma can experience symptoms more severely due their existing conditions.

Comorbidities can also be an area where mental and physical health collide. For example, physical injury or long-term illness can increase the risk of depression and anxiety. Similarly, mental health issues can develop into physical conditions, including fatigue. The potential impact of comorbidities makes it clear that workplace mental health provisions can no longer be seen simply as an add-on to physical health benefits.

Workplace health consultant Jesse Lahey discusses the connections between conditions and the importance of whole-person health in Aetna International’s Fit for Duty podcast: episode 14. He explains that conditions are often being “driven or supported in an unhealthy way by multiple sources”. For example, an employee with workplace stress may be overloaded with tasks but could also be struggling to exercise due to an injury or not sleeping well due to relationship problems. As such, Jesse calls upon employers to consider all potential influences on a person’s health and behaviour – for example, their personal and social circumstances – rather than viewing workplace wellness in silo.

A modern challenge

With varying expectations from employees, the key challenge for health care benefits providers and employers is to find a balance between the demand for both mental and physical health support.

Rather than choosing between them, employers should instead be looking at how to effectively shift health and well-being support towards whole-person health, providing a holistic solution to support the well-being of their employees and their families.

As we move closer to parity between the demand for mental and physical health benefits, expat workers should feel confident that the support they need is available to them.

Are you an expat employee? If your workplace does not offer health care benefits or if you only have cover for yourself and not your family, get a quote for international health insurance, today.

Aetna^® is a trademark of Aetna Inc. and is protected throughout the world by trademark registrations and treaties.