Stigma a key factor why employers lack insight into workers’ chronic health conditions

Key takeaways:

• Of survey respondents with chronic conditions, 76% needed to manage them at work.
• More flexible schedules, remote work when possible and breaks at work could help people with chronic conditions.

Most adults in the United States with physical chronic health conditions manage them at work but have not told their employer about them, results from a national survey showed.

Nearly 40% of employees with such conditions, like diabetes or hypertension, miss or delay their medical care as a result.

“Because of what we know about chronic disease, we weren't surprised to find that so many workers... are dealing with one,” Brian C. Castrucci, DrPH, MA, president and CEO of the de Beaumont Foundation, told Healio. “But we were surprised by the extent to which it's affecting their work, through missed work and productivity, and their personal well-being, through missed and delayed health care. Chronic disease costs our economy and our nation, not just those who are directly affected.”

The survey, conducted jointly by Harvard T.H. Chan School of Public Health and the de Beaumont Foundation, involved 1,010 part-time and full-time adults who worked at organizations with 50 or more employees.

Nearly 80% manage conditions at work

The poll showed that 58% of adults reported having chronic conditions. Of those, 76% said they needed to manage them at work, but 60% have not told their employer about the condition.

Some of the top reasons for not disclosing a chronic health condition to an employer include stigma, fear of being fired or privacy, the researchers noted.

Over one-third of adults (38%) said they have skipped medical appointments or delayed getting care to avoid interfering with work in the past year.

Those with chronic conditions also said they felt they could not take time off work (49%) or take a break while at work in the past year (49%) despite needing to because of their conditions.

The researchers also found that of adults with chronic conditions:

• 33% said they have missed out on opportunities for more hours or projects because of their conditions;
• 25% reported missing out on opportunities for promotion; and
• 21% reported receiving bad reviews or negative feedback because of their conditions.

Many help families’ chronic conditions

The survey further revealed that many in the U.S. workforce also care for others with chronic conditions, losing significant time off in the process.

Specifically, 33% said they have helped family members with their chronic conditions in the past year, and among those, 45% frequently needed to do so during working hours.

Additionally, 37% of those taking care of family members reported difficulty taking time off work, and of those taking care of family members or managing chronic conditions themselves, 25% have needed to reduce work hours for it.

The researchers found that 12% and 14% people who have chronic conditions themselves or help their families said they do not have any paid leave or have run out of paid leave in the past year due because of needing to take care of the conditions, respectively.

Under half of employees said their employers are supportive of measures that allow them to care for their chronic conditions, like taking paid leave (44%) or taking breaks when they feel like it (44%).

Even less said their employers are supportive of flexible schedules (35%) or working remotely more often if the work can be done offsite (27%).

Castrucci highlighted several strategies employers could deploy that could help better support employees with chronic conditions, including allowing employees to take breaks, providing paid leave, offering flexible scheduling and permitting offsite working arrangements where possible.

“To help people manage their chronic conditions effectively, health care providers need to understand how people manage their health in the context of their work and personal lives,” he told Healio. “Doctors’ notes can be a helpful way to document and validate employees’ conditions and the care they need. However, the stigma employees feel around their conditions has a broader effect that is not as easily remedied.”

He added that by better understanding the challenges that employees with chronic conditions face, “we can find ways to improve their lives, productivity and health outcomes.”

References:

• Poll: Most U.S. workers with chronic conditions manage them at work, haven’t told employer. Available at: https://hsph.harvard.edu/news/poll-most-u-s-workers-with-chronic-conditions-manage-them-at-work-havent-told-employer/. Published Feb. 11, 2025. Accessed Feb. 21, 2025.
• U.S. employee perspectives on managing chronic conditions in the workplace. Available at: https://hsph.harvard.edu/wp-content/uploads/2025/02/dBF-HSPH-Employee-Chronic-Conditions-Poll-February-2025.pdf. Accessed Feb. 21, 2025.