Toward a critical theory of corporate wellness | Gordon Hull & Frank Pasquale

Gordon Hull; More self-promotion: “Toward a critical theory of corporate wellness”; In His Blog; 2017-07-10.

tl;dr → employee wellness is but a surveillance-cum-control plane; a promotion of a forthcoming paper (you can read it for free if you’ve paid, which is a paywall)

Original Sources

Gordon Hull, Frank Pasquale; “Toward a critical theory of corporate wellness,”  In Biosocieties; soon.paywall.



In the U.S., “employee wellness” programs are increasingly attached to employer-provided health insurance. These programs attempt to nudge employees, sometimes quite forcefully, into healthy behaviors such as smoking cessation and exercise routines. Despite being widely promoted as saving on healthcare costs, numerous studies undermine this rationale. After documenting the programs’ failure to deliver a positive return on investment, we analyze them as instead providing an opportunity for employers to exercise increasing control over their employees. Based on human capital theory and neoliberal models of subjectivity that emphasize personal control and responsibility, these programs treat wellness as a lifestyle that employees must be cajoled into adopting, extending the workplace not just into the home but into the bodies of workers and entrenching the view that one belongs to one’s workplace. At the same time, their selective endorsement of health programs (many scientifically unsupported) produce a social truth of wellness framed as fitness for work. We conclude by arguing that the public health initiatives occluded by the private sector’s promotion of wellness programs would be a much better investment of resources.


  1. Ajunwa, I., Crawford, K. and Ford, J. (2016) Health and big data: An ethical framework for health information collection by corporate wellness programs. Journal of Law, Medicine & Ethics 44(3): 474–480. Google Scholar
  2. Ajunwa, I., Crawford, K. and Schultz, J. (in press) Limitless worker surveillance. California Law Review. Google Scholar
  3. Alexander, J. (1988) The ideological construction of risk: An analysis of corporate health promotion programs in the 1980s. Social Science and Medicine 26(5): 559–567. DOI:10.1016/0277-9536(88)90389-9. CrossRef, Google Scholar
  4. Amoore, L. (2004) Risk, reward and discipline at work. Economy and Society 33(2): 174–196. DOI:10.1080/03085140410001677111. CrossRef, Google Scholar
  5. Baicker, K., Cutler, D. and Song Z. (2010) Workplace wellness programs can generate savings. Health Affairs 29(2): 304–311. DOI:10.1377/hlthaff.2009.0626. CrossRef, Google Scholar
  6. Barr, S.I., DiFrancesco, L. and Fulgoni, V.L. (2015) Association of breakfast consumption with body mass index and prevalence of overweight/obesity in a nationally-representative survey of Canadian adults. Nutrition Journal 15: 33. DOI:10.1186/s12937-016-0151-3. CrossRef, Google Scholar
  7. Basas, C.G. (2014) What’s bad about wellness? What the disability rights perspective offers about the limitations of wellness. Journal of Health Politics, Policy and Law 39(5): 1035–1066. DOI:10.1215/03616878-2813695. CrossRef, Google Scholar
  8. Becker, G.S. (2007) Health as human capital: Synthesis and extensions. Oxford Economic Papers 59(3): 379–410. DOI:10.1093/oep/gpm020. CrossRef, Google Scholar
  9. Becker, G.S. (1975) Human Capital: A Theoretical and Empirical Analysis, with Special Reference to Education. New York: NBER/Columbia University Press. Google Scholar
  10. Bernard, T.S. (2015) The sticks and carrots of employee wellness programs. The New York Times.
  11. Binkley, S. (2009) The work of neoliberal governmentality: Temporality and ethical substance in the tale of two dads. Foucault Studies 6: 60–78. CrossRef, Google Scholar
  12. Binkley, S. (2014) Happiness as Enterprise: An Essay on Neoliberal Life. Albany: SUNY Press. Google Scholar
  13. boyd, d. and Crawford, K. (2012) Critical questions for Big Data. Information, Communication and Society 15(5): 662–679. DOI:10.1080/1369118x.2012.678878.
  14. Brown, W. (2015) Undoing the Demos: Neoliberalism’s Stealth Revolution. New York: Zone Books. Google Scholar
  15. Burris, S. (Undated) Understanding how law influences environments and behavior, a web page. Temple University for Public Health Law Research.
  16. Cauchi, R. (2016) State employee health benefits, insurance, and costs. National Conference of State Legislatures. web page.
  17. Chaloupka, F.J., Yurekli, A. and Fong, G.T. (2012) Tobacco taxes as a tobacco control strategy. Tobacco Control 21: 172–180. DOI:10.1136/tobaccocontrol-2011-050417. CrossRef, Google Scholar
  18. Chowdhury, E.A., Richardson, J.D., Holman, G.D., Tsintzas, K., Thompson, D. and Betts, J.A. (2016) The causal role of breakfast in energy balance and health: A randomized controlled trial in obese adults. American Journal of Clinical Nutrition 103(3): 747–756. DOI:10.3945/ajcn.115.122044. CrossRef, Google Scholar
  19. Conrad, P. (1988) Worksite health promotion: The social context. Social Science and Medicine 26(5): 485–489. DOI:10.1016/0277-9536(88)90381-4. CrossRef, Google Scholar
  20. Contreary, K.A., Chattopadhyay, S.K., Hopkins, D.P., Chloupka, F.J., Forster, J.L., Grimshaw, V., et al. (2015) Economic impact of tobacco price increases through taxation: A community guide systematic review. American Journal of Preventive Medicine 49(5): 800–808. DOI:10.1016/j.amepre.2015.04.026. CrossRef, Google Scholar
  21. Cooper, M. (2012) Workfare, familyfare, godfare: Transforming contingency into necessity. South Atlantic Quarterly 111(4): 643–661. DOI:10.1215/00382876-1724120. CrossRef, Google Scholar
  22. Corporate Health and Wellness Association. (n.d.) Worksite wellness – an investment in human capital. Corporate Wellness (Magazine).
  23. Crawford, K. (2016) Can an algorithm be agonistic? Ten scenes from life in calculated publics. Science, Technology and Human Values 41(1): 77–92. DOI:10.1177/0162243915589635. CrossRef, Google Scholar
  24. Crawford, R. (1980) Healthism and the medicalization of everyday life. International Journal of Health Services 10(3): 365–388. DOI:10.2190/3H2H-3XJN-3KAY-G9NY. CrossRef, Google Scholar
  25. Dale, K. and Burrell, G. (2013) Being occupied: An embodied re-reading of organizational ‘wellness’. Organization. DOI:10.1177/1350508412473865. Google Scholar
  26. Davies, W. (2015a) The Happiness Industry. New York: Verso. Google Scholar
  27. Davies, W. (2015b) Spirits of neoliberalism: ‘Competitiveness’ and ‘wellbeing’ as indicators of rival orders of worth. In: R. Rottenburg, S.E. Merry, S.-J. Park and J. Mugler (eds.) The World of Indicators: The Making of Governmental Knowledge Through Quantification (pp. 283–305). Cambridge: Cambridge University Press. CrossRef, Google Scholar
  28. EEOC v. Flambeau. (2015). Google Scholar
  29. Ernst, M. (2011). Dangerous by Design.
  30. Esposti, S.D. (2014) When Big Data meets dataveillance: The hidden side of analytics. Surveillance Society 12(2): 209-225. Google Scholar
  31. Feldman, D.I., Al-Mallah, M.H., Keteyian, S.J., Brawner, C.A., Feldman, T., Blumenthal, R.S. and Blaha, M.J. (2015) No evidence of an upper threshold for mortality benefit at high levels of cardiorespiratory fitness. Journal of the American College of Cardiology 65(6): 629–630. DOI:10.1016/j.jacc.2014.11.030. CrossRef, Google Scholar
  32. Ferrie, J.E., Virtanen, M., Jokela, M., Madsen, I.E.H., Heikkilä, K., Alfredsson, L., Batty, G.D., Bjorner, J.B., Borritz, M., Burr, H., Dragano, N., Elovainio, M., Fransson, E.I., Knutsson, A., Koskenvuo, M., Koskinen, A., Kouvonen, A., Kumari, M., Nielsen, M.L., Nordin, M., Oksanen, T., Pahkin, K., Pejtersen, J.H., Pentti, J., Salo, P., Shipley, M.J., Suominen, S.B., Tabák, A., Theorell, T., Väänänen, A., Vahtera, J., Westerholm, P.J.M., Westerlund, H., Rugulies, R., Nyberg, S.T. and Kivimäki, M. (2016) Job insecurity and risk of diabetes: a meta-analysis of individual participant data. Canadian Medical Association Journal DOI:10.1503/cmaj.150942. Google Scholar
  33. Finkelstein, E.A. (2016) Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): A randomised controlled trial, Lancet 4(12): 983–995. Google Scholar
  34. Flegal, K.M. (2014) Metabolically healthy overweight and obesity. Annals of Internal Medicine 160(7): 515–516. DOI:10.7326/L14-5007-6. CrossRef, Google Scholar
  35. Forsberg, L. (2016) 2016 State health plan annual enrollment. presentation.
  36. Foster, R. (2016) The therapeutic spirit of neoliberalism. Political Theory 44(1): 82–105. DOI:10.1177/0090591715594660. CrossRef, Google Scholar
  37. Foucault, M. (1982) The subject and power. In: H.L. Dreyfus and P. Rabinow (eds.) Michel Foucault: Beyond Structuralism and Hermeneutics (pp. 208–226). Chicago: University of Chicago Press. Google Scholar
  38. Foucault, M. (1985) The Use of Pleasure (R. Hurley, Trans.). New York: Vintage Books. Google Scholar
  39. Foucault, M. (2008) The birth of biopolitics: Lectures at the Collège de France, 1978-79 (G. Burchell, Trans., M. Senellart ed.). New York: Palgrave Macmillan. Google Scholar
  40. Foucault, M. (2011) The Courage of Truth (The Government of Self and Others II): Lectures at the Collège de France, 1983-1984 (F. Gros Ed.). New York: Palgrave Macmillan. Google Scholar
  41. Frakt, A. and Carroll, A.E. (2014) Do workplace wellness programs work? Usually not. New York Times.
  42. French, M. (2014) Gaps in the gaze: Informatic practice and the work of public health surveillance. Surveillance Society 12(2): 226–243. Google Scholar
  43. Gillespie, T. (2013) The relevance of algorithms. In J.B. Pablo and K.A. Foot (eds.) Media Technologies: Essays on Communication, Materiality, and Society (pp. 167–193). Cambridge, MA: MIT Press. Google Scholar
  44. Ginn, G.O. and Henry, L.J. (2003) Wellness programs in the context of strategic human resource management. Hospital Topics 81(1): 23–29. DOI:10.1080/00185860309598012. CrossRef, Google Scholar
  45. Goetzel, R. (2013) Workplace wellness programs: Continuing the discussion with Dinardo, Howitz, and Kelly. Health Affairs Blog. blog post.
  46. Greenfield, R. (2016) Employee wellness programs not so voluntary anymore. Bloomberg. article.
  47. Guthman, J. and Brown, S. (2016) Whose life counts: Biopolitics and the “bright line” of chloropicrin mitigation in California’s strawberry industry. Science, Technology and Human Values 41(3): 461–482. DOI:10.1177/0162243915606804. CrossRef, Google Scholar
  48. Hall, K.D., Chen, K.Y., Guo, J., Lam, Y.Y., Leibel, R.L., Mayer, L.E. et al. (2016) Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men. American Journal of Clinical Nutrition. DOI:10.3945/ajcn.116.133561. Google Scholar
  49. Hamann, T.H. (2009) Neoliberalism, governmentality, and ethics. Foucault Studies 6: 37–59. CrossRef, Google Scholar
  50. Harcourt, B.E. (2011) The Illusion of Free Markets. Cambridge, MA: Harvard University Press. Google Scholar
  51. Harvey, D. (2005) A Brief History of Neoliberalism. Oxford: Oxford University Press. Google Scholar
  52. Health Enhancement and Research Organization and Population Health Alliance. (2015) Program measurement and evaluation guide: Core metrics for employee health management.
  53. Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, 110 Stat. 1936 (1996). Google Scholar
  54. Horwitz, J.R., Kelly, B.D. and DiNardo, J.E. (2013) Wellness incentives in the workplace: Cost savings through cost shifting to unhealthy workers. Health Affairs 32(3): 468–476. DOI:10.1377/hlthaff.2012.0683. CrossRef, Google Scholar
  55. Hull, G. (2015) Successful failure: What Foucault can teach us about privacy self-management in a world of Facebook and big data. Ethics and Information Technology 17(2): 89–101. DOI:10.1007/s10676-015-9363-z. CrossRef, Google Scholar
  56. Jeppsson, S. (2015) Obesity and obligation. Kennedy Institute of Ethics Journal 25(1): 89–110. DOI:10.1353/ken.2015.0001. CrossRef, Google Scholar
  57. Jo, E. and Dolezal, B.A. (2016) Validation of the Fitbit ® Surge™ and Charge HR™ fitness trackers. pdf.
  58. Jost, T. (2007) Health Care at Risk: A Critique of the Consumer-Driven Movement. Raleigh, NC: Duke University Press. CrossRef, Google Scholar
  59. Kalecki, M. (1943) Political aspects of full employment. Political Quarterly 7: 322–331. CrossRef, Google Scholar
  60. Kitchin, R. (2014) Big Data, new epistemologies and paradigm shifts. Big Data and Society. DOI:10.1177/2053951714528481. Google Scholar
  61. Kotarba, J.A. and Bentley, P. (1988) Workplace wellness participation and the becoming of self. Social Science and Medicine 26(5): 551–558. DOI:10.1016/0277-9536(88)90388-7. CrossRef, Google Scholar
  62. Kronenfeld, J.J., Jackson, K.L., Davis, K.E. and Blair, S.N. (1988) Changing health practices: The experience from a worksite health promotion project. Social Sciences and Medicine 26(5): 515–523. DOI:10.1016/0277-9536(88)90384-X. CrossRef, Google Scholar
  63. LawAtlas. (2015) The Policy Surveillance Program.
  64. Lampert, R., Tuit, K., Hong, K.I., Donovan, T., Lee, F., Sinha, R. (2016) Cumulative stress and autonomic dysregulation in a community sample. Stress 19(3): 269–279. DOI:10.1080/10253890.2016.1174847. CrossRef, Google Scholar
  65. Langley, P. (2007) Uncertain subjects of Anglo-American financialization. CULTURAL CRITIQUE 65: 67–91. CrossRef, Google Scholar
  66. Lewis, A. (2015) Warning: Workplace wellness is hazardous to your health. Huffington Post. blog post.
  67. Lewis, A. and Khanna, V. (2014) Surviving workplace wellness with your dignity, finances, and major organs intact. The Health Care Blog. Google Scholar
  68. Lewis, A. and Khanna, V. (2015) Tag archive: “Wellness outcomes.” TheySaidWhat (blog). blog post.
  69. Lewis, A., Khanna, V. and Montrose, S. (2015) Employers should disband employee weight control programs. American Journal of Managed Care 21(2): e91–e94. Google Scholar
  70. Lupton, D. (in press) Lively data, social fitness and biovalue: the intersections of health self-tracking and social media. In: J. Burgess, A.E. Marwick, T. Poell, and J. Van Dijck (eds.) The Sage Handbook on Social Media. London: Sage. Google Scholar
  71. Lupton, D. (2016) The Quantified Self (London, UK: Polity Press). Google Scholar
  72. Martin, R. (2002) The Financialization of Everyday Life. Philadelphia, PA: Temple University Press. Google Scholar
  73. Mattke, S., Liu, H., Caloyeras, J.P., Huang, C.Y., Van Busum, K.R. Khodyakov, D. and Shier, V. (2013) Workplace wellness programs study: Final report. report.
  74. Mayer, J. (2011) State for sale. The New Yorker.
  75. McGillivray, D. (2005) Fitter, happier, more productive: Governing working bodies through wellness. Cult Organization 11(2): 125–138. DOI:10.1080/14759550500091036. CrossRef, Google Scholar
  76. Miller, C.C. (2015) Stressed, tired, rushed: A portrait of the modern family. New York Times.
  77. McMahon, J. (2015) Behavioral Economics as Neoliberalism: Producing and Governing homo economicus. Contemporary Political Theory 14: 137–158. CrossRef, Google Scholar
  78. Mirowski, P. (2011) Science-Mart: Privatizing American Science. Cambridge, MA: Harvard University Press. CrossRef, Google Scholar
  79. Mirowski, P. (2013) Never Let a Serious Crisis go to Waste: How Neoliberalism Survived the Financial Meltdown. New York: Verso. Google Scholar
  80. Mitchell, M. (2016) The ‘Tyranny’ of Positive Thinking can Threaten Your Health and Happiness. Newsweek. Google Scholar
  81. Moraine, S. (2015) The Apple Watch’s invasive trackers. blog post.
  82. Morris, F.C., Solander, A.C. and Huelle, A.E. (2015) EEOC issues proposed wellness program amendments to ADA regulations.
  83. Moss, M. (2013) Salt, Sugar, Fat: How the Food Giants Hooked Us. New York: Random House. Google Scholar
  84. O’Connor, A. (2016) Coke and Pepsi Give Millions to Public Health, Then Lobby Against It. New York Times, October 11. Google Scholar
  85. Ortega, F.B., Lavie, C.J. and Blair, S.N. (2016) Obesity and cardiovascular disease. Circulation Research 118(11): 1752–1770. DOI:10.1161/CIRCRESAHA.115.306883. CrossRef, Google Scholar
  86. Owens, A. (2009) N.C. State health plan targets smokers and the obese.
  87. Pasquale, F. (2012) Accountable care organizations in the Affordable Care Act. Seton Hall Law Review 42(1371). Google Scholar
  88. Pasquale, F. (2013) Privacy, antitrust, and power. George Mason Law Review 20(1): 1009–1024. Google Scholar
  89. Pasquale, F. (2014a) Private certifiers and deputies in American Health Care. North Carolina Law Review 92(1661). Google Scholar
  90. Pasquale, F. (2014b) Redescribing health privacy: The Importance of information policy. Houston Journal of Health Law and Policy 14. Google Scholar
  91. Pasquale, F. (2014c) The hidden costs of health care cost-cutting: Toward a postneoliberal health-reform agenda. Law and Contemporary Problems 77(171). Google Scholar
  92. Pervaaz, V. (2016) What will workplace wellness look like in 2020? Corporate Wellness Magazine.
  93. Pew Research Center. (2015) Raising kids and running a household: How working parents share the load. blog post.
  94. Pongratz, L.A. (2006) Voluntary self-control: Education reform as a governmental strategy. Educational Philosophy and Theory 38(4): 471–482. DOI:10.1111/j.1469-5812.2006.00205.x. CrossRef, Google Scholar
  95. Read, J. (2009) A genealogy of homo-economicus: Neoliberalism and the production of subjectivity. Foucault Studies 6: 25–36. CrossRef, Google Scholar
  96. Rieder, G. and Simon, J. (2016) Datatrust: Or, the political quest for numerical evidence and the epistemologies of Big Data. Big Data and Society. DOI:10.1177/2053951716649398. Google Scholar
  97. Roman, P.M. and Blum, T.C. (1988) Formal intervention in employee health: Comparisons of the nature and structure of employee assistance programs and health promotion programs. Social Science and Medicine 26(5): 503–514. 10.1016/0277-9536(88)90383-8. CrossRef, Google Scholar
  98. Rose, N.S. (2007) Politics of Life Itself: Biomedicine, Power, and Subjectivity in the Twenty-First Century. Princeton: Princeton University Press. CrossRef, Google Scholar
  99. Rosenfeld, S. (2016) Online public schools are a disaster, admits billionaire, charter-school promoter Walton Family Foundation. Alternet.
  100. Ruppert, E. (2012) The governmental topologies of database devices. Theory Culture and Society 29(4–5): 116–136. DOI:10.1177/0263276412439428. CrossRef, Google Scholar
  101. Schnohr, P., O’Keefe, J.H., Marott, J.L., Lange, P. and Jensen, G.B. (2015) Dose of jogging and long-term mortality: The Copenhagen City heart study. Journal of the American College of Cardiology 65(5): 411–419. DOI:10.1016/j.jacc.2014.11.023. CrossRef, Google Scholar
  102. Schüll, N. (2016) Data for life: Wearable technology and the design of self-care. Biosocieties 11: 317–333. CrossRef, Google Scholar
  103. Simon, J. (2002) Taking risks: Extreme sports and the embrace of risk in advanced liberal societies. In: T. Baker and J. Simon (eds.) Embracing Risk: The Changing Culture of Insurance and Responsibility (pp. 177–208). Chicago: University of Chicago Press. Google Scholar
  104. Soares, R.R. (2014) Gary Becker’s contributions in health economics. Journal of Demographic Economics 1(1). Google Scholar
  105. Stanley, J. (forthcoming, 2017) The Emergency Manager: Strategic Racism, Technocracy, and the Poisoning of Flint’s Children, The Good Society. promotion.
  106. Strandburg, K.J. (2005) Curiosity-driven research and university technology transfer. In: G.D. Libecap (ed.), University Entrepreneurship and Technology Transfer: Process, Design, and Intellectual Property (pp. 93–122). Oxford: Elsevier. CrossRef, Google Scholar
  107. Taylor, C. (1984) Foucault on freedom and truth. Political Theory 12(2): 152–183. CrossRef, Google Scholar
  108. Till, C. (in press) Commercialising bodies: The new corporate health ethic of philanthrocapitalism. In R. Lynch and C. Farrington (eds.) Critical Explorations of Health, Society and Technology Through Personal Medical Devices. Palgrave-Macmillan. Google Scholar
  109. Till, C. (2014) Exercise as labour: Quantified self and the transformation of exercise into labour. Societies 4(3): 446. CrossRef, Google Scholar
  110. Tomasetti, C. and Vogelstein, B. (2015) Variation in cancer risk among tissues can be explained by the number of cell divisions. Science 347(6217): 78–81. DOI:10.1126/science.1260825. CrossRef, Google Scholar
  111. Vander Schee, C. (2008) The politics of health as a school-sponsored ethic: Foucault, neoliberalism, and the unhealthy employee. Educational Policy 22(6): 854–874. DOI:10.1177/0895904807312471. CrossRef, Google Scholar
  112. Whitacre, P.T., Tsai, P. and Mulligan, J. (2009) The Public Health Effects of Food Deserts. Washington, DC: National Academies Press. Google Scholar
  113. Wiley, L.F. (2013) Shame, blame, and the emerging law of obesity control. University of California Davis Law Review 47(1): 121–188. Google Scholar
  114. Wiley, L.F. (2014) Access to health care as an incentive for healthy behavior? An assessment of the Affordable Care Act’s personal responsibility for wellness reforms. Indiana Health Law Review 11(2): 635–712. Google Scholar
  115. Winnubst, S. (2015) Way Too Cool: Selling Out Race and Ethics. New York: Columbia University Press. CrossRef, Google Scholar
  116. Winslow, L. (2015) The Undeserving Professor: Neoliberalism and the Reinvention of Higher Education. Rhetoric and Public Affairs 18(2): 201–245. CrossRef, Google Scholar
  117. World Health Organization (1948) WHO definition of health. web page.