Mary T. Imboden serves as a research fellow at the Health Enhancement Research Organization (HERO), where she manages the HERO Worker Well-Being Clearinghouse, Powered by the NIOSH WellBQ. She also helped lead the development of the HERO Scorecard Version 5, including the Special Best Practice Scores. Mary is also a Principal Research Scientist in Providence Heart Institute’s Center for Cardiovascular Analytics, Research and Data Science where she oversees system-wide healthcare research. She obtained her doctorate in Human Bioenergetics from Ball State University’s Human Performance Laboratory and her Master’s degree in Health and Exercise Science from Wake Forest University.
Businesses and institutions rely on brain power to make important decisions, to solve critical challenges, and to think creatively and analytically. Employees also report that their work plays a major role in their brain health.1 Brain health refers to the overall state of which a person’s brain functions in different aspects of life, including thinking, learning, remembering, and managing emotions, allowing them to reach their full potential.2 However, most employees are reporting that work negatively impacts their brain health3,4 and the Organization for Economic Cooperation and Development’s (OECD) New Approaches to Economic Challenges initiative estimates that impaired brain health is costing the global economy as much as $8.5 trillion a year in lost productivity.5 This calls attention to the need for organizations to promote a healthy brain culture in their workforce, involving the implementation of programs and policies and creating an environment that supports brain health and function.
The HERO Health and Well-being Best Practices Scorecard in Collaboration with Mercer© (HERO Scorecard) is a free online survey that was designed as an educational and benchmarking tool to help employers identify and assess their use of practices that support more effective health and well-being initiatives.6 Version 5 of the HERO Scorecard was updated in 2021 to include recent emerging best practices in health and well-being initiatives in each of the six domains that the Scorecard measures (i.e., strategic planning, organizational and cultural support, programs, program integration, participation strategies, and measurement and evaluation). In late 2023, HERO convened a group of workforce brain health experts that exhaustively reviewed all workforce health and well-being practices listed throughout the HERO Scorecard that related to brain health. After extensive discussion, the final proposed practices were assigned tentative scores (out of a possible 100 points). Six independent subject matter experts then reviewed the proposed items and scores. Their feedback was combined and used to inform further revisions to the items included and final point allocations. A list of all the practices included in the Brain Health Best Practice Score can be found in the HERO Scorecard User’s Guide.6 In brief, the score provides practices related to policies, leadership support, programs, lifestyle behaviors, and the built environment. Table 1 provides a breakdown of the number of practices and points by section for the Brain Health Best Practice Score.
Brain Health Best Practice Scores were retroactively calculated for the 388 organizations that completed the HERO Scorecard Version 5 through March 31, 2024. Organizations were categorized by size into small (<500; n=118), medium (500 to <5,000; n=161), and large (5,000+; n=104) organizations to examine variations in Brain Health Best Practice Scores. Differences by industry type were assessed between financial (n=37), hospitals/healthcare clinics (n=36), technical/professional services (n=68), government (n=52), Education (n=58), manufacturing (n=34), and other (n=55), as well as for organizations that identified as high tech (n=90) organizations. The percentage of employees working remotely was categorized as fully in-person (n=38), <25% remote (n=150), 25 to <50% remote (n=54), 50% to <75% remote (n=39), and 75% or more remote (n=70) to assess differences in brain health score. Finally, a comparison of DEI scores by geographic location was assessed by categorizing organizations into Western (n=135), Midwestern (n=86), Northeastern (n=83), and Southern (n=81) regions.
The mean Brain Health Best Practice Score for all respondents was 46.2 points. When comparing the Brain Health Best Practice Score by organization size (Table 2), large organizations received higher scores (mean = 58.8 points) than small organizations (mean = 33.2 points) or medium organizations (mean = 46.9 points).
Table 1. Brain Health Best Practice Score Questions, Practices, and Points by Section (n=388)
| Scorecard section | Number of questions | Number of practices | Points |
| Strategic planning | 5 | 21 | 25.25 |
| Organizational & Cultural Support | 8 | 45 | 34.25 |
| Programs | 7 | 34 | 18.50 |
| Program Integration | 4 | 11 | 6.50 |
| Participation Strategies | 3 | 9 | 7.25 |
| Measurement & Evaluation | 1 | 7 | 8.25 |
Table 2. A comparison of Brain Health Best Practice Score by Organization Size
| n | Brain Health Score (X ± SD) | |
| Small (<500 employees) | 118 | 33.2 ± 18.4 |
| Midsize (500 to <5,000 employees) | 161 | 46.9 ± 19.3 |
| Large (>5,000 employees) | 104 | 58.8 ± 18.7 |
Large variations in Brain Health Best Practice Scores were observed among different industry types, with mean scores ranging from 40.8 for governmental organizations to 60.5 for financial service companies (Table 3).
Table 3. A comparison of Brain Health Best Practice Score by Industry
|
|
n |
Brain Health Score (X ± SD) |
| Education | 58 | 47.3 ± 22.5 |
| Financial services | 37 | 60.5 ± 20.6 |
| Government | 52 | 40.8 ± 16.3 |
| Hospitals/Healthcare clinics | 36 | 48.1 ± 22.6 |
| Manufacturing | 34 | 41.2 ± 20.0 |
| Other services | 55 | 41.5 ± 19.9 |
| Tech/professional services | 68 | 47.0 ± 20.3 |
| High Tech Sector | 90 | 50.7 ± 21.0 |
| Not High Tech Sector | 294 | 44.6 ± 20.9 |
There were differences in the Brain Health Best Practice Score among organizations with varying proportions of remote workforce. Overall, the organizations that reported being fully in-person scored the lowest of all groups with a score of 37.0. By contrast, organizations with 25-49% of their employees working remotely reported the highest average score of 54.7. Table 4A displays the Brain Health Best Practice Score for all remote workforce categories. It should be noted, that organizations completed the HERO Scorecard at different points in time relative to the COVID-19 pandemic, which moved many organizations to remote work, as well as varied return to in-person work scenarios. Therefore, a follow-up analysis looked at Brain Health Best Practice scores by percent remote workforce in 2020-2022 and 2023-2024 to get a more clear understanding (Table 4B). We still saw that organizations that reported a fully in-person workforce scored the lowest over both time periods and those that reported that 25-49% of their employees worked remotely reported the highest scores.
Table 4A. A Comparison of Brain Health Best Practice Score by Percent Remote Workforce
| n | Brain Health Score (X ± SD) | |
| Fully in-person | 38 | 37.0 ± 21.2 |
| <25% remote | 150 | 46.5 ± 20.6 |
| 25% to <50% remote | 54 | 54.7 ± 21.5 |
| 50% to <75% remote | 39 | 47.4 ± 20.2 |
| 75% + remote | 70 | 42.9 ± 19.9 |
Table 4B. Brain Health Best Practice Score by Percent Remote Workforce for Organizations that completed the HERO Scorecard in 2020-2022 vs. 2023-2024
| 2020-2022 (X ± SD, n) | 2023-2024 (X ± SD, n) | |
| Fully in-person | 31.3 ± 19.8, n=18 | 41.9 ± 21.4, n=20 |
| <25% remote | 45.2 ± 20.8, n=97 | 47.4 ± 20.3, n=53 |
| 25% to <50% remote | 50.1 ± 21.9, n=28 | 58.7 ± 21.6, n=26 |
| 50% to <75% remote | 45.2 ± 19.7, n=17 | 50.1 ± 21.5, n=22 |
| 75% + remote | 37.2 ± 20.0, n=31 | 48.7 ± 18.2, n=39 |
The comparison by U.S. geographic regions revealed minimal differences in Brain Health Best Practice Score by region (Scores – Northeastern 47.2, Midwest 46.1, Southern 44.4, West 47.0).
Overall, these findings highlight numerous opportunities for improvement in the implementation, promotion, and evaluation of workforce health and well-being initiatives to address brain health. Insights from neuroscience highlight the connection between physical health, mental health, and brain health.7 Organizations need to understand these connections in order to develop successful workforce health and well-being initiatives that positively impact the brain health of their workforce, ultimately leading to more healthy, happy, engaged and productive employees.1,3,7 The HERO Scorecard’s Brain Health Best Practice Score can act as an educational tool to help organizations better understand how practices related to physical health, mental health, social connection, etc. are associated with brain health. Further, it can help inform an organization’s strategic plan by identifying areas of opportunity in which new programs, policies, and interventions can be implemented with the goal of improving workforce brain health. Organizations are encouraged to take the HERO Scorecard annually to measure progress and identify new areas of opportunity and focus.6
References
- The Business Collaborative for Brain Health. Retrieved June 6, 2024, from https://businessforbrainhealth.org/about
- Brain health. Retrieved November 22, 2024, from https://www.who.int/health-topics/brain-health
- Imboden M. Maintaining Brain Health: An Imperative for Successful Aging and Business Performance. Retrieved June 6, 2024, from https://journals.sagepub.com/doi/full/10.1177/08901171241232042
- Robinson B. Work Damages Your Brain Health, But 4 Strategies Can Improve It, Study Finds. Forbes. Retrieved January 15, 2024, from https://www.forbes.com/sites/bryanrobinson/2023/03/02/work-damages-your-brain-health-but-4-strategies-can-improve-it-study-finds/
- Organization for Economic Co-operation and Development (OECD). OECD Health Statistics. Retrieved January 14, 2020, from https://www.oecd-ilibrary.org/social-issues-migration-health/data/oecd-health-statistics_health-data-en
- HERO Scorecard. HERO. Retrieved January 15, 2024, from https://hero-health.org/hero-scorecard/
- Unlocking Workplace Brain Health to Fuel Prosperity and Healthy Longevity—Kelly O’Brien, 2024. Retrieved June 6, 2024, from https://journals.sagepub.com/doi/full/10.1177/08901171241232042b
