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Texas Employer Survey


To obtain information on Texas employers’ major health care costs and concerns, and the benefits they offer their employees, the Comptroller’s office surveyed 150 of the state’s largest employers. Respondents identified obesity and its related medical conditions as important factors behind rising health care costs, lost productivity and increased absenteeism.

The survey sample included national and international companies in nearly every sector of the economy. These companies were asked to provide data based on their Texas workforces; when this information was unavailable, they were asked to provide data on their national workforces.

Thirty companies responded to the survey. All 30 offer health care benefits to some or all of their employees. The overwhelming majority of these companies, 27, reported increases in the cost of health care from 2002 to 2006. The highest reported increase in health care costs was 57 percent in 2006; the lowest increase was 5 percent; and the average increase was 26.7 percent.

The most prevalent medical conditions reported among the companies surveyed were coronary artery disease (16), cancer (13), diabetes (12), hypertension (8) and gastrointestinal disorders (7). Three large companies reported obesity as one of their top three most prevalent medical conditions.

The most costly medical conditions were almost identical to the most prevalent conditions: coronary artery disease (19), cancer (18), diabetes (10) and gastrointestinal disorders (5).

Many of these medical conditions are related to, or directly attributable to, obesity.

Twenty-one companies responded when asked to list the top causes of absenteeism in their work forces. These included coronary artery disease, cancer, injury and mental health issues; four companies listed obesity as one of their top three causes of absenteeism.

The survey asked specific questions on obesity and its effect on Texas companies. Twenty-five companies estimated the percentage of their workforce that is obese; these estimates ranged from 10 percent to 70 percent. Virtually all companies responding to the survey listed increased health care costs, lost productivity and increased absenteeism as effects of obesity, although none has attempted to estimate the cost of these effects.

Employers are taking steps to address the problem of obesity. Twenty-two of the 30 responding companies have health and wellness programs, some of which offer incentives to employees who participate. Reported participation rates ranged from 9 percent to 80 percent.

Finally, the Comptroller asked one question to determine if the health of the state’s work force could influence a company’s decision to expand in, relocate to or move out of Texas; and one question to determine how much importance the company would give to health care costs in relation to labor costs and the education and skill of the workforce when considering Texas for relocation.

Four large employers out of 30 responded that the health of a region’s population and work force would factor into such a decision. Four large employers also responded that health care costs would weigh as heavily as labor costs and the education and skill level of the workforce in any decision to expand or move to a new region in Texas.

A copy of the survey instrument can be found in Appendix 2.

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