Presenteeism—the practice of working despite being unwell or facing other challenges—differs from absenteeism, which involves being away from work without a justifiable reason. Presenteeism is very prevalent among academics, including student academic appointees (SAA). Many people avoid taking sick leave, driven by personal dedication to their research and teaching. However, systemic factors also play a role, such as a lack of collective awareness and advocacy to address presenteeism. This Ally Tips explores the causes and consequences of presenteeism and its disproportionate impact on women and women of color in higher education. We also provide practical strategies to address presenteeism, reframe organizational definitions of efficiency, and prioritize the well-being of faculty and instructors.
Consequences of Presenteeism
Presenteeism, defined as working while unwell or managing an illness or other condition, is alarmingly common in higher education institutions. Studies report that 63% to 90% of employees engage in this behavior.2, 3, 4 Paradoxically, presenteeism has been shown to reduce individual productivity by a third or more and can harm organizational efficiency even more significantly than absenteeism.4 Elizabeth Popp Berman, a professor at the University of Michigan, shared her experience with presenteeism, recalling how she taught a class while recovering from thyroid surgery. "My head was just swimming," she shared, underscoring how her ability to teach effectively was compromised.
Despite these findings, organizations often overlook the negative impact of presenteeism because “unlike absenteeism, presenteeism isn’t always apparent.” Organizations often fail to recognize or address presenteeism, mistakenly assuming that employees showing up to work are operating at full capacity. This misperception prevents faculty and staff from receiving necessary support, exacerbating both physical and mental health challenges and causing long-term harm to their well-being.5
Disproportionate Impact of Presenteeism on Women and Women of Color Academics
Notably, presenteeism disproportionately affects women and women of color in higher education. Women and women of color comprise most non-tenure track lecturer and instructor positions6. These proportions are also higher in academic fields requiring high engagement in on-site services and student support (e.g., health care, social work, and teacher education). In other words, women and women of color in academia are disproportionately represented in situations where showing up for work is emphasized and deemed essential.7 Furthermore, an individual factor that causes presenteeism is the pressure to be an ideal worker.8 Who is more prone to this pressure? It would be the faculty and instructors with minoritized identities. This pressure is even more salient for the associate instructors. As an example, an Asian international woman SAA at IUB mentioned that even with multiple nights with a fever, she had to show up to her undergraduate classes because her students were in a critical phase of projects and needed her in-person support with the logistics. She felt she could not cancel the class, switch to an online format, or seek help from the faculty or other associate instructors in her program due to a concern about“looking bad”and missing a crucial opportunity to support her students as no other instructors were equipped adequately to cover her class.
Systemic Causes of Presenteeism
Though it may appear to be an individual choice, presenteeism is deeply rooted in institutional and unit-level cultures. Kinman and Wray (2018)identified high work demands, limited job control, and inadequate managerial and collegial support as significant contributors. Short staffing, rigid deadlines, and a lack of coverage policies further compound the issue.9, 10, 11 Demerouti and colleagues describe presenteeism as a "risk-taking organizational behavior," emphasizing the responsibility of institutions in perpetuating or mitigating the practice. Without systemic changes, higher education will continue to foster environments where presenteeism thrives.
Ally Tips to Tackle Presenteeism
Re-defining efficiency for well-being: Some organizations understand that presenteeism hurts their efficiency over the long term. To alleviate presenteeism, one strategy is to invest in greater employment medical and support care to improve the effectiveness of treatment and recovery, which helps employees return to work sooner and/or be more functional when facing chronic conditions.10 At a time when most institutions are trying to cut health plan costs, this would be a dramatically different approach. At the campus level, medical and support care policies should be re-evaluated to assess whether they effectively support faculty and SAAs experiencing illness, particularly those who are women and women of color. Changing the culture around presenteeism happens at the unit level, therefore, unit leaders should address the importance of well-being of faculty and SAAs for their own long-term productivity and the efficiency of the unit.
Developing a more communal, unit-level support system and offering explicit guidance on sick policy and support: This involves establishing a systemic and transparent way of supporting faculty and instructors experiencing illness. Additionally, it includes ensuring flexibility with teaching formats and deadlines within the unit. Perhaps unsurprisingly, these topics are not discussed much nor explicitly explained to faculty and SAAs what usually minimal onboarding processes are.
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Weekly Ally Resources
- Article: Presenteeism: A Review of Current Thinking—This report from the Institute for Employment Studies explores strategies for assessing and addressing presenteeism in the workplace.
- Article: The Health-Performance Framework of Presenteeism—Karanika-Murray and Biron outline four dimensions of presenteeism—functional, dysfunctional, overachieving, and therapeutic. They contend that presenteeism often causes dysfunctional experiences for sick employees yet can offer therapeutic experiences when the workplace offers adequate support for them.