American employers hoping to expand their workplace wellness strategies globally must account for variations in the needs and resources of their foreign-based employees to effectively design, implement and monitor wellness programs overseas.

While a slight majority of large U.S.-based employers provide workplace wellness and employee health management programs on a global scale, several factors can impede an employer from establishing a truly global program, experts say.

Fifty-one percent of U.S.-based multinational firms applied a global strategy to their employee health management programs in 2013, according to a survey of more than 1,000 employers in 37 countries by Secaucus, New Jersey-based Buck Consultants at Xerox.

“Companies that take this on really have their work cut out for them,” said David Ratcliffe, a Washington-based principal at Buck Consultants. “We've seen the prevalence of wellness programs in other countries increase generally over the last several years, but there are still a lot of barriers to really rolling out a global wellness strategy.”

For U.S.-based employers, experts say applying a workplace wellness strategy globally may be especially challenging, as health insurance is sponsored at least in part, if not in whole, by the government in most other industrialized countries.

“In the U.S., employers obviously have a vested interest in the health and wellness of their employees from a financial perspective in that they're the ones paying for their health care,” said Elizabeth Greenbaum, a Hong Kong-based assistant director of the Global Business Group on Health. “Outside of the United States, employers for the most part aren't incurring the medical costs associated with poor employee health care, so they're not driven to improve employee health from that perspective.”

“In general, the U.S. mindset on workplace wellness isn't going to work,” said Thomas Dolan, Boston-based senior vice president of global employee benefits solutions at Willis North America Inc. “In fact, "well-being' is probably the more widely applicable term being used globally, as opposed to wellness. What we're seeing now is a new focus among employers on adopting a global well-being framework that's configurable and adaptable to local environments.”

The word “well-being” is understood in most countries to encompass more than employees' physical health, i.e. their mental and emotional health, Mr. Dolan said.

Rather than designing wellness programs around cost-reduction goals, experts say employers' workplace wellness programs most frequently gain traction with managers and employees in foreign countries when they are designed to address elements of the organizations' local or global competitiveness, particularly their value proposition as employers.

“Outside the U.S., these programs tend to focus on employee engagement and talent,” said Dr. Lorna Friedman, a New York-based partner in Mercer L.L.C.'s global health management practice. “What we're hearing from senior human resource professionals and other executives globally is that they have a talent shortage and a skills gap, and that healthy populations and work environments are an imperative part of the human capital dialogue.”

Once global wellness objectives are established, experts say employers will need to consult locally with designated leaders within their organization, health care providers and licensed wellness providers to design and communicate a suite of culturally and demographically relevant wellness activities.

“You need a flexible framework with a set of adaptable pillars,” said Francis Coleman, director of international consulting at Towers Watson & Co. in Los Angeles. “For example, one pillar might be stress management, another could be physical activity and another might be smoking cessation. From that, you let each of your local groups select the most appropriate set of pillars for their workforce, depending on the specific issues that are most prevalent amongst their population.”

U.S. employers should pay especially close attention to international data privacy laws, experts say. In the European Union, employee health information is classified as sensitive personal data and subject to enhanced restrictions regarding its collection, retention and processing by employers.

E.U. member states — as well as nations that include Argentina, Canada, Singapore and Switzerland — also prohibit private companies from exporting personal data to countries that do not meet the E.U. privacy standard.

“When it comes to sensitive health data, you're going to need to be extra vigilant,” said Christopher Walter, a London-based partner at law firm Covington & Burling L.L.P. “Privacy must be the top consideration.”

Employers establishing wellness programs overseas also must consider local employment regulations. Specifically, Mr. Walter said, employers should consider whether local regulators might view a particular wellness activity or initiative as being indirectly discriminatory for one or more protected classes of employee, potentially leading to civil actions or fines.

On the other hand, U.S.-based employers may find some countries' laws to be more relaxed than American statutes. In many Latin American and European Union member states, Mr. Walter said, employers are generally not liable for indirectly discriminating against a certain group of employees if the company can demonstrate that the action in question serves a proportionately greater company objective when compared with its negative effect on the individuals alleging discrimination.

By contrast, U.S. laws generally require employers accused of direct or indirect discriminatory acts to demonstrate both a legitimate objective for the offending act and that it was the least restrictive means of meeting that objective.

How nondiscrimination rules are applied to workplace health management and wellness programs is largely unknown, Mr. Walter said, as actual cases addressing the issue have been rare within the last few years.

“Over time, I suspect we might begin to see some of those issues teased out,” he said. “It will be important for employers to think carefully about the potential impacts.”