Company health and wellness programs have the greatest success when those companies have an underlying culture of health.

The current buzz in the benefits business, a culture of health is the “secret sauce” that drives engagement in company wellness programs, said Seth Serxner, San Francisco-based chief health officer at Optum Inc., UnitedHealth Group Inc.'s health care services and analytics subsidiary in Eden Prairie, Minnesota.

Developing a “culture of health is part of an overall engagement strategy that includes incentives, communications ... and a whole set of programs and services,” Mr. Serxner said. “If we do everything else right, but we have a poor culture, people aren't going to change their behavior.”

“It's viewed as more of an underlying success factor or something that enables a really effective workplace health improvement program,” said LuAnn Heinen, vice president of workforce well-being, productivity and human capital at the Washington-based National Business Group on Health.

It's not a one-off wellness program or an isolated perk; rather, it's an atmosphere that permeates an organization encouraging workers to be healthy and happy, sources said.

Companies such as General Electric Co. and LafargeHolcim understand that building such a culture can help improve worker engagement and productivity and business performance, as well as reduce absences and health costs.

Still, “the culture piece is very difficult to pin down,” Ms. Heinen said.

It's also something that does not yet exist for most employers. According to a study earlier this year by the NBGH and Aon Hewitt, just 29% of employees characterized their work environment as having a strong culture of health, up from 24% in 2014.

In companies that have achieved strong cultures of health, leadership is fully engaged with the health initiatives, said Optum's Mr. Serxner. Such companies' health policies go beyond smoking-cessation, such as providing healthy cafeteria and catered food options. They also may add standing desks or make stairways more accessible, he said.

“The culture piece is where the employee feels supported and enabled. So the food is healthy, there's access to the gym and things enable the employee to do what they want to do — to do what they can do to support their health,” Ms. Heinen said.

Dave Ratcliffe, Washington-based principal at consultant Xerox HR Services, said the process starts with mining the health and business data to find out what can be improved.

For Chicago-based building material manufacturer LafargeHolcim, known as Lafarge North America Inc. before parent Lafarge S.A. merged last year with Holcim Ltd., building a culture of health began in 2004.

The legacy Lafarge was plagued by double-digit health cost increases because employees weren't getting preventive health exams, so heart disease and cancer were already advanced when discovered, said Philia Swam, Herndon, Virginia-based manager of health and wellness at LafargeHolcim.

So in 2006, Lafarge made all preventive care for employees and spouses free of cost when in-network. Financial incentives encouraged employees to complete online health risk assessments. The firm also developed a value-based formulary to promote drug compliance. In 2008, it launched free onsite health screenings to make it easier for workers to access care.

The company also promotes fitness challenges, and gives employees who enroll a Garmin wearable fitness device as well as up to $300 for completing fitness goals.

“We need employees to be safe at work, and if they are having heart issues or diabetes issues or asthma issues, they are not going to be capable of giving their 100%,” Ms. Swam said. “Tying all of that in to executive support and really linking it back to safety I think made us successful.”

Company leadership also is essential to Fairfield, Connecticut-based industrial firm General Electric's culture of health, which it has honed for the past seven to eight year under the banner Health-Ahead.

The multifacted program focuses on everything from fitness to stress management, and nutrition to reducing health-related absences. Leadership involvement, preventive health programs, worksite safety initiatives and encouraging health care consumerism also are part of the effort, said Dr. Ben Hoffman, the company's chief medical officer.

For General Electric, building that culture is not so much about reducing health costs or a return on investment; it is about value and business performance, he said.

“For us to be successful ... the people need to be healthy, because if they're not healthy, they can't be productive and innovative, and GE is built on a history of innovation,” Dr. Hoffman said. “A culture of health is not the only element of our "secret sauce' that has made us successful over 100 years, but it's certainly a very important element of that.”

There is a business case to be made for having a culture of health, recent studies show. In a January study in the Journal of Occupational and Environmental Medicine, researchers evaluated the stock performance of 45 publicly traded companies that scored high on a workplace health and well-being scorecard from the Health Enhancement Research Organization and Mercer L.L.C.

“The high-scoring portfolio of publicly traded companies appreciated 235%, compared with the S&P 500 portfolio appreciation of 159%, over a trading period of 2009 through 2014,” according to the study.