What is ‘wellness governance’ (and why you should be practicing it)

It’s time we recognize the compelling case for “wellness governance.”

Being a leader today requires a new level of performance. One that overrides fatigue, can suppress internal signals, and absorbs constant urgency, all while rapidly context-switching. Simply said, modern leadership demands have increased, and not everyone is—or wants to stay—on board.

Today’s leaders face growing expectations, dynamic responsibilities, and constant pressure to perform amid deep uncertainty and an ever-accelerating business ecosystem. This is reshaping the role of leadership into something increasingly challenging to sustain, and driving CEOs like HSBC’s Noel Quinn to step back and refocus on “better balance” between their personal and business lives.

But performance and well-being aren’t opposites—they enable each other. Wellness is a fundamental pillar of sustainable business practice. It provides the foundation of our clarity, stamina, and presence, and notably can’t be achieved through the avoidance of burnout alone.

So it’s not surprising that with new leadership demands seen to be untenable, CEO turnover is at record levels and continues to climb. Around 52% of C-suite executives feel overworked and burned out. Median tenure among the S&P 500 companies has decreased 20% from 6 years in 2013 to 4.8 years in 2022—all at a time when HR heads are warning their boards of drying pipelines for high-potential future leaders. This pipeline crisis is magnified by Gen Z and millennial workers who are progressively rejecting traditional high-demand career pathways marked by high burnout rates.

The result? Loss of key existing talent, associated productivity decline and risk during key leadership transitions, and significant erosion of internal readiness around succession planning. The data supports this: By early 2025, 44% of new S&P 500 CEOs and 52% of FTSE 100 CEOs were external hires, largely cited as due to internal benches being too thin.

Easily overlooked

While conversations on wellness in the workplace are advancing—and for good reason—to support everyday workers, leaders are often left out of the conversation. Executives have become an easily overlooked segment in employer wellness discussions at a time when they are the ones tasked with driving them. Said differently, and ironically, companies investing in corporate wellness initiatives elevate leaders championing workforce health but can inadvertently ignore the well-being of the champions themselves. So, where does that leave top leaders of companies? And who should be safeguarding and governing their wellness?

Leaders are not immune to the same physical, mental, social, and cognitive health stressors that impact any person. But they are highly skilled at maintaining external composure in muting or even ignoring the impact of such strain. Executive-level competence has a unique ability to mask the cost of declining leadership health—but only until that cost mounts toward becoming unavoidable, and with potential to ripple far beyond the individual leaders.

Market response

When Apple announced that Steve Jobs was taking indefinite medical leave related to a physical health concern, its shares dopped 6%. United Airlines CEO Oscar Munoz suffered a heart attack 37 days into the job, and uncertainty around his health condition contributed to short-term stock volatility and further share price drop for an already-declining stock. And when Bed Bath & Beyond’s CFO died by suicide, the company’s stock lost 15%.

Markets are becoming more sensitive to executive illness and death. In fact, research shows that a CEO’s medical leave can have a particularly negative impact on shareholder value, especially when the leave is extended or the CEO is older. A 2016 paper analyzing CEO deaths at U.S. public companies found that between 1950 and 2009 markets seemed to react more and more strongly to such deaths, even after accounting for other factors.

It’s clear that investor confidence is closely linked with key leader health and wellness—and it should be. Companies ranking higher in well-being yield significantly higher returns and outperform the S&P, and leadership is a key driver of this. So it’s no surprise that WTW’s 2025 global directors and officers survey found, for the second year running, that health and safety is the No. 1 risk for directors and officers globally. Top priorities include physical health and safety in the workplace and workplace impact on mental health and well-being. Yet there is no specific mention of leadership health as a stand-alone topic of distinct risk and interest.

Leadership takes a toll on health

Interestingly, recent research out of Sweden found that not only is poor health associated with greater CEO turnover, but health itself predicts appointment to a CEO position. Which implies that not only should boards be governing wellness and health for C-suite leaders to increase overall effectiveness and lengthen executive tenure, but boards should also oversee health and wellness of high-potential, next-generation leaders as part of critical succession planning.

The leadership track is an increasingly hard sell for next-generation leaders given the latest research on CEO aging. Using a database of CEO facial images and applied machine learning to estimate CEO age, new research shows industry distress causes faster visible aging—adding an average of 1.2 years to their visual appearance for a given crisis or single period of distress. And with senior leaders today navigating an era of permacrisis, stacking and simultaneous crises could amplify this effect. Further, CEOs who experience periods of industry-wide distress during their tenure are found to die significantly earlier.

This research quantifies a previously little documented yet important cost associated with serving as a leader—personal health cost. Leadership bears very real and material health consequences, especially when exposed to increased job demands and high-stress work environments of high-profile positions. The health effect is sizable. While many are quick to criticize the perks of CEO life, research has found that reduction in longevity of CEOs is consistent even with big pay packages. This signals an important trade-off for companies and individuals alike when there is a substantial personal cost to health and life expectancy. It’s no wonder newer generations may be gun-shy to take a similar path.

There is an evolving fragility to traditional social contracts that key executives have with their companies. There are real yet often unspoken limits to the complexity, demands, uncertainty, and overload that individual leaders can sustain. And there is a necessary acknowledgment of the impact on individual leaders’ health and wellness, as well as broader amplified effects for companies.

A lack of governance

Leaders have a tendency to select for short-term productivity and hard-charge without needed recovery in order to remain responsive under escalating pressure “in the moment.” Take Elon Musk touting the benefits of sleep deprivation to achieve 120-hour workweeks and making a Tesla factory his primary residence for nearly three years. Most leaders focus their energy on being effective, not necessarily being well. And we haven’t developed sufficient governance to regulate this beyond the individuals themselves, both in the best interest of the leaders and the companies they helm.

It is said to be a sign of intelligence to hold two opposing ideas at once while retaining the ability to function. This “doublethink” is equally true for balancing the health of a company (including financial health and workforce well-being) with the health of individual executives. Leaders are trained to regulate their corporate environments long before they regulate themselves, if ever at all. They often live in a state of chronic activation that is easily normalized but effectively overrides their physiology in an unsustainable way. Eventually, our bodies respond accurately to stressors and strain even if our intellect initially seeks to normalize them. And that is problematic for everyone involved.

Well-being governance isn’t just about the concept of self-care for leaders. It’s about ensuring sustainable capacity and leadership to tap into the right level of decision-making, creative thinking, and steady engagement needed. This is what allows leaders to use both a microscope and a telescope, in parallel, to solve discrete near-term problems while driving long-term strategic efforts.

Leaders are not without their own level of governance and oversight, which is typically provided by a company’s board of directors and executive team. And while wellness initiatives for populations of employees are most effective when championed by senior management, wellness initiatives for leaders are arguably most effective where championed by the board and C-suite.

Good stewardship

Effective boards and executive teams create and preserve long-term value by acting as well-being stewards of their enterprises. This includes providing appropriate levels of well-being governance and oversight, underpinned by the fact that healthy employees make better decisions and drive superior results. Effective leaders and boards understand the connection between corporate performance and well-being, including the materiality of well-being for executive-level human capital. And corporate governance of executive wellness has evolved from an HR-led perk into a strategic board-level priority, essential for both risk management and long-term value creation.

Getting this right involves formal safeguarding of the physical and mental health of senior leaders to ensure stable decision-making and organizational resilience. Ultimately, executive wellness is a “human capital” governance issue requiring top-level oversight and strategic integration. And in a way that recognizes that leadership burnout and health crises directly impact share price and operational stability. 

This necessitates having accountability via standing committees, such as governance or compensation committees, charged with reviewing wellness assessments and setting baseline health targets for leaders. It also means elevating succession planning to include proactive health governance so that leadership pipelines remain healthy and “key person” risks for executives’ health are mitigated. And given that effective governance requires leaders not only to oversee wellness but also to model it, boards can mandate resilience training and structured stress management for executives in ways that support upskilling and also help nurture a health-forward culture that filters down to the entire workforce.

Other initiatives may include:

• Visible participation of executives in wellness initiatives to legitimize and destigmatize such initiatives
• Use of KPIs to track effectiveness at the workforce population level and for key executives and high-potential succession talent
• Review of data on absenteeism, retention, and healthcare offerings engagement as well as use of frameworks for auditing workplace health and safety at the executive level
• Tying executive compensation to health and wellness goals to emphasize the importance of prioritizing health
• Setting clear standards on using existing wellness initiatives and perks, as simple as ensuring leaders use a minimum proportion of their vacation days each year 

A fiduciary duty

Forward-thinking organizations must now treat leadership health with the same rigor as financial reporting, ultimately recognizing wellness as a fiduciary duty. What began as private health concerns behind closed doors have transformed into a material business factor that now influences investor decisions, market valuations, and regulatory frameworks. At a time when nearly 70% of the C-suite are seriously considering quitting for a job that better supports their well-being, and 81% prioritize their health over advancing their career, we need to overcome old disconnects around performance and health. A strong focus on well-being is critical to both employee and executive retention.

Now is the time to legitimize executive well-being and make it part of the regular corporate dialogue. It should be explored with authentic curiosity and deep urgency around how top leaders are doing as a way for companies and investors to develop new “antennae.” This is especially important given that recent research from Spencer Stuart shows only 22% of global CEOs feel their board provides opportunities to discuss sensitive topics such as personal well-being.

And given CEOs’ shortening tenures, it is critical that boards and not just C-suite executives ensure well-being governance endures and is perpetuated. If best practice is oversight for areas most material to a business, whether to reduce risk or capture competitive advantage, it only makes sense that we ensure special wellness focus for top leaders as part of that oversight.

The financial and nonfinancial impacts are impossible to ignore. And as we move from looking at executive wellness as a personal matter to recognizing it as a fundamental pillar of sustainable business practice, it’s time we recognize a novel truth: Executive wellness governance really is the new corporate imperative.

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