We sought to provide evidence for the relationship between health risks and self-reported productivity, including health-related absence and impaired performance on the job. A cross-sectional analysis was implemented consisting of 2264 employees of a large national employer located in the Northeast. Participants responded to a health risk assessment and work productivity scale. Mean productivity loss was compared for individuals with different levels of risk factors using analysis of variance. Multivariate analyses, including logistic and linear regression, were used to determine the significance of health risks on productivity loss. Participants with more risk factors reported greater productivity loss (P < 0.001). The odds of any productivity loss were most significant for individuals with diabetes (absenteeism) and stress (presenteeism). In conclusion, higher risks are strongly associated with greater productivity loss, and different risks are associated with absenteeism than with presenteeism.