Researchers from the Centers for Disease Control and Prevention studied strategies to prevent cardiovascular disease and found that over a two- to five-year period, companies with comprehensive workplace wellness programs and appropriate health plans in place can yield US$3 to US$6 for each dollar invested and reduced the likelihood of employee heart attacks and strokes.[19] Also, a 2011 report by Health Fairs Direct which analyzed over 50 studies related to corporate and employee wellness, showed that the return on investment (ROI) on specific wellness related programs ranged between $1.17 to $6.04.[20] In general, it is estimated that worksite health promotion programs result in a benefit-to-cost ratio of $3.48 in reduced health care costs and $5.82 in lower absenteeism costs per dollar invested, according to the Missouri Department of Health & Senior Services.[21] Additionally, worksite health programs can improve productivity, increase employee satisfaction, demonstrate concern for employees, and improve morale in the workplace.[22]