Revealing research from Fidelity Investments highlights the toll financial stress takes on productivity through increased absenteeism.

Absenteeism doubles for employees with high levels of debt, according to a recent study by Fidelity Investments.

The study focused on the four pillars of well-being (financial, health, work, and life) and found that employees struggle most with their financial well-being. A whopping 98 percent of respondents reported feeling stressed in the past three months. Employees reported high levels of stress caused by debt (33%), saving for the future (34%), their job (47%), and their weight (30%).

Workers with high levels of debt were very unlikely to be in “excellent” health, only 14% compared with 35% of workers without debt issues. Those struggling with debt were also less likely to get enough sleep and more likely to be frequently stressed or anxious. On average, employees with the highest levels of debt missed an additional full week of work more than those with the lowest levels of debt.

Past-due medical bills were the leading indicator of workplace absenteeism, followed by payday loans, personal loans, retirement plans, and mortgages. Surprisingly, student loans and credit card debt were not significant causes for employees to miss work.

“When it comes to total well-being programs, employers have traditionally focused on health, but have recently expanded efforts to include financial wellness. Financial wellness programs have gone a long way toward helping workers to create a budget they can live with and have helped many employees consolidate and/or minimize debt,” said Jeanne Thompson, head of Global Workplace Insights, Fidelity Investments.

Strong healthcare plans, retirement plans, and payday advance programs could reduce absenteeism and help employers take back productivity. In order for those systems to be effective, however, employees must learn how to manage their money. Financial wellness programs, like Best Money Moves, lower the high levels of financial stress employees experience by helping them take control of their personal finances.