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Comprehensive Workplace Wellness Programming

Jane Ellery, Ph.D.

Director of Wellness Management

Fisher Institute for Wellness and Gerontology

Ball State University

jellery@bsu.edu

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Focus of Presentation

Doing Things Right vs. Doing the Right Things Supporting Evidence and Current

Programming Risk Reduction, Wellness, and Cost Sharing Suggestions for Successful Programming Reaching the “Hard to Reach” by Using Data

to Drive Decision-Making Take Home Messages

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Health Care Spending Rising (CDC, NCCDPHP)

Our nation spends more on health care than any other country in the world.– 1980 health care costs totaled $245 billion

average of $1,066/American

– 2003 total health care cost $1.7 trillion average of $5,805/American

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Costs of Chronic Disease (CDC, NCCDPHP)

Over 90 million Americans live with chronic illnesses– 75% of the Nation’s medical care costs 

Annual cost of:– Diabetes – $132 billion– Arthritis – $22 billion (additional $60 billion in lost

productivity)– Smoking – $75 billion– All Cardiovascular Diseases – $300 billion

(additional $129 billion in lost productivity)– Physical inactivity – $76 billion 

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Percentage of Adults Who Are Obese,* by State (CDC, NCCDPHP)

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Causes of Death, IN Compared to US, 2001 (CDC, NCCDPHP)

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Risk Factors and Preventive Services, IN Compared to US, 2001 – 2002 (CDC, NCCDPHP)

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Health Care System or Sick Care…

Health care spending:– Chronic Disease (75%)… $4,354/person– Prevention (2%)… $116/person

Treat the symptoms and ignore the underlying problem Obesity epidemic… convenience and excessive

consumption (inactivity and overeating) Lifestyle decisions and immediate gratification Government agencies leading the health protection

charge– CDC/National Center for Chronic Disease Prevention and

Health Promotion– Department of Health and Human Services: HP 2010

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Read this sentence…

FINISHED FILES ARE THE RESULT OF YEARS OF SCIENTIFIC STUDY COMBINED WITH THE EXPERIENCE OF YEARS.

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Why Offer Health and Wellness Programs?

Because it’s the right think to do Keep workers healthy Improve morale Retain employees Reduce medical care costs Attract good employees Improve productivity Decrease absenteeism

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Strength of Evidence for Worksite Wellness

Type of Program or Target Behavior

AMajor Cause of Disease or Cost

BPrograms Alter

Behavior

CPrograms Reduce

Cost

Multi-Component Very Strong Strong Very Strong

Hypertension Control Very Strong Very Strong Strong

Tobacco Use Very Strong Strong Strong

Medical Self-Care Very Strong Very Strong Very Strong

Nutrition Education Very Strong Strong Weak

Weight Management Strong Moderate Weak

Physical Activity Very Strong Strong Moderate

Stress Management Very Strong Moderate Strong

Back Injury Prevention Very Strong Moderate Strong

Cholesterol Reduction Very Strong Weak Weak

Pre-natal Care Very Strong Strong Strong

High Risk Intervention Very Strong Very Strong Strong- Chapman, Proof Positive, 2002

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Most Common Worksite Programs

Smoking Cessation Back Injury

Prevention Violence Prevention Blood Pressure

Screening Stress Management Fitness

HIV/Aids Nutrition/Cholesterol

Education and Screening

Health Risk Assessment

Alcohol and Drug Abuse Intervention

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Broad Approaches to Health in the Workplace

Health Promotion Prevention, Early Detection, and Risk

Reduction Wellness Cost Sharing/Cost Containment

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WHO Definition of Health

Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.

– Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 states (Official Records of the World Health Organization, no. 2, p 100) and entered into force on 7 April 1948.

– The Definition has not been amended since 1948.

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Merriam-Webster Definitions

Health – The condition of being sound in body, mind, or spirit; especially: freedom from physical disease or pain

Promotion – The act of furthering growth or development of something

Prevent – to keep from happening or existing Early – Near the beginning of a course, process, or series Detect – To discover or determine the existence,

presence, or fact of Risk – The possibility of loss or injury Reduce – To diminish in size, amount, extent, or number Wellness – The quality or state of being in good health

especially as an actively sought goal

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Risk Reduction, Prevention, and Early Detection Programs

Taking steps to decrease the chance of developing a disease or other health concern:

– Lowering your blood pressure– Losing weight– Stopping smoking

Focus on parts of self “Normal” as a criterion Professional directs action Primarily “Physical” emphasis

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Worksite Programs, revisited

Smoking Cessation Back Injury

Prevention Violence Prevention Blood Pressure

Screening Stress Management Fitness

HIV/Aids Nutrition/Cholesterol

Education and Screening

Health Risk Assessment

Alcohol and Drug Abuse Intervention

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Wellness

An integrated method of functioning which is oriented toward maximizing the potential of which the individual is capable, within the environment where he is functioning

– Halbert Dunn, 1977

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Wellness

Multidimensional and Interactional– Physical– Emotional– Social– Intellectual– Occupational– Spiritual– Environmental

Variable, not static… and Ever-Changing– Youth a Gift of Nature...Age a Work of Art

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Focus on Promoting/ Protective Factors

What makes us strong? What experiences make us more resilient? What opens us to more fully experience life? What in organizations makes us grow? How can we give meaning to life? What produces high level well-being?

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Sense of Coherence (Antonovsky, 1979)

Your world is understandable: Stimuli from internal and external sources is perceived as structured and predictable. (Comprehensible)

Your world is manageable: Resources exist to meet demands posed by stimuli (Manageability)

Your world has meaning: Demands are challenges worth spending energy/effort on (Meaningfulness)

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Tasks that Should be Considered

Manage the pace of life Set priorities Develop needed personal and occupational

skills Connect people As a manager, think about the needs of the

whole person… body, mind, and spirit

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Wellness Programs

Quality of life/life satisfaction monitoring A holistic approach Unique person directs action Multidimensional expression across lifespan Number and quality of friendships/social

support Mental engagement Environmental awareness

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Basic Life Style Behaviors

Get enough sleep Eat a balanced diet Think healthy… not thin Lead an active life Don’t smoke and avoid second hand

smoke Drink in moderation or not at all Relax and avoid or control stress Stay connected

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Cost Sharing/Cost Containment

Somewhat Newer Addition to the mix Cost shifting: Employee pays a greater

portion of the health insurance premium “Incentivizing”: Employee rewarded for

healthy lifestyle choices

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Cost Sharing/Cost Containment Programs

$100 voucher to use toward December health insurance premium for filling out an HRA

$500 check for participating in a smoking cessation program and being smoke-free for 6 months. Receives an additional $100 every year on smoke-free anniversary

$200 shopping certificate for each 20 pound weight loss

10% reduction in health insurance premium if 1 or less “risk factor”

Pay higher percentage of health premium if non-compliant

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Program Targets for Worksites… A Balancing Act

Remedial and rehabilitative– Disability and illness specific– Work hardening

Prevention/risk reduction programs Life enhancing and growth producing

– Social/fun– Financial planning– Leadership training

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What Does it Take To Be Successful in Worksite Health?

Base programs on diversity of workforce and the organizational culture

Communicate with your employees about health related concerns and goals

Ask your employees about their lifestyle-decision making interests

Implement programs that make sense for the size and type of your workplace

Make a permanent commitment to improve and maintain health of your employees… identify what is valued and live those values

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Toward Successful Programming…

Individual behavioral change Physical work environment Organizational development & policies Community collaboration and environmental

issues

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Examples of Individual Change

Work station stretching Meditation and other Relaxation Techniques Walking clubs Self-care guide use and education programs Healthy eating… when and where you eat,

as well as what. Health risk appraisal and risk management Personal/Professional Development

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Examples of Physical Work Environment

Vending machines: snacks vs. low fat Promoting walking by marking paths and

using signage to promote use Posting/delivering health messages Quiet room for relaxation Personal control of workspace Ergonomically correct workspaces Workloads consistent with a normal work day

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Organizational Development & Policies

Upper management buy-in Commitment to wellness by including it in the

company’s vision Health theme months Subsidize fitness/health club memberships Newsletters, emails, payroll inserts with health

tips Departmental competitions: walking, weight, etc. Special recognition of participants

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Health and Productivity Management

Individual Elements Health Enhancement Injury Prevention Participation Program Requests Informal Leaders-

Communication

Workplace Culture Policy Enhancement Workplace/job satisfaction Management Support Culture Change Integration

Organizational Components Disability Management Health Promotion Return-to-work programs and policies Occupational Health Regulations

Incentives Benefits Needs Assessment Evaluation Projects

Institute for Health and Productivity Management

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Community Collaboration

Advocating for sidewalks, bike trails and health-related community planning

Health related speakers from community Local restaurants sponsoring low fat foods and

cooking classes Children of employees creating health posters

and messages Sponsor parks and recreation programs Involve health related organizations in

programs for employees

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Audience Perspective

“You don’t build it for yourself. You find out what the people want and you build it for them”

- Walt Disney

Healthy lifestyle strategy that encourages an audience focus…

Wellness Marketing

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Wellness Marketing:Distinctive Features

Consumer orientation Uses commercial marketing technologies

and theory (product, price, place, promotion; exchange theory)

Voluntary behavior change Data drives decision-making Targets specific audiences

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Creating the Competitive Advantage

“Positioning our product relative to the competition” Increase the benefits of the target behavior Decrease the barriers (and/or costs) to the target

behavior Decrease the benefits of the competing behavior(s) Increase the barriers (and/or costs) of the competing

behaviors.

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The 4 Ps

Product – Tangible items and services that encourage individuals to perform the desired behavior

Price – The cost that the target market associates with the behavior

Place – Where and when the target market will perform the desired behavior, acquire any related tangible objects, and receive any associated services

Promotion – Creating messages and selecting media channels

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Back to Worker Health

Beyond unintentional injuries… Relational Theory suggests social

connectedness is the primary determinant of health (sign language interpreters and carpal tunnel… nurses and back injuries)

Gallop research in organizational development suggests relationships are what drive organizational health and vitality

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Resilient Employees… (David Lee,

www.HumanNatureAtWork.com)

Believe they are part of an organization that matters and is worthy of pride

Have a chance to make a difference, a chance to matter Experience self-efficacy Experience control in their jobs Have the chance to learn and grow Are “kept in the loop” Are treated with respect Believe their manager, and management in general, cares

about them as human beings Trust management’s ability and intentions Believe they, and their work, are appreciated

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Take Home Message

Well designed workplace wellness programs can reduce medical claims and worker’s compensation costs. ROI: about $3 for every $1 invested. (Goetzel, Chapman, Edington). But, wellness should be considered an investment, not a cost

Interventions should follow a “systems” approach to changing behavior, including individual behavior changes and organizational policy, as well as workplace culture and community-level and “built environment” issues. Collaborative efforts are important!

Programs should be tailored to the specific needs and wants of the population served, and each workplace has unique challenges. Overall, work toward having a fast, friendly, flexible, focused, and happy workforce.

Buy-in from all “customers” (upper-management, “end users,” and everyone in between) is key to the success of your initiatives.

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WellForce Development Workshops

Quarterly ½ day workshops to help HR Managers and Wellness professionals with Workplace Wellness programming

Visit www.bsu.edu/workplacewellness Next workshop: October

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Continuing Education…

Graduate Degree Programs and Graduate Certificates

Graduate Assistantships to support graduate work

Working with partners to develop an intensive workshop accompanied by technical assistance and consultation

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Workplace Wellness Resources

Fisher Institute for Wellness and Gerontology– www.bsu.edu/wwrt www.bsu.edu/wellness

Wellness Council of Indiana– http://www.wellnessin.org/

Wellness Councils of America– http://www.welcoa.com/

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Comprehensive Workplace Wellness Programming

Jane Ellery, Ph.D.

Director of Wellness Management

Fisher Institute for Wellness and Gerontology

Ball State University

jellery@bsu.edu