designing the age friendly worksite1 module 5: focus on the individual health promotion &...

Designing the Age Friendly Worksite 1

Module 5: Focus on the Individual

Health Promotion & Disease Prevention


The MAP Table

Action Area Examples

The Work Environment

COMPLETE

The Individual UP NEXT

Work/Life Balance - Work Arrangements

- Community Support


Causes of Death in the United States, 2005

26.6

22.8

5.9

5.3

4.8

3.1

2.6

2.9

1.8

0 5 10 15 20 25 30

Diseases of the Heart

All Cancers

Stroke

COPD

Unintentional Injuries

Diabetes Mellitus

Influenza & Pneumonia

Alzheimer's Disease

Nephritis & Nephrosis

% of total deaths

Source: Centers for Disease Control and Prevention


Prevalence of Chronic ConditionsCoronary Heart Disease and Age

0

5

10

15

20

25

30

18-44 45-64 65-74 75+

Age Group

Data from National Health Interview Survey, 2006

Pe

rce

nt

of

Pe

op

le w

ith

Hig

h C

HD


Prevalence of Chronic Conditions:Cancer and Age

00.5

11.5

22.5

33.5

44.5

5

18-44 45-64 65-74 75+

Age Group

Data from National Health Interview Survey, 2006

Pe

rce

nt

of

Pe

op

le w

ith

Can

ce

r


Leading Causes of Disability Among Persons Aged 18 Years or Older, United States, 1999

17.5

16.5

7.8

4.7

4.4

4.2

3.7

3.4

3.3

2.8

0 5 10 15 20

Arthritis / Rheumatism

Back / Spine

Heart

Respiratory

Deafness / Hearing

Stiff / Deformed Limb

Mental / Emotional

Diabetes

Blindness / Vision

Stroke

% of all disabilitiesSource: Centers for Disease Control and Prevention

Designing the Age Friendly Worksite 7Data from National Health Interview Survey, 2006

Chronic Disease Increases with Age:Arthritis

0

10

20

30

40

50

60

18-44 45-64 65-74 75+

Age Group

Pe

rce

nt

of

Pe

op

le w

ith

Art

hri

tis


Low Back Pain in the Last Three Months, 2006

31.235.9

24.6

32.027.4

22.1

0

10

20

30

40

18-34 35-50 51+Age group

% of respondents with back pain

Construction All industries


Construction: Chronic Conditions and Age

05

101520253035404550

Prevalence

Obesity Overweight

18-34 35-54 55+

Source: The Construction Chart Book, 4th Edition. CPWR


Diabetes in Construction

0

1

2

3

4

5

6

7

8

Prevalence

< 40 40 - 54 55 - 64Age Group1990 1995 2000 2005



Construction vs. All Industries:Risk Factors

05

101520

25303540

45

Prevalence

Smokes Overweight Obese

Construction All Industries



Annual Cost of Chronic Diseases

CDC. The Power of Prevention. Reducing the Health and Economic Burden of Chronic Disease. Atlanta: U.S. Department of Health and Human Services; 2003.

0

50

100

150

200

250

300

350

400

Heart/Stroke Cancer Diabetes Arthritis

Medical Productivity

Bill

ion

$


Per Capita Health Expenditures by Age, 2004

0

5000

10000

15000

20000

25000

30000

0-18 19-44 45-54 55-64 65-74 75-84 85+

Age Group

Do

llar

s

Centers for Medicaid and Medicare ServicesOffice of the ActuaryNational Health Statistics Group


Percentage of Employees with Health Insurance, by Industry and Source


0 20 40 60 80 100

Construction

Transportation

Public Admin

All Industries

Employment-Based Direct Purchased Public

%

Designing the Age Friendly Worksite

15

Three Levels of Health Promotion

Level of Control Examples

Primary: Preventive Services Influenza immunization

Secondary: Early Diagnosis and Health Improvement

Blood sugar screening for detecting diabetes

Tertiary: Disease Management Medicine and exercise for people with heart disease


Elements of Health Promotion

• Health-related lifestyles

• Use of clinical preventive services



• Health-related lifestyles:– healthy eating

– physical activity

– avoiding smoking

– maintaining a healthy body weight

• Use of clinical preventive services



• Health-related lifestyles

• Use of clinical preventive services:– smoking cessation treatment

– vaccination

– screening for cancer

– screening for high blood pressure

– screening for high cholesterol


Some Strategies Work Better Than Others (there are “Hierarchies of Control”)

• Preventing illnesses and injuries is more effective than treating them

• Making the job fit the worker is always better than trying to get the worker to fit the job

• Environmental or system change is more reliable than individual change


A Preventive Services Program

• Provide Services and Adopt Policies That Are Proven to Work• Provide Incentives• Communicate “why” and “how”• Track Results

Adapted From: Employment Based Prevention of Chronic Disease in Washington State, 2005 University of Washington Health Promotion

Research Center December 2005



• Provide Services and Adopt Policies That Are Proven to Work– Smoking Cessation Counseling– Influenza and pneumonia vaccines– Breast, cervical and colorectal cancer screening– Blood pressure and cholesterol screening– Physical activity and healthy eating promotion

• Provide Incentives• Communicate “why” and “how”• Track Results



• Provide Services and Adopt Policies That Are Proven to Work• Provide Incentives

– Reduce or eliminate cost sharing– Provide easy access and use: location, hours, child care

• Communicate “why” and “how”• Track Results



• Provide Services and Adopt Policies That Are Proven to Work• Provide Incentives• Communicate “why” and “how”• Track Results

– Baseline data– Measure progress



• Provide Services and Adopt Policies That Are Proven to Work– Smoking Cessation Counseling– Influenza and pneumonia vaccines– Breast, cervical and colorectal cancer screening– Blood pressure and cholesterol screening– Physical activity and healthy eating promotion

• Provide Incentives– Reduce or eliminate cost sharing– Provide easy access and use: location, hours, child care

• Communicate “why” and “how”• Track Results

– Baseline data– Measure progress


BUILT Program

• Building Trades Unions Ignite Less Tobacco

• Background– California State Building & Construction Trades Council

– Resources for employers, unions, apprenticeship programs, workers and workers’ families

– Resources in Spanish and English

– Ignore the compliance-related information

– Funding for the project’s development ended in 2007

• Great resources are still available at a very low cost!


BUILT Program

• Objectives:– Provide resources on prevention and cessation of tobacco

use to construction workers

– Educate construction workers about the dangers of tobacco and the toxic exposures they face at work

– Promote smoke-free environments on and off the job site

– Counter pro-tobacco influences by showing how the tobacco industry has targeted blue-collar workers


BUILT Program

• BUILT Tools– Tobacco-Free Construction Worksites

• A comprehensive guide to several different forms of tobacco control on construction sites

– Quitting Tobacco - The Next Step• A program designed for employers to help them build a smoking

cessation program

– Tailgate Training• Resources developed to educate workers

– Signage for Use on the Construction Site


BUILT Program

• How and where it can be used– Through local unions

– Through Health and Welfare Funds

– Through Joint Apprenticeship Training Committees

– Through Labor-Management Committees

• More information– About BUILT: http://www.sbctc.org/built/

– Placing orders: http://www.tobaccofreecatalog.org• Search the website for “construction”

http://www.sbctc.org/built/

http://www.tobaccofreecatalog.org/


69

61

47

43

16

0 20 40 60 80

Missed Flu Shot

Overweight /Obese

Missed ColonCancer Screen

Low PhysicalActivity

Smoke

WA Workers Have High Risks

From Jeff Harris, MD, U. of Washington, May 21, 2007 Source: Hughes, Hannon et al. WA BRFSS; Workers w/ Ins., age 18-64, 2004-5.

Note: 40 percent of Washingtonians are already overweight or obese by ages 18-24. Rises to 65 percent for those ages 45-54.

%


Percent of Employers’ Insurance Policies That Miss Opportunities

From Jeff Harris, MD, U. of Washington, May 21, 2007 2180 employers. Bondi et al. Am J Health Promot. 2006;20:214-22.

80

68

55

10

6

0 20 40 60 80 100

Mammogram

Colorectal Cancer Screening

Flu Vaccination

Smoking Meds, Counsel

OTC Nicotine Replacement

%


Chronic diseases can be both prevented and managed, but…

• Employers under-purchase key clinical preventive services that offer the greatest value

• Washington State workers do not engage in health-related lifestyles that could prevent, delay, or manage chronic diseases

• Washington State workers under-use those same key, high-value clinical preventive services when they are offered

From: Employment Based Prevention of Chronic Disease in Washington StateUniversity of Washington Health Promotion Research Center December 2005


Rose and Carlos


Questions

• Should Yeats encourage Rose and Carlos to exercise? Why or why not? If so, how do they go about it?

• Do you know anyone like Carlos at your organization?


Your Turn: The MAP Table

Health Promotion and Disease Prevention IdeasAction Area

The Individual


Your Turn: Funneling

From:

To:

To:

To: Early win:

From:

To:

To:

To:


Fitting Action Items into Action Plans

Action Area What Who When How Challenges Next Steps

The Individual

Action Item: ___________________________________

Who’s the leader? ___________________________________

When will it be done? __________________________________

How will it get accomplished? ____________________________

What are some initial challenges for this Action Item?:

___________________________________________________________________________________

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