Financial impact of a comprehensive multisite workplace health promotion program.

Aldana SG, Merrill RM, Price K, Hardy A, Hager R.

Source

Department of Physical Education, College of Health and Human Performance, Brigham Young University, Provo, UT 84602-2214, USA. steve_aldana@byu.edu

Abstract

INTRODUCTION:

The purpose of this study is to determine if the Washoe County School District Wellness Program impacted employee health care costs and rates of absenteeism over a 2-year period.

METHODS:

Outcome variables included health care costs and absenteeism during 2001-2002. Data were collected on 6246 employees over a 6-year period from 1997-2002. Baseline health claims costs and absenteeism from 1997-2000, age, gender, job classification, and years worked at the school district were treated as covariates. Logistic regression was used to compare 2-year costs and absenteeism rates between nonparticipants and employees who participated for 1 and 2 years.

RESULTS:

No significant differences in health care costs were found between those who participated in any of the wellness programs and those who did not participate. There was a significant negative association between participation and absenteeism; program participants averaged three fewer missed workdays than those who did not participate in any wellness programs. The decrease in absenteeism translated into a cost savings of 15.60 US dollars for every dollar spent on the program.

CONCLUSIONS:

After controlling for several confounding variables, wellness program participation was associated with large reductions in employee absenteeism.

Health benefits of a pedometer-based physical activity intervention in sedentary workers.

Chan CB, Ryan DA, Tudor-Locke C.

Source Department of Biomedical Sciences, University of Prince Edward Island, Charlottetown, PE, Canada C1A 4P3. cchan@upei.c

BACKGROUND:

Inactivity is a leading contributor to chronic health problems. Here, we examined the effects of a pedometer-based physical activity intervention (Prince Edward Island-First Step Program, PEI-FSP) on activity and specific health indices in 106 sedentary workers.

METHODS:

Participants were recruited from five workplaces where most jobs were moderately-highly sedentary. Using subjects as their own control, physical activity (pedometer-determined steps per day) was compared before and after a 12-week intervention. Changes in body mass index (BMI), waist girth, resting heart rate, and blood pressure were evaluated.

RESULTS:

The PEI-FSP was completed by 59% of participants. Steps per day increased from 7,029 +/- 3,100 (SD) at baseline to a plateau of 10,480 +/- 3,224 steps/day by 3.96 +/- 3.28 weeks of the intervention. The amount that participants were able to increase their steps per day was not related to their baseline BMI. On average, participants experienced significant decreases in BMI, waist girth, and resting heart rate. Reductions in waist girth and heart rate were significantly related to the increase in steps per day. In contrast, reductions in BMI were predicted by the initial steps per day.

CONCLUSIONS:

The PEI-FSP increased physical activity in a sedentary population. Importantly, those with a higher BMI at baseline achieved relatively similar increases in their physical activity as participants with a lower BMI.

Health and Well-Being in the Workplace: A Review and Synthesis of the Literature

Journal of Management (1999) Volume: 25, Issue: 3, Publisher: Sage Publications, Pages: 357-384

Abstract

Health and well-being in the workplace have become common topics in the mainstream media, in practitioner-oriented magazines and journals and, increasingly, in scholarly research journals. In this article, we first review the literature that serves to define health and well-being. We then discuss the primary factors associated with health and well-being, the consequences of low levels of health and well-being, and common methods for improving health and well-being in the workplace. Finally, we highlight important future directions for future theory, research, and practice regarding health and well-being from an organizational perspective

BUILDING HEALTH ORGANISATIONS TAKES MORE THAN SIMPLY PUTTING A WELLNESS PROGRAM

Physical exercise is any bodily activity that enhances or maintains physical fitness and overall health and wellness. It is performed for various reasons including strengthening muscles and the cardiovascular system, honing athletic skills, weight loss or maintenance, as well as for the purpose of enjoyment. Frequent and regular physical exercise boosts the immune system, and helps prevent the "diseases of affluence" such as heart disease, cardiovascular disease, Type 2 diabetes and obesity.[1][2] It also improves mental health, helps prevent depression, helps to promote or maintain positive self esteem, and can even augment an individual's sex appeal or body image, which is also found to be linked with higher levels of self esteem.[3] Childhood obesity is a growing global concern[4] and physical exercise may help decrease some of the effects of childhood and adult obesity. Health care providers often call exercise the "miracle" or "wonder" drug - alluding to the wide variety of proven benefits that it provides.[5][6]

Classification

[edit] Types of exercise

Physical exercises are generally grouped into three types,[7] depending on the overall effect they have on the human body:

Flexibility exercises, such as stretching, improve the range of motion of muscles and joints.[8]

Aerobic exercises , such as cycling, swimming, walking, skipping rope, rowing, running, hiking or playing tennis, focus on increasing cardiovascular endurance.[9]

Anaerobic exercises , such as weight training, functional training, eccentric training or sprinting, increase short-term muscle strength.[10]

[edit] Categories of physical exercise

Strength training Agility training Eccentric Training

Sometimes the terms 'dynamic' and 'static' are used. 'Dynamic' exercises such as steady running, tend to produce a lowering of the diastolic blood pressure during exercise, due to the improved blood flow. Conversely, static exercise (such as weight-lifting) can cause the systolic pressure to rise significantly (during the exercise).

[edit] Categories

Physical exercise is used to improve physical skills. Physical skills fall into the following general categories: Cardiovascular/respiratory endurance, Stamina, Strength, Flexibility, Power, Speed, Coordination, Agility, Balance, and Accuracy.[11]

[edit] Metabolic equivalent of task

The Compendium of Physical Activities was developed for use in epidemiologic studies to standardize the assignment of metabolic equivalent of task (MET) intensities in physical activity questionnaires. The Compendium is list of physical activities and the associated energy cost of each activity. The original Compendium was published in 1993, the first update in 2000, and the most recent update in 2011.[12]

MET (Metabolic Equivalent): The ratio of the work metabolic rate to the resting metabolic rate. One MET is defined as 1 kcal/kg/hour and is roughly equivalent to the energy cost of sitting quietly. A MET also is defined as oxygen uptake in ml/kg/min with one MET equal to the oxygen cost of sitting quietly, equivalent to 3.5 ml/kg/min.

Physical exercise is important for maintaining physical fitness and can contribute positively to maintaining a healthy weight, building and maintaining healthy bone density, muscle strength, and joint mobility, promoting physiological well-being, reducing surgical risks, and strengthening the immune system.

Exercise reduces levels of cortisol [13] , which causes many health problems, both physical and mental.[14]

Frequent and regular aerobic exercise has been shown to help prevent or treat serious and life-threatening chronic conditions such as high blood pressure, obesity, heart disease, Type 2 diabetes, insomnia, and depression.[15] Endurance exercise before meals lowers blood glucose more than the same exercise after meals.[16] According to the World Health Organization, lack of physical activity contributes to approximately 17% of heart disease and diabetes, 12% of falls in the elderly, and 10% of breast cancer and colon cancer.[17]

There is some evidence that vigorous exercise (90–95% of VO2 Max) is more beneficial than moderate exercise (40 to 70% of VO2 Max).[18] Some studies have shown that vigorous exercise executed by healthy individuals can increase opioid peptides (a.k.a. endorphins, naturally occurring opioids that in conjunction with other neurotransmitters are responsible for exercise-induced euphoria and have been shown to be addictive), increase testosterone and growth hormone,[19] effects that are not as fully realized with moderate exercise. More recent research[20]

[21] indicates that anandamide may play a greater role than endorphins in "runner's high". However, training at this[which?] intensity for long periods of time, or without proper warmup beforehand and cooldown afterwards, can lead to an increased risk of injury and overtraining.[citation needed]

Both aerobic and anaerobic exercise work to increase the mechanical efficiency of the heart by increasing cardiac volume (aerobic exercise), or myocardial thickness (strength training). Such changes are generally beneficial and healthy if they occur in response to exercise.

Not everyone benefits equally from exercise. There is tremendous variation in individual response to training; where most people will see a moderate increase in endurance from aerobic exercise, some individuals will as much as double their oxygen uptake, while others can never augment endurance.[22][23] However, muscle hypertrophy from resistance training is primarily determined by diet and testosterone.[24] This genetic variation in improvement from training is one of the key physiological differences between elite athletes and the larger population.[25][26] Studies have shown that exercising in middle age leads to better physical ability later in life.[27]

[edit] Cardiovascular system

The beneficial effect of exercise on the cardiovascular system is well documented. There is a direct relation between physical inactivity and cardiovascular mortality, and physical inactivity is an independent risk factor for the development of coronary artery disease. There is a dose-response relation between the amount of exercise performed from approximately 700 to 2000 kcal of energy expenditure per week and all-cause mortality and cardiovascular disease mortality in middle-aged and elderly populations. The greatest potential for reduced mortality is in the sedentary who become moderately active. Most beneficial effects of physical activity on cardiovascular disease mortality can be attained through moderate-intensity activity (40% to 60% of maximal oxygen uptake, depending on age). ... persons who modify their behavior after myocardial infarction to include regular exercise have improved rates of survival. ... Persons who remain sedentary have the highest risk for all-cause and cardiovascular disease mortality.[28]

Excessive exercise

Exercise is a stressor and the stresses of exercise have a catabolic effect on the body—contractile proteins within muscles are consumed for energy, carbohydrates and fats are similarly consumed and connective tissues are stressed and can form micro-tears.[citation needed] However, given adequate nutrition and sufficient rest to avoid overtraining, the body's reaction to this stimulus is to adapt and replete tissues at a higher level than that existing before exercising.[citation needed] The results are all the training effects of regular exercise: increased muscular strength, endurance, bone density, and connective tissue toughness.[citation needed]

Too much exercise can be harmful. Without proper rest, the chance of stroke or other circulation problems increases,[46] and muscle tissue may develop slowly. Extremely intense, long-term cardiovascular exercise, as can be seen in athletes who train for multiple marathons, has been associated with scarring of the heart and heart rhythm abnormalities.[47][48][49]

Inappropriate exercise can do more harm than good, with the definition of "inappropriate" varying according to the individual. For many activities, especially running and cycling, there are significant injuries that occur with poorly regimented exercise schedules. Injuries from accidents also remain a major concern,[50] whereas the effects of increased exposure to air pollution seem only a minor concern.[51][52]

In extreme instances, over-exercising induces serious performance loss. Unaccustomed overexertion of muscles leads to rhabdomyolysis (damage to muscle) most often seen in new army recruits.[53] Another danger is overtraining, in which the intensity or volume of training exceeds the body's capacity to recover between bouts.[54]

Stopping excessive exercise suddenly can also create a change in mood. Feelings of depression and agitation can occur when withdrawal from the natural endorphins produced by exercise occurs.[citation needed] Exercise should be controlled by each body's inherent limitations. While one set of joints and muscles may have the tolerance to withstand multiple marathons, another body may be damaged by 20 minutes of light jogging. This must be determined for each individual.

Too much exercise can also cause a female to miss her period, a symptom known as amenorrhea.[55]