Employer Wellness

Introduction to Employee Health Promotion Programs

The last ten years has brought major changes in company attitudes toward Corporate Health Promotion Programs. Interest in self-help and self-care programs has increased as growth in medical costs have encroached substantially into profits. Changes in the company structures of medical facilities, in particular the growth of the for-profit medical sector, and the need to contain costs are changing the ways in which purchasers of medical plans are viewing their own efforts toward provision of workplace medical programs and facilities. Projections for the next decade indicate that workplace health programs will continue to become valuable factors in the provision of medical, including prevention activities, for both government and private industry. In companies with existing Corporate Health Promotion Programs, administrative rationale for sponsoring these activities ranged from improving employee health (28%) to improving employee morale (9.7%). Programs include interventions associated with safety, health risk assessment, tobacco cessation, Blood Pressure (BP) control, diet programs and stress management. Benefits cited range from improved health and work rate to reducing medical costs.

Demographics of the U.S. Workforce
• 110 million American citizens composed the civilian labor force in 1981; by the year 2000 the civilian labor force is predicted to be nearly 140 million.
• 44 percent of the 1984 labor force was female; ten percent was Black.
• The median age of the workforce is 32 years and is expected to grow to 32 years by 2030.
• 57.9 percent of all employees work in businesses with between 2 and 500 employees; 45 percent work in businesses with fewer than 100 employees. An additional 7.5 million Americans are self-employed and 3 million are farmers.
• 18 percent of all wage and salaried employees in 1985 were union members.
• 45 percent of all staff members are employed in offices.

Prevalence of Workplace Wellness Programs Activities

Based on a 1985 survey, almost 66 percent of worksites with 50 or more workers had Corporate Wellness Programs activities in 1985.  The frequency of workplace-based activities by selected categories in 1985 was:

Activity

Smoking Control       35.6 percent
Health Risk Assessment    29.5 percent
Back Care             28.6 percent
Stress Management       26.6%
Exercise             22.1 percent
Off the Job Accidents    19.8 percent
Nutrition             16.8%
Blood Pressure Control    16.5 percent
Weight Control          14.7 percent

Job Site size is the strongest indicator of program prevalence.

Most employees believe the advantages of their Worksite Wellness Programs activities outweigh the costs, although few formal evaluations exist.

The most generally cited reason for starting programs and perceived profit from programs is improved employee health.

At most worksites with activities (85.4%), all staff members are eligible to take part. 30% of worksites with activities offer them to company dependents, and an equal percent offer them to retirees.

When worksites seek outside program assistance, they turn to voluntary, not-for-profit corporations (57.1%), private for-profit providers-consultants (50%), local hospitals (44%), and insurance corporations (43%).

Tobacco Cessation Programs

Smoking related health issues cost American businesses $26 billion per year in lost productiveness and $7 to $8 billion in smoking-related healthcare costs.

Workers who use tobacco are 50% more likely to be hospitalized than nonsmokers, have 2 times as many job-related accidents as nonsmokers and have absenteeism rates approximately 50% higher than nonsmokers.

People who used tobacco an average of one or more packs of cigarettes per day had 118% higher health care expenses than non-smokers.

76% of current smokers and 80% of former smokers and nonsmokers feel that employers must restrict smoking to certain areas.

In 1985, 65 percent of smokers, 85 percent of people that do not smoke and 78 percent of former smokers, felt that tobacco users ought to refrain from smoking in the presence of people that do not smoke.

In 1986, 17 states had laws regulating tobacco use in offices or workplaces either in government-controlled offices or offices of private staff members.

Examples of tobacco cessation intervention program used by corporations include:

• offering non-smokers a discount of health and life insurance;
• paying full or partial fees for tobacco cessation programs;
• providing cessation programs on company or shared time;
• offering cash payments to quitters after 6 of 12 tobacco-free months;
• participating in national quit smoking days; and
• adopting a smoke-free business policy and setting deadlines for implementing the policy.

Physical Fitness Programs

An active 55-year-old man can lead as vigorous a lifestyle as a sedentary 35-year-old.

Differences in work-related exercise has been demonstrated to provide a two- to three-fold difference in cardiovascular deaths between active workers and their more sedentary counterparts.

In addition to improving strength, balance, and flexibility, physical activity programs can decrease the probability of back injuries among certain occupational groups.

93 million workdays in the United States are lost each year due to back problems.

Research findings support the notion that workplace physical activity programs improve fitness and help reduce other health risks, although results related to improved productivity are weak due to lack of methods for accurately measuring productivity.

A very small proportion of worksites have on-Site physical fitness facilities.

The majority of staff members sponsored physical activity programs involve skills training such as aerobic dance, low impact aerobics, weight training, preand post-natal exercise classes, and walking/jogging groups.

Some corporations subsidize employee participation in neighborhood “Ys,” health clubs or other neighborhood programs if no onsite facilities are available.

Worksite exercise program may reduce expenditures to employers by reducing employee healthcare claims and expenditures.

Those whose weekly exercise was equivalent to climbing less than five flights of stairs or walking less than a half mile, invested 114% more on health claims than those who ascended at least 15 flights of stairs or walked 1 1/2 miles weekly.

Medical Care expenditures for obese people are roughly 11 percent higher than those for thin people.

Nutrition and Weight Control

One-third of America population is obese to the extent of decreasing their life expectancy.

Improvements in eating habits can cut the risk of somber health issues such as high Blood Pressure and blood lipid levels and is instrumental in the control of non-insulin-dependent diabetes.

The workplace offers several advantages for diet education; support and influence of co-staff members and management, availability of a daily eating situation, and opportunities for follow-up and monitoring.

Worksite diet programs can be grouped in 6 broad categories:

• cafeteria programs;
• multi-component programs;
• weight management programs;
• blood lipid reduction programs;
• programs for pregnant and lactating women; and
• other diet education topics.

Men are less likely to take part in weight-loss programs than are female staff members.

Stress Management

Estimates suggest that 50% to 80% of physician visits can be attributed to psychosomatic or stress-related origins.

Employer pays many of the costs related to employee stress, both directly in the form of medical care costs and in lower work rate.

Job factors which are associated with stress include:

• not allowing employees to take part in decisions about the work process;
• positions which require more or less skill than the employee has;
• changes in work demands;
• lack of clarity about expectations and standards; and
• conflict with co-employees or supervisors.

Most workplace stress management programs are implemented as a result of requests from workers.

Stress management programs focus on three types of skills: relaxation skills, coping skills, and interpersonal skills.

Job Site stress management programs are frequently delivered in one of three formats:

• seminars conducted by trained professionals;
• self-learning tools; and
• personal teaching to help  with self-assessment, planning for changes, learning new skills and responding to life crises.

The two primary techniques used in worksite stress management programs are:

• teaching people to decrease the negative physical effects of stress; and
• teaching people to recognize and control sources of stress at work and in personal life.

Safety Belt Usage

Motor vehicle accidents are the largest single cause of lost work time and on-the-job fatalities of U.S. business.

Motor vehicle accidents account for 27 percent of all work-related deaths and 45 million days of lost work each year.

More than 36% of the 11,300 accidental work deaths in 1983 involved motor vehicles.

Employees who regularly fail to use seat belts may spend up to 54 percent more days in the hospital.

Traffic accidents caused about 3 times as many days of restricted activity as any other type of disability.

Motor vehicle crashes cost $15.2 billion in lost productivity, 88 percent of which is attributed to losses from workforce activities and future earnings.

In work settings where safety belt policies, mandating use of belts by those riding in a organization vehicle or using a private vehicle for organization business, have been enforced, 60% to 90% use has been published.

Incentive programs, accompanied by education and use requirement restrictions have resulted in 40 percent to 70 percent initial usage rates.

Factors influencing the sources of workplace safety belt programs include:

• active commitment on the part of senior staff;
• clearly defined and well enforced policy of needed belt use working;
• beneficial rewards and incentives; and
• ongoing education and training programs.

Case Studies of Company Health Promotion Programs

Based on an extensive evaluation of its accross the board employee Employee Wellness Program, LIVE FOR LIFE, Johnson & Johnson reported the break-even point for the program occurs in year 3 and by year 5 they have a net profit of $316 per employee. Their year 9 projected profit is $677 per employee.

workers at four Johnson & Johnson companies who were exposed to the Corporate Wellness Program expanding their daily energy expenditure in vigorous exercise by 104 percent compared to a growth of 33 percent among workers at companies that were provided only an annual health screen.

Members in the United Methodist Publishing House’s Workplace Health Promotion Program submitted more claims (1.14 per participating employee and .82 for the control in 1984, 1.44 and 1.3 respectively in 1985), but the average cost per claim was less for participants ($316 for participants and $567 for control, in 1984, $262 and $602 respectively in 1985, $270 and $566 respectively in the first four months of 1986).

The United Methodist Publishing House attributes some of the reduced than projected use in medical care expenditures for 1985 ($902,116 projected with actual expenditures $142,884) to the Company Health Promotion Program although the results are not conclusive.

In 1985, the Adolph Coors Company conducted a phone interview of a random sample of its 10,000 employees to determine changes in health practices since the introduction of an employee Employee Wellness Program 4 years earlier. The sample of 495 employees was stratified to match the employer profile in terms of age, sex and job description. The survey stated that 65% of respondents started exercising in The last 4 years, 37% had improved their diets, 20% were regular users of the wellness center, 9% had stopped smoking as the result of the employer’s tobacco cessation program and regular participants of the wellness center miss an average of 1.96 workdays every year because of illness or injury compared to 3.08 days for non-participating employees.

The Coors Employer also saw a cost savings from a cardiac rehabilitation program that was begun in 1981. In 1980 staff members were out of work 7.2 months after a heart attack or bypass operation. In 1984, cardiac patients were out an average 1.9 months saving $152,000 in lost work time and in 1985 cardiac patients missed an average of 2.6 months, saving $125,000 that year.