Worksite Health Promotion Program: Research Questions

• Find out if Worksite Health Promotion Program has been done in the past. If so, what worked and what did not?
• Was it widely accepted?
• Was programming efficacious? Why or why not?
• What does your corporation hope to gain from implementing a Corporate Health Promotion Program?

Answers to these questions will help you start the process of creating a culture of wellness within your business. It is imperative that you assess the environment before starting a program.

• Approximately 95 percent of the $1.4 trillion that we spend as a nation on health goes to direct health care services, while about 5 percent is allocated to preventing disease and promoting health.
• Potentially, 50 percent to 70 percent of all diseases are avoidable as they are associated with modifiable health risks.
• In an effort to optimize employee health, decrease preventable healthcare utilization and enhance work performance, and in turn reduced healthcare expenditures and better employee satisfaction and retention, many organizations are starting, or are interested in starting, Worksite Wellness Programs for employees.

The benefits of workplace wellness are well documented. Greater than 120 research studies repeatedly show themes such as improvements in health outcomes coupled with high returns on investment (ROI). Some major findings include the following:

• Savings of $3.48 in reduced health care expenditures per dollar invested.
• Savings of $5.82 in reduce absenteeism expenditures per dollar invested.
• ROIs of at least $3 to $8 per dollar invested within five years of program implementation.
• Lifestyle behavior modification programs: $3 to $6 return on investment within 2 to 5 years.
• Self care, decision reinforcement programs: $2 to $3 ROI within a year.
• Disease management programs: $7 to $10 return on investment within a year.

By offering health improvement programs, corporations are not only providing an additional service for employees, but they are also gaining monetarily. Furthermore, the effect of a health improvement program goes beyond decreased medical care cost and ROI. A health improvement program can affect productiveness, absenteeism, morale, recruitment success, turnover, and medical care expenditures.

• Source: Rees, C., and Finch, R. (2004). Health Improvement: A comprehensive guide to designing, implementing and evaluating workplace programs. National Business Group on Health, 1 (1), 1-7.

Workplace Health Promotion Program: Action Steps

The process of creating a Workplace Wellness Program involves:

• Identifying the current health status of your employees
• Determining the appropriate programs and interventions to offer
• Promoting and launching the programs
• Building in motivational incentives/rewards
• Measuring the effect
• Revising programs based on evaluation outcomes

It may even include planning policies and procedures that support employee participation in wellness activities at your workplace (such as flextime).

Steps to Starting a Employee Health Promotion Program

• Conduct an business assessment
• Obtain management backing
• Establish a Employee Wellness Program Committee
• Obtain employee input
• Design goals
• Design and enable program activities
• Select incentives and rewards
• Assess outcomes

One of the ways the government plans to improve the nation’s health is through comprehensive Corporate Health Promotion Programs. According to the United States Department of Health and Human Services, these programs may help workers live healthier lifestyles by creating supportive work environments and offering awareness, education and behavior change programs. In fact, one of the objectives of Healthy People 2010, a set of health objectives for the nation to achieve by the year 2010, is to stimulate the proportion of workers that take part in a comprehensive Corporate Health Promotion Program at their worksite to 75 percent.

Emotional health is a state of wellness that comes from understanding and acknowledging our emotions and finding appropriate ways to express them. As employees, we often bring emotional problems from our childhood or current family life into the workplace because we haven’t dealt with them effectively outside of work. This can seriously damage workplace relationships and lead to poor performance and harmful feelings all around.

Many tools and techniques exist for helping us better our emotional health. Some of the most common are given below, with real-life case histories illustrating their use. If an unpleasant mood or feeling persists over a length of time, don’t hesitate to seek out a qualified professional. Worksite Wellness Programs usually have professional reinforcement already in place as part of their services.

1. Health Coaching / Health Counseling:
One of the hallmarks of emotional health is the willingness to ask for help when we need it. Confidential professional help, the coaching and counseling offered by employee assistance or wellness programs, can offer an external source of strength and insight for “working out” emotionally-based issues rather than “working them in” to your job.

2. Self-help Groups:
Self-help groups are designed to aid people in emotional situations in which they feel alone. The purpose of these groups is twofold: to allow people to safely feel and express their emotions, and to help break their isolation at work and/or in society at large and reintegrate them into society with the backing of a peer group.

The classic self-help group is Alcoholics Anonymous, but thanks to technology, it’s possible to make connections with others that have common health challenges, no matter how unique the situation. People are taking advantage of tele-conference groups and social websites, such as sparkpeople.com and revolutionhealth.com. Company Health Promotion Programs frequently have such groups available through online or phone support. Progressive corporate wellness provider Exan Wellness, for example, offers teleconference cell groups and moderated wellness forums for interacting with others in a supportive, confidential and anonymous environment. People with shared challenges get together and discuss the emotional challenges they are facing at work or in other areas of their lives and work through change together.

3. Journaling: Journaling is frequently recommended by counsellors as a way to help identify and process emotions. People record their emotions in writing as they experience them, in whatever form they wish. By helping the writer gain greater emotional clarity, journaling can help in making more emotionally informed decisions. In much the same way, letter writing enables people to identify and process the emotions they feel in relation to others. The letter does not have to be be sent or its contents shared: it simply supports a place for the expression of feelings.

An 18-year-old “army brat,” Brent has always done well at school, academically and athletically. But in his last year of high school, something seems to have happened to him. He has lost all interest in school, becoming moody and withdrawn.

Brent describes to his guidance counselor all the times he had to move when he was growing up. Each move wrenched him from his friends and forced him to play the role of the “new kid on the block.” The counselor suggests that Brent write letters to the friends he has missed over the years telling them how he felt. Finally, he has a chance to say a proper goodbye.

4. Evaluate Your Emotional Wellness: Organizations that seek to boost employees’ interpersonal skills, or emotional intelligence in the workplace are more thriving, according to ground-breaking journalist Daniel Goleman. And emotional intelligence is the buzzword in workplaces these days. Some Worksite Health Promotion Programs have information about emotional intelligence, or emotional health assessments. Seek out more information about emotional intelligence for better corporate wellness.

5. Friendships/Support Systems: Friendships allow people to feel supported in their emotional journeys. At the same time, they give people an opportunity to advance their empathetic skills. These skills are also significant for worksite health. When we are empathic with fellow employees, we help them resolve harmful or unhealthy emotions. New friendships are made through hobbies, classes, clubs, or even through internet based groups. Many people are finding emotional satisfaction by making friends through Facebook and other social websites.

Sometimes worksite stress that is not dealt with in a healthy manner can be brought home. A 36-year-old mother of three, Sarah, wants to be a wonderful wife, a wonderful mother, and a success at her work. One day, drained after a long day at work, she shouted at her rambunctious children and threatened to hit her youngest son. Her behavior horrified her. To make matters worse, she believes she is a failure at her work as well as at motherhood. She watches with jealousy as younger co-workers advance much more rapidly up the corporate ladder despite having less experience than she has.

On the advice of a counselor, she decides to take time out for herself and take a course for amateur painters. It doesn’t take long before she strikes up a friendship with a single mom in the class. She once led a life very similar to Sarah’s before managing to achieve a better balance between work and family. Her new friend becomes a much-required sounding board for Sarah and offers her perspectives on her life that she hadn’t considered before.

Job Site wellness for their staff members, companies are discovering, is great for the health of their companies as well. Corporate Health Promotion Programs help to cut the costs associated with poor employee health, which include absenteeism, loss of productivity and poor work quality.

A new Hewitt Associates survey of over 500 U.S. corporations indicated a significant paradigm shift in how corporations view health benefits for their staff members. Of those surveyed this year, 88% are committed to instituting long-term medical care assistance programs (over the next 3-5 years) for their staff members, with the objective of boosting the health and productivity of their workforce. This represents a 25% rise in interest in Company Wellness Programs over 2007.

A strong offering of Worksite Health Promotion Programs to meet the demand has resulted. Health assistance providers have broadened their programs with tools that address general lifestyle factors, physical, social and psychological health factors. Programs look to predict chronic disease in their staff members and give them the tools and the information to prevent it. Corporations also demand a way to measure the effectiveness of their health care spending.

“Self-care is our motive,” says Vic Lebouthillier, president of progressive health and wellness provider Exan Wellness.”We really believe giving staff members tools to help them manage their own health, and promoting the benefits, while giving people resources to reach out for help is the key to efficacious lifestyle modification. Corporations are also telling us they need a cost-effective way to deliver Workplace Wellness Programs. The type of program we have developed over years delivers the highest medical care return on investment.”

Combining workplace wellness promotions, internet based assessments and health trackers, internet based health information, phone conferences and self-help groups, and access to a wide variety of health professionals, is behind the success of the Exan program. “Having internet based statistics about staff members’ health also makes it easier to track the bottom line – ROI” says Vic Lebouthillier.

“Organizations are moving beyond their traditional role as a provider of medical care benefits to advance holistic programs that pinpoint the specific health needs of their employee populations, drive employee behavior change and eliminate barriers to healthcare,” says Jim Winkler, leader of Hewitt’s health management consulting practice.

However, in a separate survey of 30,000 staff members, 74% said that, even though they felt their corporation had an obligation to help them understand how to use their health benefits program, only 12% felt the corporation had any right to tell them how to be healthy. Based on these results, corporations need to drive home the fact that improved health is better for their staff members as well as the corporation. It’s a win-win situation.

Employers and employees did discover common ground when it came to future medical care. Both surveys indicate that 95% of employees understand that their taking care of their health today will effect future health care payments. A similar percentage also understand the valuable of early detection and prevention when it comes to saving on health care costs.

Cost is important for most businesses as well. Over 80 percent of those surveyed made cost mitigation a priority for 2008, but those cuts did not involve shifting responsibility for healthcare onto staff members. Although 64 percent of businesses have transfered costs to their staff members, only 17 percent plan  to do so in the next 3-5 years. Similarly with health reimbursement accounts, 20 percent now offer these, but only about 5 percent plan  to use them in 2008.

These survey results indicate corporations are getting more proactive in helping their staff members to shift behaviors and take ownership of their own health futures. This is obviously wonderful for the well-being of staff members, but also for the well-being of the corporations they work for. Almost half the corporations surveyed were convinced that changing health behaviors was key to enhanced productiveness and cut absentee rates. Over 60% plan  to institute programs that help staff members change and/or sustain a healthier lifestyle. Almost of these corporations will also use data and measurements to ensure their medical care strategies meet their medical care objectives?

The Insurance Problem

The first step in correcting the concern is to realize that an employee’s health is their own responsibility. Expecting employers to offer unlimited health insurance coverage is simply unrealistic and unreasonable. It’s time for employers (on a broad scale) to reconsider their role in providing health insurance coverage. Instead of providing complete coverage for all staff members through group plans, employers must start to modify the burden of health coverage to those covered.

Here’s the approach. Give catastrophic healthcare insurance as a group benefit to all staff members with a large enough deductible (say $5000 per employee) to make the cost affordable for the company. Then, allow staff members to buy their own healthcare insurance policies (based on their own needs) and pay for them through payroll deduction with pre-tax earnings. There are numerous insurance companies that sell individual plans on this basis. Everybody wins. Staff Members can tailor their coverage to their own needs and circumstances using their own doctors. Corporations win by stopping the endless cycle of rising costs and ever-changing plans. And when individuals become responsible for the cost of their own insurance, they become more attentive to their own health. Besides, if an employee is interested in working for you ONLY because your company offers great insurance benefits aren’t they telling you they’re going to cost you more money in the future?

Develop a “Wellness Culture”

Our current “sickness culture” perpetuates the health care crisis and hastens the demise of market-based solutions. By sickness culture, I mean our focus on health concerns rather than on having a healthy worksite and performance culture.

So, what would a “wellness culture” look like? First, rather than paid sick days, employees might be rewarded at year’s end with an attendance bonus. Employees would be reimbursed for thriving completion of tobacco cessation and weight-loss programs. Corporations would invest in corporate memberships at local health clubs so every employee can participate. Employees would be provided in-house wellness programs on a variety of problems ranging from ergonomics to stress management. Finally, corporations would commit to hiring and retaining healthy employees. Simply put, healthy employees cost less and are more constructive than unhealthy ones. Applicants should be screened for health habits and practices that limit their work rate and improve the likelihood of future expense. While this may seem harsh, it rewards those employees whose personal lifestyle and habits ensure the best Return on Investment by the organization committing to hire, train and pay them.

Be open to “alternative and complementary” approaches

Research studies published in primary medical care journals reveal that individuals who use “alternative and complementary” health modalities (including chiropractic, acupuncture, yoga and massage) are generally healthier, better educated, take fewer medications and miss fewer days from work than the average American. Since these individuals look for ways to stay healthy without prescriptions and surgery, they end up being a net benefit in terms of attendance and productiveness. Old prejudices in this area ought to be discarded in order for employers to better productiveness and boost profitability

Conclusion

Healthcare expenditures are rising at a staggering pace. Managed care is an abysmal failure. Employers are buckling under the pressure of offering health coverage to their workers. American competitiveness in the market is sagging. These times call for extraordinary solutions. It’s time for American employers to consider some out-of-the-box solutions to the healthcare crisis. Business wellness is an approach that is timely, achievable and reasonable given the alternatives. All options must be considered while we still have a chance.

Healthy organizations enjoy greater employee morale and an improved ability to attract and retain key people. Additionally, staff members are more alert and productive. For instance, Coca Cola reports that they save an estimated $500 a year per employee once they implemented a fitness program in which 60% of their staff members participate. Coors Brewing Corporation stated that staff members who participated in their Corporate Health Promotion Programs reduced their absentee rate by 18%.

employees enjoy their share of benefits from Workplace Health Promotion Programs too. A healthy lifestyle affects every part of a person’s life, including their work environment. Workplace Health Promotion Programs result in fewer injuries, less human error and a work environment that is more harmonious and relaxed. Additionally, employees who work at a corporation that implements a Workplace Health Promotion Program know that their corporation is concerned about their health and wellbeing. Staff Members often report a decline in their stress levels due to Workplace Health Promotion Programs.

As employees feel better, more relaxed, more valued and more human to their corporation; they enjoy a growth in productivity. This rise in productivity, while productive to the corporation, is also important to the employee as it increases their own sense of self worth and confidence levels. Employees who feel efficacious and who feel that they accomplish goals are overriding happier and in a better frame of mind.

The advantages of Company Wellness Programs, both tangible and intangible, are evident. It is a wise move for a corporation to implement a Company Wellness Program, particularly when they incorporate some form of mental health aspect into it. This also has social advantages as domestic violence and child abuse is shown to be diminished in areas where wellness programs are implemented. These days, a corporation can almost not afford to have some sort of wellness program to offer to their employees.

Health Risk Assessments or HRAs

Health Risk Assessment is a top corporate wellness program currently in use globally. Employers that enable it determine the safety and health issues of employees by the assessment of appropriateness of the facilities and equipment against the needs of the employees.

It can, for example, guide the organization into determining how the air quality within an office room affects the users and then help the assessment team to come up with the measures essential to correct the issue. An HRA can also evaluate the level of exposure staff members have to certain hazardous or dangerous materials and practices.

Immunizations

This isn’t always practiced in every country since there are regions where government sponsored immunization shots are available. However, it has also become an important component of the top Employee Wellness Programs in many businesses in North America.

Immunization shots, such as those used to combat flu, for example, are provided to workers for no cost.

Employee Assistance Program(EAP)

Employee Assistance Programs consist of a wide variety of services. It can range from providing educational resources to workers regarding health concerns to sponsoring health services and health care. In numerous businesses, medical and insurance have also become a staple part of their benefits system.

In-house nutrition and diet drives

This is another wellness program that organizations use, especially those that offer in-house commissary or cafeteria services. Instead of serving richer, high-calorie fare, cafeterias offer options for a healthier diet, usually in the form of low-calorie foods and sugar substitutes.

In-house employee wellness newsletter and campaign drives

One of the top wellness programs that businesses can implement is a self-powered tool using a newsletter to encourage wellness, coupled with a visible campaign. The campaign may be done periodically and focus on a specific topic, such as smoking risks, cancer, stress, carpal tunnel syndrome, safety in the worksite, etc.

The employee wellness newsletter in itself can be an effective means to deliver information to workers or members of a business but it is far from perfect. Some workers, for example, may not read the newsletter entirely or even pay attention to it. If the problems outlined in the newsletter are promoted through an active and highly visible campaign, it will be easier to maximize beneficial results.

Exercise and physical activity drives

Another top wellness program for corporations is one that involves physical activities. Employers often sponsor exercise-related events such as marathons and company sports programs to promote workers to remain fit or lose excess weight. In mid- to large-sized corporations, corporations may even pay for health club memberships or in-house exercise facilities.

Incentives

Some of the top wellness programs implemented by employers involve Incentives. This involves corporation-sponsored programs that reward employees for achieving specific wellness-related goals and objectives. Participation in health campaigns and signing up for wellness programs are two of the most commonly rewarded schemes. Rewards can range from special recognitions to over time acquired points (for bigger rewards) to specific gifts. In a few cases, cash may also be used.

Nevertheless, incentive systems have had mixed reactions and levels of success. But it continues to be one of the top choices among organizations who are willing to modify it in order to fit their unique needs.

Peer Pressure

In many corporations, corporations take advantage of peer pressure in order to bolster employees to participate in wellness programs. This is currently one of the favorite Worksite Health Promotion Programs currently in use today and growing in popularity. Peer pressure is often leveraged to help encourage competitions referring to worksite wellness and to persuade employees to be active in company-sponsored wellbeing and health fairs.

The wellness industry is growing phenomenally fast. Wellness guru, Paul Zane Pilzer, has labeled it the next trillion dollar industry. But wellness has two different faces. On the one hand there are the small corporations – people working from home or in small centers selling all kinds of wellness products and services at a speed of growth that is escalating rapidly. On the other hand corporate wellness is also exploding but in a very different direction.

The baby boomers who are driving the popular wellness revolution have been described as the first generation to refuse to accept the inevitability of death. They are actively looking for ways to prevent aging, stay healthy into old age and enjoy themselves more than ever before after retirement. This is a radical departure from current notions of old age, which are often dominated by pictures of sickness, frailty and suffering.

The employers have been largely forced to take on wellness. This is partly through legislative pressure, with a myriad of countries introducing laws to make employers liable for stress-related sickness in their employees. It is also fiscally motivated, as research has repeatedly established the enormous costs of absenteeism (and increasingly of presenteeism as well).

Whereas the baby boomers are actively looking for new solutions and new lifestyles the organizations are struggling to organize largely traditional and mainstream health systems, such as doctors, nurses, insurance and screening systems. The issue is that the traditional health system does not have solutions for the issues that people are handling.

Nobody ever went to see a doctor to get happy, because a doctor doesn’t have any clue how to make people happy. And countless stress-related health concerns are described as chronic diseases, which means that they last for a very long time – or perhaps for the rest of your life – because there is no medical cure. Counseling is a common offering in employers for emotional concerns, but whilst it may support a useful pressure valve it is not a powerful treatment for stress, unhappiness or depression.

Imagine walking into a corporation where the workers are happy, healthy, full of inspiration, fit, love working, have meaningful family lives, active social lives, and enjoyable relationships at work and in their neighborhood. That kind of corporation would be a pleasure to work in and bound to be thriving because people would be working to their optimum capacity.

So can we establish a system of true wellness that will serve the development of the corporations and their staff members and will pay for itself because of the advantages that both sides will gain?

First of all we have to face the fact that we can’t place all the responsibility into the hands of the current health system. Absenteeism, stress, depression, the very roots of the wellness revolution, have not been solved by the current system. If they had been we wouldn’t have this revolution, we would all be much more well. So we need to look elsewhere for solutions.

We also cannot rely on makeshift feel-good wellness offerings, such as the on-Site massage group which visits the office once a month or the wellness day that raises awareness for a little while but leaves most people unaffected. They are easy to organize but have little or no real significance on employee wellness.

Company needs are different than individual needs and many of the new small wellness companies that are springing up simply don’t have the capacity to serve the corporate market. Still it is in the best interest of both companies and employees to learn and develop systems of wellbeing and health that really work – that benefit people to be happy, handle stress, love working, and to have sufficient energy to go home at the end of the day and enjoy their family and social life. So far the corporate world has hijacked the concept of wellness and turned it into a modern version of occupational health. It is time to raise the vision and discover how to make truly healthy, happy workplaces where people thrive.

It has become increasingly clear to most managers that a well designed wellness program / fitness program with a strong nutritional and fitness lifestyle emphasis will directly meet this need. Senior Management’s objectives for a beneficial wellness program must be viewed through the perspective of increased employee productiveness, decreased absenteeism due to health related causes, improved employee morale, decreased utilisation of organization subsidised health benefits, enhanced group cohesion and effectiveness and a reduction in turnover due to lack of job satisfaction. It is obvious that an improvement in any of these areas will have a positive impact on the financial status of any organisation.

The benefits from an employees point of view can be seen in improved health, increased energy levels, lowered body fat, a more youthful fit body, an increased ability to handle job related stress, greater feelings of confidence and morale and more social connections at work contributing to greater feelings of satisfaction with their work and workplace.

To be most constructive a wellness program needs to achieve both management’s and employee’s goals and objectives, and this can be accomplished through a program that will offer the individual employee with an awareness of their current physical condition and attitudes to fitness and wellness, and the benefits of attaining a fitter, healthier lifestyle, and a plan that will allow them to achieve the significant changes to their physical condition that can be applied in the context of their life and work.

The Bottom Line – Workplace Wellness Programs

Lowered Rates of Absenteeism – Dupont reduced absenteeism by 47.5% over six years for the participants of their organization fitness program, (Health Behaviour, March 1992).

Lowered Healthcare Expenses – Steel case showed a decrease in medical care claim costs of 55 percent for corporate physical activity program participants over non-participants over a six year period – an average of $478.61 for participants vs. non-participants who averaged $868.88, (The Am. Journal of Health Promotion, Sept/Oct, 1991).

Reduced Turnover – Turnover among fitness program participants at the Canadian Life Assurance Company was 32.4% lower over a seven year period compared with non-participants (Canadian Journal of Public Health, Jan/Feb, 1988).

Positive Return on Investment – Blue Cross Blue Shield of Indiana saw that its corporation exercise program had a 250 percent return on investment; $2.51 for every $1 invested over a five year period (American Journal of Health Promotion, March, April, 1991).