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Food and the Bottom Line: Decreasing Health Care Costs and Increasing Productivity by Upgrading the Corporate Food Envi

Food and the Bottom Line: Decreasing Health Care Costs and Increasing Productivity by Upgrading the Corporate Food Environment. Karrie E. Bergman, MPH Student Walden University PUBH-6165-4 Instructor: Dr. Stephen D. Arnold Spring Quarter, 2010. Overview of the Issue The State or Our Health

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Food and the Bottom Line: Decreasing Health Care Costs and Increasing Productivity by Upgrading the Corporate Food Envi

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  1. Food and the Bottom Line: Decreasing Health Care Costs and Increasing Productivity by Upgrading the Corporate Food Environment Karrie E. Bergman, MPH Student Walden University PUBH-6165-4 Instructor: Dr. Stephen D. Arnold Spring Quarter, 2010

  2. Overview of the Issue • The State or Our Health • The Cost of our “Health” • Costs to Employers • Can Changes Improve the Bottom Line? • Upgrading the Food Environment • Why Upgrade Food? • What is a Food Environment? • Ideas for Upgrading the Food Environment What We Will Cover

  3. Why Employee Health Matters to your Profit Margin and Stakeholders • Why Food is Key to Employee Health • Types of Upgrades Learning Outcomes

  4. The Health of Adults in the U.S. • 2005: 1 out of 2 adults had a chronic disease (CDC, 2009) • 2007-2008: 33.8% of adults overweight, 68.0% of adults were overweight or obese (Flegal et al., 2010) • 2007: 23.5 million adults had diabetes (CDC, 2008) • 2003-2006: 20% of adults had hypertension (CDC, 2010) • Prevalence of Health Risk Factors (Food RDA) • In 2004 (CDC, n.d.) • Only 40% of people eat at least two daily servings of fruit • Only 4% of people eat three daily servings of vegetables (with 1/3 being dark green or orange) • Only 13% of people have a daily sodium intake less than 2,400 mg References Centers for Disease Control and Prevention. (n.d.). Focus Area 19: Nutrition and Overweight. Retrieved from ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/healthy_people/focus_areas/fa19_2.xls Centers for Disease Control and Prevention. (2008). 2007 National Diabetes Fact Sheet. Retrieved from http://www.cdc.gov/diabetes/pubs/estimates07.htm Centers for Disease Control and Prevention. (2009). Chronic Diseases and Health Promotion. Retrieved from http://www.cdc.gov/chronicdisease/overview/index.htm Centers for Disease Control and Prevention. (2010). Hypertension. Retrieved from http://www.cdc.gov/nchs/fastats/hyprtens.htm Flegal, K. M., Carroll, M. D., Ogden, C. L., & Curtin, L. R. (2010). Prevalence and Trends in Obesity Among US Adults, 1999-2008. The Journal of the American Medical Association, 303(3), pp. 235-241. doi:10.1001/jama.2009.2014. The State of Our Health

  5. Cost of Health Care in the U.S. • 2007: Total Health Expenditures - $2.2 Trillion (NCHS, 2010) • Expenditures have tripled since 1990 (CMS, 2008) • 75% goes to treat chronic disease (Anderson, 2004) References Anderson, G. (2004). Chronic conditions: making the case for ongoing care. Baltimore, MD: John Hopkins University Centers for Medicare and Medicaid Services. (2008). National health expenditures aggregate, per capita amounts, percent distribution, and average annual percent growth, by source of funds: selected calendar years 1960–2007. Retrieved from http://www.cms.gov/NationalHealthExpendData/downloads/tables.pdf National Center for Health Statistics. (2010). Health, United States, 2009: With Special Feature on Medical Technology. Retrieved from http://www.cdc.gov/nchs/data/hus/hus09.pdf#123 The Cost of Our “Health”

  6. Employee Health Care Costs • 1999-2009: Insurance premiums for family coverage increased 131% (Kaiser/HRET, 2009) • Being Overweight: Males $170 more/year; Females $495 more per/year (Peng, 2008) • 2005: Cost of health care added $1,110 to $1,500 to the cost of each of the 4.65 million vehicles sold (Appleby and Silke Carty, 2005) References Appleby, J. & Silke Carty, S. (2005, June 24). Ailing GM looks to scale back generous health benefits. USA Today. Retrieved from http://www.usatoday.com/money/autos/2005-06-22-gm-healthcare-usat_x.htm Peng, T. (2008, August 15). Five Financial Costs of American Obesity. Newsweek. Retrieved from http://www.newsweek.com/id/153309 The Kaiser Family Foundation and Health Research & Educational Trust. (2009). Employer Health Benefits: 2009 Summary of Findings. Retrieved from http://ehbs.kff.org/pdf/2009/7937.pdf Costs to Employers

  7. Lost of Productivity • 2003: Lost productivity from seven chronic diseases totaled $1.1 Trillion (DeVol and Bedroussian, 2007) • Loss of Productivity By Disease: • Hypertenstion - $280 Billion • Cancers - $271 Billion • Mental Disorders - $171 Billion • Diabetes - $105 Billion • Heart Disease - $105 Bllion • Pulmonary Conditions - $94 Billion • Stroke - $22 Billion • Absenteeism • Obese workers may lose a week of work a year due to illnesses related to their weight (Peng, 2008). • Presenteeism • Results in a loss of productivity several times greater than absenteeism (DeVol and Bedroussian, 2007) References DeVol, R. & Bedroussian, A. (2007, October). An Unhealthy America: The Economic Burden of Chronic Disease Charting a New Course to Save Lives and Increase Productivity and Economic Growth. Milken Institute. Retrieved from http://www.milkeninstitute.org/pdf/ES_ResearchFindings.pdf Peng, T. (2008, August 15). Five Financial Costs of American Obesity. Newsweek. Retrieved from http://www.newsweek.com/id/153309 Costs to Employers, Cont.

  8. Changes in Prevention and Treatment (DeVol and Bedroussian, 2007) • Avoid 40 million chronic disease cases • Reduce disease impact by 27% or $1.1 billion/year • Lower obesity rate could mean productivity gains of $254 billion/year References DeVol, R. & Bedroussian, A. (2007, October). An Unhealthy America: The Economic Burden of Chronic Disease Charting a New Course to Save Lives and Increase Productivity and Economic Growth. Milken Institute. Retrieved from http://www.milkeninstitute.org/pdf/ES_ResearchFindings.pdf Can Changes Improve the Bottom Line?

  9. Foods Affect on Health • Cardiovascular Disease and Diet • Study of Low-fat Plant Diet (Esselstyn, 1999) • Prior to study total cholesterol was 237mg/dl • At 5 years total cholesterol was 137mg/dl • At 10 years total cholesterol was 145 mg/dl • Hypertension and Diet • Dietary Approaches to Stop Hypertension (DASH) Trial (Svetkey et al., 2001) • Diet low in fat, sodium and full of fruits and veggies • In 3 weeks: • Hypertensive patients – Decrease of 11.6/5.3 mm Hg • Normotensive patients – Decrease of 3.5/2.2 mm Hg References Esselstyn, C. B. (1999, August 1). Updating a 12-Year Experience With Arrest and Reversal Therapy for Coronary Heart Disease (An Overdue Requiem for Palliative Cardiology). The American Journal of Cardiology, 84, 339-341 Svetkey, L. P., Simons-Morton, D., Vollmer, W. M., Appel, L. J., Conlin, P.R., Ryan, D. H.,... Kennedy, B.M. (1999, February 8). Effects of Dietary Patterns on Blood Pressure. Archives of Internal Medicine, 159, pp. 285-293 Why Upgrade Food?

  10. You Determine Availability and Access • Cafeterias • Vending Machines • Restaurants • Pricing Why Upgrade Food, cont.

  11. Vending Machines • What is in the vending machines? • Cafeterias or Restaurants • What types of food are they selling? • Refrigerators • Is there sufficient space for people to bring food? • Catering • Are you getting what you pay for? What is a Food Environment?

  12. Upgrading the Food • Upgrading Ingredients • Ex: Pasture Fed Beef vs. Feedlot-Fed Beef • Ex: Switching to Whole Grains • Upgrading the Menu • Ex: No Fried Items • Ex: Lots of fruits and vegetables – fresh or cooked without oils • Make it Delicious Upgrade Ideas

  13. Make Healthy Food as Easy (or easier) to Access as Unhealthy Food • Physical Access • Pricing • Make it Easier to Bring Food From Home • Vending Machines • Creative Programs ex: Farmer’s Market On Site Upgrade Ideas, cont.

  14. Education and Wellness Programs • Provide Nutritional Information • Wellness Programs • Pamphlets and Newsletters • Personal Lifestyle Change Classes • Nutrition Classes • Cooking Classes • Moral Events Upgrade Ideas, cont.

  15. State of our “Health” • The Cost of “Health” • Food and Health • Upgrading the Food Environment Let’s Review

  16. American Dietetic Association. (n.d.). Boost Your Nutrition with Beans. Retrieved from http://www.eatright.org/Public/content.aspx?id=6442452093&terms=beans+and+legumes • Anderson, G. (2004). Chronic conditions: making the case for ongoing care. Baltimore, MD: John Hopkins University • Appleby, J. & Silke Carty, S. (2005, June 24). Ailing GM looks to scale back generous health benefits. USA Today. Retrieved from http://www.usatoday.com/money/autos/2005-06-22-gm-healthcare-usat_x.htm • Centers for Disease Control and Prevention. (n.d.). Focus Area 19: Nutrition and Overweight. Retrieved from ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/healthy_people/focus_areas/fa19_2.xls • Centers for Disease Control and Prevention. (2008). 2007 National Diabetes Fact Sheet Retrieved from http://www.cdc.gov/diabetes/pubs/estimates07.htm • Centers for Disease Control and Prevention. (2009). Chronic Diseases and Health Promotion. Retrieved from http://www.cdc.gov/chronicdisease/overview/index.htm • Centers for Disease Control and Prevention. (2010). Hypertension. Retrieved from http://www.cdc.gov/nchs/fastats/hyprtens.htm • Centers for Medicare and Medicaid Services. (2008). National health expenditures aggregate, per capita amounts, percent distribution, and average annual percent growth, by source of funds: selected calendar years 1960–2007. Retrieved from http://www.cms.gov/NationalHealthExpendData/downloads/tables.pdf • Center for Science in the Public Interest. (2004, May). Dispensing Junk: How School Vending Undermines Efforts to Feed Children Well. Retrieved from http://www.cspinet.org/dispensing_junk.pdf • DeVol, R. & Bedroussian, A. (2007, October). An Unhealthy America: The Economic Burden of Chronic Disease Charting a New Course to Save Lives and Increase Productivity and Economic Growth. Milken Institute. Retrieved from http://www.milkeninstitute.org/pdf/ES_ResearchFindings.pdf • Esselstyn, C. B. (1999, August 1). Updating a 12-Year Experience With Arrest and Reversal Therapy for Coronary Heart Disease (An Overdue Requiem for Palliative Cardiology). The American Journal of Cardiology, 84, 339-341 References

  17. Flegal, K. M., Carroll, M. D., Ogden, C. L., & Curtin, L. R. (2010). Prevalence and Trends in Obesity Among US Adults, 1999-2008. The Journal of the American Medical Association, 303(3), pp. 235-241. doi:10.1001/jama.2009.2014 • Jeffery, R. W., French, S. A., Raether, C., & Baxter, J. E. (1994, November). An environmental intervention to increase fruit and salad purchases in a cafeteria. Preventive Medicine, 23(6), 788-792 • Mayo Clinic. (2008, May 23). Three main sources of sodium. Retrieved from http://www.mayoclinic.com/health/sodium/NU00284/NSECTIONGROUP • Mayo Clinic. (2008, May 31). Top 5 lifestyle changes to reduce cholesterol. Retrieved from http://www.mayoclinic.com/health/reduce-cholesterol/CL00012 • Mayo Clinic. (2008, August 7). High blood pressure (hypertension). Retrieved from http://www.mayoclinic.com/health/high-blood-pressure/DS00100/DSECTION=risk-factors • Mayo Clinic. (2009, November 19). Dietary fiber: Essential for a healthy diet. Retrieved from http://www.mayoclinic.com/health/fiber/NU00033 • Mikkelson, L., Erickson, C. S., & Nestle, M. (2007). Creating Healthy Food Environments and Preventing Chronic Disease. In L. Cohen, V. Chávez, & S. Chehimi (Eds.), Prevention is Primary (pp. 287-311). San Francisco: Jossey-Bass • National Center for Health Statistics. (2010). Health, United States, 2009: With Special Feature on Medical Technology. Retrieved from http://www.cdc.gov/nchs/data/hus/hus09.pdf#123 • Occupational Health Management. (2008, August). An Apple a day: Workers eat healthy to stay healthy. Occupational Health Management, 90-91 • Park, M. (2009, June 3). Farmers markets bloom at hospitals. Retrieved from http://www.cnn.com/2009/HEALTH/06/03/farmers.markets.hospitals/index.html • Peng, T. (2008, August 15). Five Financial Costs of American Obesity. Newsweek. Retrieved from http://www.newsweek.com/id/153309 References, cont.

  18. Svetkey, L. P., Simons-Morton, D., Vollmer, W. M., Appel, L. J., Conlin, P.R., Ryan, D. H.,... Kennedy, B.M. (1999, February 8). Effects of Dietary Patterns on Blood Pressure. Archives of Internal Medicine, 159, pp. 285-293 • The Kaiser Family Foundation and Health Research & Educational Trust. (2009). Employer Health Benefits: 2009 Summary of Findings. Retrieved from http://ehbs.kff.org/pdf/2009/7937.pdf • Time. (2006, June 11). The Grass-Fed Revolution. Retrieved from http://www.time.com/time/magazine/article/0,9171,1200759,00.html • United States Department of Agriculture. (2005). Dietary Guidelines for Americans 2005. Retrieved from http://www.health.gov/dietaryguidelines/dga2005/document/pdf/DGA2005.pdf • United States Department of Agriculture. (2009, October 1). Why is it important to eat grains, especially whole grains?. Retrieved from http://www.mypyramid.gov/pyramid/grains_why.html • United States Department of Agriculture. (2009, October 1). Why is it important to eat vegetables? Retrieved from http://www.mypyramid.gov/pyramid/vegetables_why.html • United States Department of Agriculture. (2009, October 1). Why is it important to eat fruit? Retrieved from http://www.mypyramid.gov/pyramid/fruits_why.html • Washington State Department of Health. (2006, August). Worksite Wellness and Chronic Disease Prevention Resource Kit: An Investment in Good Health, Improved Productivity and Lower Healthcare Costs. Retrieved from http://www.doh.wa.gov/cfh/NutritionPA/our_work_sites/worksite_data/Worksite_wellness_toolkit.htm • Zank, D. and Friedsam, D. (2005, September). Employee Health Promotion Programs: What is the Return on Investment?. Wisconsin Public Health & Health Policy Institute Issue Brief, 6(5) • World Health Organization. (n.d.). Cardiovascular disease: prevention and control. Retrieved from http://www.who.int/dietphysicalactivity/publications/facts/cvd/en/ • World Health Organization. (2006, September). Obesity and overweight. Retrieved from http://www.who.int/mediacentre/factsheets/fs311/en/index.html • Zeratsky, K. (2010, February 11). Junk food blues: Are depression and diet related?. Retrieved from http://www.mayoclinic.com/health/depression-and-diet/AN02057 References, cont.

  19. http://www.fruitsandveggiesmatter.gov/ - A web site from the CDC promoting the increased intake of fruit and vegetables • http://www.mypyramid.gov/ - USDA’s Food Pyramid web site • http://www.cdc.gov/chronicdisease - CDC web site with information on chronic disease • http://www.cdc.gov/obesity/ - CDC web site with information on overweight and obesity • http://www.eatright.org/ - Home Page of the American Dietetic Association where you can find registered dietitians • http://www.doh.wa.gov/cfh/NutritionPA/Documents/WA_Worksite_Wellness_Toolkit.doc - Worksite Wellness and Chronic Disease Prevention Resource Kit Additional Resources

  20. Questions?

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