GE Energy Pre Diabetes Intervention A Collaboration with Centers for Disease Control & Prevention and the National B

1. GE Energy Pre Diabetes InterventionA Collaboration withCenters for Disease Control & Prevention and the National Business Group on Health March 16, 2005 Business Health Agenda National Business Group on Health

2. CDC’s New Goal: Bridging Public Health and the Business Community

3. Business Values vs Community Health Values

4. ROI Stay in business Productivity Profit and loss Overhead Employees as a capital investment Public good Healthy people Public and private partnerships Non-profits Advocacy Business vs Community Health

5. Opportunity knocks to open the doors between business and community health

6. CDC Reinvention • Two Overarching Health Protection Goals • Health promotion and prevention of disease, injury, and disability: • Preparedness

7. CDC Reinvention: Six Strategic Imperatives • Health Impact. • CDC will be a customer-centric organization. • Public Health Research. • Leadership for the nation’s health system.Global Health. • Effectiveness and Accountability.

9. We Have an Epidemic of Diabetes !

11. Why pick diabetes for a health promotion intervention? • Costs over $100 billion/year in health care expenditures • Effective interventions promote multiple good outcomes • Leading cause of heart disease and stroke • Leading cause of blindness in adults • Leading cause of end stage renal disease requiring dialysis

12. Consequences of uncontrolled diabetes • Loss of productivity • Increased direct and indirect health care expenditures • Poorer quality of life for employees • Possible permanent disability

13. Why Control Diabetes? • Better control translates into fewer complications • Fewer complications translate into fewer days lost to absenteeism and disability, and future savings on health care expenditures

14. Why the workplace as a site of disease education? • Unique opportunity for education • Less time away from work • Improves employer-employee relations and shows employer cares about employees

15. Do Any of These Things Work? • Bottom Line: Does better glucose control translate to better outcomes or better health in the individual? • Does better glucose control translate into improved productivity in the workplace?

16. Economic Benefits of Improved Glycemic Control • Testa et al, JAMA, Nov 1, 1998 • Workers with less diabetic problems had fewer days lost to absenteeism • Fewer days of restricted activity

17. Strategies for Better Outcomes: Examples of Worksite Programs • Canada:worksite physical activity classes:savings of $679/person • Coca Cola company:worksite wellness >$500 /year/person x 2500 people • First Chicago:Worksite diabetes education program-improvement of HbA1c 9.0% to 8.3%

18. Business and Managed Care Work Group (BMC) • To increase awareness of the benefits of quality diabetes care among employers, benefits managers and managed care decision makers • To provide employers, health plans and employees with tools and information for incorporating diabetes education programs into the workplace • To promote the value of investing in prevention

19. NDEP Business/Managed Care Workgroup: Who are we? • CDC and NIH • Large and small businesses • Unions • Occupational health professionals • Public health agencies • Managed care groups • Non-profit organizations

20. NBGH GE Power GM American Association of Health Plans United Automobile Workers Union Wisconsin Diabetes Control Program Novo-Nordisk Harrington and Chappell National Fed of Ind Businesses BMC Work Group

21. NDEP TARGET GROUPS • Occupational health professionals • Wellness coordinators • Benefits personnel and HR managers • Large and small businesses • Unions • Regional and national business groups • Managed care organizations

22. BMC Workgroup Projects • Diabetes White Paper : Call to action! • Diabetes Needs Assessment Tool • Diabetes Worksite Intervention Kit • Regional partner conferences: General Motors, DFWBGH, Federal Reserve, Land’s End

24. Needs Assessment • What is it and why does my company need to address diabetes? • Helps to see the potential prevalence of diabetes in the company based on NHIS data. Each company has a unique workforce, based on age, ethnicity • Is diabetes relevant at this time?

25. Diabetesatwork.org: Content • Planning Guide • Assessment Tool • Choosing a Health Plan • Lesson Plans • Fact Sheets • Resources • Frequently Asked Questions (FAQ's)

26. Diabetesatwork: Content • General Diabetes Education • Managing Diabetes Complications • Cardiovascular Disease • Emotional Well-Being • Nutrition, Weight Control, and Physical Activity • Dealing With Type 1 Diabetes

27. Lesson Plans, Lunch & Learns • High and Low Blood Glucose Symptoms and Causes • Making Your Doctor Visit Count • Cardiovascular risk factors • Feet

28. Other Topics • Guide to choosing a health plan, developed with AAHP • Supervisor’s guide • Shift work • Links to other NDEP sites

31. What Can My Company Do? • Develop a Supportive Work Environment • Seize the moment for education • Educate other employees about diabetes • Create a wellness committee • Sponsor health screenings • Coordinate All Health Efforts

32. Resources • National Business Group on Health www.wbgh.com • WK Kellogg Foundation, The Business Interest in a Community’s Health, pdf on NBGH web site, • National Business Coalition on Health www.nbch.org • American College of Occupational and Environmental Medicine www.acoem.org • American Occupational Health Nurses www.aaohn.org

33. Resources: American College of Occupational and Environmental Health • www.acoem.org • Consensus Statement on Health and Productivity • The Business Case for Managing Health and Productivity • Health and Wellness in the Workplace • Business and Managed Care Diabetes and Health Resource Kit

34. Remember • New evidence: DPT Diabetes Prevention Trial; lifestyle and/or meds can PREVENT type 2 diabetes • The lifestyle changes and medical care recommended for diabetes control helps prevent and control MANY chronic diseases.

35. 10 year risk of cardiac event 10 year risk of stroke Existing CAD, PAD, CVA Blood pressure Including medication use Tobacco users LDL-cholesterol Including medication use Overweight/obese Hypertriglyceridemia Metabolic Syndrome Diabetes Cardiovascular Risk Assessment Output

36. GE Energy Profile 78% male mean age 42.7 2% CVD 17% metabolic syndrome

37. Percent of Population withMetabolic Syndrome Risk Factors

38. Net Effect of CRA As an Intervention • Change in Predicted Risk of Primary Cardiac Event • (Cardiac Event = fatal non-fatal MI, sudden death or surgical intervention) • Mean change in Real 5 yr. CHD risk: -0.002, p = 0.001 • Mean change in Real 10 yr. CHD risk: -0.003, p = 0.003 • Mean change in 5 yr. CHD risk (age held constant): -0.004, p = 0.000 • Mean change in 10 yr. CHD risk (age held constant): -0.008, p = 0.000 • Per 1000 employees screened, 4 events (in 5 years) are averted • 24.8 events averted in our screened population • At $40,000 per event = $992,000

39. Complications of Diabetes #1 Cause of Blindness 90% Preventable #1 Cause of Kidney Failure Most is Preventable #1 Cause of NT Amputation 40% to 50% Preventable 60% to 70% of Diabetes Deaths are Cardiovascular Stroke Heart Failure Coronary Heart Disease

40. Counting Saturated Fats (Sat fat per serving) * (Servings) = Grams of Sat Fat 3 g x 2 Servings = 6 g Sat Fat 7 g x 2 tablespoons of butter = 14 g Sat Fat 20 g Sat Fat Some examples of saturated fat content: 8 oz glass of whole milk: 5 g Sat Fat One tablespoon heavy cream: 3 g Sat Fat 1 ounce slice cheese: 5 g Sat Fat 3 oz serving skinless white chicken: 1 g Sat Fat 3 oz serving dark meat chicken: 2 g Sat Fat 3 oz lean pork: 4 g Sat Fat 3 oz marbled steak or roast: 4 to 11 g Sat Fat Hot dog: 5 to 11 g Sat Fat Double quarter pound cheeseburger: 20g Sat Fat

41. Counting Grams of Saturated Fat • Breakfast: sausage egg and cheese on a biscuit, 2 hash browns and large coffee with cream • Lunch: big bacon classic burger, biggie fries, and a medium frosty • Dinner: 10 oz steak with mashed potatoes with butter and salad with hidden valley original with bacon • Dessert: 1 pint of Haagen-Dazs ice cream

42. Counting Grams of Saturated Fat 8 g 3 g 13.2 g 12 g 3.5 g 7 g 18 g 0 g 140.3g 21.6 g 0 g 10 g 44 g

43. Diabetes and High Blood PressureAre Like Twins

44. Create a Blood Pressure Action Plan • John’s average blood pressure is 132/85 • He should reduce his systolic blood pressure down below 120 • 132 -120 = 12 points Obese Does not exercise Eats fast food daily Does not drink alcohol

45. Create a Blood Pressure Action Plan • Harry’s average blood pressure is 124/81 • He should reduce his systolic blood pressure down below 120 • 124 -120 = 4 points Healthy weight, but gained 5 pounds last year Moderately active Eats typical American diet Has 1 or 2 drinks on the weekend

47. You will learn that our nutrition message is more than just 5 A Day . . .

48. Top 10 Daily HasslesA Survey of Middle-aged Adults: • Concerns about weight • Health of a family member • Rising prices • Home maintenance • Too many things to do • Misplacing or losing things • Yard work or outside home maintenance • Property, investments, or taxes • Crime • Physical appearance

49. Diabetes Prevention @ GE EnergyProgram Sites • Houston • Pilot program complete (24 employees) • Schenectady • Program in progress (11 employees) • Minden • Program in progress (25 employees) • Bangor • CRA first week in June; program to begin same week

50. Implementation & Planning