Sheila Pudists Worksite Health & Productivity Specialist Washington State Department of Health

1. Business Case for Wellness Sheila Pudists Worksite Health & Productivity Specialist Washington State Department of Health

2. Integrated Healthy Communities Projects Build Capacity to Address Obesity, 2009-2011

3. Learning Objectives • Understand Business Case & why Employee Health is Important • Determine Ways You can Create a “Culture of Health” & Incorporate Best Practice Strategies at Your workplace • Resources to Support Your Efforts

4. Why Promote Wellness at the Workplace? Over 3.2 million adults in WA State are employed Most spend 30-50% of their waking hours at work Healthier employees are more productive, lower risk for injury& use fewer health care dollars

5. Health of WA State 10% of WA residents (25 & older) have diagnosed Diabetes; 4% have undiagnosed Diabetes and 32% have Prediabetes. Between 1993-2009 Diabetes prevalence (18 and older) has increased by 88% 26% of Washington adults are obese and another 35% are overweight About 15% of Washington adults smoke Coronary Heart Disease caused about 7,500 deaths in Washington State each year Only 25% of adults are eating fruits and vegetables at least five times per day 37% of Washington adults are Not getting enough physical activity 9% of Washington adults are not getting ANY physical activity Source: WA Behavioral Risk Factor Surveillance System (BRFSS) 2009

6. Asotin County Health Data 30% of adults are obese (state average is 26%) 34% of adults have high blood pressure (state average is 26%) 40% of adults have high cholesterol (state average is 33%) 10% of adults have diabetes (state average is 7%) 25% smoke (state average is 15%) 13% have asthma (state average is 9%) 41% of adults are Not getting adequate physical activity (state average is 38%) Source: WA Behavioral Risk Factor Surveillance System (BRFSS) 2007-2009

7. Obesity Trends* Among U.S. AdultsBRFSS,1990, 1999, 2009 (*BMI 30, or about 30 lbs. overweight for 5’4” person) 1999 1990 2009 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

8. Social Ecological Model – Health & Productivity

9. Priority Areas • Health plan/employer coverage of asthma education & medications • Clinical systems improvements • Workplace policies: commute trip reduction, anti-idling, fragrances, indoor air quality monitoring • School policies/practices re: students with asthma • Clean air • Secondhand smoke • Built environment • Health coverage • Availability of services • Cultural beliefs/attitudes • Environmental practices • Home heating • Parent/family/ caregiver support • Social stigma • Patient education • Medication/planned visit adherence • Trigger management

10. National Perspective The Centers for Disease Control estimates that more than 75% of the nation's health care costs can be attributed to patients with just five chronic conditions: congestive heart failure, asthma, diabetes, coronary artery disease and depression The National Business Group on Health estimates that U.S. employers collectively spend $170 billion annually on smoking-related health expenses, lost productivity time and absenteeism.

11. Cost of Unhealthy Employees Employees with 0–5 risk factors pay about $190 - $718 a year in medical expenses. Unhealthy lifestyle is reported to account for 25% of employee health care expenditure. It is estimated that employers spend $13 billion annually on the total cost of obesity.

12. Benefits of Promoting Worksite Health 42 published studies reviewing worksite health promotion programs show: 28% reduction in sick leave absenteeism 26% reduction in health costs 30% reduction in workers' compensation and disability management claims costs Every $1 invested in worksite program can yield up to $6.00 in health care cost savings

13. Cost of Unhealthy Employees According to the Partnership for Prevention: Indirect costs (absenteeism) of poor health can be two to three times the direct medical costs Productivity losses related to personal and family health problems cost U.S. employers $1,685 per employee per year, or $225.8 billion annually

14. Healthy Solutions: What Can Managers/Supervisor Do & How? Support and Encourage your Employees Improve the Culture of your Worksite Introduce & Implement Policies that Support a Healthy Work Environment Make Employee Health a Priority!

15. Improve the Culture of Health No longer can we work on individual behaviors without working on environmental culture Examples: We want employees to be more active, but policies/support not in place to allow more physical activity Promote healthy eating, but no policies on types of foods served in cafeteria, work functions, etc

16. Worksite Policy and Environmental Changes:Healthy Eating Support healthier food and snack options in vending machines Encourage Healthier food alternatives offered at meetings and work events (“Energize Your Meeting”) Guidelines Water is available throughout the day Employees who bring their lunch to work are supported through refrigerator access and microwaves Promote local farmer’s market

17. Worksite Policy and Environmental Changes:Physical Activity & Movement Support “alternative” or “flex” work schedules to allow more time for physical activity (Asotin County Public Health has a great policy) Build physical activity into the job: “walking meetings” Encourage fitness breaks during the day: walking groups, stretch breaks, etc Support ergonomics in the workplace Promote safe walking routes & provide maps of safe routes Clean and safe stairwells available for physical activity

18. Worksite Policy and Environmental Changes:Stress Management Everyone, including your employees are experiencing stress . . . Look to your EAP (Employee Assistance Program) for resources & support Encouraging employees to take “stress breaks” and encourage physical activity Dedicate a space (wellness room) for meditation, yoga, etc Consider “Financial Wellness” or other “stress producing” topic for lunch-time talk What is your policy on sick leave usage?

19. Encourage & Support Health Promotion • Permit Employees to Participate in Wellness Classes and Activities (if possible on paid company-time) • Tobacco Cessation Classes & Quit Line • Lunch and Learn Program • Preventative Care Appointments • Chronic Disease Self Management

20. Breastfeeding Support • Business Case: • Employees are more likely to return to work after childbirth when their workplace provides a supportive environment for continued breastfeeding • Mothers and Fathers of breastfed infants typically spend more time at work rather than taking leave to care for sick children • Do You Have a Policy? If not, we can help!

21. Evaluation of Program • How do you know if your program is paying off? (ROI) • What are you Measuring? • Participation in company programs • Health Care Utilization Rates • Employee survey (less tobacco, more activity/better nutrition, higher productivity @ work) • Evaluation Tools: • CDC: Swift Worksite Assessment & Translation (SWAT) • HERO Score Card

22. Center for Disease Control (CDC) Resources

23. CDC Workplace Health Promotion Toolkit and Portal www.cdc.gov/workplacehealthpromotion

27. Department of Health Resources

31. Created by nutrition professionals Informed by scientific advice from national organizations Designed with feedback from administrative staff and caterers

32. Why Energize Your Meetings? • Make the healthy choice the easy choice by offering healthier options • Help attendees choose healthier foods at events • Increase energy and be more productive

40. Free telephone counseling support for all WA residents. A Quit Kit of materials & personalized Quit Plan. Tools to cope with withdrawal symptoms. Medication (if appropriate) Referral to Community Resources 1-800-QUIT-NOW 1-877-2NO-FUME in Spanish www.Quitline.com

41. Washington State Department of Health:www.doh.wa.gov Washington State Alcohol and Drug Help Line: www.adhl.org1-800-562-1240 WA State Tobacco Quit Line:www.quitline.com1-800-784-8669 American Heart Association:www.americanheart.orgor www.startwalkingnow.org American Cancer Society:www.cancer.org Center for Disease Control (CDC): www.cdc.gov/workplacehealthpromotion www.cdc.gov/leanworks Wellness Council of America:www.welcoa.org Partnership for Prevention:www.prevent.org Health Observance Calendar:www.healthfinder.gov Diabetes at Work Program:www.diabetesatwork.org

42. To Change the Conversation From Health as the Absence of Diseaseto Health as Vitality and Energy From the Cost of Health Careto the Total Value of Health From Individual Participationto Population Engagement From Behavior Change to Culture Change

43. And Finally . . . • Refocus the definition of health from “Absence of Disease” to “High Level of Vitality” • Business Case Strategy is to “Keep the Healthy People” and “Keep Low-risk people low-risk” • Celebrate Your Great Work – Success Stories! • Consider applying for the AHA Fit-Friendly Company status (http://ffc.heart.org)

44. Questions? Sheila Pudists Washington State Department of Health Worksite Health & Productivity Specialist (360) 236-3794 Sheila.Pudists@doh.wa.gov