Comprehensive Workplace Wellness Programming

1. Comprehensive Workplace Wellness Programming Jane Ellery, Ph.D. Director of Wellness Management Fisher Institute for Wellness and Gerontology Ball State University jellery@bsu.edu

2. Focus of Presentation • Doing Things Right vs. Doing the Right Things • Supporting Evidence and Current Programming • Risk Reduction, Wellness, and Cost Sharing • Suggestions for Successful Programming • Reaching the “Hard to Reach” by Using Data to Drive Decision-Making • Take Home Messages

3. Health Care Spending Rising (CDC, NCCDPHP) • Our nation spends more on health care than any other country in the world. • 1980 health care costs totaled $245 billion • average of $1,066/American • 2003 total health care cost $1.7 trillion • average of $5,805/American

4. Costs of Chronic Disease (CDC, NCCDPHP) • Over 90 million Americans live with chronic illnesses • 75% of the Nation’s medical care costs  • Annual cost of: • Diabetes – $132 billion • Arthritis – $22 billion (additional $60 billion in lost productivity) • Smoking – $75 billion • All Cardiovascular Diseases – $300 billion (additional $129 billion in lost productivity) • Physical inactivity – $76 billion 

5. Percentage of Adults Who Are Obese,* by State (CDC, NCCDPHP)

6. Causes of Death, IN Compared to US, 2001 (CDC, NCCDPHP)

7. Risk Factors and Preventive Services, IN Compared to US, 2001 – 2002 (CDC, NCCDPHP)

8. Health Care System or Sick Care… • Health care spending: • Chronic Disease (75%)… $4,354/person • Prevention (2%)… $116/person • Treat the symptoms and ignore the underlying problem • Obesity epidemic… convenience and excessive consumption (inactivity and overeating) • Lifestyle decisions and immediate gratification • Government agencies leading the health protection charge • CDC/National Center for Chronic Disease Prevention and Health Promotion • Department of Health and Human Services: HP 2010

9. Read this sentence… FINISHED FILES ARE THE RESULT OF YEARS OF SCIENTIFIC STUDY COMBINED WITH THE EXPERIENCE OF YEARS.

10. Why Offer Health and Wellness Programs? • Because it’s the right think to do • Keep workers healthy • Improve morale • Retain employees • Reduce medical care costs • Attract good employees • Improve productivity • Decrease absenteeism

11. Strength of Evidence for Worksite Wellness - Chapman, Proof Positive, 2002

12. Smoking Cessation Back Injury Prevention Violence Prevention Blood Pressure Screening Stress Management Fitness HIV/Aids Nutrition/Cholesterol Education and Screening Health Risk Assessment Alcohol and Drug Abuse Intervention Most Common Worksite Programs

13. Broad Approaches to Health in the Workplace • Health Promotion • Prevention, Early Detection, and Risk Reduction • Wellness • Cost Sharing/Cost Containment

14. WHO Definition of Health • Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. • Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 states (Official Records of the World Health Organization, no. 2, p 100) and entered into force on 7 April 1948. • The Definition has not been amended since 1948.

15. Merriam-Webster Definitions • Health – The condition of being sound in body, mind, or spirit; especially: freedom from physical disease or pain • Promotion – The act of furthering growth or development of something • Prevent – to keep from happening or existing • Early – Near the beginning of a course, process, or series • Detect – To discover or determine the existence, presence, or fact of • Risk – The possibility of loss or injury • Reduce – To diminish in size, amount, extent, or number • Wellness – The quality or state of being in good health especially as an actively sought goal

16. Risk Reduction, Prevention, and Early Detection Programs • Taking steps to decrease the chance of developing a disease or other health concern: • Lowering your blood pressure • Losing weight • Stopping smoking • Focus on parts of self • “Normal” as a criterion • Professional directs action • Primarily “Physical” emphasis

17. Smoking Cessation Back Injury Prevention Violence Prevention Blood Pressure Screening Stress Management Fitness HIV/Aids Nutrition/Cholesterol Education and Screening Health Risk Assessment Alcohol and Drug Abuse Intervention Worksite Programs, revisited

18. Wellness • An integrated method of functioning which is oriented toward maximizing the potential of which the individual is capable, within the environment where he is functioning • Halbert Dunn, 1977

19. Wellness • Multidimensional and Interactional • Physical • Emotional • Social • Intellectual • Occupational • Spiritual • Environmental • Variable, not static… and Ever-Changing • Youth a Gift of Nature...Age a Work of Art

20. Focus on Promoting/ Protective Factors • What makes us strong? • What experiences make us more resilient? • What opens us to more fully experience life? • What in organizations makes us grow? • How can we give meaning to life? • What produces high level well-being?

21. Sense of Coherence (Antonovsky, 1979) • Your world is understandable: Stimuli from internal and external sources is perceived as structured and predictable. (Comprehensible) • Your world is manageable: Resources exist to meet demands posed by stimuli (Manageability) • Your world has meaning: Demands are challenges worth spending energy/effort on (Meaningfulness)

22. Tasks that Should be Considered • Manage the pace of life • Set priorities • Develop needed personal and occupational skills • Connect people • As a manager, think about the needs of the whole person… body, mind, and spirit

23. Wellness Programs • Quality of life/life satisfaction monitoring • A holistic approach • Unique person directs action • Multidimensional expression across lifespan • Number and quality of friendships/social support • Mental engagement • Environmental awareness

24. Basic Life Style Behaviors • Get enough sleep • Eat a balanced diet • Think healthy… not thin • Lead an active life • Don’t smoke and avoid second hand smoke • Drink in moderation or not at all • Relax and avoid or control stress • Stay connected

25. Cost Sharing/Cost Containment • Somewhat Newer Addition to the mix • Cost shifting: Employee pays a greater portion of the health insurance premium • “Incentivizing”: Employee rewarded for healthy lifestyle choices

26. Cost Sharing/Cost Containment Programs • $100 voucher to use toward December health insurance premium for filling out an HRA • $500 check for participating in a smoking cessation program and being smoke-free for 6 months. Receives an additional $100 every year on smoke-free anniversary • $200 shopping certificate for each 20 pound weight loss • 10% reduction in health insurance premium if 1 or less “risk factor” • Pay higher percentage of health premium if non-compliant

27. Program Targets for Worksites… A Balancing Act • Remedial and rehabilitative • Disability and illness specific • Work hardening • Prevention/risk reduction programs • Life enhancing and growth producing • Social/fun • Financial planning • Leadership training

28. What Does it Take To Be Successful in Worksite Health? • Base programs on diversity of workforce and the organizational culture • Communicate with your employees about health related concerns and goals • Ask your employees about their lifestyle-decision making interests • Implement programs that make sense for the size and type of your workplace • Make a permanent commitment to improve and maintain health of your employees… identify what is valued and live those values

29. Toward Successful Programming… • Individual behavioral change • Physical work environment • Organizational development & policies • Community collaboration and environmental issues

30. Examples of Individual Change • Work station stretching • Meditation and other Relaxation Techniques • Walking clubs • Self-care guide use and education programs • Healthy eating… when and where you eat, as well as what. • Health risk appraisal and risk management • Personal/Professional Development

31. Examples of Physical Work Environment • Vending machines: snacks vs. low fat • Promoting walking by marking paths and using signage to promote use • Posting/delivering health messages • Quiet room for relaxation • Personal control of workspace • Ergonomically correct workspaces • Workloads consistent with a normal work day

32. Organizational Development & Policies • Upper management buy-in • Commitment to wellness by including it in the company’s vision • Health theme months • Subsidize fitness/health club memberships • Newsletters, emails, payroll inserts with health tips • Departmental competitions: walking, weight, etc. • Special recognition of participants

33. Organizational Components Disability Management Health Promotion Return-to-work programs and policies Occupational Health Regulations Incentives Benefits Needs Assessment Evaluation Projects Health and Productivity Management Individual Elements Health Enhancement Injury Prevention Participation Program Requests Informal Leaders-Communication Workplace Culture Policy Enhancement Workplace/job satisfaction Management Support Culture Change Integration Institute for Health and Productivity Management

34. Community Collaboration • Advocating for sidewalks, bike trails and health-related community planning • Health related speakers from community • Local restaurants sponsoring low fat foods and cooking classes • Children of employees creating health posters and messages • Sponsor parks and recreation programs • Involve health related organizations in programs for employees

35. Audience Perspective “You don’t build it for yourself. You find out what the people want and you build it for them” - Walt Disney • Healthy lifestyle strategy that encourages an audience focus… Wellness Marketing

36. Wellness Marketing:Distinctive Features • Consumer orientation • Uses commercial marketing technologies and theory (product, price, place, promotion; exchange theory) • Voluntary behavior change • Data drives decision-making • Targets specific audiences

37. Creating the Competitive Advantage “Positioning our product relative to the competition” • Increase the benefits of the target behavior • Decrease the barriers (and/or costs) to the target behavior • Decrease the benefits of the competing behavior(s) • Increase the barriers (and/or costs) of the competing behaviors.

38. The 4 Ps • Product – Tangible items and services that encourage individuals to perform the desired behavior • Price – The cost that the target market associates with the behavior • Place – Where and when the target market will perform the desired behavior, acquire any related tangible objects, and receive any associated services • Promotion – Creating messages and selecting media channels

39. Back to Worker Health Beyond unintentional injuries… • Relational Theory suggests social connectedness is the primary determinant of health (sign language interpreters and carpal tunnel… nurses and back injuries) • Gallop research in organizational development suggests relationships are what drive organizational health and vitality

40. Resilient Employees… (David Lee, www.HumanNatureAtWork.com) • Believe they are part of an organization that matters and is worthy of pride • Have a chance to make a difference, a chance to matter • Experience self-efficacy • Experience control in their jobs • Have the chance to learn and grow • Are “kept in the loop” • Are treated with respect • Believe their manager, and management in general, cares about them as human beings • Trust management’s ability and intentions • Believe they, and their work, are appreciated

41. Take Home Message • Well designed workplace wellness programs can reduce medical claims and worker’s compensation costs. ROI: about $3 for every $1 invested. (Goetzel, Chapman, Edington). But, wellness should be considered an investment, not a cost • Interventions should follow a “systems” approach to changing behavior, including individual behavior changes and organizational policy, as well as workplace culture and community-level and “built environment” issues. Collaborative efforts are important! • Programs should be tailored to the specific needs and wants of the population served, and each workplace has unique challenges. Overall, work toward having a fast, friendly, flexible, focused, and happy workforce. • Buy-in from all “customers” (upper-management, “end users,” and everyone in between) is key to the success of your initiatives.

42. WellForce Development Workshops • Quarterly ½ day workshops to help HR Managers and Wellness professionals with Workplace Wellness programming • Visit www.bsu.edu/workplacewellness • Next workshop: October

43. Continuing Education… • Graduate Degree Programs and Graduate Certificates • Graduate Assistantships to support graduate work • Working with partners to develop an intensive workshop accompanied by technical assistance and consultation

44. Workplace Wellness Resources • Fisher Institute for Wellness and Gerontology • www.bsu.edu/wwrtwww.bsu.edu/wellness • Wellness Council of Indiana • http://www.wellnessin.org/ • Wellness Councils of America • http://www.welcoa.com/

45. Comprehensive Workplace Wellness Programming Jane Ellery, Ph.D. Director of Wellness Management Fisher Institute for Wellness and Gerontology Ball State University jellery@bsu.edu