Employee Wellness Newsletter : Corporate Health Promotion Programs: The Facts

Introduction to Employee Wellness Programs

The previous ten years has brought big changes in corporation attitudes toward Worksite Health Promotion Programs. Interest in self-help and self-care programs has increased as growth in healthcare costs have encroached substantially into profits. Changes in the corporation structures of healthcare facilities, in particular the growth of the for-profit healthcare sector, and the need to contain costs are changing the ways in which purchasers of healthcare plans are viewing their own efforts toward provision of worksite healthcare programs and facilities. Projections for the next decade indicate that worksite health programs will continue to become valuable factors in the provision of healthcare, including prevention activities, for both government and private industry. In companies with existing Worksite Health Promotion Programs, administrative rationale for sponsoring these activities ranged from improving employee health (28%) to improving employee morale (9.7%). Programs include interventions associated with safety, health risk assessment, smoking cessation, Blood Pressure (BP) control, nutrition programs and stress management. Benefits cited range from improved health and productivity to reducing healthcare costs.

Demographics of the U.S. Workforce
• 110 million American citizens composed the civilian labor force in 1981; by the year 2000 the civilian labor force is expected to be nearly 140 million.
• 44% of the 1984 labor force was female; ten% was Black.
• The median age of the workforce is 32 years and is expected to increase to 32 years by 2030.
• 57.9 percent of all employees work in businesses with between 2 and 500 employees; 45 percent work in businesses with fewer than 100 employees. An additional 7.5 million Americans are self-employed and 3 million are farmers.
• 18% of all wage and salaried workers in 1985 were union members.
• 45 percent of all staff members are employed in offices.

Prevalence of Workplace Wellness Programs Activities

Based on a 1985 survey, almost 66% of worksites with 50 or more staff members had Workplace Wellness Programs activities in 1985.  The frequency of workplace-based activities by selected categories in 1985 was:

Activity

Smoking Control       35.6%
Health Risk Assessment    29.5%
Back Care             28.6%
Stress Management       26.6%
Exercise             22.1 percent
Off the Job Accidents    19.8 percent
Nutrition             16.8 percent
Blood Pressure (BP) Control    16.5%
Weight Control          14.7%

Worksite size is the strongest indicator of program prevalence.

Most workers believe the advantages of their Employee Wellness Programs activities outweigh the costs, even though few formal evaluations exist.

The most usually given reason for starting programs and perceived advance from programs is improved employee health.

At most worksites with activities (85.4%), all staff members are eligible to take part. 30% of worksites with activities offer them to employer dependents, and an equal percent offer them to retirees.

When worksites seek outside program assistance, they turn to voluntary, not-for-profit companies (57.1%), private for-profit providers-consultants (50%), local hospitals (44%), and insurance companies (43%).

Smoking Cessation Programs

Smoking related health problems cost U.S. organizations $26 billion per year in lost productiveness and $7 to $8 billion in smoking-related health care expenditures.

Staff Members who use tobacco are 50 percent more likely to be hospitalized than non-smokers, have 2 times as countless job-related accidents as non-smokers and have absenteeism rates approximately 50 percent higher than non-smokers.

People who smoked an average of one or more packs of cigarettes per day had 118% higher medical costs than non-smokers.

76 percent of current smokers and 80 percent of former smokers and people that do not use tobacco feel that businesses ought to restrict smoking to certain areas.

In 1985, 65% of smokers, 85% of people that do not use tobacco and 78% of former smokers, felt that tobacco users must refrain from smoking in the presence of people that do not use tobacco.

In 1986, 17 states had laws regulating smoking in offices or workplaces either in government-controlled offices or offices of private employees.

Examples of tobacco cessation intervention program used by companies include:

• providing non-smokers a discount of health and life insurance;
• paying full or partial fees for smoking cessation programs;
• offering cessation programs on organization or shared time;
• making available cash payments to quitters after 6 of 12 tobacco-free months;
• participating in national quit smoking days; and
• adopting a smoke-free company policy and setting deadlines for implementing the policy.

Physical Fitness Programs

An active 55-year-old man can lead as vigorous a lifestyle as a sedentary 35-year-old.

Differences in work-related activity has been shown to provide a two- to three-fold difference in cardiovascular deaths between active staff members and their more sedentary counterparts.

In addition to improving strength, balance, and flexibility, exercise programs are able to lower the probability of back injuries among certain occupational groups.

93 million workdays in the United States are lost each year due to back concerns.

Research findings support the notion that worksite exercise programs better fitness and help lower other health risks, although results related to improved productiveness are weak due to lack of methods for accurately measuring productiveness.

A very small percentage of worksites have on-Site physical fitness facilities.

The majority of staff members sponsored exercise program involve skills training such as aerobic dance, low impact aerobics, weight training, preand post-natal physical activity classes, and walking/jogging groups.

Some businesses subsidize employee participation in neighborhood “Ys,” health clubs or other neighborhood programs if no onsite facilities are available.

Job Site exercise program may decrease expenditures to employers by lowering employee medical care claims and expenditures.

Participants whose weekly exercise was equivalent to climbing less than five flights of stairs or walking less than a half mile, spent 114 percent more on health claims than those who climbed at least 15 flights of stairs or walked 1 1/2 miles weekly.

Healthcare costs for obese people are roughly 11% higher than those for thin people.

Nutrition and Weight Control

One-third of this country population is obese to the extent of decreasing their life expectancy.

Improvements in eating habits have the potential to lower the risk of weighty health issues such as elevated Blood Pressure and blood lipid levels and is instrumental in the control of non-insulin-dependent diabetes.

The workplace offers several advantages for diet education; support and influence of co-staff members and upper management, availability of a daily eating situation, and opportunities for follow-up and monitoring.

Job Site diet programs can be grouped in 6 broad categories:

• cafeteria programs;
• multi-component programs;
• weight management programs;
• blood lipid reduction programs;
• programs for pregnant and lactating women; and
• other diet education issues.

Men are less likely to take part in weight-loss programs than are female workers.

Stress Management

Estimates suggest that 50 percent to 80 percent of physician visits are able to be attributed to psychosomatic or stress-related origins.

Company pays many of the expenditures related to employee stress, both directly in the form of medical expenditures and in decreased productiveness.

Job factors which are associated with stress include:

• not allowing staff members to take part in decisions about the work process;
• positions which require more or less skill than the employee has;
• changes in work demands;
• lack of clarity about expectations and standards; and
• conflict with co-workers or supervisors.

Most workplace stress management programs are implemented as a result of requests from employees.

Stress management programs focus on three types of skills: relaxation skills, coping skills, and interpersonal skills.

Worksite stress management programs are often delivered in one of three formats:

• classes conducted by trained professionals;
• self-learning tools; and
• personal teaching to assist  with self-assessment, planning for changes, learning new skills and responding to life crises.

The two major techniques used in worksite stress management programs are:

• teaching people to lower the negative physical effects of stress; and
• teaching people to recognize and control sources of stress at work and in personal life.

Safety Belt Usage

Motor vehicle accidents are the largest single cause of lost work time and on-the-job fatalities of United States business.

Motor vehicle accidents account for 27 percent of all work-related deaths and 45 million days of lost work annually.

Greater than 36% of the 11,300 accidental work deaths in 1983 involved motor vehicles.

Staff Members who routinely fail to use seat belts may spend up to 54% more days in the hospital.

Traffic accidents caused about 3 times as many days of restricted exercise as any other type of disability.

Motor vehicle crashes cost $15.2 billion in lost productiveness, 88% of which is attributed to losses from workforce activities and future earnings.

In work settings where safety belt policies, requiring use of belts by anyone riding in a organization vehicle or using a private vehicle for organization business, have been enforced, 60 percent to 90 percent use has been stated.

Incentive programs, accompanied by education and use requirement restrictions have resulted in 40 percent to 70 percent initial usage rates.

Factors influencing the sources of workplace safety belt programs include:

• active commitment on the part of senior staff;
• clearly defined and well enforced policy of necessitated belt use on the job;
• beneficial rewards and incentives; and
• ongoing education and training programs.

Case Studies of Company Wellness Programs

Based on an extensive assessment of its inclusive employee Worksite Health Promotion Program, LIVE FOR LIFE, Johnson & Johnson reported the break-even point for the program occurs in year 3 and by year 5 they have a net benefit of $316 per employee. Their year 9 projected benefit is $677 per employee.

employees at four Johnson & Johnson employers who were exposed to the Worksite Health Promotion Program increased their daily energy expenditure in vigorous activity by 104 percent compared to a rise of 33 percent among employees at employers that were provided only an annual health screen.

Participants in the United Methodist Publishing House’s Corporate Wellness Program submitted more claims (1.14 per participating employee and .82 for the control in 1984, 1.44 and 1.3 respectively in 1985), but the average cost per claim was less for participants ($316 for participants and $567 for control, in 1984, $262 and $602 respectively in 1985, $270 and $566 respectively in the first four months of 1986).

The United Methodist Publishing House attributes some of the reduced than projected use in medical care costs for 1985 ($902,116 projected with actual costs $142,884) to the Employee Health Promotion Program even though the results are not conclusive.

In 1985, the Adolph Coors Organization conducted a phone interview of a random sample of its 10,000 staff members to determine changes in health practices since the introduction of an employee Corporate Wellness Program 4 years earlier. The sample of 495 staff members was stratified to match the business profile in terms of age, sex and job description. The survey reported that 65% of respondents started exercising in The previous 4 years, 37% had improved their diets, 20% were regular users of the wellness center, 9% had stopped smoking as the result of the business’s tobacco cessation program and active participants of the wellness center miss an average of 1.96 workdays every year due to illness or injury compared to 3.08 days for non-participating staff members.

The Coors Business also saw a cost savings from a cardiac rehabilitation program that was launched in 1981. In 1980 workers were out of work 7.2 months after a heart attack or bypass operation. In 1984, cardiac patients were out an average 1.9 months saving $152,000 in lost work time and in 1985 cardiac patients missed an average of 2.6 months, saving $125,000 that year.