Wellness Program Facts.

Health Promotion Program Introduction

The last ten years has brought major changes in business attitudes toward wellness programs. Interest in self-help and self-care programs has increased as growth in health care costs have encroached substantially into profits.

Changes in the organizational structures of health care facilities, particularly the growth of the for-profit health care sector, and the need to contain costs are changing the ways in which purchasers of health care plans are viewing their own efforts toward provision of worksite health care programs and facilities.

Projections for the next decade indicate that wellness programs will continue to become important factors in the provision of health care, including prevention activities, for both government and private industry.

In corporations with existing health promotion programs, administrative rationale for sponsoring these activities ranged from improving staff member health (28%) to improving staff member morale (9.7%).

Programs include interventions associated with safety, health risk assessment, use of tobacco cessation, blood pressure control, nutrition programs and stress management. Benefits cited range from improved health and productivity to reducing health care costs.

Demographics of the USA  Workforce

o  110 million Americans were in the civilian labor force in 1981; by the year 2000 the civilian labor force is expected to be nearly 140 million.

o  44% of the 1984 labor force was female; 10% was Black.

o  The median age of the workforce is 32 years and is expected to increase to 32 years by 2030.

o  57.9% of all employees work in businesses with between 2 and 500 employees; 45% work in businesses with fewer than 100 employees.  An additional 7.5 million American Citizens are self-employed and 3 million are farmers.

o  18% of all wage and salaried workforce in 1985 were union members.            

o  45% of all workers are employed in offices.            

Prevalence of Company Wellness Activities

Based on a 1985 survey, nearly 66% of workplaces with 50 or more workers had employee wellness activities in 1985.  The frequency of workplace-based activities by selected categories in 1985 was -

Health Promotion Program Activities

Tobacco use Control          35.60%

Health Risk Assessment (HRA)    29.50%

Back Care             28.60%

Stress Management       26.60%

Exercise             22.10%

Off the Job Accidents    19.80%

Nutrition             16.80%

Blood Pressure (BP) Control    16.50%

Weight Control          14.70%

Workplace size is the strongest indicator of health promotion program prevalence.

Most workers believe the benefits of their company health promotion activities outweigh the costs, even though few formal examinations exist.

The most frequently cited reason for starting health promotion programs and perceived benefit from programs is improved staff member health.

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

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

Smoking Cessation Programs

Tobacco use related medical problems cost USA businesses $26 billion annually in lost productivity and $7 to $8 billion in tobacco-related healthcare costs.

Workers who smoke are 50 percent more likely to be hospitalized than nonsmokers, have 2 times as many job-related accidents as nonsmokers and have absenteeism rates approximately 50 percent higher than nonsmokers.

Individuals  who smoked an average of one or more packs of cigarettes per day had 118% higher medical expenditures than nonsmokers.

76 percent of current smokers and 80 percent of former smokers and nonsmokers feel that companies should restrict smoking to certain areas.

In 1985, 65 percent of smokers, 85 percent of nonsmokers and 78 percent of former smokers, felt that smokers should refrain from smoking in the presence of nonsmokers.

In 1986, 17 states had laws regulating use of tobacco in offices or worksites either in government-controlled offices or offices of private workers.

Examples of tobacco use cessation intervention program used by businesses include -

o  offering nonsmokers a discount of health and life insurance;

o  paying full or partial fees for smoking cessation programs;

o  providing cessation programs on company or shared time;

o  offering cash payments to quitters after 6 of 12 tobacco-free months;

o  participating in national quit use of tobacco days; and

o  Adopting a smoke free corporation 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 yield a two- to three-fold difference in cardiovascular deaths between active workforce and their more sedentary counterparts.

In addition to improving strength, balance, and flexibility, exercise plans can reduce  the probability of back injuries among certain occupational groups.

93 million workdays in the United States are lost yearly as the result of back problems.

Research findings support the notion that worksite exercise plans improve fitness and help reduce other health risks, although results related to improved productivity are weak as a result of lack of methods for accurately measuring productivity.

A very small proportion of workplaces have onsite fitness facilities.

The majority of staff sponsored physical fitness programs involve skills training like aerobic dance, low impact aerobics, weight training, preand post-natal exercise classes, and walking/jogging groups.

Some businesses subsidize employee participation in community “Ys,” fitness centers or other community programs when no on-site facilities are available.

Workplace physical fitness programs may reduce costs to employers by reducing worker health care claims and expenditures.

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

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

Nutrition and Weight Control

One-third of the U.S.  population is obese to the extent of decling their life expectancy.

Improvements in eating habits can reduce  the risk of serious health problems like high blood pressure (BP) and cholesterol levels and is instrumental in the control of non-insulin-dependent diabetes.

The workplace offers a few advantages for nutrition education; support and influence of coworkers and management, availability of a daily eating situation, and opportunities for follow-up and monitoring.

Workplace nutrition programs could be grouped in 6 broad categories -

o  cafeteria programs;

o  multi-component programs;

o  weight control programs;

o  cholesterol reduction programs;

o  programs for pregnant and lactating women; and

o  other nutrition education topics.

Men are less likely to participate in weight-loss programs than are female staff.

Stress Management

Estimates suggest that 50 percent to 80 percent of doctor visits could be attributed to psychosomatic or stress-related origins.

Corporation pays many of the costs related to worker stress, both directly in the form of health care costs and in lower productivity.

Job factors which are associated with stress include -

o  not permitting workforce to participate in decisions about the work process;

o  positions which require more or less skill than the employee has;

o  changes in work demands;

o  lack of clarity about expectations and standards; and

o  conflict with peers or supervisors.

Most worksite stress management programs are implemented thus of requests from workforce.

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

Workplace stress management programs are often delivered in one of three formats -

o  seminars conducted by trained specialists;

o  self-learning tools; and

o  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 -

o  Teaching individuals  to reduce the negative physical effects of stress; and

o  Teaching individuals  to recognize and control sources of stress at work and in personal life.

Seat Belt Usage

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

Motor automobile accidents account for 27% of all work-related deaths and 45 million days of lost work yearly.

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

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

Traffic accidents caused about 3 times as many days of restricted activity as any other kind of disability.

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

In corporate settings where seatbelt policies, requiring use of belts by anybody riding in a business car or using a private car on business business, have been enforced, 60% to 90% use has been reported.

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

Factors influencing the sources of workplace safety belt programs include -

o  Active commitment for management;

o  obviously defined and well enforced policy of required belt use on the job;

o  positive incentives; and

o  ongoing education and training programs.

Case Studies of Wellness Programs

Based on an comprehensive evaluation of its comprehensive staff member health promotion program, LIVE FOR LIFE, Johnson and Johnson stated the break-even point for the program occurs in year 3 and by year 5 they have a net benefit of $316 per staff member. Their year 9 projected benefit is $677 per staff member.

Staff Members at four Johnson and Johnson companies who were exposed to the health promotion program increased their daily energy expenditure in vigorous activity by 104 percent compared to an increase of 33 percent among personnel at companies that were offered only an annual medical test.

Participants in the United Methodist Publishing House’s 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 typical 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 lower than projected use in healthcare costs for 1985 ($902,116 projected with actual costs $142,884) to the health promotion program even though the results are not conclusive.

In 1985, the Adolph Coors Company conducted a telephone interview of a random sample of its 10,000 staff to determine changes in health practices since the introduction of an employee health promotion program 4 years earlier.

The sample of 495 workforce was stratified to match the corporation profile in terms of age, sex and job description.

The survey stated that 65 percent of respondents started exercising in the last 4 years, 37 percent had improved their diets, 20 percent were regular users of the wellness center, 9 percent had stopped tobacco use as the result of the organization’s tobacco use cessation program and regular participants of the wellness center miss an average of 1.96 workdays each year because of illness or injury compared to 3.08 days for non-participating workers.

The Coors Company also achieved a cost savings from a cardiac rehabilitation program that was implemented in 1981. In 1980 workforce were out of work 7.2 months after a heart attack or bypass operation.

In 1984, cardiac patients were out an typical 1.9 months saving $152,000 in lost work time and in 1985 cardiac patients missed an typical of 2.6 months, saving $125,000 that year.