Posted by admin | Posted in Health Program Ideas, Screening and Intervention Programs, Wellness Program Incentives | Posted on 09-03-2009
Introduction to Workplace Health Promotion Programs
The previous ten years has brought primary changes in business attitudes toward Company Health Promotion Programs. Interest in self-help and self-care programs has increased as growth in medical expenditures have encroached substantially into profits. Changes in the business structures of medical facilities, in particular the growth of the for-profit medical sector, and the need to contain expenditures are changing the ways in which purchasers of medical plans are viewing their own efforts toward provision of worksite medical programs and facilities. Projections for the next decade indicate that worksite health programs will continue to become significant factors in the provision of medical, including prevention activities, for both government and private industry. In businesses with existing Company 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, tobacco cessation, Blood Pressure control, nutrition programs and stress management. Benefits given range from improved health and work rate to decreasing medical expenditures.
Demographics of the U.S. Workforce
• 110 million American citizens were in the civilian labor force in 1981; by the year 2000 the civilian labor force is predicted to be nearly 140 million.
• 44 percent of the 1984 labor force was female; ten percent was Black.
• The median age of the workforce is 32 years and is expected to grow to 32 years by 2030.
• 57.9 percent of all workers work in organizations with between 2 and 500 workers; 45 percent work in organizations with fewer than 100 workers. An additional 7.5 million Americans are self-employed and 3 million are farmers.
• 18% of all wage and salaried employees in 1985 were union participants.
• 45 percent of all employees are employed in offices.
Prevalence of Corporate Wellness Programs Activities
Based on a 1985 survey, almost 66 percent of worksites with 50 or more staff members had Workplace Wellness Programs activities in 1985. The frequency of worksite-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%
Off the Job Accidents 19.8 percent
Nutrition 16.8%
Blood Pressure (BP) Control 16.5 percent
Weight Control 14.7%
Job Site size is the strongest indicator of program prevalence.
Most employees believe the advantages of their Workplace Health Promotion Programs activities outweigh the costs, even though few formal evaluations exist.
The most generally given reason for starting programs and perceived profit 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 business dependents, and an equal percent offer them to retirees.
When worksites seek outside program assistance, they turn to voluntary, not-for-profit businesses (57.1%), private for-profit providers-consultants (50%), local hospitals (44%), and insurance businesses (43%).
Smoking Cessation Programs
Smoking related health concerns cost United States companies $26 billion per year in lost productiveness and $7 to $8 billion in tobacco-related healthcare expenditures.
Staff Members who smoke are 50 percent more likely to be hospitalized than non-smokers, have 2 times as a myriad of 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 health care costs than nonsmokers.
76% of current tobacco users and 80% of former tobacco users and nonsmokers feel that companies must restrict smoking to certain areas.
In 1985, 65 percent of smokers, 85 percent of nonsmokers and 78 percent of former smokers, felt that tobacco users must refrain from smoking in the presence of nonsmokers.
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 employers include:
• offering non-smokers a discount of health and life insurance;
• paying full or partial fees for tobacco cessation programs;
• offering cessation programs on organization or shared time;
• offering cash payments to quitters after 6 of 12 tobacco-free months;
• participating in national quit smoking days; and
• adopting a tobacco-free employer 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 employees and their more sedentary counterparts.
In addition to improving strength, balance, and flexibility, physical activity programs have the potential to cut the probability of back injuries among certain occupational groups.
93 million workdays in the United States are lost annually due to back concerns.
Research findings support the notion that worksite physical activity programs better fitness and help cut other health risks, although results related to improved work rate are weak due to lack of methods for accurately calculating work rate.
A very small proportion of worksites have on-Site physical fitness facilities.
The majority of employees sponsored fitness programs involve skills training such as aerobic dance, low impact aerobics, weight training, preand post-natal physical activity classes, and walking/jogging groups.
Some organizations subsidize employee participation in neighborhood “Ys,” health clubs or other neighborhood programs if no on-Site facilities are available.
Worksite exercise program may decrease costs to employers by reducing employee medical care claims and expenditures.
People whose weekly physical activity 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 ascended at least 15 flights of stairs or walked 1 1/2 miles weekly.
Health Care expenditures 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 are able to decrease the risk of weighty health issues such as elevated Blood Pressure and cholesterol 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-employees and management, availability of a daily eating situation, and opportunities for follow-up and monitoring.
Worksite diet programs are able to be grouped in 6 broad categories:
• cafeteria programs;
• multi-component programs;
• weight management programs;
• cholesterol 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.
Business pays many of the expenditures related to employee stress, both directly in the form of medical expenditures and in lower 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-staff members or supervisors.
Most worksite stress management programs are implemented as a result of requests from staff members.
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:
• seminars conducted by trained professionals;
• self-learning tools; and
• personal teaching to support with self-assessment, planning for changes, learning new skills and responding to life crises.
The two primary techniques used in worksite stress management programs are:
• teaching people to decrease the detrimental 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 American 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 activity as any other kind of disability.
Motor vehicle crashes cost $15.2 billion in lost work rate, 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 those 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 responsibility on the part of upper management;
• clearly defined and well enforced policy of required belt use on the job;
• beneficial incentives/rewards; and
• ongoing education and training programs.
Case Studies of Company Wellness Programs
Based on an extensive assessment of its comprehensive employee Workplace Wellness 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 advance of $316 per employee. Their year 9 projected advance is $677 per employee.
employees at four Johnson & Johnson companies who were exposed to the Company Wellness Program increased their daily energy expenditure in vigorous activity by 104% compared to a rise of 33% among employees at companies that were offered only an annual health screen.
Members in the United Methodist Publishing House’s Workplace 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 lower than projected use in medical expenditures for 1985 ($902,116 projected with actual expenditures $142,884) to the Employee Health Promotion Program although the results are not conclusive.
In 1985, the Adolph Coors Corporation 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 Company Wellness Program 4 years earlier. The sample of 495 staff members was stratified to match the employer profile in terms of age, sex and job description. The survey published 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 employer’s smoking cessation program and active 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 staff members.
The Coors Organization also saw a cost savings from a cardiac rehabilitation program that was begun in 1981. In 1980 employees 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.