Wellness Program Introduction
The last ten years has brought major changes in business attitudes toward health promotion 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, specifically 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 worksite health programs will continue to become important factors in the provision of healthcare, including avoidance activities, for both government and private industry.
In businesses with existing health promotion programs, administrative rationale for sponsoring these activities ranged from bettering employee health (28%) to bettering employee morale (9.7%).
Programs include interventions associated with safety, health risk (assessment|appraisal}, smoking 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 United States Workforce
• 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.
• 44 percent of the 1984 labor force was female; 10 percent was Black.
• The median age of the workforce is 32 years and is expected to increase to 32 years by 2030.
• 57.9% of all staff work in companies with between 2 and 500 employees; 45% work in companies with fewer than 100 staff. An additional 7.5 million Americans are self-employed and 3 million are farmers.
• 18% of all wage and salaried personnel in 1985 were union members.
• 45% of all staff members are employed in offices.
Prevalence of Company Wellness Activities
Based on a 1985 survey, nearly 66% of worksites with 50 or more staff had company health promotion activities in 1985. The frequency of worksite-based activities by selected categories in 1985 was –
Health Promotion Program Activities
Use of tobacco Control 35.60%
Health Risk (Assessment|Appraisal} 29.50%
Back Care 28.60%
Stress Management 26.60%
Exercise 22.10%
Off the Job Accidents 19.80%
Nutrition 16.80%
Blood Pressure Control 16.50%
Weight Control 14.70%
Worksite size is the strongest indicator of program prevalence.
Most staff believe the benefits of their employee wellness activities outweigh the costs, even though few formal investigations exist.
The most frequently cited reason for beginning programs and perceived benefit from programs is improved worker health.
At most worksites with activities (85.4%), all employees are eligible to participate. 30 percent 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 organizations (57.1%), private for-profit providers-consultants (50%), local hospitals (44%), and insurance organizations (43%).
Use of tobacco Cessation Programs
Use of tobacco related health problems cost USA corporations $26 billion per year in lost productivity and $7 to $8 billion in tobacco use-related health costs.
Employees who smoke are 50% more likely to be hospitalized than nonsmokers, have 2 times as many job-related accidents as nonsmokers and have absenteeism rates approximately 50% higher than nonsmokers.
Individuals who smoked an typical of one or more packs of cigarettes per day had 118% higher health expenditures than nonsmokers.
76 percent of current smokers and 80 percent of former smokers and nonsmokers feel that companies should restrict use of tobacco 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 smoking in offices or workplaces either in government-controlled offices or offices of private employees.
Examples of smoking cessation intervention program used by businesses include –
• offering nonsmokers a discount of health and life insurance;
• compensating full or partial fees for tobacco use cessation programs;
• providing cessation programs on organization or shared time;
• offering cash payments to quitters after 6 of 12 smoke-free months;
• participating in national quit tobacco use days; and
• adopting a smoke free company policy and setting deadlines for beginning the policy.
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 proven to yield a two- to three-fold difference in cardiovascular deaths between active staff and their more sedentary counterparts.
In addition to bettering strength, balance, and flexibility, exercise programs could reduce the probability of back injuries among certain occupational groups.
93 million workdays in the USA are lost each year as the result of back problems.
Research findings support the notion that worksite fitness plans improve fitness and help reduce other health risks, although results related to improved productivity are weak due to lack of methods for accurately measuring productivity.
A very small proportion of worksites have onsite fitness facilities.
The majority of personnel sponsored fitness programs involve skills training like aerobic dance, low impact aerobics, weight training, preand post-natal exercise classes, and walking/jogging groups.
Some organizations subsidize worker participation in community “Ys,” health clubs or other community programs when no onsite facilities are available.
Worksite physical fitness programs could reduce costs to corporations by lowering worker health care claims and expenditures.
People 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 ascended 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 United States population is obese to the extent of lowering their life expectancy.
Improvements in consuming habits can reduce the risk of serious health problems such as high blood pressure (BP) and cholesterol levels and is instrumental in the control of non-insulin-dependent diabetes.
The workplace offers several advantages for nutrition education; support and influence of coworkers and management, availability of a daily consuming situation, and opportunities for follow-up and monitoring.
Worksite nutrition programs could be grouped in 6 broad categories –
• cafeteria programs;
• multi-component programs;
• weight control programs;
• cholesterol reduction programs;
• programs for pregnant and lactating women; and
• other nutrition education topics.
Men are less likely to take part in weight-loss programs than are female staff.
Stress Management
Estimates suggest that 50% to 80% of doctor visits can be attributed to psychosomatic or stress-related origins.
Business pays many of the costs related to employee stress, both directly in the form of health care costs and in lower productivity.
Job factors which are associated with stress include –
• not permitting 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 coworkers or supervisors.
Most worksite stress management programs are implemented thus of requests from workforce.
Stress management programs focus on three kinds 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 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 individuals to reduce the negative physical effects of stress; and
• teaching people 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 U.S. corporation.
Motor car accidents account for 27 percent of all work-related deaths and 45 million days of lost work yearly.
More than 36 percent of the 11,300 accidental work deaths in 1983 involved cars.
Employees 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 type of disability.
Motor automobile crashes cost $15.2 billion in lost productivity, 88 percent of which is attributed to losses from workforce activities and future earnings.
In corporate establishings where safety belt policies, requiring use of belts by whoever riding in a organization car or using a private car on organization organization, have been enforced, 60 percent to 90 percent 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 worksite safety belt programs include –
• active commitment by management;
• obviously defined and well enforced policy of required belt use on the job;
• positive incentives; and
• ongoing education and training programs.
Case Studies of Wellness Programs
Based on an comprehensive investigation of its comprehensive worker wellness 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 advantage of $316 per worker. Their year 9 projected benefit is $677 per worker.
Employees at four Johnson and Johnson organizations who were exposed to the wellness program increased their daily energy expenditure in vigorous activity by 104 percent compared to an increase of 33 percent among workers at organizations that were offered only an annual health screen.
Participants in the United Methodist Publishing House’s wellness program submitted more claims (1.14 per participating staff member 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 health care 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 Corporation conducted a telephone interview of a random sample of its 10,000 workers to determine changes in health practices since the introduction of an employee health promotion program 4 years earlier.
The sample of 495 staff members was stratified to match the business profile respecting age, sex and job description.
The survey reported that 65 percent of respondents began 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 use of tobacco as the result of the company’s use of tobacco cessation program and regular participants of the wellness center miss an typical of 1.96 workdays each year because of disease or injury compared to 3.08 days for non-participating personnel.
The Coors Business 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.
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