Wellness Program Introduction
The last ten years has brought major changes in company attitudes toward wellness programs. Interest in self-help and self-care programs has increased as growth in healthcare costs have encroached substantially into profits.
Changes in the organizational structures of healthcare facilities, specifically 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 health promotion programs will continue to become important factors in the provision of healthcare, including avoidance activities, for both government and private industry.
In companies with existing health promotion programs, administrative rationale for sponsoring these activities ranged from bettering worker health (28%) to bettering worker morale (9.7%).
Programs include interventions associated with safety, health risk assessment, use of tobacco 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 United States Workforce
o 110 million American Citizens 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 percent of the 1984 labor force was female; 10 percent was Black.
o The median age of the workforce is 32 years and is expected to raise to 32 years by 2030.
o 57.9% of all workers work in organizations with between 2 and 500 employees; 45% work in organizations with fewer than 100 workers. An additional 7.5 million Americans are self-employed and 3 million are farmers.
o 18 percent of all wage and salaried staff members in 1985 were union members.
o 45% of all personnel are employed in offices.
Prevalence of Corporate Health Promotion Activities
Based on a 1985 survey, almost 66 percent of worksites with 50 or more employees had employee wellness activities in 1985. The frequency of worksite-based activities by selected categories in 1985 was -
Health Promotion Program Activities
Smoking Control 35.60%
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%
Worksite size is the strongest indicator of wellness program prevalence.
Most staff believe the benefits of their company health promotion activities outweigh the costs, even though few formal investigations exist.
The most frequently cited reason for beginning wellness programs and perceived benefit from programs is improved employee health.
At most workplaces with activities (85.4%), all employees are eligible to participate. 30% of workplaces 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 corporations (57.1%), private for-profit providers-consultants (50%), local hospitals (44%), and insurance corporations (43%).
Smoking Cessation Programs
Tobacco use related medical problems cost U.S. businesses $26 billion annually in lost productivity and $7 to $8 billion in use of tobacco-related health care costs.
Staff Members 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 typical of one or more packs of cigarettes per day had 118 percent higher health costs than nonsmokers.
76 percent of current smokers and 80 percent of former smokers and nonsmokers feel that corporations should restrict use of tobacco to certain areas.
In 1985, 65% of smokers, 85% of nonsmokers and 78% of former smokers, felt that smokers should refrain from tobacco use in the presence of nonsmokers.
In 1986, 17 states had laws regulating smoking in offices or worksites either in government-controlled offices or offices of private personnel.
Examples of smoking cessation intervention program used by businesses include -
o offering nonsmokers a discount of health and life insurance;
o compensating full or partial fees for smoking cessation programs;
o providing cessation programs on business or shared time;
o offering cash payments to quitters after 6 of 12 smoke-free months;
o participating in national quit smoking days; and
o Adopting a smoke free business policy and establishing deadlines for implementing 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 shown 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 plans could reduce the probability of back injuries among certain occupational groups.
93 million workdays in the USA are lost yearly as the result of back problems.
Research findings support the notion that workplace exercise programs 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 on-site fitness facilities.
The majority of staff members sponsored fitness programs involve skills training such as aerobic dance, low impact aerobics, weight training, preand post-natal exercise classes, and walking/jogging groups.
Some companies subsidize staff member participation in community “Ys,” health clubs or other community programs when no on-site facilities are available.
Workplace physical fitness programs can reduce costs to corporations by decreasing 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 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 reducing their life expectancy.
Improvements in eating habits may reduce the risk of serious medical problems like high blood pressure 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 eating situation, and opportunities for follow-up and monitoring.
Worksite nutrition programs may be grouped in 6 wide 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 take part in weight-loss programs than are female staff members.
Stress Management
Estimates suggest that 50 percent to 80 percent of physician visits could be attributed to psychosomatic or stress-related origins.
Corporation compensates 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 allowing workforce to take part 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 kinds 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 people 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 automobile accidents are the largest single cause of lost work time and on-the-job fatalities of USA company.
Motor car accidents account for 27% of all work-related deaths and 45 million days of lost work yearly.
Greater than 36 percent of the 11,300 accidental work deaths in 1983 involved automobiles.
Workers 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 automobile crashes cost $15.2 billion in lost productivity, 88% of which is attributed to losses from workforce activities and future earnings.
In corporate establishings where seatbelt policies, requiring use of belts by anybody riding in a business automobile or using a private automobile 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 percent to 70 percent initial usage rates.
Factors influencing the sources of workplace seatbelt programs include -
o Active commitment by 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 Health Promotion Programs
Based on an extensive evaluation of its extensive staff member wellness program, LIVE FOR LIFE, Johnson and Johnson reported the break-even point for the program occurs in year 3 and by year 5 they have a net advantage of $316 per staff member. Their year 9 projected benefit is $677 per staff member.
Workers at four Johnson and Johnson companies who were exposed to the wellness program increased their daily energy expenditure in vigorous activity by 104% compared to an increase of 33% among staff at companies that were offered only an annual medical screen.
Participants in the United Methodist Publishing House’s health promotion program submitted more claims (1.14 per participating worker 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 healthcare costs for 1985 ($902,116 projected with actual costs $142,884) to the wellness program even though the results aren’t 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 staff member health promotion program 4 years earlier.
The sample of 495 staff members was stratified to match the organization profile respecting age, sex and job description.
The survey announced that 65% of respondents began exercising in the last 4 years, 37% had improved their diets, 20% were regular users of the wellness center, 9% had stopped tobacco use as the result of the organization’s tobacco use cessation program and regular participants of the wellness center miss an typical of 1.96 workdays annually because of disease or injury compared to 3.08 days for non-participating workforce.
The Coors Corporation also achieved a cost savings from a cardiac rehabilitation program that was implemented 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.
