Employee Wellness

Wellness Program Introduction

The last ten years has brought major changes in employer 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, especially 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 prevention activities, for both government and private industry.

In businesses with existing wellness programs, administrative rationale for sponsoring these activities ranged from improving worker health (28%) to improving worker morale (9.7%).

Programs include interventions associated with safety, health risk (assessment|appraisal}, tobacco use cessation, blood pressure (BP) control, nutrition programs and stress management. Benefits cited range from improved health and productivity to decreasing healthcare costs.

Demographics of the United States  Workforce

• 110 million American Citizens were in the civilian labor force in 1981; by the year 2000 the civilian labor force is expected to be almost 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 elevate to 32 years by 2030.

• 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 Americans are self-employed and 3 million are farmers.

• 18% of all wage and salaried staff members in 1985 were union members.            

• 45% of all employees are employed in offices.            

Prevalence of Corporate Wellness Activities            

Based on a 1985 survey, nearly 66 percent of worksites with 50 or more employees had corporate wellness activities in 1985.  The frequency of worksite-based activities by selected categories in 1985 was –             

Wellness 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 (BP) Control    16.50%         

Weight Control          14.70%   

Worksite size is the strongest indicator of program prevalence.            

Most employees believe the benefits of their corporate wellness activities outweigh the costs, even though few formal investigations exist.            

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

At most worksites with activities (85.4%), all workers are eligible to participate. 30 percent of worksites with activities offer them to company 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 companies (43%).

Smoking Cessation Programs

Tobacco use related medical problems cost United States  corporations $26 billion per year in lost productivity and $7 to $8 billion in use of tobacco-related healthcare costs.

Workers 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.

People  who smoked an typical of one or more packs of cigarettes per day had 118% higher health expenses than nonsmokers.

76% of current smokers and 80% of former smokers and nonsmokers feel that businesses 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 smoking in offices or workplaces either in government-controlled offices or offices of private staff members.

Examples of smoking cessation intervention program used by corporations include –

• offering nonsmokers a discount of health and life insurance;

• paying full or partial fees for use of tobacco cessation programs;

• providing cessation programs on company or shared time;

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

• participating in national quit tobacco use days; and

• adopting a smoke free company policy and establishing 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 employees and their more sedentary counterparts.

In addition to bettering strength, balance, and flexibility, exercise programs may reduce  the probability of back injuries among certain occupational groups.

93 million workdays in the United States 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 staff members sponsored physical fitness programs involve skills training such as aerobic dance, low impact aerobics, strength training, preand post-natal exercise classes, and walking/jogging groups.

Some corporations subsidize worker participation in community “Ys,” fitness centers or other community programs if no on-site facilities are available.

Worksite fitness programs could reduce costs to companys by decreasing worker healthcare 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% 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 decling their life expectancy.

Improvements in consuming habits can reduce  the risk of serious health problems such as 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 colleagues and management, availability of a daily consuming situation, and opportunities for follow-up and monitoring.

Worksite nutrition programs may 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 participate in weight-loss programs than are female staff members.

Stress Management

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

Corporation compensates many of the costs related to worker stress, both directly in the form of healthcare costs and in lower productivity.

Job factors which are associated with stress include –

• not permitting workers to participate 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 workers.

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 –

• workshops conducted by trained experts;

• 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 automobile accidents are the largest single cause of lost work time and on-the-job fatalities of U.S.  company.

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

More than 36% of the 11,300 accidental work deaths in 1983 involved cars.

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 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 settings where safety belt policies, requiring use of belts by anyone riding in a company car or using a private car on company company, 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 percent to 70 percent initial usage rates.

Factors influencing the sources of worksite safety belt programs include –

• active commitment for 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 robust investigation of its robust 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 benefit of $316 per worker. Their year 9 projected benefit is $677 per worker.

Staff Members at four Johnson and Johnson corporations 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 staff members at corporations that were offered only an annual biometric screen.

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 wellness 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 employees to determine changes in health practices since the introduction of an worker wellness 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 announced 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 tobacco use as the result of the corporation’s tobacco use cessation program and regular participants of the wellness center miss an typical of 1.96 workdays annually because of illness or injury compared to 3.08 days for non-participating employees.

The Coors Company also achieved a cost savings from a cardiac rehabilitation program that was implemented 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.