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 healthcare 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 health promotion programs will continue to become important factors in the provision of health care, including prevention activities, for both government and private industry.
In organizations 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 control, nutrition programs and stress management. Benefits cited range from improved health and productivity to reducing health care costs.
Demographics of the U.S. 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 almost 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 increase to 32 years by 2030.
o 57.9 percent of all personnel work in companies with between 2 and 500 employees; 45 percent work in companies with fewer than 100 personnel. An additional 7.5 million American Citizens are self-employed and 3 million are farmers.
o 18% of all wage and salaried staff members in 1985 were union members.
o 45% of all personnel are employed in offices.
Prevalence of Corporate Wellness Activities
Based on a 1985 survey, almost 66 percent 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 –
Wellness Program Activities
Use of tobacco Control 35.60%
Health Risk Appraisal (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 members believe the advantages of their employee wellness activities outweigh the costs, even though few formal evaluations exist.
The most frequently cited reason for starting health promotion programs and perceived benefit from programs is improved employee health.
At most workplaces with activities (85.4%), all employees are eligible to participate. 30 percent of workplaces with activities offer them to business dependents, and an equal percent offer them to retirees.
When worksites seek outside health promotion 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%).
Use of tobacco Cessation Programs
Smoking related medical problems cost USA organizations $26 billion a year in lost productivity and $7 to $8 billion in tobacco use-related health 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.
People who smoked an average of one or more packs of cigarettes per day had 118 percent higher health expenses than nonsmokers.
76 percent of current smokers and 80 percent 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 tobacco use in offices or workplaces either in government-controlled offices or offices of private employees.
Examples of tobacco use cessation intervention program used by corporations 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 organization or shared time;
o offering cash payments to quitters after 6 of 12 tobacco-free months;
o participating in national quit smoking days; and
o Adopting a smoke free corporation 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 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 can 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 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 onsite fitness facilities.
The majority of employees sponsored fitness programs involve skills training like aerobic dance, low impact aerobics, resistance training, preand post-natal exercise classes, and walking/jogging groups.
Many companies subsidize worker participation in community “Ys,” fitness clubs or other community programs if no on-site facilities are available.
Workplace fitness programs can 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 percent 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 percent higher than those for thin people .
Nutrition and Weight Control
One-third of the USA population is obese to the extent of decling their life expectancy.
Improvements in consuming habits could 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 a few advantages for nutrition education; support and influence of colleagues and management, availability of a daily eating situation, and opportunities for follow-up and monitoring.
Worksite nutrition programs could 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% to 80% of doctor visits can be attributed to psychosomatic or stress-related origins.
Company 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 authorizing personnel to take part in decisions about the work process;
o positions which require more or less skill than the staff member has;
o changes in work demands;
o lack of clarity about expectations and standards; and
o conflict with coworkers or supervisors.
Most worksite stress management programs are implemented thus of requests from employees.
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 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 United States corporation.
Motor automobile accidents account for 27% of all work-related deaths and 45 million days of lost work annually.
More 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 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 car 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 safety belt policies, requiring use of belts by whoever riding in a company automobile or using a private automobile on company company, 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 worksite seatbelt programs include -
o Active commitment for management;
o clearly 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 comprehensive investigation of its comprehensive staff member 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 staff member. Their year 9 projected benefit is $677 per staff member.
Workers at four Johnson and Johnson companies who were exposed to the health promotion 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 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 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 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 staff member wellness program 4 years earlier.
The sample of 495 staff was stratified to match the business profile respecting age, sex and job description.
The survey reported 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 company’s tobacco use cessation program and regular participants of the wellness center miss an average of 1.96 workdays annually because of disease or injury compared to 3.08 days for non-participating staff.
The Coors Business also achieved a cost savings from a cardiac rehabilitation program that was implemented in 1981. In 1980 personnel 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.