Workplace Wellness Program by J.Ellery

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Comprehensive Workplace Wellness
Programming
Jane Ellery, Ph.D.
Director of Wellness Management
Fisher Institute for Wellness and Gerontology
Ball State University
jellery@bsu.edu

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Focus of Presentation
 Doing Things Right vs. Doing the Right Things
 Supporting Evidence and Current
Programming
 Risk Reduction, Wellness, and Cost Sharing
 Suggestions for Successful Programming
 Reaching the “Hard to Reach” by Using Data
to Drive Decision-Making
 Take Home Messages

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Health Care Spending Rising (CDC, NCCDPHP)
 Our nation spends more on health care
than any other country in the world.
– 1980 health care costs totaled $245 billion
 average of $1,066/American
– 2003 total health care cost $1.7 trillion
 average of $5,805/American

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Costs of Chronic Disease (CDC, NCCDPHP)
 Over 90 million Americans live with chronic
illnesses
– 75% of the Nation’s medical care costs
 Annual cost of:
– Diabetes – $132 billion
– Arthritis – $22 billion (additional $60 billion in lost
productivity)
– Smoking – $75 billion
– All Cardiovascular Diseases – $300 billion
(additional $129 billion in lost productivity)
– Physical inactivity – $76 billion

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Percentage of Adults Who Are
Obese,* by State (CDC, NCCDPHP)

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Causes of Death, IN Compared to
US, 2001 (CDC, NCCDPHP)

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Risk Factors and Preventive Services,
IN Compared to US, 2001 – 2002 (CDC, NCCDPHP)

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Health Care System or Sick Care…
 Health care spending:
– Chronic Disease (75%)… $4,354/person
– Prevention (2%)… $116/person
 Treat the symptoms and ignore the underlying problem
 Obesity epidemic… convenience and excessive
consumption (inactivity and overeating)
 Lifestyle decisions and immediate gratification
 Government agencies leading the health protection
charge
– CDC/National Center for Chronic Disease Prevention and
Health Promotion
– Department of Health and Human Services: HP 2010

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Read this sentence…
FINISHED FILES ARE THE RESULT
OF YEARS OF SCIENTIFIC STUDY
COMBINED WITH THE
EXPERIENCE OF YEARS.

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Why Offer Health and Wellness
Programs?
 Because it’s the right think to do
 Keep workers healthy
 Improve morale
 Retain employees
 Reduce medical care costs
 Attract good employees
 Improve productivity
 Decrease absenteeism

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Strength of Evidence for Worksite
Wellness
Type of Program or
Target Behavior
A
Major Cause of
Disease or Cost
B
Programs Alter
Behavior
C
Programs Reduce
Cost
Multi-Component Very Strong Strong Very Strong
Hypertension Control Very Strong Very Strong Strong
Tobacco Use Very Strong Strong Strong
Medical Self-Care Very Strong Very Strong Very Strong
Nutrition Education Very Strong Strong Weak
Weight Management Strong Moderate Weak
Physical Activity Very Strong Strong Moderate
Stress Management Very Strong Moderate Strong
Back Injury Prevention Very Strong Moderate Strong
Cholesterol Reduction Very Strong Weak Weak
Pre-natal Care Very Strong Strong Strong
High Risk Intervention Very Strong Very Strong Strong
- Chapman, Proof Positive, 2002

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Most Common Worksite Programs
 Smoking Cessation
 Back Injury
Prevention
 Violence Prevention
 Blood Pressure
Screening
 Stress Management
 Fitness
 HIV/Aids
 Nutrition/Cholesterol
Education and
Screening
 Health Risk
Assessment
 Alcohol and Drug
Abuse Intervention

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Broad Approaches to Health in the
Workplace
 Health Promotion
 Prevention, Early Detection, and Risk
Reduction
 Wellness
 Cost Sharing/Cost Containment

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WHO Definition of Health
 Health is a state of complete physical,
mental, and social well-being and not
merely the absence of disease or
infirmity.
– Preamble to the Constitution of the World Health Organization as
adopted by the International Health Conference, New York, 19-22
June, 1946; signed on 22 July 1946 by the representatives of 61
states (Official Records of the World Health Organization, no. 2, p
100) and entered into force on 7 April 1948.
– The Definition has not been amended since 1948.

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Merriam-Webster Definitions
 Health – The condition of being sound in body, mind, or
spirit; especially: freedom from physical disease or pain
 Promotion – The act of furthering growth or development
of something
 Prevent – to keep from happening or existing
 Early – Near the beginning of a course, process, or series
 Detect – To discover or determine the existence,
presence, or fact of
 Risk – The possibility of loss or injury
 Reduce – To diminish in size, amount, extent, or number
 Wellness – The quality or state of being in good health
especially as an actively sought goal

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Risk Reduction, Prevention, and
Early Detection Programs
 Taking steps to decrease the chance of developing a
disease or other health concern:
– Lowering your blood pressure
– Losing weight
– Stopping smoking
 Focus on parts of self
 “Normal” as a criterion
 Professional directs action
 Primarily “Physical” emphasis

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Worksite Programs, revisited
 Smoking Cessation
 Back Injury
Prevention
 Violence Prevention
 Blood Pressure
Screening
 Stress Management
 Fitness
 HIV/Aids
 Nutrition/Cholesterol
Education and
Screening
 Health Risk
Assessment
 Alcohol and Drug
Abuse Intervention

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Wellness
 An integrated method of functioning which is
oriented toward maximizing the potential of
which the individual is capable, within the
environment where he is functioning
– Halbert Dunn, 1977

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Wellness
 Multidimensional and Interactional
– Physical
– Emotional
– Social
– Intellectual
– Occupational
– Spiritual
– Environmental
 Variable, not static… and Ever-Changing
– Youth a Gift of Nature...Age a Work of Art

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Focus on Promoting/ Protective
Factors
 What makes us strong?
 What experiences make us more resilient?
 What opens us to more fully experience life?
 What in organizations makes us grow?
 How can we give meaning to life?
 What produces high level well-being?

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Sense of Coherence (Antonovsky, 1979)
 Your world is understandable: Stimuli from
internal and external sources is perceived as
structured and predictable. (Comprehensible)
 Your world is manageable: Resources exist
to meet demands posed by stimuli
(Manageability)
 Your world has meaning: Demands are
challenges worth spending energy/effort on
(Meaningfulness)

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Tasks that Should be Considered
 Manage the pace of life
 Set priorities
 Develop needed personal and occupational
skills
 Connect people
 As a manager, think about the needs of the
whole person… body, mind, and spirit

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Wellness Programs
 Quality of life/life satisfaction monitoring
 A holistic approach
 Unique person directs action
 Multidimensional expression across lifespan
 Number and quality of friendships/social
support
 Mental engagement
 Environmental awareness

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Basic Life Style Behaviors
 Get enough sleep
 Eat a balanced diet
 Think healthy… not thin
 Lead an active life
 Don’t smoke and avoid second hand smoke
 Drink in moderation or not at all
 Relax and avoid or control stress
 Stay connected

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Cost Sharing/Cost Containment
 Somewhat Newer Addition to the mix
 Cost shifting: Employee pays a greater
portion of the health insurance premium
 “Incentivizing”: Employee rewarded for
healthy lifestyle choices

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Cost Sharing/Cost Containment
Programs
 $100 voucher to use toward December health
insurance premium for filling out an HRA
 $500 check for participating in a smoking cessation
program and being smoke-free for 6 months.
Receives an additional $100 every year on smoke-
free anniversary
 $200 shopping certificate for each 20 pound weight
loss
 10% reduction in health insurance premium if 1 or
less “risk factor”
 Pay higher percentage of health premium if non-
compliant

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Program Targets for Worksites… A
Balancing Act
 Remedial and rehabilitative
– Disability and illness specific
– Work hardening
 Prevention/risk reduction programs
 Life enhancing and growth producing
– Social/fun
– Financial planning
– Leadership training

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What Does it Take To Be
Successful in Worksite Health?
 Base programs on diversity of workforce and the
organizational culture
 Communicate with your employees about health
related concerns and goals
 Ask your employees about their lifestyle-decision
making interests
 Implement programs that make sense for the size
and type of your workplace
 Make a permanent commitment to improve and
maintain health of your employees… identify what is
valued and live those values

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Toward Successful Programming…
 Individual behavioral change
 Physical work environment
 Organizational development & policies
 Community collaboration and environmental
issues

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Examples of Individual Change
 Work station stretching
 Meditation and other Relaxation Techniques
 Walking clubs
 Self-care guide use and education programs
 Healthy eating… when and where you eat,
as well as what.
 Health risk appraisal and risk management
 Personal/Professional Development

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Examples of Physical Work
Environment
 Vending machines: snacks vs. low fat
 Promoting walking by marking paths and
using signage to promote use
 Posting/delivering health messages
 Quiet room for relaxation
 Personal control of workspace
 Ergonomically correct workspaces
 Workloads consistent with a normal work day

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Organizational Development &
Policies
 Upper management buy-in
 Commitment to wellness by including it in the
company’s vision
 Health theme months
 Subsidize fitness/health club memberships
 Newsletters, emails, payroll inserts with health
tips
 Departmental competitions: walking, weight, etc.
 Special recognition of participants

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Health and Productivity Management
Individual Elements
 Health Enhancement
 Injury Prevention
 Participation
 Program Requests
 Informal Leaders-
Communication
Workplace Culture
 Policy Enhancement
 Workplace/job satisfaction
 Management Support
 Culture Change
 Integration
Organizational Components
 Disability Management
 Health Promotion
 Return-to-work programs and policies
 Occupational Health
 Regulations
 Incentives
 Benefits
 Needs Assessment
 Evaluation Projects
Institute for Health and Productivity Management

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Community Collaboration
 Advocating for sidewalks, bike trails and
health-related community planning
 Health related speakers from community
 Local restaurants sponsoring low fat foods and
cooking classes
 Children of employees creating health posters
and messages
 Sponsor parks and recreation programs
 Involve health related organizations in
programs for employees

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Audience Perspective
“You don’t build it for yourself. You find out
what the people want and you build it for
them”
- Walt Disney
 Healthy lifestyle strategy that encourages
an audience focus…
Wellness Marketing

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Wellness Marketing:
Distinctive Features
 Consumer orientation
 Uses commercial marketing technologies
and theory (product, price, place, promotion;
exchange theory)
 Voluntary behavior change
 Data drives decision-making
 Targets specific audiences

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Creating the Competitive
Advantage
“Positioning our product relative to the competition”
 Increase the benefits of the target behavior
 Decrease the barriers (and/or costs) to the target
behavior
 Decrease the benefits of the competing behavior(s)
 Increase the barriers (and/or costs) of the competing
behaviors.

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The 4 Ps
 Product – Tangible items and services that
encourage individuals to perform the desired
behavior
 Price – The cost that the target market associates
with the behavior
 Place – Where and when the target market will
perform the desired behavior, acquire any related
tangible objects, and receive any associated
services
 Promotion – Creating messages and selecting media
channels

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Back to Worker Health
Beyond unintentional injuries…
 Relational Theory suggests social
connectedness is the primary determinant of
health (sign language interpreters and carpal
tunnel… nurses and back injuries)
 Gallop research in organizational
development suggests relationships are what
drive organizational health and vitality

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Resilient Employees… (David Lee,
www.HumanNatureAtWork.com)
 Believe they are part of an organization that matters and is
worthy of pride
 Have a chance to make a difference, a chance to matter
 Experience self-efficacy
 Experience control in their jobs
 Have the chance to learn and grow
 Are “kept in the loop”
 Are treated with respect
 Believe their manager, and management in general, cares
about them as human beings
 Trust management’s ability and intentions
 Believe they, and their work, are appreciated

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Take Home Message
 Well designed workplace wellness programs can reduce medical
claims and worker’s compensation costs. ROI: about $3 for every $1
invested. (Goetzel, Chapman, Edington). But, wellness should be
considered an investment, not a cost
 Interventions should follow a “systems” approach to changing
behavior, including individual behavior changes and organizational
policy, as well as workplace culture and community-level and “built
environment” issues. Collaborative efforts are important!
 Programs should be tailored to the specific needs and wants of the
population served, and each workplace has unique challenges.
Overall, work toward having a fast, friendly, flexible, focused, and
happy workforce.
 Buy-in from all “customers” (upper-management, “end users,” and
everyone in between) is key to the success of your initiatives.

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WellForce Development Workshops
 Quarterly ½ day workshops to help HR
Managers and Wellness professionals with
Workplace Wellness programming
 Visit www.bsu.edu/workplacewellness
 Next workshop: October

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Continuing Education…
 Graduate Degree Programs and Graduate
Certificates
 Graduate Assistantships to support graduate
work
 Working with partners to develop an
intensive workshop accompanied by
technical assistance and consultation

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Workplace Wellness Resources
 Fisher Institute for Wellness and Gerontology
– www.bsu.edu/wwrt www.bsu.edu/wellness
 Wellness Council of Indiana
– http://www.wellnessin.org/
 Wellness Councils of America
– http://www.welcoa.com/

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Comprehensive Workplace Wellness
Programming
Jane Ellery, Ph.D.
Director of Wellness Management
Fisher Institute for Wellness and Gerontology
Ball State University
jellery@bsu.edu