Health Promotion Blog

Dr. Moore of Nationwide maintains that immunization is the most cost-effective treatment in medicine. For example, vaccinating children against the influenza virus averages a savings (including healthcare costs, parents’ missed work, etc.) of up to $35 per vaccine recipient. And experts predict that estimate is low, because it doesn’t take into account the rapid spread of the flu.

The American Association of Family Physicians’ Web site, www.aafp.org, offers a recommended adult immunization schedule created by the Advisory Committee on Immunization Practices. This schedule, tiered by age and chances of exposure, recommends diphtheria, tetanus, influenza, pneumonococcal, hepatitis B, hepatitis C, measles, mumps and rubella, varicella and meningococcal vaccinations.

Ideas to incorporate prevention and early detection:

• Hold a wellness fair and invite organizations that provide testing services for such conditions as blood pressure, blood iron, cholesterol, body mass index (BMI) and diabetes.
• Offer educational materials about well-baby care and immunizations.
• Choose healthcare coverage plans that include wellness check-ups and immunizations.
• Offer onsite mammograms for employees.
• Sponsor onsite flu vaccinations to coincide with flu season.

Benefits of Stress Reduction Programs

While stress cannot be eliminated from life, or even from the worksite, coping skills can be developed with relative ease. Stress management skills lead to reduced absenteeism and more effective, more productive employees. Because stress has been shown to contribute to such physical conditions as ulcers, high blood pressure and stroke, stress reduction has a direct impact on improving physical health.

Studies have shown that heart patients who attend stress management programs have 42% lower healthcare costs. Other studies have documented a 50% reduction in medical services use when stress management programs are employed. Further, Employee Assistance Program (EAP) experts estimate that 20% of any workforce is affected by personal problems that can influence work performance.

Stress reduction tactics to consider:

• Offer onsite yoga or meditation classes.
• Organize support groups among employees.
• Sponsor stress management classes during the workday.
• Offer an employee assistance program that includes both counseling and referral.
• Offer onsite counseling for employees in the case of a work-related trauma, such as the death of a co-worker.

Benefits of Prenatal Care and Breastfeeding

The old adage “an ounce of prevention is worth a pound of cure” is particularly relevant to when applied to preventive measures taken during pregnancy, when a few extra ounces of birth weight can save a child’s life. During pregnancy, simple precautions can help avoid catastrophic results; giving up smoking, for instance, drastically reduces the risk of miscarriage and pre-term labor.

The March of Dimes reports that if all women took adequate folic acid before conception and during pregnancy, the number of babies born with a neural tube defect could drop by as much as 70%. The physical and emotional benefits of proper prenatal care to a mother and child are underscored by a strong corporation case for offering prenatal wellness benefits. Nationwide’s Chief Medical Director, Dr. Michael Moore, estimates costs to care for one baby delivered prematurely could approach $500,000.

First steps in fostering a prenatal program:
• Invite the March of Dimes to present information about prenatal health at an worker brownbag lunch or breakfast meeting.
• Hold prenatal care information classes for interested employees at lunchtime.
• Offer educational materials about the effects of alcohol, drugs and smoking on an unborn child.
• Offer incentives for adopting healthy lifestyles during pregnancy.
• Offer prenatal programs and education as part of the corporation healthcare package.

Benefits of smoking Cessation Programs

Instances of respiratory diseases, cancer and other illnesses can be reduced through smoking cessation efforts. smoking cessation programs can provide huge opportunities for improved health.

The American Cancer Society reports that smoking employees cost businesses an average of $1,429 per smoker per year in increased healthcare costs over non-smoking employees. Implementing a smoking cessation program costs an average of $45 per worker per year, saving businesses an average of $1,383 per year for each worker who quits smoking. Additionally, the American Cancer Society reports that smokers are absent from work 50% more often than nonsmokers. They are also 50% more likely to be hospitalized and have 15% higher disability rates. smoking decreases onthe- job productivity as well. Employees who take four 10- minute smoking breaks a day work more than a month less per year than workers who don’t take smoke breaks.

Places to start with smoking cessation programs:

1.    Establish a corporation policy prohibiting tobacco use anywhere on the property.
2.    Offer prompts/posters to support no tobacco use policy.
3.    Policy supporting participation in smoking cessation activities during duty time (flex-time).
4.    Offer counseling through an individual, group, or telephone counseling program onsite.
5.    Offer counseling through a health plan sponsored individual, group, or telephone counseling program.
6.    Offer cessation medications through health insurance.

Benefits of Nutrition Programs

Nutrition directly impacts nearly every aspect of physical and mental health. A healthy diet can help protect against such conditions as heart disease, diabetes, arthritis, stroke, certain cancers and depression. Obesity, which is among the most common conditions linked to diet, affects a record number of Americans.

The American Journal of Health Promotion estimates the cost of obesity to U.S. corporation to exceed $12.5 billion in health care, sick leave, and life and disability insurance. Further, one study reports that obesity raises healthcare costs by 36% and medication costs by 77%. To offset the health risks of obesity and poor diet, many businesses have committed to helping employees ensure proper nutrition and undertake weight control programs.

Popular nutrition programs:

Fruit and Vegetable Consumption

1.    Offer healthy eating reminders and prompts to employees via multiple means (i.e. e-mail, posters, payroll stuffers, etc.).
2.    Offer appealing, low-cost fruits and vegetables in vending machines and in the cafeteria.
3.    Offer cookbooks, food preparation, and cooking classes for employees’ families.
4.    Ensure onsite cafeterias follow healthy cooking practices and set nutritional standards for foods served that align with the U.S. Dietary Guidelines for Americans.
5.    Offer healthy foods at meetings, conferences, and catered events.
6.    Use point-of-decision prompts as a marketing technique to promote healthier choices.
7.    Offer healthy cooking demonstrations that teach skills (i.e. fruit and vegetable selection and preparation).
8.    Offer taste-testing opportunities at the worksite.
9.    Offer worker-led campaigns, demonstrations or programs.
10.    Offer local fruits and vegetables at the worksite (i.e. worksite farmer’s market or community-supported agriculture drop-off point).
11.    Use competitive pricing (price non-nutritious foods in vending machines and cafeterias at higher prices).
12.    Offer protected time and dedicated space away from the work area for breaks and lunch.
13.    Make kitchen equipment available to employees.
14.    Offer an opportunity for onsite gardening if possible.

Sweetened Beverage Consumption

1.    Make water available throughout the day.
2.    Offer appealing, low-cost healthful drink options in vending machines and the cafeteria.
3.    Modify worksite vending contracts to increase the number of healthy options.
4.    Price non-nutritious beverages at a higher cost.
5.    Use point-of-decision prompts to promote healthier choices.

Portion Control

1.    Label foods to show serving size and/or nutritional content.
2.    Offer food models, food scales for weighing and pictures to help employees assess portion size.
3.    Offer appropriate portion sizes at meetings, worksite events and in the cafeteria.

Nutrition programs in action

While many businesses address weight management through fitness initiatives, businesses are increasingly focusing on nutrition through separate programming. Recognizing the productivity boost and lowered medical expenditures that come with maintaining a healthy weight, many businesses may help pay for obesity treatments for employees. For example, to improve the health of dangerously obese employees, drug maker Wyeth reportedly pays for stomach-shrinking surgeries that carry price tags of up to $40,000.

A 2003 Society of Human Resource Management study shows that 24% of employers offer weight loss programs. In Ohio, Honda offers an onsite, registered dietitian who provides individual or group consultations on weight management. Body fat analysis and body mass index (BMI) measurements are available to employees at any time.

At Grange Insurance’s Columbus headquarters, the cafeteria chef analyzes meals and provides employees basic nutrition information, including Weight Watchers points. Many businesses partner with the American Cancer Society to offer nutrition information through the ”5-ADay” program, which provides employers free signage and educational materials about the importance of eating five servings of fruits and vegetables a day. The program also offers a fruit and vegetable ”frequency card” that gives employees a free portion of fruit or vegetables after he or she has purchased a preset number.

Benefits of Exercise Programs

Exercise reduces weight, lowers risks of heart attack and stroke, helps to control blood pressure and diabetes, and improves mood. Studies increasingly show that physical fitness may also help reduce the occurrence of certain types of cancer. Researchers at the Centers for Disease Control and Prevention (CDC) recently documented another major advantage: physical fitness improves the health of the nation’s medical care expenditures.3 According to the CDC, physically active individuals incur $865 less per year in medical costs than inactive people.

Dr. Michael Moore, vice president and chief medical director at Nationwide Insurance in Columbus, maintains that physical fitness is the most effective tool in health maintenance. “If you could prescribe exercise in a pill, it would be the number-one prescribed treatment in the world,” he said. In step with Dr. Moore’s prescription, nearly one-third of U.S. corporationes help employees pay for gym memberships, according to an Associated Press report. Subsidizing gym memberships is just one way businesses encourage active lifestyles.

Popular Exercise Initiatives:

1.    Allow access to on- and off- worksite gyms and recreational activities before, during, and after work hours.
2.    Offer and encourage participation in after work recreation or leagues.
3.    Offer cash incentives or reduced insurance costs for participation in physical activity and/or weight management or maintenance activities.
4.    Offer shower and/or changing facilities onsite.
5.    Offer outdoor physical fitness areas such as fields and trails for worker use.
6.    Offer bicycle racks in safe, convenient, and accessible locations.
7.    Offer onsite fitness opportunities, such as group classes or personal training.
8.    Offer an onsite physical fitness facility.
9.    Start programs that have strong social support systems and incentives, such as:
• Buddy or team physical activity goals
• Programs that involve workers and family
• Programs to encourage physical activity, such as pedometer walking challenges
• Explore discounted or subsidized memberships at local health clubs, recreation centers, or YMCAs
10.     Offer flexible work hours to allow for physical activity during the day.
11.    Support physical activity breaks during the workday, such as stretching or walking.
12.    Host walk-and-talk meetings.
13. Map out onsite trails or nearby walking routes and destinations.
14. Have employees map out their own biking or walking route to and from work.
15. Post motivational signs at elevators and escalators to encourage stair usage.
16. Offer exercise/physical fitness messages and information to employees.
17. Offer or support recreation leagues and other physical activity events onsite or in the community.
18. Start worker activity clubs such as walking or bicycling clubs.
19. Offer onsite child care facilities to facilitate physical activity.
20. Sponsor a bike to work day and reward employees who participate.
21. Start a box and solicit fitness and health tips.

Wellness programming means different things to different businesses. Effective wellness initiatives can be as simple as bringing bushel baskets of fresh fruit into break rooms to encourage better eating. They can be as extensive as building fitness facilities onsite or paying for obesity treatments.

A driving factor behind the push toward wellness spans businesses of all types, sizes and cultures: that is, healthcare expenses are spilling over the corporate belt buckle. The annual cost of medical services in the United States is rising at seven times the rate of inflation. And the rise in medical costs is one boom pundits expect our economy to sustain.1

This trend makes it increasingly challenging for employers to maintain current levels of insurance coverage. In 2003, healthcare inflation forced 65% of businesses to increase employees’ share of health costs.

Seventy-nine% of large firms said they will increase workers’ share of health costs in 2004.2 But with lost benefits and increased financial burdens come lost morale and productivity.

Employers are searching for another way. While businesses cannot control many of the supply-side elements contributing to rising healthcare costs—malpractice insurance rates, the nursing shortage—they can help curb demand. That’s why efforts are being redirected from illness to wellness.

The case for Corporate Health Promotion Programs is supported by an ever growing body of evidence demonstrating the high costs associated with controllable health risks:

• One study reports that obesity raises healthcare costs by 36% and medication costs by 77%.
• Michigan officials estimate physical inactivity cost the state nearly $8.9 billion in 2002, a cost estimated to be largely borne by employers through insurance premiums and lost productivity.
• The not-for-profit National Committee for Quality Assurance reports that the estimated average cost for postnatal care for women who did not receive prenatal care was $2,341 more than for women who had. And the indirect costs of unhealthful behavior can be just as high.

Data shows that healthier employees are more productive, spending more time at work and showing increased “presenteeism,” or productivity, while there. Further, healthier employees use fewer medical services. The five leading causes of death in the United States — heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes —  are directly linked to unhealthy lifestyles. Clearly, encouraging healthful habits presents an opportunity to improve employees’ well being, reduce the need for healthcare services and help control costs.

Offering worker wellness benefits — large or small — represents an intersection between corporate social responsibility and responsibility to stakeholders. Between worker health and corporate health. It’s often the right thing to do for employees and employers.

Research by Traveler’s Corp. shows a $3.40 return for every dollar invested in Corporate Health Promotion Programs. For many businesses, the choice to offer worker wellness benefits is easy—one where conscience and pragmatism align.

The challenge arises in selecting the programs that will deliver the most impact based on trends in your employees’ health risks and medical claims costs. From large businesses to the corner deli, corporation owners welcome ways to boost productivity, reduce absenteeism and cut costs. Likewise, Corporate Health Promotion Programs can range from modest to elaborate.

In determining where to focus a corporation’s limited resources, looking at costs, benefits and best practices is a good starting point. This section profiles six aspects of wellness and explores their benefits to employees and employers.

When it comes to working wellness into your workforce, you want someone who knows the ins and outs of health promotion, and who can counsel employees and provide primary care – all within the context of the current regulatory and legal environment.

AAOHN’s survey found that more than half of employees (61%) want to receive health and wellness information from a healthcare professional, such as a consultant or an worksite occupational health nurse (OHN), compared to pamphlets or brochures (18%) or human resources staff (15%).

OHNs can develop, implement and evaluate components of work site Corporate Health Promotion Programs such as testing programs, exercise/fitness courses, Stress management, smoking cessation, nutrition and weight control programs, as well as chronic illness management programs. Plus, OHNs can help employees navigate through complicated health plans and may even serve as a triage point between employees and their personal healthcare providers.

Employees might refrain from seeing their healthcare provider when it means time away from work, inconvenient parking, waiting time in the office and co-pays. In situations where employees are under treatment for chronic diseases like heart disease, worksite nurses can routinely monitor risk factors such as blood pressure or cholesterol on a regular basis.

It’s often easier for an worker to ask an worksite nurse for information about symptoms or prescription medication than it is to schedule a follow-up visit to a personal healthcare provider. Benefits realized by employers include enhanced worker morale and retention, a recruitment advantage, increased productivity and decreased time away from work.

In businesses with a safety department, the OHN can evaluate and address work-related health issues, including participation in workstation evaluations to correct potential ergonomic problems, and proactively addressing muscle strains by developing stretching programs and involving employees in leading stretches.

Good for waistlines & your bottom line

By Sandra Simpson, APRN, BC, COHN-S, manager in Occupational Health Services at a Fortune 500 corporation in Memphis, Tenn., and a member of the board of directors of the American Association of Occupational Health Nurses (AAOHN). For a copy of the AAOHN wellness survey, visit www.aaohn.org, or call (800) 241-8014, x0.

In today’s hectic world, most of us are spending more time at work, and have increasingly less time to look after our health. For a long time, employers have understood the benefits associated with keeping workers well – increased productivity from reduced absenteeism and lowered disability claims. For these reasons, coupled with the fact that many businesses realized double-digit healthcare costs last year, businesses should consider Corporate Health Promotion Programs as a way to keep employees healthy.

But just how important are these programs to employees? How often are they willing to take part in programs designed to positively impact their health and wellness? Who do employees trust to provide them with important information about their health?

Answers to these questions and more were recently garnered from a study commissioned by the American Association of Occupational Health Nurses Inc. (AAOHN).

The AAOHN survey questioned 500 employees nationwide about their perceptions of Corporate Health Promotion Programs. More than three-quarters of all participants indicated these programs are a good way to improve their overall health, and nearly 60% consider these offerings an incentive to remain with their current employer. worker retention and turnover impact the bottom line, so building Corporate Health Promotion Programs into the work site culture is a valuable way to help retain talented employees in addition to enhancing personal health and worksite productivity.

Health wish list

Employees appear to have their own agenda when it comes to their health. With new pressures resulting from an unstable economy, national security threats and work/balance issues, it’s not surprising that 85% of survey respondents cited Stress management as a priority topic for work site wellness.

In addition to stress, other preferred topic areas include testing programs (84%), exercise/physical fitness programs (84%), health insurance education (81%) and disease management lunch and learns (80%).

In addition to lifestyle and personal health issues, those asked expressed concern about work-related health issues, including strains and injuries resulting from lifting or task-oriented muscle repetition, exposure to harmful substances, personal injury, vision changes due to computer work and worksite violence.

What you should do

With such a broad range of health concerns, a key goal for employers is finding a way to proactively address the health needs of the largest number of employees, and effectively change unhealthy behaviors, promote wellness and ward off disease and illness.

Printed materials such as brochures, posters, fliers or pamphlets present an easy solution. But it’s important to remember that different people require different formats for learning. A good rule of thumb: provide information in a variety of learning formats such as videos, pamphlets, health-related quizzes, display boards, lunch-and-learn presentations and reimbursement or incentive programs.

This assumes you’ve overcome the first hurdle – getting people to sign on to a Corporate Health Promotion Program. While survey respondents indicated health and Corporate Health Promotion Programs are important, just six out of 10 (60%) reported that they participated in the Corporate Health Promotion Programs at their businesses. The other 40% cited lack of interest and lack of time as deterrents.

This points to the need for a comprehensive, structured Corporate Health Promotion Program using a innovative approach, with an incentive for participation and effective program marketing.

By investing in an organized Corporate Health Promotion Program headed by a qualified healthcare professional such as an worksite nurse, businesses can give employees the access to the health information they want, and increase participation and generate interest at the same time.

The result: employees become savvier healthcare consumers who feel more in charge of their personal health. And healthier employees make for a healthier bottom line.

Stress continues to drive employees’ work-related health concerns, which is probably why most respondents (78%) in a recent survey claim they would take part in a Corporate Health Promotion Program to help their overall health and wellness.

In a recent study commissioned by the American Association of Occupational Health Nurses, Inc. (AAOHN), 500 full-time employees nationwide were interviewed by telephone.

“Today’s employees are clearly dealing with a lot of pressures such as the effects of 9/11, an unstable economy, national security threats and work/balance issues. There is a real opportunity for employers to serve as an ally to their employees by providing them with resources to better manage their physical and emotional health – anything from stress management lunch and learns to nutrition and physical fitness counseling,” says Deborah V. DiBenedetto, president of AAOHN.

Nearly 80% of respondents believe their health would improve if they were offered the right information and tools through a viable Corporate Health Promotion Program.

Topping the list of most interesting Corporate Health Promotion Programs cited by employees is stress management (85%), closely followed by testing programs (84%), exercise/physical fitness programs (84%), health insurance education (81%) and disease management lunch and learns (80%).

More than half of employees (61%) would prefer to receive health and wellness information from a healthcare consultant or worksite nurse, compared to pamphlets or brochures (18%) or human resources staff (15%).