Health and Wellness Leads : Worksite Health Promotion Programs: The Statistics

Introduction to Workplace Wellness Programs

The previous ten years has brought primary changes in organization attitudes toward Company 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 organization structures of healthcare facilities, in particular 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 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 Company Wellness Programs, administrative rationale for sponsoring these activities ranged from improving employee health (28%) to improving employee morale (9.7%). Programs include interventions associated with safety, health risk assessment, tobacco cessation, Blood Pressure control, diet programs and stress management. Benefits given range from improved health and productivity to reducing healthcare costs.

Demographics of the American Workforce
• 110 million Americans composed the civilian labor force in 1981; by the year 2000 the civilian labor force is expected to be nearly 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 increase to 32 years by 2030.
• 57.9% of all staff members work in businesses with between 2 and 500 staff members; 45% work in businesses with fewer than 100 staff members. An additional 7.5 million Americans are self-employed and 3 million are farmers.
• 18% of all wage and salaried employees in 1985 were union participants.
• 45 percent of all staff members are employed in offices.

Prevalence of Worksite Wellness Programs Activities

Based on a 1985 survey, almost 66 percent of worksites with 50 or more employees had Employee Health Promotion Programs activities in 1985.  The frequency of worksite-based activities by selected categories in 1985 was:

Activity

Smoking Control       35.6 percent
Health Risk Assessment    29.5%
Back Care             28.6%
Stress Management       26.6%
Exercise             22.1 percent
Off the Job Accidents    19.8%
Nutrition             16.8%
Blood Pressure Control    16.5 percent
Weight Control          14.7 percent

Job Site size is the strongest indicator of program prevalence.

Most staff members believe the advantages of their Employee Wellness Programs activities outweigh the costs, even though few formal evaluations exist.

The most generally given reason for starting programs and perceived profit from programs is improved employee health.

At most worksites with activities (85.4%), all staff members are eligible to participate. 30% of worksites with activities offer them to corporation dependents, and an equal percent offer them to retirees.

When worksites seek outside 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%).

Tobacco Cessation Programs

Smoking related health problems cost United States businesses $26 billion per year in lost productivity and $7 to $8 billion in smoking-related health care costs.

Workers who use tobacco 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 used tobacco an average of one or more packs of cigarettes per day had 118% higher medical expenditures than nonsmokers.

76 percent of current smokers and 80 percent of former smokers and nonsmokers feel that corporations ought to restrict smoking to certain areas.

In 1985, 65% of smokers, 85% of non-smokers and 78% of former smokers, felt that tobacco users ought to refrain from smoking in the presence of non-smokers.

In 1986, 17 states had laws regulating smoking in offices or workplaces either in government-controlled offices or offices of private workers.

Examples of smoking cessation intervention program used by employers include:

• making available nonsmokers a discount of health and life insurance;
• paying full or partial fees for tobacco cessation programs;
• offering cessation programs on corporation or shared time;
• making available cash payments to quitters after 6 of 12 tobacco-free months;
• participating in national quit smoking days; and
• adopting a smoke-free organization policy and setting 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 exercise has been established to provide a two- to three-fold difference in cardiovascular deaths between active workers and their more sedentary counterparts.

In addition to improving strength, balance, and flexibility, physical activity programs can cut the probability of back injuries among certain occupational groups.

93 million workdays in the United States are lost each year due to back concerns.

Research findings support the notion that workplace exercise programs improve fitness and help cut other health risks, although results related to improved productiveness are weak due to lack of methods for accurately measuring productiveness.

A very small percentage of worksites have on-Site physical fitness facilities.

The majority of workers 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 employee participation in neighborhood “Ys,” health clubs or other neighborhood programs if no onsite facilities are available.

Job Site physical activity programs may cut costs to employers by reducing employee healthcare claims and expenditures.

Participants whose weekly physical activity was equivalent to climbing less than five flights of stairs or walking less than a half mile, invested 114% more on health claims than those who ascended at least 15 flights of stairs or walked 1 1/2 miles weekly.

Medical Care expenditures for obese people are roughly 11% higher than those for thin people.

Nutrition and Weight Control

One-third of the U.S. population is obese to the extent of decreasing their life expectancy.

Improvements in eating habits can reduce the risk of serious health issues such as high Blood Pressure (BP) and cholesterol levels and is instrumental in the control of non-insulin-dependent diabetes.

The workplace offers several advantages for diet education; support and influence of co-staff members and upper management, availability of a daily eating situation, and opportunities for follow-up and monitoring.

Worksite nutrition programs are able to be grouped in 6 broad categories:

• cafeteria programs;
• multi-component programs;
• weight control programs;
• blood lipid reduction programs;
• programs for pregnant and lactating women; and
• other diet education subject matters.

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 are able to be attributed to psychosomatic or stress-related origins.

Business pays many of the costs related to employee stress, both directly in the form of health care costs and in reduced productivity.

Job factors which are associated with stress include:

• not allowing employees to take part 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 co-staff members or supervisors.

Most workplace stress management programs are implemented as a result of requests from employees.

Stress management programs focus on three types of skills: relaxation skills, coping skills, and interpersonal skills.

Job Site stress management programs are often delivered in one of three formats:

• courses conducted by trained professionals;
• self-learning tools; and
• personal teaching to help  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 people to lower the harmful physical effects of stress; and
• teaching people to recognize and control sources of stress at work and in personal life.

Safety Belt Usage

Motor vehicle accidents are the largest single cause of lost work time and on-the-job fatalities of American business.

Motor vehicle accidents account for 27 percent of all work-related deaths and 45 million days of lost work each year.

Greater than 36 percent of the 11,300 accidental work deaths in 1983 involved motor vehicles.

Employees 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 vehicle crashes cost $15.2 billion in lost productivity, 88% of which is attributed to losses from workforce activities and future earnings.

In work settings where safety belt policies, requiring use of belts by anyone riding in a employer vehicle or using a private vehicle for employer 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 safety belt programs include:

• active responsibility on the part of upper management;
• clearly defined and well enforced policy of necessitated belt use on the job;
• beneficial incentives/rewards; and
• ongoing education and training programs.

Case Studies of Employee Health Promotion Programs

Based on an extensive assessment of its comprehensive employee Employee Wellness Program, LIVE FOR LIFE, Johnson & Johnson stated the break-even point for the program occurs in year 3 and by year 5 they have a net profit of $316 per employee. Their year 9 projected profit is $677 per employee.

employees at four Johnson & Johnson companies who were exposed to the Company Wellness Program expanding their daily energy expenditure in vigorous exercise by 104 percent compared to a growth of 33 percent among employees at companies that were offered only an annual health screen.

Members in the United Methodist Publishing House’s Company Health Promotion 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 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 expenditures for 1985 ($902,116 projected with actual expenditures $142,884) to the Company Health Promotion Program although the results are not conclusive.

In 1985, the Adolph Coors Company conducted a phone interview of a random sample of its 10,000 employees to determine changes in health practices since the introduction of an employee Worksite Wellness Program 4 years earlier. The sample of 495 employees was stratified to match the corporation profile in terms of age, sex and job description. The survey published that 65% of respondents started exercising in The last 4 years, 37% had improved their diets, 20% were regular users of the wellness center, 9% had stopped smoking as the result of the corporation’s tobacco cessation program and active participants of the wellness center miss an average of 1.96 workdays each year because of illness or injury compared to 3.08 days for non-participating employees.

The Coors Organization 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.