Introduction to Workplace Wellness Programs
The last ten years has brought big changes in employer attitudes toward Worksite Health Promotion Programs. Interest in self-help and self-care programs has increased as growth in healthcare costs have encroached substantially into profits. Changes in the employer 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 workplace healthcare programs and facilities. Projections for the next decade indicate that workplace health programs will continue to become significant factors in the provision of healthcare, including prevention activities, for both government and private industry. In organizations with existing Worksite Health Promotion 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, smoking cessation, Blood Pressure (BP) control, diet programs and stress management. Benefits given range from improved health and productiveness 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 percent of all employees work in businesses with between 2 and 500 employees; 45 percent work in businesses with fewer than 100 employees. An additional 7.5 million American citizens are self-employed and 3 million are farmers.
• 18 percent of all wage and salaried staff members 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% of worksites with 50 or more workers had Workplace Wellness 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 percent
Blood Pressure (BP) Control 16.5 percent
Weight Control 14.7%
Worksite size is the strongest indicator of program prevalence.
Most workers believe the advantages of their Company Wellness Programs activities outweigh the expenditures, even though few formal evaluations exist.
The most usually cited reason for starting programs and perceived profit from programs is improved employee health.
At most worksites with activities (85.4%), all workers are eligible to take part. 30 percent 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 companies (57.1%), private for-profit providers-consultants (50%), local hospitals (44%), and insurance companies (43%).
Tobacco Cessation Programs
Smoking related health concerns cost United States organizations $26 billion per year in lost productiveness and $7 to $8 billion in smoking-related healthcare costs.
Employees who smoke are 50 percent more likely to be hospitalized than nonsmokers, have 2 times as a myriad of 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 care expenditures than nonsmokers.
76 percent of current smokers and 80 percent of former smokers and people that do not smoke feel that organizations 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 must refrain from smoking in the presence of non-smokers.
In 1986, 17 states had laws regulating tobacco use in offices or workplaces either in government-controlled offices or offices of private staff members.
Examples of tobacco cessation intervention program used by corporations include:
• providing nonsmokers a discount of health and life insurance;
• paying full or partial fees for smoking cessation programs;
• providing cessation programs on organization 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 tobacco-free business 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 shown to give 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, exercise programs have the potential to cut the probability of back injuries among certain occupational groups.
93 million workdays in the United States are lost annually as the result of back problems.
Research findings support the notion that worksite physical activity programs better fitness and help decrease other health risks, although results related to improved work rate are weak due to lack of methods for accurately quantifying work rate.
A very small proportion of worksites have on-Site physical fitness facilities.
The majority of employees sponsored physical activity programs involve skills training such as aerobic dance, low impact aerobics, weight training, preand post-natal exercise classes, and walking/jogging groups.
Some organizations subsidize employee participation in community “Ys,” health clubs or other community programs if no onsite facilities are available.
Job Site physical activity programs may cut expenditures 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, spent 114 percent more on health claims than those who ascended at least 15 flights of stairs or walked 1 1/2 miles weekly.
Healthcare costs for obese people are roughly 11 percent higher than those for thin people.
Nutrition and Weight Control
One-third of this country population is obese to the extent of decreasing their life expectancy.
Improvements in eating habits are able to lower the risk of weighty health issues such as elevated Blood Pressure and blood lipid levels and is instrumental in the control of non-insulin-dependent diabetes.
The workplace offers several advantages for nutrition education; support and effect of co-workers and management, availability of a daily eating situation, and opportunities for follow-up and monitoring.
Worksite diet programs can be grouped in 6 broad categories:
• cafeteria programs;
• multi-component programs;
• weight management programs;
• cholesterol reduction programs;
• programs for pregnant and lactating women; and
• other diet education issues.
Men are less likely to participate in weight-loss programs than are female staff members.
Stress Management
Estimates suggest that 50% to 80% of physician visits are able to be attributed to psychosomatic or stress-related origins.
Company pays many of the costs related to employee stress, both directly in the form of medical care costs and in reduced productivity.
Job factors which are associated with stress include:
• not allowing staff members 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 co-workers or supervisors.
Most worksite 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.
Worksite stress management programs are frequently delivered in one of three formats:
• seminars 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 reduce the harmful physical effects of stress; and
• teaching people to recognize and control sources of stress at work and in personal life.
Seat 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.
Workers who regularly 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 vehicle crashes cost $15.2 billion in lost work rate, 88% of which is attributed to losses from workforce activities and future earnings.
In work settings where safety belt policies, mandating use of belts by anyone riding in a employer vehicle or using a private vehicle for employer business, have been enforced, 60 percent to 90 percent use has been stated.
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 responsibility on the part of upper management;
• clearly defined and well enforced policy of needed belt use working;
• beneficial incentives and rewards; and
• ongoing education and training programs.
Case Studies of Workplace Wellness Programs
Based on an extensive assessment of its comprehensive employee Employee Wellness Program, LIVE FOR LIFE, Johnson & Johnson published the break-even point for the program occurs in year 3 and by year 5 they have a net benefit of $316 per employee. Their year 9 projected benefit is $677 per employee.
staff members at four Johnson & Johnson corporations who were exposed to the Employee Health Promotion Program expanding their daily energy expenditure in vigorous activity by 104 percent compared to a growth of 33 percent among staff members at corporations that were provided only an annual health screen.
Members in the United Methodist Publishing House’s Workplace 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 reduced than projected use in healthcare costs for 1985 ($902,116 projected with actual costs $142,884) to the Employee Wellness Program although 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 employee Corporate Wellness Program 4 years earlier. The sample of 495 employees was stratified to match the employer profile in terms of age, sex and job description. The survey stated that 65 percent of respondents started 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 smoking as the result of the employer’s tobacco cessation program and regular participants of the wellness center miss an average of 1.96 workdays every year due to illness or injury compared to 3.08 days for non-participating employees.
The Coors Organization also saw a cost savings from a cardiac rehabilitation program that was launched 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.
