Category — Wellness In The Workplace

Workplace Wellness Programs that support employees and the setting that they work in have been shown to be a good return on investment (ROI). Workplace Wellness Programs may be extensive and sometimes expensive. However, there are ways for small corporations to make positive changes at little or no cost.

Workplace Wellness Program: Nutrition Activities

Fruit and Vegetable Consumption

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

Sweetened Beverage Consumption

1. Make water available throughout the day.
2. Make available appealing, low-cost healthful drink options in vending machines and the cafeteria.
3. Modify worksite vending contracts to raise 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. Make available food models, food scales for weighing and pictures to help employees assess portion size.
3. Make available appropriate portion sizes at meetings, workplace events and in the cafeteria.

Breastfeeding

1. Support nursing mothers by providing them rooms for expressing milk in a secure and relaxed setting, a refrigerator for storage of breast milk, policies that support breast feeding, and lactation education programs.
2. Make available flexible scheduling and/or worksite or near-site child care to allow for milk expression during the workday.
3. Adopt alternative work options (i.e. teleworking, part-time, extended maternity) for breastfeeding mothers returning to work.
4. Educate personnel on the importance of supporting breastfeeding co-workers.

Television & Food Advertising

1. Place TVss in non-eating areas of the workplace.
2. Limit food advertising in the cafeteria (i.e. print and other media).

(Adapted from The Health Promotion First Act prepared by David Anderson, Ph.D., StayWell Health Management)

Employee Lifestyles Impact Employee Health
•    Approximately 40 percent of all deaths in the U.S. are premature (at least 900,000 deaths each year) and are due to unhealthy lifestyle choices such as tobacco use, poor diet, sedentary lifestyle, misuse of alcohol and drugs, and accidents. Other contributors to early death include genetic predisposition (30 percent), social circumstances (15 percent), poor access to quality health care (10 percent), and environmental  exposures (5 percent).
•    Unhealthy lifestyle is the primary factor to the six leading causes of death in the United States – heart disease, cancer, stroke, respiratory diseases, accidents, and diabetes – which collectively account for over 70 percent of all deaths.
•    People with healthier lifestyles live an average of 6 to 9 years longer,  postpone disability by 9 years and compress disability into fewer years at the end of life.
•    The prevalence of obesity among American adults rose to 30 percent in 1999-2000, a 33 percent increase from a decade earlier,  and the prevalence of diabetes also rose by 33 percent during approximately the same period (1990 to 1998).
•    About two-thirds of American adults are overweight or obese, 55 percent do not get enough physical activity,  26 percent are completely inactive,10 and only 25 percent eat recommended amounts of fruit and vegetables  If diet/physical activity patterns continue worsening at their current rate, these behaviors will soon surpass tobacco use as contributors to mortality.
•    Among young people, the prevalence of overweight has more than quadrupled in the past 20 years to 16 percent,  daily participation in high school physical education classes has dropped from 42 percent in 1991 to 28 percent in 2003,  more than 60 percent eat too much saturated fat, and almost 80 percent do not eat recommended amounts of fruit and vegetables.
•    Lifestyle diseases disproportionately affect women, ethnic and racial minorities, the poor and seniors:
•    The prevalence of diabetes among African Americans is about 70 percent higher than among white Americans, and the prevalence among Hispanics is nearly double that for white Americans.
•    Women comprise more than 50% of the people who die each year of cardiovascular disease.
•    Chronic conditions significantly limit daily activity for 35 percent of persons over 65 years of age.

Financial Impact of Lifestyle
•    It is estimated that lifestyle-related chronic diseases account for 70 percent of the nation’s health care costs, which translates to over 11 percent of the entire United States gross domestic product.
•    Two comprehensive scientific reviews identified 83 peer-reviewed research studies reporting that people with unhealthy habits have higher health costs.
•    Research conservatively estimates that high health risks (high blood cholesterol, high blood pressure, etc) account for at least 25 percent of total health costs.
•    Recent research indicates a direct relationship between modifiable lifestyle risks and lower worker productivity, and relevant data suggest that the costs to corporations in lost productivity due to poor employee health may be substantially more than the direct health and disability costs.
•    Unhealthy lifestyles frequently lead to chronic disease, many of which cannot be cured and require years or decades of expensive treatments. Below are estimated annual costs of selected unhealthy lifestyles and chronic diseases including obesity,  tobacco use,  hypertension,  diabetes,  stress,  and inactivity.

Workplace Wellness Programs Improve Health and Yield Major Savings
•    Comprehensive scientific reviews identified 378 peer-reviewed research studies showing that Workplace Wellness Programs improve health knowledge, health behaviors, and underlying health conditions.
•    Research studies have demonstrated that lifestyle modification may frequently be more effective and cost-effective than health intervention in lowering morbidity  and mortality.
•    Several scientific reviews indicate that Workplace Wellness Programs reduce health costs and rates of absenteeism and produce a positive return on investment (ROI).  The most definitive review of financial impact reported that:
•    18 research studies indicated that these Workplace Wellness Programs reduce health costs, and 14 research studies indicated that they decrease rates of absenteeism costs.
•    13 research studies that calculated benefit/cost ratios all showed the savings from these Workplace Wellness Programs are much greater than their cost, with health cost savings averaging $3.48 and the rates of absenteeism savings averaging $5.82 per dollar invested in the Workplace Wellness Programs.
•    Medical costs are expected to exceed 16 percent of United States gross domestic product (GDP) in 2005 and to grow at 7.2 percent each year through 2015, when health expenditures will account for 20 percent of GDP:
•    Per capita health costs in the United States are the highest in the world and more than double the median for OECD countries,  yet the U.S. ranks 26th in terms of healthy life expectancy.
•    Medicaid is the second largest item in the majority of state budgets, and its portion of the total budgets is increasing each year.
•    Increasing health costs for United States corporations continue to outpace general inflation, averaging 12 percent per year for the past 10 years.   This trend is causing a tremendous financial hardship on United States corporations.

1. Senior management involvement in the Workplace Wellness Program- Evidence of enthusiastic commitment and involvement of senior management helps employees understand their corporations’ serious commitment to health.  Staff Members need to perceive that their senior management, supervisors, and coworkers have positive attitudes toward health since these factors have all been associated with improved employee health status.   Management-related factors have been shown to contribute more to success than the content of the intervention.

2. Participatory planning - A Worksite Wellness Plan should be undertaken in partnership with the workforce.  Staff Members from all levels of staff should be actively engaged in the health and management aspects of the project as well as all on-going processes of any Workplace Wellness Program.  Planning must also include processes for maintaining communication with all staff and building their commitment to the process.   Creating Worksite Wellness Plan steering committees to guide interventions during the planning and delivery of workplace health promotion programming improves worker awareness, participation, and satisfaction. Employee committees may establish perceived employee interests regarding educational programming, determine work site-specific characteristics that may affect the intervention or influence participation, and suggest the best methods for promotion and delivery of Workplace Wellness Programs and initiatives.  Ways to maximize employee input and involvement might include interest surveys, focus groups, and peer counsellors.

3. Primary focus on employees’ needs - A Worksite Wellness Plan should meet the needs of all employees, regardless of their current level of health and recognize the needs, preferences, and attitudes of different groups of participants. Program designers should consider the major health risks in the target population, the specific risks within the particular group of employees, and the business’s needs.   In other words, interventions should be tailor-made to the characteristics and needs of the recipients.   This means that varied programs must be provided at different levels.   Participation and commitment may be improved if a group of staff members has the opportunity to address a specific modifiable risk factor of their choice.

4. Optimal use of on-site resources - Planning and implementation of Workplace Wellness Programs should optimize use of on-site personnel, physical resources, and organizational capabilities.   For example, whenever possible, initiatives should use on-site health and safety, management, work organization, communication, HR, and other specialists.   Well-qualified external leadership may be introduced when in-house expertise is lacking.

5. Integration - An overall workplace health policy should be developed.  The policies governing employee health must align with the organization mission, vision, and values, supporting both short- and long-term objectives. These consistent policies must affirm the value of employee health and a commitment to engage employees in health enhancement.  Worksite Wellness Plan Strategies should be integrated into a company’s regular management practices and eventually should be formally incorporated into the company’s corporate plan  with adequate resources attached to them.

6. Recognition that a person’s health is determined by an interdependent set of factors - Any Worksite Wellness Plan must address multiple components of an individual’s life:
•    the workplace physical and psychosocial setting;
•    their individual resources such as social support, sense of empowerment, etc.; and
•    their lifestyle practices influencing health.

7. Tailoring to the special features of each workplace setting - Workplace Wellness Programs must be responsive to the unique needs of each workplace’s procedures, organization and culture.   Integrating health behaviors and program participation into the existing organization culture will normalize program participation.

8. Worksite Wellness Plan Evaluation - Project management should flow through needs analysis, setting priorities, planning, implementation, continuous monitoring, and evaluation.   Evaluation must include a clearly-defined range of process measures and outcomes  as well as mechanisms for monitoring the impact of non-intervention workplace changes such as plant closure, major workplace re-organization, and new technology on staff health.

9. Long-term commitment - To sustain the benefits of the Workplace Wellness Program, the worksite must continue the initiative over time, reinforcing risk-reduction behaviours and adapting the programs to ongoing individual, social, economic, and workplace changes.

Introduction to Workplace Wellness Programs

Risky health behaviors by employees cost a company. Changing those behaviors can save the employer money and raise the employee’s productivity.

Because work gives an employee a stable environment and support system, Workplace Wellness Programs can have a great impact on lowering high-risk behaviors. This impact results in reduce health claims cost, less rates of absenteeism, and less short-term disability.

Workplace Wellness Programs may include:

Awareness Rasing Activities: Health and wellness newsletters, health topics covered in payroll stuffers, healthy emails.

Health Risk Assessment: Employee health screenings, wellness fairs, health risk appraisals.

Educational Programs: Lunch and Learn wellness presentations, guest speakers at staff meetings.

Skill Building: Healthy cooking demostrations, activity challenges, CPR instruction opportunites, stress management classes, weight management classes.

Interventions: Massage, tobacco cessation, and skills to help you get the most out of your doctor visit.

Physical setting: Healthy items in the vending machines and cafeterias, clean air practices, ergonomics, bike racks, flex time, welllit stairways.

Evaluation: Employee needs assessment, baseline Worksite Wellness Plan evaluation measures, ongoing Worksite Wellness Plan evaluation of overall effectiveness.

Why Make available Workplace Wellness Programs

The typical employer spends about $8,000 a year on an employee’s medical care. This includes medical insurance, disability and worker’s compensation. As these costs climb, medical insurance is expected to rise at least 10 percent per year.

A 1999 research study showed that corporations using Workplace Wellness Programs had a return on investment (ROI) from $1.49 – $13 in benefits per dollar spent. The amount depended on the nature of the Workplace Wellness Programs used. (S. Aldana, American Journal of Wellness, 2001; 15:296-320)

One research study showed that a “stop smoking” element to Workplace Wellness Programs may save between $404 -$40,829 per employee, depending on the age and sex of the employee.

The Workplace Wellness Programs at Traveler’s Company included a self-care book, a newsletter, single-topic brochures, and videotapes. The Workplace Wellness Programs saved the company $7.8 million in employee benefi t costs, decreased doctor visits, and it decreased rates of absenteeism by 1.2 days per employee per year. The estimated Workplace Wellness Programs ROI was $3.40 per dollar spent.

In 1998, the Health Enhancement Research Organization (HERO) reported a study of 46,026 employees from six large corporations for three years. Staff Members with an inactive lifestyle had 10 percent higher costs; employees with depression had 70 percent higher costs.

Benefits of Workplace Wellness Programs

Improved Productivity - The Canada Life Assurance Company realized a 4 percent rise in productivity after establishing an employee fitness program.

Improved Job Satisfaction - According to employee opinion surveys conducted by the Silverstone Group about thier Workplace Wellness Programs, employees’ morale improved, which helped support a more creative work environment.

Enhanced Recruitment & Retention - In the midst of a tight labor market, Workplace Wellness Programs could be a vital tool to draw new recruits.

Decreased Absenteeism - Canada Life Assurance Company’s rates of absenteeism dropped 42 percent among employees in the Workplace Wellness Programs.

Decreased Workers Comp & Disability - In one year, Boeing Company’s number of back injuries decreased by 34 percent. Six million dollars was saved by tracking injuries as they occurred.

Managed Healthcare Costs - Golden, Colorado Adolf Coors Company’s Workplace Wellness Programs returned $6.19 for each dollar spent.

Why have Worksite Wellness Plan objectives?

Worksite Wellness Plan objectives take your business’s priorities for employee health improvement and make them specific and measurable. Well-defined Worksite Wellness Plan objectives provide direction for selecting Strategies and a basis for which to measure progress.

Writing Worksite Wellness Plan objectives

Writing Worksite Wellness Plan objectives is not complicated or difficult. It does require some thought, about your business’s Worksite Wellness Plan vision for a culture of wellness and they should be:

Specific Worksite Wellness Plan Goals
Measurable Worksite Wellness Plan Goals
Attainable Worksite Wellness Plan Goals
Realistic Worksite Wellness Plan Goals
Timely Worksite Wellness Plan Goals

Specific Worksite Wellness Plan Goals: What is the specific outcome your business is looking for? “Reduce tobacco use among employees” is more specific than “Improve the health of employees.” You may wish to write some objectives about specific outcomes (reducing smoking among employees) and other objectives about specific progress (implementing a smoke-free campus policy or lowering the price of fresh fruit in the cafeteria to 25 cents a piece).

Measurable Worksite Wellness Plan Goals: Making your objectives measurable provides a means of evaluating your progress and success. There is a saying: “what gets measured, gets done.” Goals which are measurable can be powerful motivators for your business. “Provide more time for employees to be physically active” is much less measurable than “implement a daily 15-minute walking break into the schedule of all employees.” “Increase the number of employees who want to quit smoking” is less measurable than “increase enrollments in the stop-using tobacco program to 120 employees per year.”

Attainable Worksite Wellness Plan Goals: Set objectives that challenge your business to change and that will demonstrate a real commitment to employee health. At the same time, set objectives that are achievable. Goals that are set too far out of reach can be overwhelming and may become a barrier rather than a motivator.

Realistic Worksite Wellness Plan Goals: Write objectives that are do-able, given the skills, time, finances and overall strategy of the business. A realistic project may push the skills and knowledge of the people working on it but it shouldn’t break them.

Timely Worksite Wellness Plan Goals: When do you hope to achieve the goal? Next week? Next year? Without a timeframe, the goal is still not clear and is much less likely to galvanize resources and energy within your business.

“Reduce the percent of employees who use tobacco from 20 percent to 10 percent” is much less of a challenge than “By the end of 2010, reduce the percent of employees who use tobacco from 20 percent to 15 percent”.

If your business is interested in measuring the impact of your Worksite Wellness Plan efforts in future years, you’ll want to gather relevant baseline data on the health and health behaviors of your employee population.

Worksite Wellness Plan Data on your employee population

Health Risk Assessments

Some health plans offer corporations free online Health Risk Assessments, complete with summary aggregate reports. If your health plan does not offer a free HRA, you could pay for an HRA either through your health plan or through a third party vendor.

To encourage participating in an HRA, assure employees of confidentiality and consider providing incentives for completing the assessment. The higher the participation rate, the more likely that the aggregate data will accurately represent the behaviors and risks of your employee population.

Worksite Wellness Plan Health Surveys

You can get a general sense of employees’ health-related attitudes and behaviors using a “lowtech” paper survey. As with a health risk assessment, employees will be more likely to respond to a survey if there is an incentive and if they are confident that their responses are confidential. Remember that without widespread participation you’ll only get a “feel” for employee behaviors rather than a statistically accurate picture.

Worksite Wellness Plan Focus Groups and Informational Interviews

The information you can collect from focus groups or informational interviews with employees is an important supplement to the anonymous survey or HRA data. Listening to employees discuss their attitudes, values, receptivity and barriers related to health provides a wealth of information on which to base decisions on how to improve your business’s Workplace Wellness Program. Worksite Wellness Plan focus groups are especially useful for gaining information from hard-to-reach employee populations, such as those for whom English is a learned language.

Keep Worksite Wellness Plan focus groups small (8-19 employees, ideally all of a similar job class). If possible, offer incentives such as movie tickets or lunch, to recruit participants. Develop a list of open-ended questions in advance and allow 60-90 minutes for the discussion.

Informational interviews are an alternative to Worksite Wellness Plan focus groups. The Worksite Wellness Plan coordinator of your health improvement Strategies or selected members of the Health and Wellness Committee can conduct one-on-one interviews with employees in a variety of positions to better understand their attitudes, interests and barriers related to a) health behaviors and b) the workplace policies, settings and practices.

Population data

If data on the employee population are not available, you can use state or national data to estimate the prevalence of risk behaviors among employees.

In addition to looking at the health behaviors of employees, take a good look at your business. The following questions can help you establish opportunities for your business to support and encourage healthy behaviors among employees.

A strong foundation for employee health improvement

1. To what extent does the senior management in your business actively and visibly support the Workplace Wellness Program?

__ No support for the Worksite Wellness Plan
__ Support, but not at senior level
__ Support at senior level, but not visible to employees
__ Strong and visible Worksite Wellness Plan support
Comments:

2. Is the Worksite Wellness Plan tied to your business’s mission statement?

__ No
__ Yes, the Worksite Wellness Plan is tied to business plan OR mission statement
__ Yes, the Worksite Wellness Plan is tied to both business plan and mission statement
Comments:

3. Is there an employee within your business whose job responsibilities include Worksite Wellness Plan coordination?

__ No
__ Yes, but has little time available to dedicate to Worksite Wellness Plan
__ Yes, and has at least part of the job dedicated to Worksite Wellness Plan
__ Yes, and has at least one full-time position dedicated to Worksite Wellness Plan
__ Yes, and has at least part of the job dedicated to wellness AND has a background that includes Worksite Wellness Plan qualifications
__ Yes, our business has at least one full-time position dedicated to health improvement AND the employee’s background includes Worksite Wellness Plan qualifications
Comments:

4. Does your business have an active wellness committee with diverse representation?

__ No (does not have a Health and Wellness Committee, or has a committee that doesn’t meet)
__ Yes, we have a Health and Wellness Committee, but with limited representation
__ Yes, we have a Health and Wellness Committee with widespread representation
__ Yes, we have a Health and Wellness Committee with widespread representation AND committee involvement is a component of each representative’s job responsibilities
Comments:

5. Does your business have an annual budget for Worksite Wellness Plan expenses?

(Workplace Wellness Program expenses may be associated with providing a health assessment, paying for behavior change programs/coaching programs, covering incentives that encourage healthy behaviors, subsidizing healthy food options, communications and activities around specific health topics, fitness centers/walking paths, etc).

__ No
__ Yes, but funds are earmarked for Workplace Wellness Programs (e.g. only for Weight Watchers or fitness discounts) and do not meet all existing Worksite Wellness Plan needs
__ Yes, funds are available to meet current Worksite Wellness Plan needs
Comments:

6. Does your business have a plan for engaging employees in the Workplace Wellness Program?

__ No
__ Yes, we have a communications plan for our Worksite Wellness Plan
__ Yes, we have a communication plan AND we offer meaningful incentives or rewards (such as premium discounts or debit cards) for the Worksite Wellness Plan to engage in healthy behaviors.
Comments:

A data-based approach to the Worksite Wellness Plan

7. Does your business have clearly stated Worksite Wellness Plan objectives and priorities for employee health improvement?

__ No
__ Yes
__ Yes, data (e.g. HRA, claims, productivity) are the basis for defining Worksite Wellness Plan objectives or priorities
__ Yes, data AND evidence-based best practices are a basis for defining Worksite Wellness Plan objectives or priorities
__ Yes, data and best practices are basis for defining Worksite Wellness Plan objectives or priorities as well as measuring Worksite Wellness Plan progress (evaluation)
Comments:

8. Has your business completed a Health Risk Assessment?

__ No
__ Yes, but more than 2 years ago
__ Yes, within the last two years, and achieved a participation rate of less than 50 percent
__ Yes, within the last two years, and achieved a 50 percent - 79 percent participation rate
__ Yes, within the last two years, and achieved an 80 percent or greater participation rate
Comments:

A workplace setting that supports healthy behaviors

9. Does your business’s tobacco reduction strategy reflect best practices?

(Check all that apply)
__ A no-tobacco use policy that includes both buildings AND grounds
__ 100 percent coverage for the cost of over-the-counter nicotine replacement therapy
__ Employee access to – and strong promotion of — a tailored stop-smoking program
Comments:

10. Does your business provide opportunities (time and places) for physical activity during the work day?

__ No
__ Yes, indoor places for physical activity (on-site fitness center) OR outdoor places for physical activity (walking paths)
__ Yes, both indoor AND outdoor places for physical activity
__ Yes, indoor and outdoor opportunities AND employees can use work time for physical activity
Comments:

11. Does your business promote healthy eating by providing access to fruits and vegetables?

__ No
__ Yes, fruits and vegetables are available at the workplace (in vending machines, break areas, or cafeterias)
__ Yes, fruits and vegetables are available and discounted at the workplace
Comments:

Benefits that support employee health improvement

12. Does your business provide employees with self-care resources?

(Check all that apply)
__ Distribution of self-care books
__ online access to health information
__ Nurse advice line
Comments:

13. Which of the following preventive services are covered at 100 percent by your business’s health benefits?

(Check all that apply)
__ Vision screening
__ Hearing
__ Immunizations (per CDC/ACIP recommendations)
__ Radiology
__ Laboratory services
__ STD screening
__ Preventive health examination for adults
__ Cancer screen (includes: colon, cervical, breast, prostate and ovarian cancers)
__ Contraceptive management
Comments:

14. Which of the following are included in your business’s pharmacy benefit?

(Check all that apply)
__ Mail order or other 90-day supply option for medications
__ Specialty pharmacy network
__ Incentive-based tiered formulary design
Comments:

15. Do your business’s health benefits provide coverage for behavioral health (such as depression, mental illness, counseling, stress management, and chemical dependency)?

__ Yes, at the same level as health benefits
__ Yes, but at a lower level (less coverage) than health benefits
__ No coverage for mental or behavioral health
Comments: