Wellness Program Introduction
The last ten years has brought major changes in business attitudes toward 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 organizational structures of healthcare facilities, namely 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 health care, including avoidance activities, for both government and private industry.
In companies with existing wellness programs, administrative rationale for sponsoring these activities ranged from bettering worker health (28%) to bettering worker morale (9.7%).
Programs include interventions associated with safety, health risk (assessment|appraisal}, tobacco use cessation, blood pressure (BP) control, nutrition programs and stress management. Benefits cited range from improved health and productivity to reducing healthcare costs.
Demographics of the United States Workforce
110 million Americans were in the civilian labor force in 1981; by the year 2000 the civilian labor force is expected to be almost 140 million.
44% of the 1984 labor force was female; 10% 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 staff members work in corporations with between 2 and 500 employees; 45 percent work in corporations with fewer than 100 staff members. an additional 7.5 million Americans are self-employed and 3 million are farmers.
18 percent of all wage and salaried employees in 1985 were union members.
45 percent of all workers are employed in offices.
Prevalence of Corporate Wellness Activities
Based on a 1985 survey, almost 66% of worksites with 50 or more staff members had corporate wellness activities in 1985. The frequency of worksite-based activities by selected categories in 1985 was –
Wellness Program Activities
Smoking Control 35.60%
Health Risk (Assessment|Appraisal} 29.50%
Back Care 28.60%
Stress Management 26.60%
Off the Job Accidents 19.80%
Blood Pressure Control 16.50%
Weight Control 14.70%
Worksite size is the strongest indicator of program prevalence.
Most employees believe the advantages of their corporate wellness activities outweigh the costs, even though few formal examinations exist.
The most frequently cited reason for starting programs and perceived benefit from programs is improved worker health.
At most worksites with activities (85.4%), all employees are eligible to participate. 30% of worksites with activities offer them to corporation dependents, and an equal% offer them to retirees.
When worksites seek outside program assistance, they turn to voluntary, not-for-profit organizations (57.1%), private for-profit providers-consultants (50%), local hospitals (44%), and insurance corporations (43%).
Use of tobacco Cessation Programs
Tobacco use related health problems cost U.S. corporations $26 billion per year in lost productivity and $7 to $8 billion in smoking-related health costs.
Staff Members who smoke are 50% more likely to be hospitalized than nonsmokers, have 2 times as many job-related accidents as nonsmokers and have absenteeism rates approximately 50% higher than nonsmokers.
People who smoked an typical of one or more packs of cigarettes per day had 118% higher health care expenses than nonsmokers.
76% of current smokers and 80% of former smokers and nonsmokers feel that businesses should restrict smoking to certain areas.
In 1985, 65% of smokers, 85% of nonsmokers and 78% of former smokers, felt that smokers should refrain from use of tobacco in the presence of nonsmokers.
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 companies include –
offering nonsmokers a discount of health and life insurance;
compensating full or partial fees for smoking cessation programs;
providing cessation programs on corporation or shared time;
offering cash payments to quitters after 6 of 12 tobacco-free months;
participating in national quit smoking days; and
adopting a smoke free company policy and establishing deadlines for implementing the policy.
An active 55-year-old man can lead as vigorous a lifestyle as a sedentary 35-year-old.
Differences in work-related activity has been shown to yield a two- to three-fold difference in cardiovascular deaths between active employees and their more sedentary counterparts.
In addition to improving strength, balance, and flexibility, fitness plans can reduce the probability of back injuries among certain occupational groups.
93 million workdays in the United States are lost yearly as the result of back problems.
Research findings support the notion that worksite exercise programs improve fitness and help reduce other health risks, although results related to improved productivity are weak due to lack of methods for accurately measuring productivity.
A very small proportion of worksites have onsite physical fitness facilities.
The majority of employees sponsored fitness programs involve skills training like aerobic dance, low impact aerobics, resistance training, preand post-natal exercise classes, and walking/jogging groups.
Some businesses subsidize worker participation in community “Ys,” health clubs or other community programs if no onsite facilities are available.
Worksite physical fitness programs could reduce costs to companys by decreasing staff member health care claims and expenditures.
Individuals whose weekly exercise was equivalent to climbing less than five flights of stairs or walking less than a half mile, spent 114% more on health claims than those who climbed at least 15 flights of stairs or walked 1 1/2 miles weekly.
Health care costs for obese people are roughly 11 percent higher than those for thin people .
Nutrition and Weight Control
One-third of the United States population is obese to the extent of lowering their life expectancy.
Improvements in eating habits may reduce the risk of serious health problems such as high blood pressure and cholesterol levels and is instrumental in the control of non-insulin-dependent diabetes.
The workplace offers several advantages for nutrition education; support and influence of coworkers and management, availability of a daily eating situation, and opportunities for follow-up and monitoring.
Worksite nutrition programs can be grouped in 6 wide categories –
weight control programs;
cholesterol reduction programs;
programs for pregnant and lactating women; and
other nutrition education topics.
Men are less likely to participate in weight-loss programs than are female workers.
Estimates suggest that 50 percent to 80 percent of doctor visits can be attributed to psychosomatic or stress-related origins.
Corporation pays many of the costs related to employee stress, both directly in the form of healthcare costs and in lower productivity.
Job factors which are associated with stress include –
not allowing workers to participate in decisions about the work process;
positions which require more or less skill than the staff member has;
changes in work demands;
lack of clarity about expectations and standards; and
conflict with colleagues or supervisors.
Most worksite stress management programs are implemented then 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 often delivered in one of three formats –
workshops conducted by trained professionals;
self-learning tools; and
personal teaching to assist 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 negative physical effects of stress; and
teaching people to recognize and control sources of stress at work and in personal life.
Seat Belt Usage
Motor car accidents are the largest single cause of lost work time and on-the-job fatalities of U.S. business.
Motor car accidents account for 27% of all work-related deaths and 45 million days of lost work yearly.
More than 36% of the 11,300 accidental work deaths in 1983 involved cars.
Workers who routinely 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 car crashes cost $15.2 billion in lost productivity, 88 percent of which is attributed to losses from workforce activities and future earnings.
In corporate settings where safety belt policies, requiring use of belts by anyone riding in a business car or using a private car on business business, have been enforced, 60 percent to 90 percent 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 worksite safety belt programs include –
active commitment for management;
obviously defined and well enforced policy of required belt use on the job;
positive incentives; and
ongoing education and training programs.
Case Studies of Wellness Programs
Based on an comprehensive analysis of its comprehensive staff member wellness program, LIVE FOR LIFE, Johnson and Johnson announced the break-even point for the program occurs in year 3 and by year 5 they have a net advantage of $316 per staff member. Their year 9 projected benefit is $677 per staff member.
Employees at four Johnson and Johnson corporations who were exposed to the wellness program increased their daily energy expenditure in vigorous activity by 104 percent compared to an increase of 33 percent among employees at corporations that were offered only an annual health test.
Participants in the United Methodist Publishing House’s wellness program submitted more claims (1.14 per participating worker and .82 for the control in 1984, 1.44 and 1.3 respectively in 1985), but the typical 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 costs for 1985 ($902,116 projected with actual costs $142,884) to the wellness program even though the results aren’t conclusive.
In 1985, the Adolph Coors Business conducted a telephone interview of a random sample of its 10,000 workers to determine changes in health practices since the introduction of an worker wellness program 4 years earlier.
The sample of 495 staff members was stratified to match the corporation profile as for age, sex and job description.
The survey stated that 65% of respondents began 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 smoking cessation program and regular 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 Corporation 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 typical 1.9 months saving $152,000 in lost work time and in 1985 cardiac patients missed an typical of 2.6 months, saving $125,000 that year.