Wellness Program Introduction
The last ten years has brought major changes in employer 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 health care facilities, particularly the growth of the for-profit health care sector, and the need to contain costs are changing the ways in which purchasers of health care plans are viewing their own efforts toward provision of workplace health care programs and facilities.
Projections for the next decade indicate that wellness programs will continue to become important factors in the provision of healthcare, including prevention activities, for both government and private industry.
In corporations with existing 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 appraisal, smoking cessation, blood pressure (BP) control, nutrition programs and stress management. Benefits cited range from improved health and productivity to decreasing healthcare costs.
Demographics of the U.S. Workforce
o 110 million American Citizens were in the civilian labor force in 1981; by the year 2000 the civilian labor force is expected to be nearly 140 million.
o 44 percent of the 1984 labor force was female; 10 percent was Black.
o The median age of the workforce is 32 years and is expected to raise to 32 years by 2030.
o 57.9 percent of all workers work in organizations with between 2 and 500 employees; 45 percent work in organizations with fewer than 100 workers. An additional 7.5 million American Citizens are self-employed and 3 million are farmers.
o 18% of all wage and salaried employees in 1985 were union members.
o 45 percent of all workforce are employed in offices.
Prevalence of Corporate Health Promotion Activities
Based on a 1985 survey, almost 66% of workplaces with 50 or more staff had company health promotion activities in 1985. The frequency of workplace-based activities by selected categories in 1985 was
Health Promotion Program Activities
Use of tobacco Control 35.60%
Health Risk Assessment (HRA) 29.50%
Back Care 28.60%
Stress Management 26.60%
Exercise 22.10%
Off the Job Accidents 19.80%
Nutrition 16.80%
Blood Pressure (BP) Control 16.50%
Weight Control 14.70%
Workplace size is the strongest indicator of wellness program prevalence.
Most personnel believe the advantages of their employee wellness activities outweigh the costs, even though few formal evaluations exist.
The most frequently cited cause for starting wellness programs and perceived benefit from programs is improved worker health.
At most workplaces with activities (85.4%), all personnel meet the requirements to participate. 30% of workplaces with activities offer them to company dependents, and an equal% offer them to retirees.
When workplaces seek outside wellness 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 use Cessation Programs
Use of tobacco related health problems cost United States businesses $26 billion a year in lost productivity and $7 to $8 billion in tobacco-related health care costs.
Workers 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 percent higher medical costs than nonsmokers.
76 percent of current smokers and 80 percent of former smokers and nonsmokers feel that organizations should restrict use of tobacco to certain areas.
In 1985, 65 percent of smokers, 85 percent of nonsmokers and 78 percent of former smokers, felt that smokers should refrain from smoking in the presence of nonsmokers.
In 1986, 17 states had laws regulating use of tobacco in offices or worksites either in government-controlled offices or offices of private employees.
Examples of tobacco use cessation intervention program used by corporations include
o offering nonsmokers a discount of health and life insurance;
o compensating full or partial fees for tobacco use cessation programs;
o providing cessation programs on organization or shared time;
o giving cash payments to quitters after 6 of 12 tobacco-free months;
o participating in national quit tobacco use days; and
o Adopting a smoke free company policy and establishing 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 activity has been proven to yield a two- to three-fold difference in cardiovascular deaths between active workers and their more sedentary counterparts.
Additionally bettering strength, balance, and flexibility, fitness programs could reduce the probability of back injuries among certain occupational groups.
93 million workdays in the United States are lost each year as the result of back problems.
Research findings support the notion that workplace fitness plans improve fitness and help reduce other health risks, although results related to improved productivity are weak due to insufficient methods for accurately measuring productivity.
A very small proportion of workplaces have on-site physical fitness facilities.
The majority of workers sponsored physical fitness 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 worker participation in community “Ys,” gyms or other community programs when no onsite facilities are available.
Worksite physical fitness programs could reduce costs to companys by lowering worker 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 ascended at least 15 flights of stairs or walked 1 1/2 miles weekly.
Health care costs for obese individuals are roughly 11% higher than those for thin individuals .
Nutrition and Weight Control
One-third of the United States population is obese to the extent of reducing their life expectancy.
Improvements in consuming habits can reduce the risk of serious health problems like high blood pressure and cholesterol levels and is instrumental in the control of non-insulin-dependent diabetes.
The worksite offers a few advantages for nutrition education; support and influence of peers and management, availability of a daily eating situation, and opportunities for follow-up and monitoring.
Workplace nutrition programs can be grouped in 6 wide categories
o cafeteria programs;
o multi-component programs;
o weight control programs;
o cholesterol reduction programs;
o programs for pregnant and lactating women; and
o other nutrition education topics.
Men are less likely to participate in weight-loss programs than are female workforce.
Stress Management
Estimates suggest that 50 percent to 80 percent of doctor visits can be attributed to psychosomatic or stress-related origins.
Company compensates many of the costs related to employee stress, both directly in the form of health care costs and in lower productivity.
Job factors which are associated with stress include
o not authorizing employees to take part in decisions about the work process;
o positions which require more or less skill than the worker has;
o changes in work demands;
o insufficient clarity about expectations and standards; and
o conflict with colleagues or supervisors.
Most workplace stress management programs are implemented as a result of requests from personnel.
Stress management programs focus on three types of skills – relaxation skills, coping skills, and interpersonal skills.
Workplace stress management programs are often delivered in one of three formats
o seminars conducted by trained experts;
o self-learning tools; and
o personal teaching to assist with self-assessment, planning for changes, learning new skills and responding to life crises.
The two major methods used in worksite stress management programs are
o Teaching people to reduce the negative physical effects of stress; and
o Teaching individuals 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 United States company.
Motor automobile 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.
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 automobile 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 seatbelt policies, requiring use of belts by anybody riding in a corporation automobile or using a private automobile on corporation corporation, have been enforced, 60% to 90% use has been reported.
Incentive programs, accompanied by education and use requirement restrictions have resulted in 40% to 70% initial usage rates.
Factors influencing the sources of worksite seatbelt programs include
o Active commitment on the part of management;
o clearly defined and well enforced policy of required belt use on the job;
o positive incentives; and
o ongoing education and training programs.
Case Research studies of Wellness Programs
Based on an comprehensive investigation of its comprehensive staff member wellness program, LIVE FOR LIFE, Johnson and Johnson stated 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.
Workers at four Johnson and Johnson organizations who were exposed to the health promotion program increased their daily energy expenditure in vigorous activity by 104% compared to an increase of 33% among workers at organizations that were offered only an annual biometric screen.
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 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 lower than projected use in healthcare costs for 1985 ($902,116 projected with actual costs $142,884) to the health promotion program even though the results are not conclusive.
In 1985, the Adolph Coors Company 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 workers was stratified to match the organization profile in terms of age, sex and job description.
The survey stated 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 tobacco use as the result of the corporation’s tobacco use cessation program and regular participants of the wellness center miss an average of 1.96 workdays yearly because of disease or injury compared to 3.08 days for non-participating personnel.
The Coors Corporation also achieved a cost savings from a cardiac rehabilitation program that was implemented in 1981. In 1980 personnel 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.
