Health Fairs

Introduction to Employee Wellness

The last ten years has brought primary changes in business attitudes toward Employee Wellness . Interest in self-help and self-care programs has increased as growth in medical expenditures have encroached substantially into profits. Changes in the business structures of medical facilities, in particular the growth of the for-profit medical sector, and the need to contain expenditures are changing the ways in which purchasers of medical plans are viewing their own efforts toward provision of worksite medical programs and facilities. Projections for the next decade indicate that worksite health programs will continue to become significant factors in the provision of medical, including prevention activities, for both government and private industry. In corporations with existing Employee Wellness , 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 (BP) control, diet programs and stress management. Benefits given range from improved health and work rate to reducing medical expenditures.

Demographics of the U.S. Workforce
• 110 million American citizens composed the civilian labor force in 1981; by the year 2000 the civilian labor force is predicted 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 grow to 32 years by 2030.
• 57.9 percent of all employees work in corporations with between 2 and 500 employees; 45 percent work in corporations 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 employees in 1985 were union members.
• 45 percent of all employees are employed in offices.

Prevalence of Employee Wellness  Activities

Based on a 1985 survey, almost 66 percent of worksites with 50 or more employees had Employee Wellness 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 percent
Back Care                 28.6 percent
Stress Management         26.6 percent
Exercise                 22.1 percent
Off the Job Accidents     19.8 percent
Nutrition                 16.8 percent
Blood Pressure (BP) Control     16.5 percent
Weight Control             14.7 percent

Job Site size is the strongest indicator of program prevalence.

Most employees believe the advantages of their Employee Wellness  activities outweigh the expenditures, even though few formal evaluations exist.

The most usually given reason for starting programs and perceived benefit from programs is improved employee health.

At most worksites with activities (85.4%), all employees are eligible to participate. 30 percent of worksites with activities offer them to business 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%).

Smoking Cessation Programs

Smoking related health concerns cost United States corporations $26 billion per year in lost work rate and $7 to $8 billion in tobacco-related healthcare expenditures.

Workers who smoke are 50 percent more likely to be hospitalized than nonsmokers, have 2 times as numerous 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 healthcare costs than nonsmokers.

76 percent of current smokers and 80 percent of former smokers and nonsmokers feel that corporations should restrict smoking 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 tobacco use in offices or workplaces either in government-controlled offices or offices of private employees.

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 tobacco cessation programs;
• providing cessation programs on business or shared time;
• providing 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 is able to lead as vigorous a lifestyle as a sedentary 35-year-old.

Differences in work-related exercise has been determined to provide 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, exercise programs have the potential to lower 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 worksite exercise programs improve fitness and help lower other health risks, although results related to improved work rate are weak due to lack of methods for accurately calculating work rate.

A very small percentage 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 corporations subsidize employee participation in neighborhood “Ys,” health clubs or other neighborhood programs if no on-Site facilities are available.

Job Site physical activity programs may lower expenditures to employers by reducing employee medical claims and expenditures.

Those whose weekly exercise was equivalent to climbing less than five flights of stairs or walking less than a half mile, invested 114 percent more on health claims than those who climbed at least 15 flights of stairs or walked 1 1/2 miles weekly.

Health Care expenditures for obese people are roughly 11 percent 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 have the potential to lower the risk of serious health concerns 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 effect of co-employees and management, availability of a daily eating situation, and opportunities for follow-up and monitoring.

Job Site diet programs have the potential to be grouped in 6 broad categories:

• cafeteria programs;
• multi-component programs;
• weight control programs;
• cholesterol reduction programs;
• programs for pregnant and lactating women; and
• other diet education topics.

Men are less likely to participate in weight-loss programs than are female employees.

Stress Management

Estimates suggest that 50 percent to 80 percent of physician visits have the potential to be attributed to psychosomatic or stress-related origins.

Company pays many of the expenditures related to employee stress, both directly in the form of medical expenditures and in reduced work rate.

Job factors which are associated with stress include:

• not allowing employees 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-employees 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.

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

• sessions conducted by trained professionals;
• self-learning tools; and
• personal teaching to support  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 detrimental 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 United States business.

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

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

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 exercise as any other kind of disability.

Motor vehicle crashes cost $15.2 billion in lost work rate, 88 percent 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 business vehicle or using a personal vehicle for business 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 commitment on the part of management;
• clearly defined and well enforced policy of required belt use on the job;
• positive incentives/rewards; and
• ongoing education and training programs.

Case Studies of Employee Wellness

Based on an extensive evaluation of its accross the board employee Employee Wellness , 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 benefit of $316 per employee. Their year 9 projected benefit is $677 per employee.

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

Participants in the United Methodist Publishing House’s Employee Wellness  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 decreased than projected use in medical expenditures for 1985 ($902,116 projected with actual expenditures $142,884) to the Employee Wellness  even though 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 Employee Wellness  4 years earlier. The sample of 495 employees was stratified to match the business profile in terms of age, sex and job description. The survey stated that 65 percent of respondents started working out 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 business’s tobacco cessation program and regular participants of the wellness center miss an average of 1.96 workdays each year due to illness or injury compared to 3.08 days for non-participating employees.

The Coors Company 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.