Worksite health promotion, Dec. 2007

"Something I think people would find surprising is that the most expensive component of a Chrysler brand vehicle isn't steel or plastic, but health care."
-Senior HR Executive, Chrysler Corporation

Worksite Health Promotion

Vol 1, Issue 2 December 2007

Health and Productivity Management

Worksite wellness is typically viewed as the application of health promotion strategies to the worksite setting. We have spent many years organizing health fairs, lunchand-learns, and other events. We have printed, posted and distributed health information materials. We have even organized educational classes and walking groups to provide opportunities for learning and increasing self-efficacy. While the typical worksite wellness model is one that is activities based, there are other models which are data- and results-driven. One such model is health and productivity management.

"Integration" Employee health is not a health insurance issue. Neither is it an occupational safety issue. It is a worksite issue and requires the pulling together of any and all company resources that have a role in health. When we speak of worksite wellness, keep in mind that it is affected by and impacts multiple company departments and thus requires integration. HPM integrates the resources of the following company areas: occupational

health and safety, disability management, wellness and health promotion.
"Comprehensive Approach" The HPM model utilizes a comprehensive wellness program structure that incorporates health promotion and disease management. This structure offers components for all employees and ensures that all employees are reached with needed services and resources. Low-risk
Continued on page 3.

The Institute for Health and Productivity Management defines health and productivity management (HPM) as "The Integration of all organizational Human Capital/Resource-related departments designed to accomplish a comprehensive approach to reducing or eliminating health and injury risks while enhancing the portion of personal performance that is related to health". Simply put, health and productivity management pulls together every resource within a company to address issues of health and safety so that employees are more productive. Let us take a brief look at some of the components of this model.

WELLNESS WATCH
Many companies do not offer health benefits to their employees. According to the 2007 Employer Health Benefits Survey, only 60% of employers offer health benefits, down from 69% in 2000. This is more true of smaller companies (<200 employees) who cite the following reasons: high premiums (72%), firm is too small (61%), and employees are covered elsewhere (40%). Furthermore, 71% of these companies believe that employees would prefer higher wages more than health insurance.
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The Cost of Workplace Stress

Often overlooked when we speak of employee health are issues related to stress and mental health. It is important that the employer see workplace stress as a major health issue and cost driver. According to a survey by National Northwest Life, 40% of workers reported that their jobs were "very or extremely stressful". Some estimates place the costs of occupational stress at more than $300 billion a year in health costs, absenteeism, presenteeism, and lost productivity. In a newly released report by the American Psychological Association, 74% of those surveyed cited work as a "very or somewhat significant" source of stress.
There are a number of things that can lead to workplace stress. Among them are: Job insecurity Excessive workload Long work hours Work environment (noise, overcrowding,
poor air quality, etc). Other factors outside of the work environment can also lead to stress including demands of family life and illness.

in the workplace can create an atmosphere that is less stressful. Provide ergonomic furniture and work
areas. Break room or lounge where employees
can take breaks Workplace dcor and colors.
Organizational Changes Ensure that workload fits employees'
capabilities. Allow for flexible work schedules so
employees can better balance demands of work and family. Create opportunities for employees to provide input and feedback, particularly on decisions affecting them.

The mind-body connection tells us that there is a link between stress and physical problems. Often times, stress can present itself in physical symptoms including headache, sleeplessness, and upset stomach. Furthermore, stress plays a role in conditions like cardiovascular disease, muscoskeletal conditions, ulcers, impaired immune function, and psychological disorders.
There are many ways a company can reduce workplace stress and help it's employees to "Be Positive".
Programs and Services The workplace is an ideal setting for programs and services that can address stress. Consider the following: Offer educational classes on stress
management. Topics can include relaxation techniques, coping strategies, and time management skills. Provide EAP or other counseling services. Include coverage for mental health services in health benefits. Share tips on stress management with employees.
Physical Environment Minor changes to the physical environment

Workplace Culture Does the culture in your workplace increase or limit stress? Here are some things you can do: Communicate with employees regularly
and courteously. Provide opportunities for social
interaction among employees. Consider things like holiday parties, company picnics, etc. Recognize and reward employees for their work. Something like an employee recognition program would encourage employees and give them a "pat on the back".
Helping employees manage stress is an important part of a worksite wellness program. Left unattended, stress can be a major crippler to any company's health costs and productivity.
For more information on stress, visit the American Psychological Association's website at http://www.apa.org/topics/topicstress.html.

HEALTH OBSERVANCES
Health observances are an easy to use component of a worksite wellness program. They afford businesses an opportunity to promote health messages and offer health information to their employees at limited cost.
Here are some advantages of incorporating health observances into your wellness program: Already developed materials; National campaigns that
employees can identify with; Opportunity for health education; Resources like organization
contacts and subject matter experts.
While some might see health observances as an easy substitute for a wellness program, it is important to expand health observance activities beyond the distribution of materials. Find ways to tie the health observance to wellness program components. Here are some tips: Combine a health observance
with a screening event. You can offer blood glucose screenings on Diabetes Alert Day. Use the health observance as a kick off date for your new wellness initiative. Consider National Nutrition Month as an opportunity to promote the new healthy options available at your cafeteria. Re-launch or promote an existing program component on the day of a health observance. This will increase awareness about your program, particularly to employees who have not participated in the past. You can promote your walking group or fitness classes on National Employee Health and Fitness Day.
The 2008 National Health Observances Calendar is available at http://healthfinder.gov/library/nho/
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Health and Productivity Management (Cont'd)

employees benefit from the health promotion components while those who fall into a high-risk category benefit from much needed self-care and medical case management interventions.
""Reducing and Eliminating Health and Injury Risk" This is nothing less than prevention. Health productivity management aims to manage the health of employees so they are more productive, rather than focusing only on treating those who are already sick or injured.
"Personal Performance" In the end, HPM comes down to the bottom line. Improvements in employee health translate to increased productivity and job performance. Under HPM, productivity is documented and tracked in order to demonstrate economic return.
Advantages of HPM Economic return is tracked and
documented. Behavior change is accomplished
through skill building and not just education. The program reaches out to spouses so that lifestyle changes are reinforced at home. The program components and rewards are often linked to employee benefits. The onsite and virtual components expand the program's reach.

Limitations of HPM High cost of implementation. The
components of an HPM-based worksite wellness program tend to be pricey, particularly because they are opened to all employees. These include telephonic wellness coaching, mailings, and incentives. The HPM model works best in larger companies. The larger sample size makes calculations of cost savings more valid. Participation is required. All employees are considered participants unless they opt out of the program. Rigorous evaluation. Evaluating the effectiveness and economic return of HPM programs requires analysis that is beyond the scope of work for wellness coordinators and HR personnel.
The ultimate goal of worksite health promotion is healthier and more productive employees. However, the same model for a worksite wellness program will not work in all worksites. It is important to assess the business for things such as leadership goals and interests, access to data, resource limitations, and even company size. These characteristics significantly determine what the best fit for a worksite wellness program would be.
For more information on health and productivity management, visit the Institute for Health and Productivity Management at www.ahpm.org.

RESOURCE CORNER
Health and Productivity Management: An Emerging Paradigm for the Workplace. Chapman L, Sullivan S. The Art of Health Promotion Newsletter, July/August, 7(3):1-12. Available at http://www.commonwealthnorth.org/ro undtable/AHP39HPM.pdf
Stress at Work. National Institute for Occupational Health and Safety. Booklet examines the causes of workplace stress and strategies to reduce/prevent stress on the job. Available at http://www.cdc.gov/niosh/pdfs/stress.pdf.
Working with Stress. National Institute for Occupational Health and Safety. This training and educational video is a companion to the Stress at Work booklet. To lean more, visit http://www.cdc.gov/niosh/video/stressd vd1002.html.
UPCOMING EVENTS
Health Benefits Conference and Expo January 17-18, 2008, Tampa, FL http://www.hbce.com/
International Conference on Occupational Stress and Health March 6-8, 2008, Washington, DC http://www.apa.org/pi/work/wsh.html
Health Management Conference March 31-April 2, 2008, Orlando, FL http://www.ihpm.org/

GA's Worksite Health Initiative
GA DHR Div. of Public Health www.health.state.ga.us/programs /worksitehealth
WorksiteHealth@dhr.state.ga.us

WORKSITE WELLNESS IN THE NEWS
Male business owners place emphasis on health care USA Today, September 30, 2007 http://www.usatoday.com/money/smallbusiness/2007-09-30-small-business-health_N.htm?csp=34
Your Money: Consider employer's health options carefully USA Today, October 1, 2007 http://www.usatoday.com/money/perfi/columnist/block/2007-10-01-health-benefits-choices_N.htm?csp=34
Rethinking the office environment BusinessWeek, October 15, 2007 http://www.businessweek.com/innovate/content/oct2007/id20071015_701506.htm?chan=search
Advocates who help you negotiate healthcare BusinessWeek, October 22, 2007 http://www.businessweek.com/magazine/content/07_43/b4055089.htm?chan=search
Now the stick: Workers pay for poor health habits Washington Post, November 13, 3007 http://www.washingtonpost.com/wp-dyn/content/article/2007/11/09/AR2007110902102.html
You've Got Dependents? Prove It BusinessWeek, November 26, 2007 http://www.businessweek.com/magazine/content/07_48/b4060082.htm?chan=search
Businesses Reconsider the Holiday Handout BusinessWeek, December 5, 2007 http://www.businessweek.com/smallbiz/content/dec2007/sb2007125_459684.htm?chan=search
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