Worksite health promotion, Dec. 2009

We have almost succeeded in leveling all human activities to the common denominator of securing the necessities of life and providing for their abundance. -- Hannah Arendt
Habit is a cable; we weave a thread of it each day, and at last we cannot break it. -- Horace Mann

Worksite Health Promotion

Vol. 3, Issue 2 December 2009

COMMON DENOMINATORS

Worksite wellness invokes different program ideas for many people. There are those who take the route of focusing program efforts on employees with a particular disease or condition like diabetes or heart disease. This approach offers much-needed support to employees with existing diagnoses, but overlooks employees who want to stay healthy or who have not yet developed a full-blown condition. On the other hand, there are those who focus only on keeping healthy employees healthy and do not provide programming to help employees with existing diagnoses manage their conditions or limit/delay the onset of comorbidities. While neither approach is entirely wrong--there are significant merits to both--it is more significant to take a population-based approach to develop a wellness program that reaches ALL employees.
Whether one looks at the employee health dilemma through the lens of prevention or disease management, there are certain common denominators that, if included in the wellness program, will help all employees on the road to health and wellness, and the company on the road to containing rising health care costs. Physical activity, proper nutrition and tobacco avoidance are the three threads that help an individual weave a healthy

lifestyle. An approach to worksite wellness that employs these three common denominators is beneficial for everyone at a worksite irrespective of risk level or diagnosed condition. Employees with low health risks can stay healthy and stave off many chronic diseases. Employees with moderate health risks can mitigate their risk for developing disease. Employees with an existing condition can better manage and control their disease. Take the case of a female employee who at 5'6" and 220 pounds has a body mass index (BMI) of 35.5 and is categorized as obese. This employee was recently diagnosed with diabetes and put on medication. Without losing weight, she is very likely to develop heart disease and arthritis. Making dietary changes and engaging in physical activity would reduce this risk and help the employee control her diabetes.
Let's take a look at how physical activity, healthy eating and tobacco avoidance can be incorporate into the workplace.
Physical Activity Less than half of those in the United States meet the recommended level of physical activity with 24 percent getting no leisure-time physical activity. The numbers are about the same in Georgia with only 48 percent of adults being

regularly physically active (2007 Georgia Behavioral Risk Factor Surveillance System). In 2006, poor levels of physical activity among Georgians accounted for $543 million in hospital charges (Georgia Hospital Discharge Data). The new physical activity guidelines recommend that adults get at least 2.5 hours of moderate-intensity physical activity a week. With working adults spending most of their waking hours at work, incorporating physical activity into the workday can help meet these recommendations. However, only 1 in 4 Georgia worksites offer physical activity programs to their employees (2008 Georgia Worksite Survey).
There are many ways employers can provide support to and encourage employees to Be Active during the workday. If you do not have a fitness center
onsite, you can offer employees subsidies to local gyms. Contact your local fitness facilities (including YMCAs and park and recreation facilities) to learn about corporate rates and other discounts. You can also contact your health insurance carrier to learn about discounts available to employee members Make use of available space by converting an old storage space or

WELLNESS WATCH
The 20th anniversary edition of America's Health Rankings indicate that as a nation we are a lot better at treating illnesses than we are at preventing them. We continue to invest a lot into treatment--a price tag of $1.8 trillion for medical costs associated with chronic diseases like diabetes, heart disease, and cancer--but struggle with major risk factors like obesity and tobacco use. Without addressing the determinants of health (i.e. risk factors for disease), chronic diseases and the costs of treating them will continue to be a major issue for employers and the nation at large.

Worksite Health Promotion, December 2009

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COMMON DENOMINATORS
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meeting area into a lunchtime exercise room. Fancy equipment is not required--particularly if you are concerned about injuries, equipment management, etc. With a TV/DVD combo, you can organize exercise classes for employees Adopt a wellness policy that allows employees to be physically active during the workday. Consider extending lunch periods and combining mid-day breaks to be used for physical activity Post signage encouraging employees to take the stairs Organize walking groups and company sports teams
Healthy Eating Eating healthy is another area in which Georgia adults are lacking. Only 1 in 4 adults consume the recommended minimum of 5 daily serving of fruits and vegetables (2007 Georgia Behavioral Risk Factor Surveillance System). The implication of this is that our diets are increasingly made up of refined carbohydrates and little fiber. Such a diet puts one at increased risk for obesity, diabetes, heart disease, and some cancers.
Within the work environment, there is little support available to employees with only 26 percent of employers offering a nutrition/healthy eating program. Here are some things you can do: Add healthy options to vending
machines, cafeterias and snack bars. Work with your vending machine and food service vendor(s) to include options that are low-fat, low-salt and have whole grains Offer nutrition education classes to employees. You can work with your local hospital to find a dietitian or health educator that can facilitate sessions on-site. You can also work with your health insurance carrier to provide coverage for nutritional counseling for employees Adopt policies that ensure healthy food, snack and beverage options are available to employees at work and at company functions (meetings and other events like holiday parties) Provide employees with healthy eating skills and not just nutrition information. This can include healthy recipes and meal-planning ideas, or sessions on label reading and healthy grocery shopping

Tobacco Use More than 10,000 Georgians die every year from tobacco-related illnesses. Of all deaths due to smoking, 42 percent are attributable to cancer, 32 percent to cardiovascular diseases and 26 percent to respiratory diseases (Georgia Vital Statistics, 2002-2006). Those in Georgia who are most likely to be smokers have less than a high school education, are male, and live in the northwest and southeast regions of the state. Tobacco use and its related diseases disproportionately affect men working in blue-collar environments in the state, but are not limited to these populations alone.
Although 65 percent of worksites have policies that completely prohibit smoking, only twenty percent of worksites provide cessation services to employees. It is important that employers complement smoking bans with cessation support for employees. Promote the Georgia Tobacco Quit
Line. Brochures and pamphlets are available through local public health offices and online Provide coverage for cessation services and/or nicotine replacement therapy (NRT) to employees. Research has shown that the combination of counseling and NRT is more effective in helping a person quit Adopt a tobacco-free policy that covers more than just smoking and would apply to company grounds and vehicles. Make sure however that you allow time for employees to quit and provide them with support to transition into the new policy
In order to truly control the rising costs of health care, the underlying factors of chronic diseases must be addressed. The health messages have always been "eat right, exercise, and don't smoke." Those in worksite wellness must realize that these messages are not for prevention only, but that they apply also to disease management. Keeping these as a core part of your wellness program will ensure that the program reaches more employees and that the outcomes are long-term and sustained.

Worksite Health Promotion, December 2009

Health Observances
December
World AIDS Day (December 1) Joint United Nations Programme on HIV/AIDS http://www.unaids.org/en/Partnerships/Adv ocacy+partners/WAC/default.asp
National Aplastic Anemia & MDS Awareness Week (Dec 1-7) Aplastic Anemia & MDS International Foundation, Inc. http://www.aamds.org/
National Handwashing Week (Dec 6-12) Henry the Hand Foundation http://www.henrythehand.com/
January
National Healthy Weight Week Healthy Weight Network http://www.healthyweight.net/hww.htm
Cervical Health Awareness Month National Cervical Cancer Coalition http://www.nccc-online.org/awareness.html
Glaucoma Awareness Month Prevent Blindness America http://preventblindness.org/news/observe.html
National Birth Defects Prevention Month March of Dimes http://www.marchofdimes.com/professional s/14332_1206.asp
Thyroid Awareness Month NBCAM Board of Sponsors www.thyroidawareness.com
February
National Wear Red Day (February 5) National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/health/hearttruth
AMD/Low Vision Awareness Month Prevent Blindness America http://www.preventblindness.org/
American Heart Month American Heart Association http://www.americanheart.org/
National Cancer Prevention Month M.D. Anderson Cancer Center http://www.mdanderson.org/
National Children's Dental Health Month American Dental Association http://www.ada.org/goto/ncdhm
National Wise Health Consumer Month American Institute for Preventive Medicine www.healthylife.com
National Women's Healthy Heart Campaign Sister to Sister Foundation http://www.sistertosister.org/
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WELLNESS GO-ROUND
News from around the state
Georgia Falls in National Health Rankings
Georgia fell from 41 to 43 among states in national health rankings according to an annual report commissioned by the United Health Foundation, American Public Health Association, and Partnership for Prevention. The study considers 22 measures that make up two categories: health determinants and health outcomes. Health determinants include risk factors for disease and speak to the future health of a population while health outcomes tell of what has already happened. Georgia ranks much lower for health determinants than outcomes, indicating that the health of our state is likely to continue to decline.
The Georgia Department of Community Health, Division of Public Health (DPH) maintains its commitment to improving the health of Georgians. Efforts to improve the state's overall health ranking span across school, healthcare, faith-based and worksite settings. In 2009, Georgia's Worksite Health Initiative launched the Model Worksite Project, a comprehensive worksite wellness program that provides employees with behavior change interventions and employers with recommendations of policy and environmental changes that address healthy eating, physical activity and tobacco avoidance. Additionally, the Initiative provides technical assistance and resources to assist employers in developing and implement wellness programs that address these risk factors and improve the health of employees.
For more information about America's Health Rankings, go to http://www.americashealthrankings.org.
Smoking Ban at State Facilities
Beginning January 1, 2010, the Georgia Department of Corrections will begin phasing out tobacco use in all of its 37 facilities across the state. The new tobacco-free policy will prohibit smoking and the use of tobacco on agency grounds and applies to inmates as well as employees. To support transition into this new policy, the Department of Corrections will offer cessation programs to all who are interested.
In a similar decision, the Department of Behavioral Health and Developmental Disabilities has also issued a ban on smoking in state mental health hospitals beginning January 5, 2010. This ban applies to staff and patients.
For more information on making your workplace smoke free, read: Making Your Workplace Smokefree--A Decision Maker's Guide available at
http://www.cdc.gov/tobacco/basic_information/secondhand_smoke/guides/workplace/index.htm Save Lives, Save Money: Make Your Business Smoke-Free at
http://www.cdc.gov/tobacco/basic_information/secondhand_smoke/guides/business/index.htm.
Walk Georgia!
The goals of this program, which is sponsored by the University of Georgia Cooperative Extension and its partners, are to help individuals:
Develop regular physical activity habits Get healthier and more physically fit Have fun!
Participants travel virtually across the state of Georgia by logging minutes of physical activity each week. They will discover interesting facts about each county and learn new ways to improve their health.
The Walk Georgia program is implemented in Spring and Fall cycles. The next Spring cycle will begin March 2010.
For more information or to register, go to http://www.walkgeorgia.org/.
GOT NEWS?
Tell us what you are doing at your worksite. Share success stories and accomplishments. It can spark an idea for someone else. Send your submission to WorksiteHealth@dhr.state.ga.us.

Worksite Health Promotion, December 2009

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RESOURCE CORNER

OTHER GEORGIA PROGRAMS
Live Healthy Georgia The Live Healthy Georgia Campaign serves as the umbrella for an outreach initiative that aims to raise awareness about the risk factors associated with chronic diseases and to provide Georgians with information about ways to live healthier and reduce their risk of developing chronic diseases. The overarching messages of the campaign are: Get Checked Eat Healthy Be Active Be Smoke Free Be Positive
For more information, go to http://www.livehealthygeorgia.org/.

RESOURCE MATERIALS
Arthritis as a Potential Barrier to Physical Activity Among Adults With Heart Disease United States, 2005 and 2007 http://www.cdc.gov/mmwr/preview/mmw rhtml/mm5807a2.htm?s_cid=mm5807a2_e Arthritis as a Potential Barrier to Physical Activity Among Adults with Diabetes -- United States, 2005 and 2007 http://www.cdc.gov/mmwr/preview/mmw rhtml/mm5718a3.htm?s_cid=mm5718a3_e
Arthritis is a chronic disease that affects millions of Americans and is the leading cause of disability for adults. These briefs present data on the impact of arthritis on those with other chronic diseases.
Healthy Behaviors: Addressing Chronic Disease at Its Roots For more about the common determinants of chronic diseases, here is a report from Grantmakers in Health. http://www.gih.org/usr_doc/Healthy_Behavio rs_Issue_Brief.pdf

UPCOMING EVENTS
Health Benefits Conference & Expo Jan 25-26, 2010 ~ Clearwater Beach, FL http://www.hbce.com/index.html
Be Safe, Be Profitable Jan 27-28, 2010 ~ Fort Worth, TX http://www.ashca.com
18th Annual HIPAA Summit February 2-5, 2010 ~ Washington, DC http://www.hipaasummit.com/
Construction Safety Conference & Expo February 16-17, 2010 ~ Rosemont, IL http://www.buildsafe.org/
Business Health Agenda 2010 March 10-12, 2010 ~ Washington, DC http://www.businessgrouphealth.org/conference10/
Int'l Health & Productivity Management March 29-31, 2010 ~ Orlando, FL http://www.ihpm.org
Am Assoc of Occupational Health Nurses April 13-15, 2010 ~ Anaheim, CA https://www.aaohn.org/conferenceitems/aaohn-2010-annual-conference.html

Prepared by Beatrice Olanihun for Georgia's Worksite Health Initiative Georgia DCH Div. of Public Health www.health.state.ga.us/programs/
worksitehealth WorksiteHealth@dhr.state.ga.us
Worksite Health Promotion, December 2009

WORKSITE WELLNESS IN THE NEWS
Business Concerned Over Swine Flu Disruption Financial Times, September 21, 2009 The Perils of Revealing Your Illness at Work Financial Times, October 4, 2009 Survey: Fewer US Workers Fired for Faking Illness Reuters, October 7, 2009 Health Costs Jump for Employees Wall Street Journal, October 14, 2009 Employers' Wellness Rewards Come with Risks Wall Street Journal, October 15, 2009 Patient Money: Making Sense of High-Deductible Health Plans New York Times, October 17, 2009 Are You Missing Out on These `Wellness' Freebies? Wall Street Journal, October 28, 2009 On-the-job Exercise Good for Employee and Employer Reuters, October 28, 2009 Takes a Pro to Make Offices Pain-Free BusinessWeek, October 28, 2009 Depression Often Goes Untreated in Working Moms BusinessWeek, October 27, 2009 NC Businesses See Workers' Comp Coverage Savings BusinessWeek, November 4, 2009 Official Endorses Workplace Clinics for Vaccine Distribution New York Times, November 7, 2009 Your Company on the Couch Financial Times, November 11, 2009 Healthy Worker Programs Survive Economic Crisis Reuters, November 16, 2009 Report: Companies Not Reporting All Injuries BusinessWeek, November 16, 2009 Neb. Court Revives Union Pacific Worker's Lawsuit BusinessWeek, November 17, 2009 US Lags in Paid Sick Days, Work Benefits Reuters, November 17, 2009 Group Rallies for Maine Paid Sick Leave Bill BusinessWeek, November 18, 2009 At Software Powerhouse, the Good Life is Under Siege New York Times, November 22, 2009 Editorial: A Ban on Genetic Discrimination New York Times, November 22, 2009 New Hampshire Considering Paid Sick Leave Mandate New York Times, November 23, 2009 Employers Play Dr. Mom to Limit Swine Flu Impact BusinessWeek, November 29, 2009
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