Worksite health promotion policies and practices in Georgia: 2002 Georgia worksite survey

WORKSITE HEALTH PROMOTION POLICIES AND PRACTICES IN GEORGIA:
2002 Georgia Worksite Survey

Worksites are important settings for policies, programs, and environments with potential to reach a large proportion of the adult population. According to the 1999 National Worksite Health Promotion Survey, the top concern related to employee health reported by worksites was healthcare costs (94%).1 Healthcare costs for people with chronic diseases account for 75% of total healthcare costs in the nation.2 As most employers share the burden of healthcare costs, keeping workers healthy and free from diseases and risk factors should be a major concern and goal. In addition to lower direct healthcare costs, some studies suggest that healthy workers are more productive and absent less often.3
With the majority of adults in Georgia not getting enough physical activity or proper nutrition,4 worksites provide an opportune setting to tackle these challenges by modifying and creating policies and environments that support healthy behaviors.5 The following is a summary of results from the 2002 Georgia Worksite Health Promotion Polices and Practices Survey of private sector worksites with at least 15 employees.
Key Results

73% of all worksites reported offering at least one health promotion program.
Larger worksites were more likely to provide health promotion programs than smaller worksites.
Small worksites are important since 78% of worksites in Georgia had less than 100 employees while accounting for 31% of employees in 2000.6
Worksite Policies Supporting Healthy Behavior
Physical Activity Policies
Policies to encourage activity during commute to and from work were uncommon. Only 2% had a policy to encourage commute by foot or bike and 6% subsidized the cost of public transportation.
17% of worksites offered flextime or special breaks for physical activity.
23% of worksites offered subsidized or reduced rate health memberships.
Tobacco Policies
The majority (90%) of worksites had a formal tobacco policy to prohibit or restrict smoking on the job.
77% of worksites with a tobacco policy allowed smoking on the grounds but not inside.
14% of worksites with a tobacco policy allowed smoking in designated areas inside.

Percent

Percent

Percent

At least one health promotion program

100

80

68

60

40

20

0

15-99

86 100-249

94 250+

Number of employees at worksite

Policies to support physical activity

Policy to encourage commute by foot/bike Subsidized cost of public transportation Flextime for physical activity Subsidized/reduced rate health membership

60

40 20

1 5 16 19

0

18 29 25

51 12 15 25

15-99

100-249

250+

Number of employees at worksite

Policy to prohibit or restrict smoking on the job

100

89

80

60

40

20

0

15-99

94 100-249

97 250+

Number of employees at worksite

Worksite Environment Supporting Healthy Behavior
Environments Supporting Physical Activity
On-site exercise facilities were available in 13% of worksites overall; indoor gyms and workout rooms were most common.
Availability of bike racks (15%) and locker room with showers (21%) support active commuting.
Indoor stairways available in almost half of worksites (47%) can be used to promote stair usage to increase activity during work hours.
Environments Supporting Food Availability
Worksites with cafeterias (19%) and snack bars (26%) provide possible venues for promoting healthy eating.
Vending machines were widely available (74%), providing opportunity to supply and promote bottled water and healthier snacks instead of soda and candy.
Having a place to refrigerate, freeze, and heat food was the norm (97%) allowing employees to bring healthier alternatives to fast foods.
Health Promotion Practices
Physical Activity, Nutrition, and Tobacco Programs
Physical activity or fitness programs were offered in 17% of worksites.
Healthy eating or weight management classes or counseling were offered in 10% of worksites.
Smoking cessation classes or counseling were offered
in 8% of worksites.
Screenings, Disease and Stress Management
32% of worksites offered at least one screening; blood pressure screenings were most common.
19% of worksites offered at least one disease management program which included heart disease, hypertension, diabetes and mental health management programs.
25% of worksites offered stress management information or activities.

Percent

Percent

Percent

Percent

Environments to support physical activity

On-site exercise facilities

Bike racks available

Locker room with showers

Have indoor stairway 100

81

80

60

60 40 20

41 111218

141728

353244

0

15-99

100-249

250+

Number of employees at worksite

Environments to support healthy eating

Have cafeteria Have snack bar Have vending machines Place to refrigerate/freeze/heat food

100

96

9097

9797

80

69

5760

60 40 1422 20

2531

0

15-99

100-249

250+

Number of employees at worksite

Worksite health promotion programs

Physical activity program Healthy eating/weight management Tobacco cessation programs

60 40 20 14 7 5
0 15-99

24 14 11

43 34 26

100-249

250+

Number of employees at worksite

Screenings, disease and stress management

At least one screening

At least one disease management

Stress management info/activities

100 80 60 40 26 15 21 20

46 24 33

70 47 54

0

15-99

100-249

250+

Number of employees at worksite

Company Mission to Improve Employee Health
42% of the worksites had employee health improvement as a stated mission for the company, which did not vary significantly according to size.
Worksites with a mission to improve employee health were more likely to offer health promotion programs such as screenings, healthy behavior and awareness classes, and provide financial incentives for participation.
Comparison with 1999 National Data
Physical Activity Programs
36% of US worksites with 50 or more employees offered physical activity and/or fitness programs at the worksite and 46% offered the program at the worksite or through their health plans in 1999.
24% of Georgia worksites with 50 or more employees offered a physical activity or fitness program in 2002.
Nutrition or Weight Management Programs
28% of US worksites with 50 or more employees offered nutrition or weight management classes or counseling at the worksite and 55% of worksites offered the program at the worksite or through their health plans in 1999.
16% of Georgia worksites with 50 or more employees offered nutrition or weight management classes or counseling.
Tobacco Policy
79% of US worksites with 50 or more employees had formal smoking policies that prohibited or limited smoking to separately ventilated areas in 1999.
93% of Georgia worksites with 50 or more employees had a formal tobacco policy in 2002.
The Healthy People 20107 objective for worksites having a formal tobacco policy that prohibits or limits smoking to separately ventilated areas is 100% for worksites with 50 or more employees.

Percent

Percent

Percent

Stated mission to improve employee health

60

48

50

42

39

40

30 20

10

0 15-99

100-249

250+

Number of employees at worksite

Physical activity and/or fitness programs

100 80

60

36

40

24

20

0 1999 US

2002 GA

Worksites with 50 or more employees

Nutrition/weight management classes/counseling

Percent

100

80

60

40

28

20

0

1999 US

16 2002 GA

Worksites with 50 or more employees

Formal tobacco policy

100

79

80

60

40

20

0

1999 US

93 2002 GA

Worksites with 50 or more employees

Recommendations for Promoting a Healthy Work Environment and Workforce
Create a worksite wellness committee and a company mission to improve employee health.
Implement the Georgia Worksite Assessment Tool* to create a needs and priority list for worksite health. Post signs and point-of-decision prompts near elevators and stairways to promote stair usage.8 Create or enhance access to places for physical activity combined with informational outreach activities.8
Provide subsidized or reduced fees for health memberships and flexible schedules for physical activity. Promote active commuting by parking 15 minutes from work or getting off one stop early from public transport. 9
Offer healthy choices in cafeterias, snack bars, and vending machines and promote them through point-ofpurchase signs and price subsidies. 10
Implement or expand coverage of tobacco policy to prohibit smoking anywhere at worksite.
Provide health risk assessments and health screenings and follow up with high-risk employees.
Provide appropriate disease management programs on topics such as hypertension and diabetes.
Provide training and post information on signs and symptoms of heart attack and stroke and when to call 911.
Maintain automated external defibrillators (AED) onsite and provide appropriate AED and CPR training.
Methodology and Sample Size
The Georgia Worksite Health Promotion Polices and Practices Survey, modeled after the National Worksite Health Promotion Survey, was conducted for the first time in 2002 to document existing policies, environments, and programs affecting the health of Georgia workers. Computer-assisted telephone interviews were conducted with the director of human resources or employee health. Survey findings represent a random sample of private sector worksites with at least 15 employees identified from the Dun and Bradstreet database. Worksites were stratified into three size categories: small (15-99), medium (100-249), and large (250+) and four industry categories. A total of 1,085 worksites completed the survey with a response rate of 54%. Final data were weighted so that each stratum represented its true proportion in the worksite population.
References
1. 1999 National Worksite Health Promotion Survey: Report of Survey Findings Conducted by the Association for Worksite Health Promotion; William M. Mercer, Incorporated; and the U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion.
2. The Burden of Chronic Diseases and Their Risk Factors. National and State Perspectives 2002. National Center for Chronic Disease Prevention and Health Promotion. Centers for Disease Control and Prevention.
3. Burton, WN, Conti, DJ, Chen, CY, et al. The Role of Health Risk Factors and Disease on Worker Productivity. J Occup Environ Med 1999;41:863-877. 4. Martin, LM, Chowdhury, PP, Powell, KE, Clanton J. Georgia Behavioral Risk Factor Surveillance System, 2001 Report. Georgia Department of Human Resources,
Division of Public Health, Chronic Disease, Injury, and Environmental Epidemiology Section, March 2003. Publication number KPH03-069HW. 5. Centers for Disease Control and Prevention. Promising Practices in Chronic Disease Prevention and Control: A Public Health Framework for Action. Atlanta, GA:
Department of Health and Human Services, 2003. 6. U.S. Census Bureau, Statistics of U.S. Businesses: 2000: All industries Georgia (www.census.gov/epcd/susb/2000/ga/GA--.HTM) 7. U.S. Department of Health and Human Resources. Healthy People 2010. 2nd ed. Vol. 1. Washington DC: U.S. Government Printing Office, November 2000. 8. Centers for Disease Control and Prevention. Increasing physical activity: a report on recommendations of the Task Force on Community Preventive Services. MMWR
2001; 50(No. RR-18): [7-12]. 9. Carney, MC, Crawford, AB, Atchison T. et al. "Walk in to Work Out": a randomized controlled trial of self help intervention to promote active commuting. J Epidemiol
Community Health. 2002;56:407-412. 10. French, SA, Jeffery, RW, Story, M. et al. Pricing and promotion effects on low-fat vending snack purchases: the CHIPS Study. Am J Public Health. 2001;91:112-117.

The Georgia Worksite Health Promotion Polices and Practices Survey was funded by the Georgia Cardiovascular Health Initiative Program through a grant from the Centers for Disease Control and Prevention (#U5O/CCU421331-02).

*For more information and resources for worksite wellness programs including the Georgia Worksite Assessment Tool, please contact:

For more information on the 2002 Georgia Worksite Health Promotion Policies and Practices Survey, please contact:

Pam Wilson R.D., L.D. or Jon Ducote 2 Peachtree Street, NW, 16th Floor Atlanta, GA 30303-3142 (404) 657-6633/6645 pswilson@dhr.state.ga.us jaducote@dhr.state.ga.us

Hannah Choi, M.P.H. 2 Peachtree Street, NW, 14th Floor Atlanta, GA 30303-3142 (404) 463-4628 hschoi@dhr.state.ga.us http://health.state.ga.us

Suggested citation: Choi HS, Bricker SK, Troy K, Kanny D, Powell KE. Worksite Health Promotion Policies and Practices in Georgia: 2002 Georgia Worksite Survey. Georgia Department of Human Resources, Division of Public Health, January 2004. Publication Number DPH03/156HW.