Wellness
Bringing Order to Chaos
For Good Purpose
Or
Tai Chi for Lunch?
Warren Silverman MD
May 2006
Fill in the Blank
Safety Programs
Are to Workers’ Compensation
As
________ Programs
Are to Health Care Insurance
Statistics
• 2004 Health care premiums up 12%
• 13.6% in companies with 3-24 workers
• Average cost: $7,308/employee up $742
• US Cost projection 1.66 trillion 2003 to 2.7
trillion 2010
• Prescription drugs > 10%/year increase
14% in 2002
• 10.5% average payroll to health insurance
• Out of pocket expenses $558 for
single and $2,661 for family
• 56% of firms sought out new plans,
31% changed carriers, 34% changed
type of plan
• 5 million less workers covered in
2004 due to cost increases
Statistics
• : $500/employee savings after
implementing a fitness program with 60%
employee participation
• : $5.50 savings/$1 spent + 18%
reduction absenteeism
• : benefits costs for employees
participating in their program were $312,
as opposed to $574 for non-participants
Annual cost savings of $225
per employee
Annual healthcare costs of
2.5% in participants vs. 18% in
non-participants
On site health clinic saves
$400,000 annually in
healthcare costs
Legal Obligations
• The Fair Labor Standards Act:
– Does not require an employer to provide
wellness programs or employee
assistance programs.
– Generally an agreement between the
employer and the employee or
employee representative
Benefits
1. Improved Morale
2. Reduced Turnover
3. Increased Recruitment Potential
4. Reduced Absenteeism
5. Health Care Cost Containment
6. Improved Employee Health Status
People participate for reasons as diverse as...
• Stress — job, family or financial
• Chronic pain and illness
• Anxiety and panic
• GI distress
• Sleep disturbances
• Fatigue
• High blood pressure
• Headaches
• Desire for health and longevity
Kinds of Wellness Programs
• Educational
• Diagnostic
• Physical / Rehabilitative
• Lifestyle behavioral adjustment
• Psychosocial
• (Assistance Programs)
Educational Training
Forums
• Lunch n’Learns
• Brown Bag Seminars
• Employee Forums
• Health Fairs
• Designed to transmit information to
promote well behaviors and choices
Screenings
• Breast Cancer
detection/Mammograms
• Cholesterol/lipid screening
• Blood pressure
• Bone Density Osteoporosis
• Diabetes Glucose
• Cardiac Health
Screening Programs
• 28% of companies responding to a
questionnaire reported health
screenings attracted the most
employee participation
• Over 70% participation is reported
Stress Management
• Well Attended
• 15 % of companies reported that
these were perceived as the best
programs
Popular programs
• Mindfulness-Based Stress reduction
• Simplify your Life
MBSR Program
• Mindfulness is a way of learning to relate
directly to whatever is happening in your
life, a way of taking charge of your life, a
way of doing something for yourself that
no one else can do for you — consciously
and systematically working with your own
stress, pain, illness, and the challenges
and demands of everyday life.
• increased awareness of all aspects of self,
including body and mind, heart and soul
Eight weekly classes and one daylong class on a Saturday or
Sunday. Morning or evening course availability
• Guided instruction in mindfulness
meditation practices
• Gentle stretching and mindful Yoga
• Inquiry exercises to enhance awareness in
everyday life
• Individually tailored instruction
• Group dialogue
• Daily home assignments
• Two audio-cassette tapes and a workbook
Simplify your Life Approach
• Start the day right. Save all that frantic wasted time used in the
morning to prepare for the day. Spend the night before
preparing for the next day.
• Declutter your space. It takes energy to keep possessions in
working order or dusted. Get rid of the stuff that's broken or
missing a part.
• Learn to say "no." Don't overload your schedule with more
tasks, more jobs, more volunteer time. It's OK to say no.
• Turn off the TV. We waste too much time sitting in front of the
TV. Curb how many hours the TV is on. And before you pick up
the remote control, ask yourself if there are activities to share
with the family, or entertainment, like a museum visit or play,
that you've been putting off.
• Commit to number one. When the demands of work,
parenthood, or household chores get you down, it's time to
schedule a date with yourself. Whether it's every Sunday night
or 20 minutes each morning, the important thing is to make a
plan and stick to it.
• Find a sanctuary. Escape to a place to enjoy peaceful solitude.
• Be spontaneous. Spontaneity is key to feeling like you're in
control of your own destiny. Every once in a while, a change
in routine can spark your spirits and your energy.
• Live beneath your means. Did you know that 80% of
America's self-made millionaires are frugal? If you want to
achieve economic independence, try buying only what you
can afford, not what you think you need. See how long you
can go without cashing a check, charging on credit, or
buying anything. You'll be amazed how ingenious and
inventive you can be.
• Rewrite the course of your day. When the newspaper's
horoscope doesn't tell you what you want to hear, write your
own, using words that make you feel great. Or start jotting
down phrases you like on slips of paper, put them in a box,
and pick as many as you need to start the day.
• Listen to your body. You know what your biological clock
prefers. Indulge it and watch your productivity grow.
Relaxation Modalities
• Massage Therapy
• Yoda
• Tai Chi
• Biofeedback
• Meditation
Nutrition and Exercise
• 9% said walking was the most popular
wellness activity
• 7% said any variety of exercise program
attracts high employee participation
• 5% fell onsite fitness centers were a big
draw
• 7% mentioned weight loss and weight
management especially with a focus on
nutrition
• Increasing popularity of healthy cooking
technique programs
www.gmap-pedometer.com
Current State of Affairs
• 93 % of US companies offer some
type of health promotion up from
89% in 1996 (945 companies
surveyed)
• 72% some kind of education or
training (up 2%)
• 42% offer financial incentives and
disincentives (up from 34%)
Absenteeism
Ipsos-Reid Study 3/04
• Preventable contributors to employee
absenteeism:
1. 66%: Depression/Anxiety/other mental health
disorders
2. 60%: Stress
3. 44%: Negative relationship with supervisor or
manager
4. 35%: Childcare issues
5. 28%: Coworker conflict in the workplace
6. 21%: Parenting
7. 20%: Addictions/substance abuse issues
8. 19%: Eldercare issues
Health Fairs, Seminars,
Counseling
• Health Fairs that address a variety of
health issues are well attended
• Single subject health fairs/seminars are
highly rated
• 13% report utilizing individual counseling:
personal issues, general assessment,
parenting, health risk assessment, eye
surgery, immunization, alternative
medicine/holistic
Disease Management
• 66% offer disease management programs
• Most go through self insured or fully
insured health plans
• 28% administer health risk appraisal
questionnaires and promote early
detection programs: 44% do appraisals
periodically, 40% annually: online
appraisals with ―serial evaluations‖
Obesity
• Obesity is the leading cause of heart disease, cancer and
stroke the top 3 causes of death
• 1/3 of Americans are obese, 2/3 overweight
• 85-95% of Americans predicted to be overweight by 2040
• 40% do not do any leisure time physical activity
• Obesity and lack of exercise may cause as many as 1/3 of
cancers
Diabetes
• 18.2 million with diabetes and another 20.1
million with prediabetes
• 1/3 of children born in 2000 will develop diabetes
in their lifetime (2/5 of blacks and ½ Hispanics);
if diagnosed by age 40 average loss of 11-14
years
• Diabetes rates increased 27% between 1997 and
2002
• Diabetes is 5th cause of death in women 6th in
men
Health Screening
• 75% perform health screening (up
from 68% in 1996)
• Blood pressure or cholesterol through
health plan or onsite health fairs
• 69% special programs (i.e.: flu
vaccination, well baby / child care /
prenatal care)
Additional Offerings
• Smoke Free Workplace 57%
• Health Fairs 42%
• Onsite or employer owned fitness
facilities 35%
• Employer sponsored sports
teams/tournaments 30%
• Discounts at health clubs 23%
Financial
Incentive/Disincentive
• Examples
– Higher medical of life insurance
expense for smoker
– Lower medical benefit if not wearing a
seat belt in an MVA or if driving under
the influence of alcohol or drugs
Participation
• 75% or respondents have 50% participation
Payoff
• Positive Direct benefits can be noted
in as little as 6-18 months
Institution
1. Capture senior level support
2. Create cohesive wellness team
3. Collect data to drive health efforts
4. Craft an operating plan
5. Choose appropriate intervention
6. Create a supportive environment
7. Consistently evaluate outcomes
Wellness Department
Survey of 150 wellness program managers
• 34% 1 person Department
• 12% 2 person
• 10% 3 Person
• 12% 4-5 Persons
• 13% 6-12 Persons
• 4% 15-25 Persons
• 1% 50-60 Persons
Scenario
• Sprained ankle
– Employee was trained on how to look up
home health techniques on the internet.
– Applied ice packs and looked for signs
and symptoms requiring additional
assessment
– Emergency Room visit avoided
Scenario
• Employee with sweating, nausea,
―heart burn‖
– Had been to seminar about signs of
coronary ischemia
– Able to recognize signs of heart attack
earlier than might otherwise have done
– Prompt emergency care resulted in
early intervention preventing heart
muscle damage