Healthier, Safer anHow Your Workplace Culture How Your Workplace Culture

6th Annual Glo6th Annual GloMay 10

L. Casey Chosewood, MD – Sr. MedicaNational Institute for Occup

Centers for Disease Co

nd More Engaged Can Create Maximum Health Can Create Maximum Health

balFit SummitbalFit Summit0, 2012

l Officer for Total Worker HealthTM

pational Safety and Healthntrol and Prevention

Discla

• The views herein represent those ofreflect opinions of the US Departmereflect opinions of the US Departme(DHHS), the Centers for Disease ConNational Institute for Occupational S

• For official guidance from CDC and • The mention of organizations and/or

presentation is for illustrative purpopresentation is for illustrative purpoendorsement by NIOSH, CDC or DHH

aimer

f the author and do not necessarily nt of Health and Human Services nt of Health and Human Services ntrol and Prevention (CDC), or the Safety and Health (NIOSH). NIOSH, visit www.cdc.gov. r commercial entities in this

oses only and does not represent an oses only and does not represent an HS.

2

Today’s CDC workplace looks like this…

But Here are the DeadlieBut Here are the Deadlie

Extreme aging

est Threats Facing CDCest Threats Facing CDC

Extreme environment

Extreme convenience

Obesity Trends* Amon(*BMI 30, or about 30 lbs ov

No Data <10% 10%-14%

Source: Behavioral Risk Factor Surveill

ng U.S. Adults, 1990verweight for 5’4” person)

15%-19 20%-24% 25%

ance System, CDC

Obesity Trends* Amo(*BMI ≥30, or ~ 30 lbs. ov

(*BMI 30, or about 30 l

No Data <10% 10%–14% 15%–19% 2

Source: Behavioral Risk Factor Surve

ong U.S. Adults, 2008verweight for 5’ 4” person)lbs overweight for 5’4” person)

20%–24% 25%–29% ≥30%

illance System, CDC

Obesity Trends* Amo

Source: Behavioral Risk Factor Surve

ong U.S. Adults, 2010

7illance System, CDC

Isn’t Behavior CSir Michael Marmot

“ It is unreasonable to expe It is unreasonable to expebehavior when the social, culturaround them fully conspire agaiy p g

Adapted from M. Marmot/Institute of Medicine Report

hange Enough?

ct people to change their ct people to change their ral and physical environments inst them….”

Where and How Do WWe Spend Our Time?

What Matters More…G

ObesityStress

BehaviorDrugs

HS

Drugs

ChemicalBiological

StressPhysicalChemical Stress

dermalinhalation

ingestion

Genome or Exposome?

Gut floraInflammation

ealth Status

Lipid PeroxidationOxidative stress

WaterWaterAir

Attributable Risk of

Unknown45‐55%

f Chronic Diseases

GeneticsGenetics15‐20%

Occupational/Pollution5‐10%

Smoking25%25%

Rappaport 2011

What What

Am I healthAm I healthDo I care if others in

What influ

Does this job help maHow can my workplace help

D b Does my boss care

is health? is health?

hy?hy? my life are healthy?y yuences my health?

ake me healthier?p me change my health?

if I h l h ?e if I am healthy?

Growing ShortageGrowing Shortage

I MilliIn Millions

Source: Employment Policy Foundation anp y y

e of U.S. Workerse of U.S. Workers

nalysis and projections of Census/BLS and BEA data.y p j

Dramatically Different Patterns

Percent Growth in U.S. Population b

2. Fewer young adults

1. Middle age pop

Source: U.S. Cen

s of Population Growth by Age

by Age: 2000-2010

3. Rapid growth in the population ≥55

AgeAgepulation declines

sus Bureau, 2000

. . . Impacts the F. . . Impacts the F

Percent Growth in U.S. Workforce by A

Age of WoAge of Wo

Source: U.S. Ce

Future WorkforceFuture Workforce

Age: 2000-2020

orkersorkers

ensus Bureau

Obesity IncreasedObesity Increased from 5% to 17%from 5% to 17%

A comprehensive workspromotion progpromotion prog

o Strong senior leadership commito Worker protection and respecto Worker protection and respecto High quality occupational healo A variety of opportunities for heao a ety o oppo tu t es o ea

ages, interests, abilities, and heao Programs that reduce organizatio Adequate social, technical and po Frequent, clear communication, o Strong evaluation and process im

ite health protection and gram containsgram contains…tmentt as the primary cornerstonet as the primary cornerstonelth and safety programming

alth enhancement for persons at all a t e a ce e t o pe so s at aalth and fitness levelsonal stress and build resilience

programmatic supportmarketing, and brandingmprovement process

17

Have you got the essenntial elements covered?

Essential Elements of EffeOrganizational Culture and Leadership1. Develop a “Human Centered

Culture”Culture2. Demonstrate Leadership3. Engage Mid-Level Management

Program Design4. Establish Clear Principles5. Integrate Relevant Systems6. Eliminate Recognized Occupational

Hazards7. Be Consistent7. Be Consistent8. Promote Employee Participation9. Tailor Programs to the Specific

WorkplaceWorkplace

ctive Workplace Programs10. Consider Incentives and Rewards11. Find and Use the Right Tools12 Adjust the Program as Needed12. Adjust the Program as Needed13. Make Sure the Program Lasts14. Ensure Confidentiality

P I l t ti d RProgram Implementation and Resources15. Be Willing to Start Small & Scale Up16. Provide Adequate Resources17. Communicate Strategically18. Build Accountability into Program

Implementation pProgram Evaluation19. Measure and Analyze20 Learn from Experience20. Learn from Experience

19

Dr. Frieden’s Parking Spot and 12-Floor Stair Climb

Does Your Company Have Support HealSupport Heal

• Tobacco-free campus • Flexible work/schedule policie• Flexible work/schedule policie

o Leave, telework, job share, parNutritious foods at meetings • Nutritious foods-at-meetings

• Healthy transportation policieS k f ti li• Smoke-free meetings policy

• Time during work hours for wT i i d i l o Training or educational opportu

o Screenings, health coaching, EPh i l A ti it ( ff t i o Physical Activity (efforts in prog

These Policies to lth?lth?

esesrental/dependent carepolicypolicy

es

wellness activitiesi i h l h f i unities, health fairs, events

EAP)gress)

Five Key Work-Life Balancee ey o e a a ce

5. Workers Want, Need and Will Organizing Work around PeopOrganizing People around Wo

4. Every workplace policy will hav k t k t t your workers—take steps to ma

View every workplace decision

e Truthse ut s

Seek Out More Flexibility: ple Works Better than ork.

ve some effect on the health of k it i iti ake sure it is a positive one.

through the lens of health.

Five Key Work-Life Balance Truth

3. View Your Employees as ExtenReach, Service Ethic and Your and Community. Investing in tWorkforce = Investing in Your CWorkforce = Investing in Your C

2 A k l d th B l i A2. Acknowledge the Balancing Acthe Rest of Life. Offer Special SEventsEvents.

hs (cont.)

nsions of Your Mission, Impact on Your Customers he Wellbeing of Your Corporate BrandCorporate Brand.

t b t W k F il d ct between Work, Family and Supports during Hallmark Life

Work and Life: Acknowledgthe Balancing Actthe Balancing Act

Provide links to your workplace’s and community’s parenting and adult care resourcreferrals articles podcasts webinars forumsreferrals, articles, podcasts, webinars, forumslist servs, blogs.

Develop specific resource kits arou• Develop specific resource kits aroucritical topics and hallmark eventso Prenatal periodo Lactationo A New Parents Return to Worko Child Safetyo Child Safetyo College: Decision support and Financingo Children with ADHD

ge

ces: ,

und und

o Autism Information and Resourceso Parenting Teenso Family Wellness, Nutrition and o Adult Care-giving

o Adult Care giving o Grief and Loss, Death of spouse/childo Diagnosis with Serious Illness

Five Key Work-Life Balance Tru

1. Respect for Your Workers is tCornerstone of OrganizationaSSuccess

o Protect Workers and Ensuo Offer Health and Wellbeino Offer Health and Wellbein

Opportunitieso Protect Privacy yo Engage at Employee’s Le

Need, Pace and Priority

ths (cont.)

the al

ure Safetyng ng

evel of

Designing HealthC Y BCan You Become a

• Choice-making is never neu• Choice-making is never neu• Directing default options tow• Subtle “nudges” toward hea• Subtle “nudges” toward hea

health outcomes • Policy interventions provide• Policy interventions provide

choices• Incentives and spotlights caIncentives and spotlights ca• Providing structure around

Themes from Thaler R, Sunstein, C: Nudge ImprovHappiness, 2008.

hier Workplaces“Ch i A hit t”?“Choice Architect”?

utral utral ward health can be powerfulalthier choices can improve althier choices can improve

e a strong basis for better e a strong basis for better

an motivatean motivatecomplex choices helpsving Decisions About Health, Wealth, and

Does Your WorkplaceAllow HealthAllow Health

• Safe, hazard-free workplace• Welcoming, user-friendly, ergo• Commitment to employee resp• Stairs, walkways, paths, trails t• Onsite food choices that make • Transportation and parking opt• Onsite or nearby health clinic oy

providers• Fitness facilities or opportuniti

e’s Built Environment h to Thrive?h to Thrive?

o-appropriate workspacesect, engagement, and inputthat are safe and inviting eating healthier easytions that enhance healthor access to healthcare

es for physical activity

StairWELStairWELSimple changes to dreary stairw

increase usageincrease usage• Painting • Carpeting• Carpeting• Framed artwork• Motivational signsg• Music

Low-cost, high-impactg p

LL ProjectLL Projectwells

Connecting others to ma

Question: In 2012, Facebook meml d t th billiexplode to more than one billio

women. How many users of Fa

a) 200 millionb) 100 illib) 100 millionc) 50 milliond) Less than 1 million

aximize engagement….

mbership is projected to t f th on users—most of them

acebook were there in 2002?

40

Does Stress Affect

On the average US h US, how many

absent dueabsent due

t Your Workplace?

workday in the l employees are e to stress?e to stress?

Address t• An estimated 1 million workers

stress. 1

• Job stress costs U.S. businessdue to absenteeism; employee

d ti it di l l l dproductivity; medical, legal andWorkers' Compensation paymeWork stress vs home stress?• Work stress vs home stress?o Craft a less-stressful workplace fo Build resilient workers secondo Build resilient workers second

• Find out more at www.cdc.gov/

Source: 1. American Institute of Stress

the Stresss are absent every day due to

ses of over $300 billion yearly turnover; diminished d i d d insurance expenses; and ents. 1

first

/niosh/topics/stress

CanW

At IBM, 11,631 employees completed the voluntary12-week program, participants chose family goals from a

week, walking children to school at least once per winvolving children in meal preparation once per weeinvolving children in meal preparation once per wee

Results• Family physical activity increased by 17.1 %• Eating healthy dinners five nights a week incre

Li iti ti t 1 h /d i• Limiting screen time to a max 1 hour/day increchildren and 6.1% for adults

Study authors suggest the results show thimprove short-term behaviors in children

physical activity, meal planning, and s

Source: American Academy of Pediatrfor Children's Healthy Weight Behavio

n Employers Influence the p yWellbeing of Families?

y, web-based program and earned the $150 rebatea list of options, such as limiting fast food to once per

week, limiting video games to 30 minutes per day, or k k.

eased by 11.8 %d b 8 3 % i eased by 8.3 % in

hat employers can n and parents in screen times.

rics, An Observational Study of an Employer Intervention ors, published in the November 2010 issue of Pediatrics.

What looks like a playgground for the kids…..

…is really a health opportuunity for mom and dad, too.

The Guide to Commun(The Comm

• Summarizes what is known abeconomic efficiency, and feaspromote health and prevent dpromote health and prevent d

• www.thecommunityguide.org

ity Preventive Servicesunity Guide)

bout the effectiveness, sibility of interventions to diseasediseaseg

Community GuideyPhysical Activity and

Promoting Physical Activity and Oo Worksite programs to control oo Worksite programs to control o

(Recommended)o Point-of-decision prompts to enp p

(Recommended)o Creation of or enhanced acces

bi d ith i f ti l combined with informational ou

e Worksite Reviewsd Obesity Prevention

besity Preventionoverweight and obesity overweight and obesity

ncourage use of stairs g

ss to places for physical activity t h ti iti (R d d)utreach activities (Recommended)

Community GuideCommunity GuideAssessment of Healthto Change Employeg y

Assessment of Health Risks with FAssessment of Health Risks with Fo AHRF used alone

(Insufficient Evidence)(Insufficient Evidence)o AHRF plus health education wi

(Recommended)(Recommended)

e Worksite Reviewse Worksite Reviewsh Risks with Feedback ees’ Health Behaviors

Feedback (AHRF)Feedback (AHRF)

ith or without other interventions

Community Guide Decreasing Emplo

Incentives and Competitions to Ino Incentives and competitions when combin

(Recommended, based on sufficient evideamong workers)

o Incentives and competitions when used al(Insufficient evidence was found to determand competitions alone work to reduce tob

Smoke-free policies to reduce tob(R d d b d ffi i t id(Recommended, based on sufficient evideamong workers)

Soler, et al. American Journal of P

Worksite Reviewsoyee Tobacco Use

ncrease Smoking Cessationed with additional interventions ence of effectiveness in reducing tobacco use

one mine whether or not worksite-based incentives bacco use among workers)

bacco use among workersf ff ti i d i t b ence of effectiveness in reducing tobacco use

Preventive Medicine, February 2010

Workplace Preventiop• Worksite Health Promotion Program

Investment of Nearly $4 for Each $1 y $ $• Reduce the Cost of Absenteeism by• A Review of 42 Published Studies of

Programs Shows:Programs Shows:• Average 28% reduction in sic• Average 26% reduction in heag• Average 30% reduction in wo

management claims costs • Average savings of $5 93 for

Sources:1. Anderson, E. Wellness Councils of America, 20022. Aldana SG. Financial impact of health promotion program

• Average savings of $5.93 for

2001;15(5):296-320

n: What’s My ROI?yms Yield an Average Return on

Spent on Direct Health Care Costs1py $5 for Every $1 Spent1

f Worksite Health Promotion

ck leave absenteeism alth costs

orkers’ compensation and disability

every $1 spent2

ms: a comprehensive review of the literature. Am J Health Promotion.

every $1 spent2

CDC LEAwww cdc gowww.cdc.go

ANWorks!ov/leanworksov/leanworks

CDC and NIOSH Workplaace Tools and Resources

Total Worker HeTotal Worker He• NIOSH is dedicated to the preserp

enhancing the Total Health of W

• Total Worker HealthTM is a comprehenorganizational strategy that integratesoccupational safety and health protecoccupational safety and health protecwith health promotion to prevent illneso that all workers have opportunitieshealth and well-being.

ealthTMealthrving and gorkers

nsive s traditional ction efforts ction efforts ess and injury s to achieve

Total Worker HealthTM - A R

Sorensen & Barbeau (2004)• Workers’ risk of disease is increased by exp

individual risk related behaviors• Workers at highest risk for exposures to ha

most likely to engage in risk-related health communities

• Worker participation in integrated programs• Manufacturing: Greater reduced risks - erg

job control risks• Blue collar: Smoking quit rates in an integr

to a non-integrated program

http://www.cdc.gov/niosh/steps/pdfs/NIOSH-post-symprevision.pdf

Rationale for Coordination

posure to both occupational hazards and

azardous working conditions are often behaviors and live in higher risk

s is higher than in single-interventiongonomic, cardiovascular, job demand and

rated program more than doubled relative

Total Worker HealthTM - A R

Goetzel (2005)• Sharing resources across departments and

in a lack of duplication in program offering• Common set of metrics can be used by all p• Reduced competition for senior manageme• Improvements in employee health will redu

worker safety, productivity, and organizatio• Successful coordinated programs can save

significant ROI

http://www.cdc.gov/niosh/worklife/steps/default.html

Rationale for Coordination

d functions can be cost efficient and result

programsent attention and scarce resourcesce medical care costs AND enhance

onal competitivenesse MORE money than they cost and achieve

T t l WTotal WoExamples of Integrated ProgramsExamples of Integrated Programs

o Respiratory protection programs that co Ergonomic consultations that also disco Stress management efforts that first seo Stress management efforts that first se

only then work on building worker resilo Integrated training and prevention prog

hearing conservation stretching flexibhearing conservation, stretching, flexibo Comprehensive screenings for work ano Occupational health combined with a wo Full integration of: clinics, behavioral h

programs, coaching, EAP, nutrition, dis

k H lthTMorker HealthTM

omprehensively address tobacco abusecuss arthritis management strategies

eek to diminish workplace stressors and eek to diminish workplace stressors, and iency

grams (falls, motor vehicle safety, first aid, bility and lifting programs)bility and lifting programs)nd non-work risksworkplace primary care home modelhealth, traditional safety, health promotion sability and workers compensation.

NIOSH Centersfor Total Worfor Total Wor

• University of Iowa Healthier Workfor http://www public health uiowa edu http://www.public-health.uiowa.edu

• Center for the Promotion of Health in At the University of Massachusetts y

http://www.uml.edu/centers/cph-ne At the University of Connecticut

http://www.oehc.uchc.edu/healthywhttp://www.oehc.uchc.edu/healthyw• Harvard School of Public Health Cen http://centerforworkhealth.sph.harv

New Center named in late 2011Oregon Healthy WorkLife Center, O

UniversityUniversity

s of Excellence rker HealthTMrker Healthrce Center for Excellence /hwce//hwce/n the New England Workplace w/

work/index.aspwork/index.aspnter for Work, Health and Wellbeingard.edu/

Oregon Health Sciences

Resou• Centers for Disease Control and Prevention

www.cdc.gov/workplacehealthpromotion• NIOSH Total Worker HealthTM Initiative

http://www.cdc.gov/niosh/twh• Essential Elements of Effective Workplace

Programs and Policies for Improving Worker g p gHealth and Well-Being www.cdc.gov/niosh/TWH/essentials.html

• HHS Physical Activity Toolkithttp://www.health.gov/PAGuidelines/toolkit.aspx

• CDC Healthier Worksite Initiativehttp://www cdc gov/hwihttp://www.cdc.gov/hwi

• OPM’s Site for Workplace Resourceswww.opm.gov/Employment_and_Benefits/WorkLife/H

althWellness/wellnessresourcesalthWellness/wellnessresources

urces• NIOSH: Worker Health and Safety

www.cdc.gov/niosh• Alliance to Make US Healthiest

www.healthiestnation.org• CDC’s Division of Nutrition, Physical

Activity & Obesityy yhttp://www.cdc.gov/nccdphp/dnpao

• Smallstephttp://www smallstep gov

x.http://www.smallstep.gov

• Community Toolboxhttp://ctb.ku.edu/en

• APHA Healthiest Nation in 1 Generation

He

• APHA - Healthiest Nation in 1 Generationhttp://www.generationpublichealth.org

• CDC LeanWorks!http://www.cdc.gov/leanworks