Wellness

Bringing Order to ChaosFor Good Purpose

OrTai Chi for Lunch?

Warren Silverman MDMay 2006

Fill in the BlankSafety 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

Benefits1. Improved Morale2. Reduced Turnover3. Increased Recruitment

Potential4. Reduced Absenteeism5. Health Care Cost Containment6. 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 TrainingForums

• 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%)

AbsenteeismIpsos-Reid Study 3/04

• Preventable contributors to employee absenteeism:

1. 66%: Depression/Anxiety/other mental health disorders

2. 60%: Stress3. 44%: Negative relationship with supervisor or

manager4. 35%: Childcare issues5. 28%: Coworker conflict in the workplace6. 21%: Parenting7. 20%: Addictions/substance abuse issues8. 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% employee participation

• 25% have > 50% participation

Payoff• Positive Direct benefits can be

noted in as little as 6-18 months

Institution1. Capture senior level support2. Create cohesive wellness team3. Collect data to drive health

efforts4. Craft an operating plan5. Choose appropriate intervention6. Create a supportive environment7. Consistently evaluate outcomes

Wellness DepartmentSurvey 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