workplace health and why employers should act

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www.hertsdirect .org Health, productivity and employers: public health approaches bring competitive workforces Jim McManus, CPsychol, CSci, AFBPsS, FFPH, FRSPH, MCIPD Director of Public Health

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Presentation from meetings with employers on workforce health and links to productivity

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Page 1: Workplace health and why employers should act

www.hertsdirect.org

Health, productivity and employers:public health approaches bring competitive workforces

Jim McManus, CPsychol, CSci, AFBPsS, FFPH, FRSPH, MCIPD

Director of Public Health

Page 2: Workplace health and why employers should act

www.hertsdirect.org

Page 3: Workplace health and why employers should act

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The Problem

• Increasing non-communicable disease

– Smoking, obesity• Increasing mental ill health• Increasing sickness absence• Increasing loss to business productivity and

performance from sick pay• Avoidable cost of managing and replacing sick

and absent staff

Page 4: Workplace health and why employers should act

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Where’s the evidence?

Established relationship between lifestyle related risk factors (smoking, inactivity, obesity) and productivity absenteeism and health claims.

• (Buron et al,2005, Wellsource, 2006 & University of Michigan, 2006)

Page 5: Workplace health and why employers should act

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What is the root issue?

• There is a flow from low risk to high risk to disease for the working age population

• This leads to:• Diseases of lifestyle• More risk, more absence• Compound risk, compound absence• Low productivity

Page 6: Workplace health and why employers should act

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What does this mean for you as employers?• Chronic disease related deaths account for 56% of all deaths in the

working-age population in the world (World Health Organization).

• High prevalence of major modifiable health risks contributes to the epidemic of chronic disease.

– Elevated BMI (BMI ≥25kg/m2) Obesity (BMI ≥ 30 kg/m2)– Inactivity Smoking– Stress Elevated blood pressure

– Elevated cholesterol High blood sugar– Alcohol

• Places an increasing burden on employers: decreased productivity, increased absenteeism, increased health and worker’s compensation claims.

Page 7: Workplace health and why employers should act

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Page 8: Workplace health and why employers should act

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The upshot of this unless we do something is that 2/3 of people will be in chronic ill health or disability before age 68, the new retirement age

Page 9: Workplace health and why employers should act

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And Hertfordshire shows the same pattern!

Page 10: Workplace health and why employers should act

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Why should you care?

• You’re paying for it• The do-nothing strategy of waiting for sickness and then

paying for treatment isn’t cost neutral – it costs you• Lifestyle related risk factors and behaviours of

employees as well as unhealthy work environments and practices drive costs.

• High risk employees incur high costs whatever the outcome measure: pharmaceutical, absenteeism, compensation costs or productivity.

• Now I’m going to prove it….

Page 11: Workplace health and why employers should act

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Productivity Decreases with Number of Health Risks

Excess

Productivity Loss

Productivity

Loss (%)

Base Cost

Number of Health Risks

(Journal of Occupational and Environmental Medicine 2005;47:769-77 (n = 28,375))

Page 12: Workplace health and why employers should act

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Absenteeism Increases with Number of Health Risks

Number of Health Risks

(Journal of Occupational and Environmental Medicine 2005;47:769-77 (n = 28,375))

Base work loss days/yr

Excess Work Loss days/yr

work loss days/yr

Page 13: Workplace health and why employers should act

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Work done for Herts byeconomists at

Example: Smoking costs in Herts

• total annual cost in Hertfordshire £45,972,899– NHS Treatment and Care costs: £32,429,375

– Costs to businesses (productivity losses): £12,931,914

– Passive smoking costs: £598,947 (adults: £425,607; children: £173,340)

Page 14: Workplace health and why employers should act

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Root causes

One of the root causes of unsustainable increases in costs is natural flow of individuals from

low risk → high risk →disease →higher employer costs

natural flow estimated at 2% - 4% per year. • (Edington et al, 2009).

Page 15: Workplace health and why employers should act

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What can be done

• An effective Workplace Wellness strategy is to stop migration of people to higher risk and keep low risk people at low risk.

• • Employers costs go up as people age, regardless of their

health risk status and as health risk status gets worse, costs go up regardless of age.

Page 16: Workplace health and why employers should act

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NICE Business Case 1: Gross Savings

• Worked example - for a company with 300 employees earning average £8.20/hr

Average no. of days sickness

absence

Total no. of days sickness

absence Hours per day

Total annual cost

£

% reduction in sickness absence

Total annual savings

£

8.4 2520 7.5 154,980 20% -30,996

On average, sickness absence costs employers 8.4 working days per employee per year (Chartered Institute of Personal Development 2007a). Physical activity programmes at work have been found to reduce absenteeism by up to 20%; physically active workers take 27% fewer sick days (Health, Work and Wellbeing Programme 2008).

Page 17: Workplace health and why employers should act

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Nice Business Case 2: InterventionsExamples of Interventions

Cost per employee

£

% of employees taking part

Total Cost£

Health champion/coordinator NA 100% 3,000

Health check

35 100% 10,500

Pedometer challenge

20 50% 3,000

Lunchtime walks

10 50% 1,500

Workplace travel plans

10 100% 3,000

Activity classes

50 30% 4,500

Social events

100 30% 9,000

Discounted local gym membership

100 30% 9,000

Team days - estimated

20 100% 6,000

Signs and posters NA 100%

200

Booklets, leaflets and promotional material

2 100%

600

Total Cost£50,300

Page 19: Workplace health and why employers should act

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Interventions with Gold Standard Evidence (Systematic Reviews)• Musculoskeletal disorders

– education about stress management, principles of ergonomics, anatomy, musculoskeletal disorders, and the importance of physical activity.

– 'pause gymnastics', how to use a relaxed work posture, proper positioning, the importance of rest breaks, and strategies to improve relaxation.

– Some studies also included how to modify work tasks, work load, working techniques, working positions, and working hours.

– adjustments and recommended alternatives to the existing furniture and equipment at the workplace.

Page 20: Workplace health and why employers should act

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Interventions with Gold Standard Evidence (Systematic Reviews)• Standing workers and vein problems

• flexible working interventions that increase worker control and choice (such as self-scheduling or gradual/partial retirement) are likely to have a positive effect on health outcomes

• Smoking Cessation• Healthy weight management• Stopping movement from low – high risk -

disease

Page 21: Workplace health and why employers should act

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Healthy Herts

• County Council Programme• Reduced Sickness Absence• Increased Health Offer including smoking

cessation, gym, physical activity, emotional wellbeing, roll out of alternatives to Lifts

• Nominated for two awards• Will be rolled out further

Page 22: Workplace health and why employers should act

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Coming soon

• Hertfordshire workplace health offer for employers

• Online tools for behaviour change and mental wellbeing

• First six Herts major commercial Employers already engaged

• Working closely with Business in the Community as key partner

Page 23: Workplace health and why employers should act

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2011 Census – Hertfordshire Projected Population Change

Page 24: Workplace health and why employers should act

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Hertfordshire percentage projected population change 2010 to 2035

Age Group Percentage Change All persons - 0-4 6.89 All persons - 5-9 21.27 21.27All persons - 10-14 24.04All persons - 15-19 18.36All persons - 20-24 13.32All persons - 25-29 13.56All persons - 30-34 11.68All persons - 35-39 8.35All persons - 40-44 9.49All persons - 45-49 11.91 All persons - 50-54 20.83All persons - 55-59 25.24All persons - 60-64 20.16All persons - 65-69 59.04 All persons - 70-74 69.54 All persons - 75-79 51.01All persons - 80-84 53.82All persons - 85-89 102.96All persons - 90+ 231.33