Health Handouts : Company Health Promotion Programs: The Stats

Introduction to Worksite Health Promotion Programs

The last ten years has brought big changes in company attitudes toward Workplace Health Promotion Programs. Interest in self-help and self-care programs has increased as growth in health care costs have encroached substantially into profits. Changes in the company structures of health care facilities, in particular the growth of the for-profit health care sector, and the need to contain costs are changing the ways in which purchasers of health care plans are viewing their own efforts toward provision of workplace health care programs and facilities. Projections for the next decade indicate that workplace health programs will continue to become important factors in the provision of health care, including prevention activities, for both government and private industry. In organizations with existing Workplace Health Promotion Programs, administrative rationale for sponsoring these activities ranged from improving employee health (28%) to improving employee morale (9.7%). Programs include interventions associated with safety, health risk assessment, tobacco cessation, Blood Pressure (BP) control, diet programs and stress management. Benefits given range from improved health and productivity to decreasing health care costs.

Demographics of the American Workforce
• 110 million American citizens composed the civilian labor force in 1981; by the year 2000 the civilian labor force is expected to be nearly 140 million.
• 44 percent of the 1984 labor force was female; ten percent was Black.
• The median age of the workforce is 32 years and is expected to grow to 32 years by 2030.
• 57.9% of all staff members work in businesses with between 2 and 500 staff members; 45% work in businesses with fewer than 100 staff members. An additional 7.5 million Americans are self-employed and 3 million are farmers.
• 18 percent of all wage and salaried staff members in 1985 were union participants.
• 45 percent of all staff members are employed in offices.

Prevalence of Worksite Health Promotion Programs Activities

Based on a 1985 survey, almost 66 percent of worksites with 50 or more staff members had Company Health Promotion Programs activities in 1985.  The frequency of workplace-based activities by selected categories in 1985 was:

Activity

Smoking Control       35.6 percent
Health Risk Assessment    29.5%
Back Care             28.6%
Stress Management       26.6 percent
Exercise             22.1%
Off the Job Accidents    19.8%
Nutrition             16.8%
Blood Pressure Control    16.5%
Weight Control          14.7%

Job Site size is the strongest indicator of program prevalence.

Most staff members believe the advantages of their Workplace Health Promotion Programs activities outweigh the expenditures, even though few formal evaluations exist.

The most commonly cited reason for starting programs and perceived profit from programs is improved employee health.

At most worksites with activities (85.4%), all employees are eligible to participate. 30 percent of worksites with activities offer them to company dependents, and an equal percent offer them to retirees.

When worksites seek outside program assistance, they turn to voluntary, not-for-profit corporations (57.1%), private for-profit providers-consultants (50%), local hospitals (44%), and insurance corporations (43%).

Tobacco Cessation Programs

Smoking related health issues cost United States corporations $26 billion per year in lost productiveness and $7 to $8 billion in tobacco-related healthcare expenditures.

Employees who smoke are 50 percent more likely to be hospitalized than people that do not smoke, have 2 times as a myriad of job-related accidents as people that do not smoke and have absenteeism rates approximately 50 percent higher than people that do not smoke.

People who used tobacco an average of one or more packs of cigarettes per day had 118 percent higher healthcare expenses than people that do not use tobacco.

76 percent of current smokers and 80 percent of former smokers and non-smokers feel that organizations should restrict smoking to certain areas.

In 1985, 65% of smokers, 85% of non-smokers and 78% of former smokers, felt that tobacco users should refrain from smoking in the presence of non-smokers.

In 1986, 17 states had laws regulating smoking in offices or workplaces either in government-controlled offices or offices of private staff members.

Examples of tobacco cessation intervention program used by organizations include:

• making available people that do not use tobacco a discount of health and life insurance;
• paying full or partial fees for tobacco cessation programs;
• providing cessation programs on corporation or shared time;
• making available cash payments to quitters after 6 of 12 tobacco-free months;
• participating in national quit smoking days; and
• adopting a smoke-free company policy and setting deadlines for implementing the policy.

Physical Fitness Programs

An active 55-year-old man can lead as vigorous a lifestyle as a sedentary 35-year-old.

Differences in work-related activity has been determined to provide a two- to three-fold difference in cardiovascular deaths between active employees and their more sedentary counterparts.

In addition to improving strength, balance, and flexibility, physical activity programs are able to lower the probability of back injuries among certain occupational groups.

93 million workdays in the United States are lost each year due to back problems.

Research findings support the notion that worksite physical activity programs better fitness and help reduce other health risks, although results related to improved productivity are weak due to lack of methods for accurately measuring productivity.

A very small percentage of worksites have onsite physical fitness facilities.

The majority of staff members sponsored exercise program involve skills training such as aerobic dance, low impact aerobics, weight training, preand post-natal physical activity classes, and walking/jogging groups.

Some employers subsidize employee participation in community “Ys,” health clubs or other community programs if no on-Site facilities are available.

Worksite exercise program may decrease expenditures to employers by lowering employee health care claims and expenditures.

Those whose weekly exercise was equivalent to climbing less than five flights of stairs or walking less than a half mile, spent 114% more on health claims than those who climbed at least 15 flights of stairs or walked 1 1/2 miles weekly.

Medical Care expenditures for obese people are roughly 11% higher than those for thin people.

Nutrition and Weight Control

One-third of this country population is obese to the extent of decreasing their life expectancy.

Improvements in eating habits have the potential to cut the risk of serious health concerns such as elevated Blood Pressure (BP) and blood lipid levels and is instrumental in the control of non-insulin-dependent diabetes.

The workplace offers several advantages for nutrition education; support and effect of co-workers and senior staff, availability of a daily eating situation, and opportunities for follow-up and monitoring.

Worksite nutrition programs are able to be grouped in 6 broad categories:

• cafeteria programs;
• multi-component programs;
• weight management programs;
• blood lipid reduction programs;
• programs for pregnant and lactating women; and
• other nutrition education issues.

Men are less likely to participate in weight-loss programs than are female workers.

Stress Management

Estimates suggest that 50% to 80% of physician visits are able to be attributed to psychosomatic or stress-related origins.

Corporation pays many of the expenditures related to employee stress, both directly in the form of healthcare expenditures and in reduced productivity.

Job factors which are associated with stress include:

• not allowing employees to take part in decisions about the work process;
• positions which require more or less skill than the employee has;
• changes in work demands;
• lack of clarity about expectations and standards; and
• conflict with co-employees or supervisors.

Most workplace stress management programs are implemented as a result of requests from employees.

Stress management programs focus on three types of skills: relaxation skills, coping skills, and interpersonal skills.

Job Site stress management programs are frequently delivered in one of three formats:

• courses conducted by trained professionals;
• self-learning tools; and
• personal teaching to help  with self-assessment, planning for changes, learning new skills and responding to life crises.

The two major techniques used in workplace stress management programs are:

• teaching people to reduce the detrimental physical effects of stress; and
• teaching people to recognize and control sources of stress at work and in personal life.

Safety Belt Usage

Motor vehicle accidents are the largest single cause of lost work time and on-the-job fatalities of American business.

Motor vehicle accidents account for 27% of all work-related deaths and 45 million days of lost work each year.

Greater than 36% of the 11,300 accidental work deaths in 1983 involved motor vehicles.

Employees who regularly fail to use seat belts may spend up to 54% more days in the hospital.

Traffic accidents caused about 3 times as many days of restricted exercise as any other type of disability.

Motor vehicle crashes cost $15.2 billion in lost productiveness, 88 percent of which is attributed to losses from workforce activities and future earnings.

In corporate settings where safety belt policies, requiring use of belts by those riding in a organization vehicle or using a personal vehicle for organization business, have been enforced, 60% to 90% use has been reported.

Incentive programs, accompanied by education and use requirement restrictions have resulted in 40 percent to 70 percent initial usage rates.

Factors influencing the sources of worksite safety belt programs include:

• active responsibility on the part of senior staff;
• clearly defined and well enforced policy of required belt use working;
• positive incentives and rewards; and
• ongoing education and training programs.

Case Studies of Worksite Health Promotion Programs

Based on an extensive assessment of its accross the board employee Corporate Health Promotion Program, LIVE FOR LIFE, Johnson & Johnson stated the break-even point for the program occurs in year 3 and by year 5 they have a net profit of $316 per employee. Their year 9 projected profit is $677 per employee.

employees at four Johnson & Johnson businesses who were exposed to the Workplace Health Promotion Program expanding their daily energy expenditure in vigorous activity by 104 percent compared to an increase of 33 percent among employees at businesses that were provided only an annual health screen.

Members in the United Methodist Publishing House’s Company Health Promotion Program submitted more claims (1.14 per participating employee and .82 for the control in 1984, 1.44 and 1.3 respectively in 1985), but the average cost per claim was less for participants ($316 for participants and $567 for control, in 1984, $262 and $602 respectively in 1985, $270 and $566 respectively in the first four months of 1986).

The United Methodist Publishing House attributes some of the lower than projected use in medical care expenditures for 1985 ($902,116 projected with actual expenditures $142,884) to the Employee Wellness Program although the results are not conclusive.

In 1985, the Adolph Coors Corporation conducted a phone interview of a random sample of its 10,000 employees to determine changes in health practices since the introduction of an employee Corporate Wellness Program 4 years earlier. The sample of 495 employees was stratified to match the employer profile in terms of age, sex and job description. The survey stated that 65 percent of respondents started exercising in The previous 4 years, 37 percent had improved their diets, 20 percent were regular users of the wellness center, 9 percent had stopped smoking as the result of the employer’s smoking cessation program and regular participants of the wellness center miss an average of 1.96 workdays each year because of illness or injury compared to 3.08 days for non-participating employees.

The Coors Company also saw a cost savings from a cardiac rehabilitation program that was implemented in 1981. In 1980 employees were out of work 7.2 months after a heart attack or bypass operation. In 1984, cardiac patients were out an average 1.9 months saving $152,000 in lost work time and in 1985 cardiac patients missed an average of 2.6 months, saving $125,000 that year.