Wellness Articles

What Are Employee Health and Wellness Programs?

Employee Health and Wellness Programs are designed to promote and support employee health and wellness through education and awareness programs primarily based at the worksite. The program is a win-win in that workers benefit from learning and staying well, and the employer has increased loyalty and less absenteeism.

As companies become more aware of the importance of employee health on productivity, there is increased interest in encouraging and supporting healthy lifestyle choices. Employer costs for Employee Health and Wellness Programs can rapidly be offset with fewer work-related injuries, improved attendance, less turnover, and increased morale.

Types of Employee Health and Wellness Programs

Employee Health and Wellness Programs: Lunch & Learn Wellness Seminars

The easiest Employee Health and Wellness Programs are one’s where the employer arranges to have quarterly seminars during lunchtime on topics such as stress management, nutrition, and exercise. A local mental health clinic, hospital, or the Employee Assistance Program (Employee Assistance Program) may provide these. This type of corporate health and Employee Health and Wellness Program is usually arranged through HR, the health department, or the safety manager. Participation is generally voluntary.

Before selecting topics for wellness seminars, it is a good idea to do some type of worker polling to see what topics people are interested in. This can be as simple as an e-mail to all staff asking for suggestions or as formal as having an outside group come in to conduct interviews and design a complete corporate health and Employee Health and Wellness Program.

Employee Health and Wellness Programs: Health Risk Assessments

An employer can provide comprehensive Health Risk Assessments for workers. Health Risk Assessments are detailed questionnaires that covers all areas of behavior (seatbelt use, smoking, alcohol use, frequency of exercise, family history of disease and illness, etc.). This is usually done in conjunction with employee health screening / biometric testing for things like cholesterol and blood sugar screening.

Once the Health Risk Assessments are scored, the results are shared with workers along with suggestions for changes. The employer is able to get aggregate statistics that will show trends that he or she may want to address. For example, if a lot of people have high blood pressure, the employer may consider an educational seminar, biweekly worksite blood pressure readings, and low-salt, low-fat selections in the cafeteria or snack machines as interventions to include in the corporate health and Employee Health and Wellness Program.

If the Health Risk Assessments show that there is a “trend” toward not wearing seatbelts, perhaps having the State police come in and give a presentation about what occurs in an accident when you don’t have a seatbelt on would change some behavior.

Employee Health and Wellness Programs: tobacco Cessation

tobacco cessation programs are very popular elements of Employee Health and Wellness Programs. Often, the local chapter of the American Cancer Society or American Lung Association will come in to run a group. Another option is for workers to attend a tobacco cessation group in the community. Costs for the tobacco cessation group can be offset by the employer after workers complete the program.

Employee Health and Wellness Programs: Stress Management

Stress is a major area of concern for companies. Stressed out staff members get sick more frequently, make more errors, and generally do not perform up to capacity. As a result, Employee Health and Wellness Programs frequently take steps to address employee stress. There are many ways to address stress within your Employee Health and Wellness Programs, and the beauty of these ideas is that everyone can benefit from them.

Certainly, stress management seminars are educational and informative and should be included in any corporate health and Employee Health and Wellness Program.

Employee Health and Wellness Programs and Work/Life Programs

Many companies offer a work/life program that offers assistance with things from finding day care for a child or elderly parent and information on obscure college scholarship funds to information on which PC to buy and where to find someone to walk your dog. These programs fit into Employee Health and Wellness Programs because they help your workers handle many of the things that are taking up work time and increasing stress.

Employee Health and Wellness Programs and Employee Assistance Programs

An Employee Assistance Programs are integral parts of effective Employee Health and Wellness Programs. By helping workers address personal/mental health problems and concerns, an Employee Assistance Program can go a long way toward improving overall health and productivity. Representatives from your Employee Assistance Program can also work closely with you to design Employee Health and Wellness Programs that are integrated and effective.

Time Management and Employee Health and Wellness Programs

Time is one of our most precious commodities, and anything you can do as an employer to help your workers manage their time is going to be welcome. Although not traditionally thought to be a component of Employee Health and Wellness Programs, providing flextime and telecommuting are two ways to decrease stress and increase productivity.

These programs take thought and planning and are not appropriate for all workers or all positions; however, in many workplaces, they are underused. Either your HR manager or an outside consultant can help you design a program. If you belong to a business group or Chamber of Commerce, you may find assistance there. Also, talk to colleagues who are doing this in their corporations to see how it is working.

The Culture of Wellness

Worker wellness has to be a component of your company culture, not just something you throw in as an afterthought. It isn’t a Band-Aid, but rather a thoughtful piece of your business strategy. For example, if productivity is down due to tobacco breaks, providing tobacco cessation classes can help. But it’s also important to establish a no tobacco policy.

When workers feel valued, they are more loyal and tend to work harder. They take pride in their work and talk about what a great company they work for. A healthy workforce is a productive workforce.

Even the best and most innovative companies are experiencing the impact worker well-being on their organizations’ performance. The bad news is that many of these companies are unaware of the extent to which less-than-optimal worker health and well-being is impacting workforce capacity and performance. The goods news is that there is an increasing body of research and practice than can help companies mitigate this frequently unseen issue and develop significant opportunities for improved workforce attraction, retention and performance! This article focuses on how companyal leaders can improve physical and financial worker wellness in the workplace.

The Problems of Chronic Disease

According to the World Health Organization (WHO), 60 percent of deaths in 2005 could be attributed to chronic disease (cardiovascular disease, cancer, chronic respiratory diseases, and diabetes).1 The largest attributing factors to the chronic diseases include smoking, physical activity, and diet.2 The costs of these diseases are staggering. For example, if there were a 10 percent reduction in mortality from heart disease and cancer, it could save the US $10.4 trillion annually.3 Further the WHO projects that over 80 percent of the US population will be either considered overweight or obese by the year 2015.

The Problems of Financial Distress and Dissatisfaction

As hard as it may be to fathom, a 2004 study found that 67 percent of U.S. Workers are dealing with Personal Financial Issues.4 In another study, it was found that these issues can exist in all segments of any workforce, regardless of income, education, or position level.5 Couple these facts with our workforce reality:

* The workforce is aging and demand for professionals in many industries continues to exceed the supply – and will for the foreseeable future.
* Due to the shortages of quality personnel the stress on our current workforce is increasing.
* With these workforce shortages, most companies cannot continue to pay spiraling market prices for professionals.
* Lastly, those personality attributes that make many professionals great caregivers or service-providers also tend to make them less apt to focus on matters of personal financial management.

The Return On Investment

There are significant reasons why companies should employ Strategies to implement Employee Health and Wellness Programs for their workers:

* Increase Productivity including reductions in healthcare and workers compensation claims, absenteeism, and presenteesism;
* Reduce employer paid healthcare and re-insurances premiums; and
* Increase worker, physicians and patient satisfaction; and
* Increase staff retention and productivity.

A recent Towers Perrin case study6 found that a ten percentage point improvement on worker engagement was linked to a 4.6 percentage point improvement on customer satisfaction and revenue growth and labor cost improvements equal to a 2.8 percent impact on controllable margin.

What all this shows is that providing Employee Health and Wellness Programs and incentives and rewards is more than just “the right thing to do.” Rather, there is a profound business case. As workforce capacity and engagement increase, a bottom-up cultural change takes place in your company. These changes drive improvements in customer satisfaction, productivity, absenteeism, and presenteesism – all of which drive improvements in profitability.

The Course of Change

As an employer, you can have a tremendous impact on the health of the community. Here are a few suggestions on how you can engage your workers (possibly include flowchart):

1. Define the Plan – Determine if you have the internal resource availability and knowledge to develop a formal Employee Health and Wellness Program. Many organizations, due to confidentiality legal and other reasons, choose to engage outside partners to manage these processes.
2. Communication – Once you have developed the plan, communicate the plan to all workers – using multiple media and approaches.
3. Lead by Example –Begin Employee Health and Wellness Programs at the top (walk the walk). Give yourselves the opportunity to go through a health risk assessment and a financial assessment. If you can, communicate your results and your action steps to staff.
4. Develop incentives and rewards for Staff Participation – Here are a couple of financial incentives and rewards you can provide staff that are low cost and optimally have a return on investment:

1. Pay workers to take a risk assessment
2. Lower employee contributions to health plan for those with lowered risk of chronic disease and correspondingly increase employee contribution to health plan for those with increased risk of chronic disease

5. Make available Personal Risk Assessment Counseling – Make available resources that can meet one on one with each worker to understand their health risks and opportunities
6. Eliminate Trans-Fat from Your Dietary Offerings – If you have worksite food facilities, and haven’t been required by legislative statute, you should eliminate trans-fatty oils from the worker and customer meals
7. Eliminate Smoking Areas for Employees – More and more organizations, including large cities, are now banning smoking on their facilities.
8. Make available Proper Monitoring Programs – Probably the hardest part of the plan, the ongoing monitoring is critical. Some organizations are large enough to own or build wellness centers – but even then, many workers feel uncomfortable in using them. Typically the users of wellness centers are those least in need. The good news is that there are many external and web-based tools and options that are available today.
9. Encourage Other Local Businesses to Make available Employee Health and Wellness Programs. In some cases (e.g. hospitals), there are options where this can even generate revenue and/or deepen relationships with the communities you serve.

Legal Concerns

When thinking about a Employee Health and Wellness Program, one must take into account certain requirements under ERISA, the Internal Revenue Code (Code) and the Public Health Service Act (PHSA). All three laws were amended by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to provide for improved portability and continuity of health coverage. HIPAA also added Code section 9802, ERISA section 702 and PHSA section 2702, each of which prohibits discrimination in health coverage based on health status.

To be a bona fide Employee Health and Wellness Program, the plan must satisfy the following requirements:

* An individual’s total incentive must be limited. A limit of 10 percent to 20 percent of the total cost of employee-only coverage may be appropriate, according to the DOL.
* The program must be reasonably designed to promote good health or prevent disease.
* The incentive must be available to all similarly situated individuals. The program must allow any individual for whom it is unreasonably difficult because of a health condition to meet the Employee Health and Wellness Program standard (or for whom it is medically inadvisable to attempt to meet the Employee Health and Wellness Program standard) an opportunity to satisfy a reasonable alternative standard.

1 2005 Preventing chronic disease: A vital investment. World Health Organization
2 2007 Working Towards Wellness: Accelerating the prevention of chronic disease. World Economic Forum
3 2007 The Value of Health and Longevity. Kevin M. Murphy and Robert H. Topal, University of Chicago
4 2004 Employer/Employee Equation Research on Worker Types, Preferences and Engagement Issues – Concours Group, Age Wave and Harris Poll
5 1997 Neal E. Cutler, Ph.D
6 2003 Talent Report: New Realities in Today’s Workforce – Towers Perrin

Employee Health and Wellness Programs that support workers and the setting that they work in have been shown to be a good return on investment. Employee Health and Wellness Programs can be extensive and sometimes expensive. However, there are ways for small companies to make positive changes at little or no cost.

Employee Health and Wellness Program: Weight Management/Physical Fitness Programs

1. Give access to on- and off- worksite gyms and recreational programs before, during, and after work hours.
2. Make available and encourage participation in after work recreation or leagues.
3. Make available cash incentives or lowered insurance costs for participation in physical activity and/or weight management or maintenance programs.
4. Make available shower and/or changing facilities onsite.
5. Make available outdoor exercise areas such as fields and trails for worker use.
6. Make available bicycle racks in safe, convenient, and accessible locations.
7. Make available worksite fitness opportunities, such as group classes or personal training.
8. Make available an onsite exercise facility.
9. Set up programs that have strong social support systems and incentives and rewards, such as:
o Buddy or team physical activity goals
o Programs that involve staff members and family
o Programs to encourage physical activity, such as pedometer walking challenges
o Explore discounted or subsidized memberships at local health clubs, recreation centers, or YMCAs
10. Make available flexible work hours to allow for physical activity during the day.
11. Support physical activity breaks during the workday, such as stretching or walking.
12. Host walk-and-talk meetings.
13. Map out worksite trails or nearby walking routes and destinations.
14. Have workers map out their own biking or walking route to and from work.
15. Post motivational signs at elevators and escalators to encourage stair usage.
16. Make available exercise/physical fitness messages and information to workers.
17. Make available or support recreation leagues and other physical activity events onsite or in the community.
18. Start worker activity clubs such as walking or bicycling clubs.
19. Make available worksite child care facilities to facilitate physical activity.
20. Sponsor a bike to work day and reward workers who participate.
21. Set up a box and solicit fitness and health tips.

Employee Health and Wellness Program: General Health Education Programs

1. Have a current policy outlining the requirements and functions of a broad-based workplace Employee Health and Wellness Program.
2. Have a wellness plan in place that addresses the purpose, nature, duration, resources required, participants in, and expected results of a workplace Employee Health and Wellness Program.
3. Orient workers to the Employee Health and Wellness Program and give them copies of the physical activity, nutrition, and tobacco use policies.
4. Promote and encourage worker participation in the physical activity/fitness and nutrition education/weight management program.
5. Make available health education information to workers.
6. Have a committee that meets at least once a month to oversee the Employee Health and Wellness Program.
7. Make available regular health education presentations on various physical activity, nutrition, and wellness-related topics. Ask voluntary health associations, healthcare providers, and/or public health agencies to offer worksite education classes.
8. Host a health fair as a kick-off event or as a celebration for completion of a wellness campaign.
9. Designate specific areas to support workers such as diabetics and nursing mothers.
10. Conduct preventive wellness screenings for blood pressure, body composition, blood cholesterol, and diabetes.
11. Make available confidential health risk appraisals.
12. Make available worksite weight management/maintenance programs for workers.
13. Add weight management/maintenance, nutrition, and physical activity counseling as a member benefit in health insurance contracts.

Employee Health and Wellness Program: Tobacco Cessation

1. Establish a company policy prohibiting tobacco use anywhere on the property.
2. Make available prompts/posters to support no tobacco use policy.
3. Policy supporting participation in tobacco cessation programs during duty time (flex-time).
4. Make available counseling through an individual, group, or telephone counseling program onsite.
5. Make available counseling through a health plan sponsored individual, group, or telephone counseling program.
6. Make available cessation medications through health insurance.

Employee Health and Wellness Programs that support workers and the setting that they work in have been shown to be a good return on investment. Employee Health and Wellness Programs can be extensive and sometimes expensive. However, there are ways for small companies to make positive changes at little or no cost.

Employee Health and Wellness Program: Nutrition Programs

Fruit and Vegetable Consumption

1. Make available healthy eating reminders and prompts to workers via multiple means (i.e. e-mail, posters, payroll stuffers, etc.).
2. Make available appealing, low-cost fruits and vegetables in vending machines and in the cafeteria.
3. Make available cookbooks, food preparation, and cooking classes for workers’ families.
4. Ensure worksite cafeterias follow healthy cooking practices and set nutritional standards for foods served that align with the U.S. Dietary Guidelines for Americans.
5. Make available healthy foods at meetings, conferences, and catered events.
6. Use point-of-decision prompts as a marketing technique to promote healthier choices.
7. Make available healthy cooking demonstrations that teach skills (i.e. fruit and vegetable selection and preparation).
8. Make available taste-testing opportunities at the workplace.
9. Make available worker-led campaigns, demonstrations or programs.
10. Make available local fruits and vegetables at the workplace (i.e. workplace farmer’s market or community-supported agriculture drop-off point).
11. Use competitive pricing (price non-nutritious foods in vending machines and cafeterias at higher prices).
12. Make available protected time and dedicated space away from the work area for breaks and lunch.
13. Make kitchen equipment available to workers.
14. Make available an opportunity for worksite gardening if possible.

Sweetened Beverage Consumption

1. Make water available throughout the day.
2. Make available appealing, low-cost healthful drink options in vending machines and the cafeteria.
3. Modify worksite vending contracts to increase the number of healthy options.
4. Price non-nutritious beverages at a higher cost.
5. Use point-of-decision prompts to promote healthier choices.

Portion Control

1. Label foods to show serving size and/or nutritional content.
2. Make available food models, food scales for weighing and pictures to help workers evaluate portion size.
3. Make available appropriate portion sizes at meetings, workplace events and in the cafeteria.

Breastfeeding

1. Support nursing mothers by providing them rooms for expressing milk in a secure and relaxed setting, a refrigerator for storage of breast milk, policies that support breast feeding, and lactation education programs.
2. Make available flexible scheduling and/or worksite or near-site child care to allow for milk expression during the workday.
3. Adopt alternative work options (i.e. teleworking, part-time, extended maternity) for breastfeeding mothers returning to work.
4. Educate personnel on the importance of supporting breastfeeding co-workers.

Television & Food Advertising

1. Place TVss in non-eating areas of the workplace.
2. Limit food advertising in the cafeteria (i.e. print and other media).

(Adapted from The Health Promotion First Act prepared by David Anderson, Ph.D., StayWell Health Management)

Worker Lifestyles Impact Worker Health
• Approximately 40 percent of all deaths in the United States are premature (at least 900,000 deaths annually) and are due to unhealthy lifestyle choices such as tobacco use, poor diet, sedentary lifestyle, misuse of alcohol and drugs, and accidents. Other contributors to early death include genetic predisposition (30 percent), social circumstances (15 percent), poor access to quality health care (10 percent), and environmental exposures (5 percent).
• Unhealthy lifestyle is the primary contributor to the six leading causes of death in the U.S. – heart disease, cancer, stroke, respiratory diseases, accidents, and diabetes – which collectively account for over 70 percent of all deaths.
• People with healthier lifestyles live an average of 6 to 9 years longer, postpone disability by 9 years and compress disability into fewer years at the end of life.
• The prevalence of obesity among U.S. adults rose to 30 percent in 1999-2000, a 33 percent increase from a decade earlier, and the prevalence of diabetes also rose by 33 percent during approximately the same period (1990 to 1998).
• About two-thirds of American adults are overweight or obese, 55 percent do not get enough physical activity, 26 percent are completely inactive,10 and only 25 percent eat recommended amounts of fruit and vegetables If diet/physical activity patterns continue worsening at their current rate, these behaviors will soon surpass tobacco use as contributors to mortality.
• Among young people, the prevalence of overweight has more than quadrupled in the past 20 years to 16 percent, daily participation in high school physical education classes has dropped from 42 percent in 1991 to 28 percent in 2003, more than 60 percent eat too much saturated fat, and almost 80 percent do not eat recommended amounts of fruit and vegetables.
• Lifestyle diseases disproportionately affect women, racial and ethnic minorities, the poor and seniors:
• The prevalence of diabetes among African Americans is about 70 percent higher than among white Americans, and the prevalence among Hispanics is nearly double that for white Americans.
• Women comprise more than half of the people who die each year of cardiovascular disease.
• Chronic conditions significantly limit daily activity for 35 percent of persons over 65 years of age.

Financial Impact of Lifestyle

• It is estimated that lifestyle-related chronic diseases account for 70 percent of the nation’s health care costs, which translates to over 11 percent of the entire U.S. gross domestic product.
• Two broad-based scientific reviews identified 83 peer-reviewed studies reporting that people with unhealthy habits have higher health costs.
• Research conservatively estimates that high health risks (high blood cholesterol, high blood pressure, etc) account for at least 25 percent of total health costs.
• Recent research indicates a direct relationship between modifiable lifestyle risks and reduced worker productivity, and relevant data suggest that the costs to companies in lost productivity due to poor employee health may be substantially more than the direct health and disability costs.
• Unhealthy lifestyles frequently lead to chronic disease, many of which cannot be cured and require years or decades of expensive treatments. Below are estimated annual costs of selected unhealthy lifestyles and chronic diseases including obesity, smoking, hypertension, diabetes, stress, and inactivity.

Employee Health and Wellness Programs Improve Health and Yield Major Savings
• Comprehensive scientific reviews identified 378 peer-reviewed studies showing that Employee Health and Wellness Programs improve health knowledge, health behaviors, and underlying health conditions.
• Research has demonstrated that lifestyle modification may frequently be more effective and cost-effective than health intervention in decreasing morbidity and mortality.
• Several scientific reviews indicate that Employee Health and Wellness Programs reduce health costs and absenteeism and produce a positive return on investment. The most definitive review of financial impact reported that:
• 18 studies indicated that these programs reduce health costs, and 14 studies indicated that they decrease absenteeism costs.
• 13 studies that calculated benefit/cost ratios all showed the savings from these programs are much greater than their cost, with health cost savings averaging $3.48 and the absenteeism savings averaging $5.82 per dollar invested in the programs.
• Medical costs are expected to exceed 16 percent of U.S. gross domestic product (GDP) in 2005 and to grow at 7.2 percent annually through 2015, when health expenditures will account for 20 percent of GDP:
• Per capita health costs in the U.S. are the highest in the world and more than double the median for OECD countries, yet the United States ranks 26th in terms of healthy life expectancy.
• Medicaid is the second largest item in most state budgets, and its portion of the total budgets is increasing each year.
• Rising health costs for U.S. companies continue to outpace general inflation, averaging 12 percent per year for the past 10 years. This trend is causing a tremendous financial hardship on U.S. companies.