Health Screening Company

Health Promotion Program Introduction

The last ten years has brought major changes in corporation attitudes toward 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 organizational structures of health care facilities, specifically 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 wellness programs will continue to become important factors in the provision of healthcare, including prevention activities, for both government and private industry.

In businesses with existing health promotion programs, administrative rationale for sponsoring these activities ranged from improving staff member health (28%) to improving staff member morale (9.7%).

Programs include interventions associated with safety, health risk assessment, tobacco use cessation, blood pressure (BP) control, nutrition programs and stress management. Benefits cited range from improved health and productivity to decreasing health care costs.

Demographics of the USA  Workforce

o  110 million American Citizens were in the civilian labor force in 1981; by the year 2000 the civilian labor force is expected to be nearly 140 million.

o  44% of the 1984 labor force was female; 10% was Black.

o  The median age of the workforce is 32 years and is expected to raise to 32 years by 2030.

o  57.9% of all workforce work in companies with between 2 and 500 employees; 45% work in companies with fewer than 100 workforce.  An additional 7.5 million American Citizens are self-employed and 3 million are farmers.

o  18 percent of all wage and salaried staff in 1985 were union members.            

o  45 percent of all staff members are employed in offices.            

Prevalence of Company Wellness Activities            

Based on a 1985 survey, almost 66 percent of workplaces with 50 or more personnel had company health promotion activities in 1985.  The frequency of workplace-based activities by selected categories in 1985 was –             

Health Promotion Program Activities            

Tobacco use Control          35.60%   

Health Risk Appraisal (HRA)    29.50%         

Back Care             28.60%

Stress Management       26.60%      

Exercise             22.10%

Off the Job Accidents    19.80%         

Nutrition             16.80%

Blood Pressure (BP) Control    16.50%         

Weight Control          14.70%   

Workplace size is the strongest indicator of wellness program prevalence.            

Most workers believe the advantages of their corporate wellness activities outweigh the costs, even though few formal investigations exist.            

The most frequently cited reason for starting wellness programs and perceived benefit from programs is improved worker health.

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

When worksites seek outside wellness 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 use Cessation Programs

Tobacco use related medical problems cost United States businesses $26 billion each year in lost productivity and $7 to $8 billion in smoking-related health care costs.

Staff Members who smoke are 50% more likely to be hospitalized than nonsmokers, have 2 times as many job-related accidents as nonsmokers and have absenteeism rates approximately 50% higher than nonsmokers.

Individuals  who smoked an typical of one or more packs of cigarettes per day had 118% higher health care costs than nonsmokers.

76% of current smokers and 80% of former smokers and nonsmokers feel that businesses should restrict use of tobacco to certain areas.

In 1985, 65% of smokers, 85% of nonsmokers and 78% of former smokers, felt that smokers should refrain from tobacco use in the presence of nonsmokers.

In 1986, 17 states had laws regulating use of tobacco in offices or workplaces either in government-controlled offices or offices of private workers.

Examples of smoking cessation intervention program used by businesses include -

o  offering nonsmokers a discount of health and life insurance;

o  compensating full or partial fees for smoking cessation programs;

o  providing cessation programs on organization or shared time;

o  offering cash payments to quitters after 6 of 12 smoke-free months;

o  participating in national quit tobacco use days; and

o  Adopting a smoke free corporation 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 shown to yield 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, exercise plans may reduce  the probability of back injuries among certain occupational groups.

93 million workdays in the U.S. are lost annually as the result of back problems.

Research findings support the notion that workplace fitness plans improve 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 proportion of workplaces have onsite physical fitness facilities.

The majority of workforce sponsored fitness programs involve skills training like aerobic dance, low impact aerobics, resistance training, preand post-natal exercise classes, and walking/jogging groups.

A number of businesses subsidize staff member participation in community “Ys,” health clubs or other community programs if no onsite facilities are available.

Worksite physical fitness programs may reduce costs to corporations by reducing worker health care claims and expenditures.

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

Health care costs for obese people  are roughly 11 percent higher than those for thin people .

Nutrition and Weight Control

One-third of the U.S.  population is obese to the extent of reducing their life expectancy.

Improvements in eating habits can reduce  the risk of serious health problems like high blood pressure (BP) and cholesterol levels and is instrumental in the control of non-insulin-dependent diabetes.

The workplace offers a few advantages for nutrition education; support and influence of coworkers and management, availability of a daily consuming situation, and opportunities for follow-up and monitoring.

Workplace nutrition programs may be grouped in 6 broad categories -

o  cafeteria programs;

o  multi-component programs;

o  weight control programs;

o  cholesterol reduction programs;

o  programs for pregnant and lactating women; and

o  other nutrition education topics.

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

Stress Management

Estimates suggest that 50 percent to 80 percent of physician visits may be attributed to psychosomatic or stress-related origins.

Corporation pays many of the costs related to employee stress, both directly in the form of health care costs and in lower productivity.

Job factors which are associated with stress include -

o  not authorizing workers to take part in decisions about the work process;

o  positions which require more or less skill than the staff member has;

o  changes in work demands;

o  lack of clarity about expectations and standards; and

o  conflict with colleagues or supervisors.

Most workplace stress management programs are implemented thus of requests from personnel.

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

Workplace stress management programs are often delivered in one of three formats -

o  seminars conducted by trained specialists;

o  self-learning tools; and

o  personal teaching to assist with self-assessment, planning for changes, learning new skills and responding to life crises.

The two major techniques used in worksite stress management programs are -

o  Teaching individuals  to reduce the negative physical effects of stress; and

o  Teaching individuals  to recognize and control sources of stress at work and in personal life.

Seat Belt Usage

Motor car accidents are the largest single cause of lost work time and on-the-job fatalities of U.S. corporation.

Motor automobile accidents account for 27 percent of all work-related deaths and 45 million days of lost work annually.

More than 36 percent of the 11,300 accidental work deaths in 1983 involved automobiles.

Workers who routinely fail to use seat belts may spend up to 54 percent more days in the hospital.

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

Motor car crashes cost $15.2 billion in lost productivity, 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 whoever riding in a organization car or using a private car on organization organization, 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 -

o  Active commitment for management;

o  obviously defined and well enforced policy of required belt use on the job;

o  positive incentives; and

o  ongoing education and training programs.

Case Studies of Health Promotion Programs

Based on an robust evaluation of its robust staff member health promotion program, LIVE FOR LIFE, Johnson and Johnson announced the break-even point for the program occurs in year 3 and by year 5 they have a net benefit of $316 per staff member. Their year 9 projected benefit is $677 per staff member.

Workers at four Johnson and Johnson businesses who were exposed to the health promotion program increased their daily energy expenditure in vigorous activity by 104% compared to an increase of 33% among personnel at businesses that were offered only an annual health screen.

Participants in the United Methodist Publishing House’s wellness program submitted more claims (1.14 per participating worker 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 lower than projected use in health care costs for 1985 ($902,116 projected with actual costs $142,884) to the wellness program even though the results are not conclusive.

In 1985, the Adolph Coors Business conducted a telephone interview of a random sample of its 10,000 staff members to determine changes in health practices since the introduction of an employee health promotion program 4 years earlier.

The sample of 495 workers was stratified to match the corporation profile in terms of age, sex and job description.

The survey reported that 65 percent of respondents started exercising in the last 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 company’s smoking cessation program and regular participants of the wellness center miss an typical of 1.96 workdays yearly because of illness or injury compared to 3.08 days for non-participating staff members.

The Coors Corporation also achieved a cost savings from a cardiac rehabilitation program that was implemented in 1981. In 1980 workers 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.