Introduction to Company Wellness Programs
The last ten years has brought big changes in company attitudes toward Company Wellness Programs. Interest in self-help and self-care programs has increased as growth in medical care costs have encroached substantially into profits. Changes in the company structures of medical care facilities, in particular the growth of the for-profit medical care sector, and the need to contain costs are changing the ways in which purchasers of medical care plans are viewing their own efforts toward provision of workplace medical care programs and facilities. Projections for the next decade indicate that workplace health programs will continue to become valuable factors in the provision of medical care, including prevention activities, for both government and private industry. In employers with existing Company Wellness 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, smoking cessation, Blood Pressure (BP) control, nutrition programs and stress management. Benefits given range from improved health and productivity to reducing medical care costs.
Demographics of the U.S. Workforce
• 110 million American citizens were in the civilian labor force in 1981; by the year 2000 the civilian labor force is predicted to be nearly 140 million.
• 44% of the 1984 labor force was female; 10% was Black.
• The median age of the workforce is 32 years and is expected to increase to 32 years by 2030.
• 57.9% of all workers work in employers with between 2 and 500 workers; 45% work in employers with fewer than 100 workers. An additional 7.5 million American citizens are self-employed and 3 million are farmers.
• 18% of all wage and salaried workers in 1985 were union members.
• 45% of all workers are employed in offices.
Prevalence of Company Wellness Programs Activities
Based on a 1985 survey, almost 66% of worksites with 50 or more workers had Company Wellness Programs activities in 1985. The frequency of workplace-based activities by selected categories in 1985 was:
Activity
Smoking Control 35.6%
Health Risk Assessment 29.5%
Back Care 28.6%
Stress Management 26.6%
Exercise 22.1%
Off the Job Accidents 19.8%
Nutrition 16.8%
Blood Pressure (BP) Control 16.5%
Weight Control 14.7%
Worksite size is the strongest indicator of program prevalence.
Most workers believe the advantages of their Company Wellness Programs activities outweigh the costs, even though few formal evaluations exist.
The most usually given reason for starting programs and perceived benefit from programs is improved employee health.
At most worksites with activities (85.4%), all workers are eligible to take part. 30% 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 employers (57.1%), private for-profit providers-consultants (50%), local hospitals (44%), and insurance employers (43%).
Smoking Cessation Programs
Smoking related health problems cost United States employers $26 billion per year in lost productivity and $7 to $8 billion in smoking-related medical costs.
Workers who use tobacco are 50% more likely to be hospitalized than people that do not use tobacco, have 2 times as countless job-related accidents as people that do not use tobacco and have absenteeism rates approximately 50% higher than people that do not use tobacco.
People who smoked an average of one or more packs of cigarettes per day had 118% higher medical costs than people that do not use tobacco.
76% of current smokers and 80% of former smokers and people that do not use tobacco feel that employers ought to restrict smoking to certain areas.
In 1985, 65% of smokers, 85% of people that do not use tobacco and 78% of former smokers, felt that smokers ought to refrain from smoking in the presence of people that do not use tobacco.
In 1986, 17 states had laws regulating tobacco use in offices or workplaces either in government-controlled offices or offices of private workers.
Examples of smoking cessation intervention program used by employers include:
• making available people that do not use tobacco a discount of health and life insurance;
• paying full or partial fees for smoking cessation programs;
• offering cessation programs on company 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 tobacco-free company policy and setting deadlines for implementing the policy.
Physical Fitness Programs
An active 55-year-old man is able to lead as vigorous a lifestyle as a sedentary 35-year-old.
Differences in work-related exercise has been determined to give a two- to three-fold difference in cardiovascular deaths between active workers and their more sedentary counterparts.
In addition to improving strength, balance, and flexibility, physical activity programs can decrease 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 workplace physical activity programs better fitness and help decrease other health risks, although results related to improved productivity are weak due to lack of methods for accurately calculating productivity.
A very small proportion of worksites have onsite physical fitness facilities.
The majority of workers sponsored fitness programs 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 onsite facilities are available.
Worksite fitness programs may decrease costs to employers by reducing employee medical care claims and expenditures.
People whose weekly physical activity 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.
Health Care costs for obese people are roughly 11% higher than those for thin people.
Nutrition and Weight Control
One-third of the U.S. population is obese to the extent of decreasing their life expectancy.
Improvements in eating habits can decrease the risk of weighty health problems 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 impact of co-workers and management, availability of a daily eating situation, and opportunities for follow-up and monitoring.
Worksite nutrition programs can 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 topics.
Men are less likely to take part in weight-loss programs than are female workers.
Stress Management
Estimates suggest that 50% to 80% of physician visits can be attributed to psychosomatic or stress-related origins.
Business pays many of the costs related to employee stress, both directly in the form of medical care costs and in reduced productivity.
Job factors which are associated with stress include:
• not allowing workers 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-workers or supervisors.
Most workplace stress management programs are implemented as a result of requests from workers.
Stress management programs focus on three types of skills: relaxation skills, coping skills, and interpersonal skills.
Worksite stress management programs are often delivered in one of three formats:
• classes conducted by trained professionals;
• self-learning tools; and
• personal teaching to support with self-assessment, planning for changes, learning new skills and responding to life crises.
The two primary techniques used in workplace stress management programs are:
• teaching people to decrease 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 United States 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.
Workers who routinely 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 productivity, 88% of which is attributed to losses from workforce activities and future earnings.
In corporate settings where safety belt policies, mandating use of belts by those riding in a company vehicle or using a personal vehicle for company business, have been enforced, 60% to 90% use has been stated.
Incentive programs, accompanied by education and use requirement restrictions have resulted in 40% to 70% initial usage rates.
Factors influencing the sources of workplace safety belt programs include:
• active commitment on the part of management;
• clearly defined and well enforced policy of required belt use on the job;
• positive incentives/rewards; and
• ongoing education and training programs.
Case Studies of Company Wellness Programs
Based on an extensive assessment of its all-inclusive employee Company Wellness , 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 benefit of $316 per employee. Their year 9 projected benefit is $677 per employee.
workers at four Johnson & Johnson employers who were exposed to the Company Wellness increased their daily energy expenditure in vigorous exercise by 104% compared to a growth of 33% among workers at employers that were provided only an yearly health screen.
Members in the United Methodist Publishing House’s Company Wellness 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 decreased than projected use in medical care costs for 1985 ($902,116 projected with actual costs $142,884) to the Company Wellness even though the results are not conclusive.
In 1985, the Adolph Coors Business conducted a phone interview of a random sample of its 10,000 workers to determine changes in health practices since the introduction of an employee Company Wellness 4 years earlier. The sample of 495 workers was stratified to match the company profile in terms of age, sex and job description. The survey stated that 65% of respondents started exercising in The last 4 years, 37% had improved their diets, 20% were regular users of the wellness center, 9% had stopped smoking as the result of the company’s smoking cessation program and active 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 workers.
The Coors Business also saw a cost savings from a cardiac rehabilitation program that was begun 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.
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