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Cervical Health Awareness & Cervical Cancer

Cervical Health Awareness & Cervical Cancer

January is Cervical Health Awareness Month, and there’s a lot people can do to prevent cervical cancer. HPV (human papillomavirus) is a very common infection that can cause cervical cancer. About 79 million Americans currently have HPV, but many people with HPV don’t know they are infected.1

Each year, more than 11,000 women in the United States get cervical cancer.1

What Are the Risk Factors for Cervical Cancer?

Almost all cervical cancers are caused by human papillomavirus (HPV), a common virus that can be passed from one person to another during sex. There are many types of HPV. Some HPV types can cause changes on a woman’s cervix that can lead to cervical cancer over time, while other types can cause genital or skin warts.

HPV is so common that most people contract it at some point in their lives. HPV usually causes no symptoms so it can be difficult to determine if you have it. For most women, HPV will go away on its own; however, if it does not, there is a chance that over time it may cause cervical cancer.2

Other things can increase risk of cervical cancer:

  • Having HIV (the virus that causes AIDS) or another condition that makes it hard for your body to fight off health problems.
  • Using birth control pills for a long time (five or more years).
  • Having given birth to three or more children.
  • Having several sexual partners.

The good news?

  • The HPV vaccine (shot) can prevent HPV.
  • Cervical cancer can often be prevented with regular screening tests (called Pap tests) and follow-up care. A Pap test can help detect abnormal (changed) cells before they turn into cancer. Most deaths from cervical cancer can be prevented if women get regular Pap tests and follow-up care.

In support of National Cervical Health Awareness Month, National Cervical Cancer Coalition encourages:

  • Women to start getting regular Pap tests at age 21
  • Parents to make sure pre-teens get the HPV vaccine at age 11 or 12

It is recommended that teens and young adults get the HPV vaccine if they did not get vaccinated as pre-teens. Women up to age 26 and men up to age 21 can still get the vaccine. Visit www.nccc-online.org to learn more.


References:

  1. https://healthfinder.gov/NHO/PDFs/JanuaryNHOToolkit.pdf
  2. https://www.cdc.gov/cancer/cervical/basic_info/risk_factors.htm
Create Your Healthy New Year

Create Your Healthy New Year

It’s that time of the year when we evaluate and set our health goals. Goal setting can be challenging but it doesn’t have to be. Goals help us kick off the new year and should be set throughout the year to help keep us on the path of better health.

To create a happy and healthy new year, you should identify what you want to accomplish and how you will carry out your plan. This is a very important step when planning to make positive changes that help you succeed.

 Set S.M.A.R.T. short-term and long-term goals.

  • S Specific
  • M Measurable
  • A Attainable
  • R Relevant
  • T Time-based

Short-Term Goals

Identify at least two or three of your own short-term goals and write them on the personal goal-setting worksheet. If you have more goals, write them down as well. Remember that each goal should be S-M-A-R-T—specific, measurable, attainable, relevant, and time-based. Setting these short-term goals will help motivate you to make the program a regular part of your life.

Examples: 

  • I will talk to my doctor about starting a healthy eating program.
  • I will buy the equipment I need and get ready to exercise within 2 weeks.
  • I will schedule into my calendar 2 or 3 45-minute blocks of time for exercise each week.
  • I will invite my spouse/friend/family member to join me in these exercises.

Long-Term Goals

Identify at least two or three long-term goals and write them on the personal goal-setting worksheet. If you have more goals, write them down as well. Listing your goals will help you stay with the program, see your progress, and enjoy your success. (Remember to use the S-M-A-R-T technique.)

Examples: 

  • I will do each exercise 2 or 3 times each week. Within 3 months, I will do each exercise with 5 lb. weights.
  • I will lose 20 pounds over next 5 months, focusing on one pound per week.

4 Tips to Help You Reach Your Goals

  1. Establishing a social support network is essential for reaching your health goals. Your social support network should consist of friends, family and co-workers who know about you, your health journey and the goals you have set for yourself. They work to keep you motivated, provide support and accountability to keep you on track and moving forward toward your goal. Start by selecting a few chosen people within your social network and bring them along on your journey to a new and improved you.
  2. Setbacks are only temporary. If your goal is focused on eating better and you have a day when you get off track, don’t throw your entire plan out the window. Instead, recognize that you had a slip and focus on the areas where you could have made better choices. Record your strategies to avoiding slips in a journal or your smart phone and revisit them when you are faced with a similar situation again.
  3. Baby step your way to achieving your goals. We didn’t learn to walk in 30 days, so why should you set short timelines for yourself with big goals? Set smaller tasks that you can accomplish in a shorter amount of time that will help build your confidence toward achieving your goals.
  4. Stick to the plan. Set your goal date and stick to it. Even if you have some setbacks, keep moving toward your goal. There are always things you can do to modify your plan, but stay the course.

References

https://www.cdc.gov/phcommunities/resourcekit/evaluate/smart_objectives.html

https://www.cdc.gov/physicalactivity/

Financial Fitness: Essential to Your Employees’ Wellbeing

Financial Fitness: Essential to Your Employees’ Wellbeing

About half of Americans believe they are unprepared for a sudden financial need such as the purchase of a new car, appliance or furniture or a significant home repair, according to Gallup Daily tracking survey through 2015.1

So how can we get financially fit? How do we find balance between spending and saving – between living in the present and saving for life’s unexpected financial needs? And why is this important?

First let’s define financial wellbeing – it is defined as a state of being wherein you:2

  • Have control over day-to-day, month-to-month finances;
  • Have the capacity to absorb a financial shock;
  • Are on track to meet your financial goals; and
  • Have the financial freedom to make the choices that allow you to enjoy life.

Organizations that don’t implement financial wellbeing into their wellness programs are missing the  mark. In a survey conducted by the American Psychological Association, money is a somewhat or significant source of stress for 64% of Americans but especially for parents of children below the age of 18 and younger adults (77% of parents, 75% of millennials, ages 18 to 35, and 76% of Gen Xers, ages 36 to 49).3

The added financial stress has a significant impact on many Americans’ lives.

“Some are putting their health care needs on hold because of financial concerns. Nearly 1 in 5 Americans say that they have either considered skipping (9 percent) or skipped (12 percent) going to a doctor when they needed health care because of financial concerns.”3

Many adults are coping with health and lifestyle challenges and are beginning to recognize the connection between stress and physical and mental health.

  • Money and work remain the top two sources of very/somewhat significant stress, but in 2015, for the first time, family responsibilities emerged as the third most common stressor (54 percent).
  • The majority of adults report having at least one chronic illness (67 percent). In addition, many adults lack exercise and remain sedentary for much of the day. More than 10 percent of adults also report having a mental health-related diagnosis (13 percent for anxiety disorder and 16 percent for depression).
  • About two in five adults (39 percent) report overeating or eating unhealthy foods in the past month due to stress, compared to 33 percent in 2014.
  • Adults in urban areas have a significantly higher reported stress level on average than those in suburban and rural settings (urban: 5.6 on a 10-point scale, vs. 5.0 for suburban and 4.7 for rural).
  • Almost one-third of adults report that stress has a very strong or strong impact on their body/physical health and mental health (31 and 32 percent in 2015, compared to 25 and 28 percent in 2014, respectively).4

To help employees improve their financial fitness, organizations should provide financial education, programs, and other content into their wellness programs.

Here are 6 ways employees can improve their financial wellbeing:

  1. Make a simple plan to monitor and track your spending habits and to gain control over your financial decision making.
  2. Have a budget and stick to it. Set short-term and long-term goals to provide structure for your financial decision making. For example, set a spending budget for the holidays. More stuff doesn’t mean less stress.
  3. Spend some time researching before making major financial decisions to ensure you make the most-informed financial decisions.
  4. Get smart about money – Use free educational resources available at http://www.consumerfinance.gov.
  5. Don’t compare yourself to others. Compare yourself to your own standards. Don’t purchase things to keep up with the Joneses. Instead think about long-term impacts of every purchase.
  6. Avoid impulse shopping. Keep your spending under control by stopping to think about whether you need that purchase or postpone the purchase to a later date if you can.

References

  1. Gallup, Inc. “Half of Americans Unprepared for Sudden Financial Need.” http://www.gallup.com/poll/188009/half-americans-unprepared-sudden-financial-need.aspx?g_source=FINANCIAL_WELLBEING&g_medium=topic&g_campaign=tiles
  2. Consumer Financial Protection Bureau “Financial well-being: The goal of financial education.” January 2015: http://files.consumerfinance.gov/f/201501_cfpb_report_financial-well-being.pdf
  3. American Psychological Association. “Money Stress Weighs on Americans’ Health” 2015, Vol. 46, No.4 http://www.apa.org/monitor/2015/04/money-stress.aspx
  4. http://www.apa.org/news/press/releases/stress/2015/highlights.aspx
5 Things We Can Do To Cut The Prevalence of Chronic Disease

5 Things We Can Do To Cut The Prevalence of Chronic Disease

Today’s health care costs in the United States are a consequence of poor health. Poor health has cost consequences to organizations, industry and our economy. The impact of poor health on employers includes not only the medical and pharmacy costs but also costs from productivity losses. “As of 2012, 117 million Americans have one or more chronic illnesses, which account for 75% of all health care costs and 70% of deaths in the United States.”1,2

However, there is a light at the end of the health care cost crisis tunnel, and that is prevention. In fact, 96% of all Medicare dollars are spent on chronic conditions that have lifestyle health risk factors.3

Michael Roizen, M.D., Chair Cleveland Clinic Wellness Institute, has determined that there are five behaviors that mitigate chronic disease:

  • walking 30 minutes a day,
  • eating healthy,
  • not smoking,
  • having a waist size that is less than half of your height, and
  • drinking alcohol only in moderation.

If an individual engages in these five behaviors, they typically spend 33% to 50% less on health care costs compared with people who have health risks. Currently, only 4% of Medicare beneficiaries possess these five health behaviors. If 75% of all Americans had these characteristics, more than $600 billion and perhaps up to $1 trillion per year could be saved.4,5,6,7


Dr. Roizen and Dr. Loeppke VideoWatch this video where Dr. Roizen from the Cleveland Clinic and Dr. Loeppke from U.S. Preventive Medicine discuss the 5 things you can do to reduce your risk of chronic disease.

Watch Video!

 

 


Be part of the movement to prevent the health risk factors that lead to chronic disease, to help us move from a reactive sick care system to a proactive health care system.

Here’s to More Good Years®!


References:

  1. Shin-Yi Wu and Anthony Green, Projection of Chronic Illness Prevalence and Cost Inflation (Santa Monica, CA: RAND Health, 2000).
  2. Centers for Disease Control and Prevention,“ Chronic Disease Overview,” 2016. http://www.cdc.gov/nccdphp/overview.htm
  3. Partnership for Solutions, Chronic Conditions: Making the Case for Ongoing Care (Baltimore, MD: Johns Hopkins University and The Robert Wood Johnson Foundation, 2004).
  4. Michael F. Roizen, M.D., and Ted Spiker, This Is Your Do-Over: The 7 Secrets to Losing Weight, Living Longer, and Getting a Second Chance at the Life You Want (New York, NY: Scribner, 2015), introduction, xxiii.
  5. Agneta Åkesson et al., “Low-Risk Diet and Lifestyle Habits in the Primary Prevention of Myocardial Infarction in Men: A Population-Based Prospective Cohort Study,” Journal of the American College of Cardiology 64 (13) (2014): 1,299–1,306.
  6. Andrea K. Chomistek et al., “Healthy Lifestyle in the Primordial Prevention of Cardiovascular Disease Among Young Women,” Journal of the American College of Cardiology 65 (1) (2015): 43–51.
  7. Meir J. Stampfer et al., “Primary Prevention of Coronary Heart Disease in Women through Diet and Lifestyle,” The New England Journal of Medicine 343 (2000): 16–22.
Employee Wellness Program

5 Ways to Spread Workplace Wellness

Look around and you’ll notice we are spending the greatest amount of our time at work; most full-time employees will spend over 2,000 hours at work every year, some even more. This not only minimizes the amount of time we have to spend with family and do the things that make us happy, but it also makes it more difficult to fit in the required physical activity and to make healthier nutrition choices.

We are seeing rates in health care spending on the rise – but also increased rate of chronic diseases such as diabetes, heart disease, heart failure, hypertension, and obesity; many of these could be prevented with a few behavior modifications in our nutrition and physical activity.

According to the Organization for Economic Co-operation and Development (OECD), the United States spends far more on health care than any other nation, yet the life expectancy of the average American is only 78.3 years, which is lower than the average and the lowest among the top health care spending nations. Chronic diseases are responsible for 7 out of 10 deaths every year in the United States, and treating people with chronic diseases accounts for 86% of our nation’s health care costs.¹ Our lifestyle choices in this country are partially to blame.

Spending more on health care is not making us healthier nor bringing us longevity; we are realizing that prevention is considerably cheaper than managing any health condition and/or chronic disease. As a result, wellness is getting a lot of attention lately as we become more aware that we own our health and have complete control of our wellness.

Many businesses are adopting new approaches and beginning to implement workplace wellness programs – which are proving essential for creating and maintaining healthier, happier, hard-working employees while reducing the costs of health insurance claims, absenteeism and receiving maximum productivity in return. Happy, healthy employees are more productive. It’s nothing short of a win-win symbiosis.

So, what is a workplace wellness program? A successful workplace wellness program enables employees to increase control over, and improve, their health by offering healthier opportunities and empowering them to make healthier choices with ease.

The wellness program may offer risk assessments, screenings, flexibility for time to exercise, healthier snacking options in vending machines, behavior modification, educational and tobacco cessation programs, and much more. Access to a wellness program gives the employee the opportunity to take care of their health on a more regular basis and reduce stress. Offering incentives may also be used to encourage employee participation and increase engagement.

Here are a few low-cost tips to get you started on spreading workplace wellness and transforming your organization into one of the best places to work:

  1. Healthy Pantry Club: Start a healthy pantry stocked with healthy choices essential to a healthy diet and productivity at work. Keep it junk-food free by stocking it with healthy snacks, fresh fruits, vegetables and low-sugar, low-sodium drinks. A contribution box for employees to donate to keep the pantry stocked is a great way to get everyone involved.
  2. Fitness Trackers: Fitness trackers can encourage employees to increase their steps while being more active through participation in challenges that will keep them motivated and mindful of their health and nutrition choices. Office challenges are a fun way to increase steps and also build camaraderie. Award prizes for the top stepper, wellness champion, best effort, etc.
  3. Office Gym or Gym Memberships: Transform an unused office or space into a gym by adding yoga mats, free weights, and other fitness equipment. This helps the strapped-for-time employee fit exercise into their busy schedule. Subsidize or reimburse gym membership fees bringing fitness within reach for all employees to help create a routine they can stick with.
  4. Walking Meetings: Incorporate moving meetings to stimulate creativity and new ideas by walking around the building. Physical activity gives you energy and makes you feel more alert.
  5. Wellness Communications: Communication is the key to a successful wellness program. Get employees excited and engaged by sending wellness communications that provide ideas, strategies, short articles, tips, recipes, reminders and more. Create awareness posters and flyers to display around the office and coordinate your content with the seasons of the year, and monthly health observances.

Remember, it’s not the number of extravagant perks you offer, it’s how successful you are at fulfilling the employees’ basic human and emotional needs to foster a healthy, conscious, and happy environment that inspires employees to be their best.


Written by: Sonia Rosemond, USPM Marketing Content Designer


References:

http://www.cdc.gov/chronicdisease/

https://data.oecd.org/healthres/health-spending.htm

http://www.oecd.org/unitedstates/Briefing-Note-UNITED-STATES-2014.pdf

http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT

http://www.oecd.org/els/health-systems/health-data.htm

Reducing Stress With Online Mindfulness Program

Reducing Stress with Online Mindfulness Programs – At a Fraction of the Cost of Traditional Programs

Thomas J. Morledge, MD, Didier Allexandre, PhD, Emily Fox, MBA, MSSA, LSW, et al. “Feasibility of an Online Mindfulness Program for Stress Management – A Randomized, Controlled Trial.” JOEM. Volume 58: Number 3, March 2016.

ABSTRACT:

  • Purpose: This study aims to determine feasibility of an 8-week Internet-based stress management program (ISM) based on mindfulness principles in reducing stress in a 12-week, parallel, randomized, controlled trial.
  • Methods: Participants were randomly allocated to ISM, ISM plus online message board (ISM+), or control groups. Perceived stress, mindfulness, self-transcendence, psychological well-being, vitality, and quality of life were measured at baseline, week 8, and week 12 using standard validated questionnaires.
  • Results: ISM and ISM+ groups demonstrated statistically significant improvements compared with control on all measures except vitality and physical health.
  • Conclusions: The ISM program effectively and sustainably reduced measures of stress. The magnitude of improvement is comparable to traditional mindfulness programs, although fewer participants were engaged. This feasibility study provides strong support for online stress management programs, which increase access at a fraction of the cost of traditional programs.

Chronic stress affects many Americans – approximately 35% of North Americans are affected by severe psychological stress.1 Stress is a major public health issue, and calls have been made for better access to stress management programs to prevent and manage chronic diseases. Stress can be reduced by “cultivating mindfulness, a state of consciousness that focuses on individual’s attention and awareness on the present moment and developing a nonjudgmental, conscious awareness of the moment-to-moment experience of one’s environment, thoughts, feelings, and actions.”2, 3, 4

However, stress management programs may be expensive or have limited access. The purpose of this study was to determine the feasibility of an 8-week Internet-based stress management program (ISM) based on mindfulness principles in reducing stress in a 12-week, parallel, randomized, controlled trial.

The 12-week, randomized, parallel, controlled trial was administered entirely online at the program Website. Participants provided their name and e-mail address and were automatically randomized (using a computer-generated list with a block size of three) into one of three groups: ISM, ISM plus online message board (ISM+), or control. All participants were asked to complete online questionnaires at 0 (baseline), 8, and 12 weeks and to fill out weekly activity logs for weeks 1-8. ISM+ group was asked to participate in an online message board hosted by iVillage.com.

Since high dropout rates are expected for online studies 5, 6, 7, the study enrolled approximately 700 people to obtain the target sample size.

  • 1,204 people received the study description, and 684 (57%) people enrolled in the study between September 2010 and August 2011.
  • The study ended in November 2011. Of those enrolled, 133 (19%) were lost prior to providing baseline data.
  • Of the remaining (81%) who enrolled and completed the baseline questionnaire (n=551), more than half (57%) also completed one or both follow-up questionnaires (n=312).
  • The 8- and 12-week completion rates differed across treatment groups: 41 and 33% for ISM, 44 and 38% for ISM+, and 67 and 65% for the control group at weeks 8 and 12, respectively.

This study demonstrates that Internet-based stress management program (ISM) participants experienced significant reductions in stress. The study found that a person who practices meditation techniques an average of 5 times/week will experience a 6.12 decrease (1.53 times 4) in Perceived Stress Scale (PSS) score versus practicing once per week.

Feedback about the ISM program and message board was provided by 78 ISM and 68 ISM+ participants who practiced the relaxation exercise at least once. Of those respondents, 45% found the overall program to be very or extremely helpful, 35% somewhat helpful and 19% little or not at all helpful.

Approximately one third (35%) of all ISM and ISM+ enrollees showed online program activity for 6–8 weeks, and 42% completed the questionnaires at 8 weeks. Program and study retention may be lower than most small-sample size studies of Web-based programs for psychological disorders, which range from 17 to 98% with an average of about 70%6 ; the rates are comparable to larger effectiveness studies5,7 and may be more reflective of real-world settings.

When asked about how helpful and beneficial specific components were, 53% found the meditation techniques, 43% the weekly audio lesson and 48% the articles to be very or extremely helpful.

This study demonstrated an 8-week ISM program could feasibly and effectively reduce stress. Benefits were sustained through week 12 for a well-educated, mostly female and computer savvy self-selected population. Although the participant completion rate was low, the magnitude of improvement was significant for those who completed the online program. This study provides support for online stress management programs that are publicly accessible and not cost prohibitive.

About USPM and Cleveland Clinic

U.S. Preventive Medicine (USPM) partnered with the Cleveland Clinic Wellness Institute in an innovative strategic partnership to integrate their next generation information technology platform and population health management services with their best-of-class wellness programs and e-Coaching services. Cleveland Clinic Wellness focuses on changing behavior in the “Big 4” causes of chronic diseases (food choices, tobacco, physical inactivity, and stress) through programs such as Healthy Performance with Stress Free Now, Cleveland Clinic Wellness e-Coaching, and interactive online programs Stress Free Now, Go! Foods, and Go! to Sleep. Cleveland Clinic’s Healthy Performance with Stress Free Now and CC e-Coaching have driven remarkable results across a wide variety of industries. Cleveland Clinic has led numerous successful community and institutional campaigns committed to improving the lives of children and adults. Also, in 2005 they were the first hospital to become a smoke-free workplace.


References

  1. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case–control study. Lancet. 2004;364(9438):937-952. doi:10.1016/S01406736(04)17018-9.
  2. Baer RA.Mindfulness training as a clinical intervention: A conceptual and empirical review. Clin Psychol Sci Pract. 2003;10(2):125-143.
  3. Shapiro SL, Oman D, Thoresen CE, Plante TG, Flinders T. Cultivating mindfulness: Effects on well-being. J Clin Psychol. 2008;64(7):840-862.
  4. Chiesa A, Serretti A. Mindfulness-based stress reduction for stress management in healthy people: A review and meta-analysis. J Altern Complement Med. 2009;15(5):593-600.
  5. Meyer B, Berger T, Caspar F, Beevers CG, Andersson G,Weiss M. Effectiveness of a novel integrative online treatment for depression (Deprexis): Randomized controlled trial. J Med Internet Res. 2009;11(2):e15.
  6. Melville KM, Casey LM, Kavanagh DJ. Dropout from Internet based treatment for psychological disorders. Br J Clin Psychol. 2010;49(Pt 4):455-471.
  7. Verheijden MW, Jans MP, Hildebrandt VH, Hopman-Rock M. Rates and determinants of repeated participation in a Web-based behavior change program for healthy body weight and healthy lifestyle. J Med Internet Res. 2007;9(1):e1.
Healthy Workplace Healhty Performance

Can a Healthier and Safer Workforce Promote a Healthier Bottom Line for Employers?

Fabius, R; Loeppke, R; Hohn, T: et.al. “Tracking the Market Performance of Companies That Integrate a Culture of Health and Safety: An Assessment of Corporate Health Achievement Award Applicants”. JOEM. Volume 58: Number 1. Jan, 2016.

ABSTRACT:

  • Objective: To test the hypothesis that comprehensive health and safety efforts, judged separately on their merits by the CHAA, contribute to better performance in the marketplace.
  • Methods: Stock market performance of CHAA winners tracked under 6 different scenarios using simulation and past market performance.
  • Results: The results demonstrate that a portfolio of companies recognized for excellence in workforce health or safety, or both, outperform in the marketplace. When we deconstructed the CHAA process and established portfolios among the applicants and award winners that achieved threshold scores in either health or safety as well as threshold scores in both, all significantly outperformed the S&P 500 standard index companies.
  • Conclusions: This study adds to the growing evidence that a healthy and safe workforce correlates with a company’s performance and its ability to provide “healthy” returns to shareholders.

A growing body of evidence supports the notion that focusing on the health and safety of a workforce is good business. Engaging in a comprehensive effort to reduce the health risks of a workforce and mitigate the complications of chronic illness within these populations, can produce remarkable impacts on health care costs, productivity and performance.

To more objectively test this hypothesis, the stock market performance of the prior American College of Occupational and Environmental Medicine (ACOEM) Corporate Health Achievement Award (CHAA) winners were tracked under 4 different scenarios. Using simulation and past market performance, a theoretical initial $10,000 investment in publicly traded award winners was tracked from 1999 to 2012.  This portfolio of publicly traded award winning companies clearly outperformed the market. Though correlation is not the same as causation, the results consistently and significantly suggest that companies focusing on the health and safety of their workforce are yielding greater value for their investors as well. More research needs to be done to better understand the value of building these “cultures of health” in the workplace. Perhaps such efforts as this simply identify “smart” companies that outperform. But the evidence appears to be building that healthy workforces provide a competitive advantage in ways that benefit their investors.

The literature is replete with examples demonstrating that the health of employees impacts their performance and productivity. Additionally, for the majority of employers who pay for the cost of health care provided to their employees there is a direct impact on the bottom line.

Consider these statistics:

  • Over 22% of working age adults surveyed reported health-related work impairment from chronic illness in the previous 30 days. Those with impairment average 6.7 lost days. This is equivalent to $2.5 billion impaired days per year.(1)
  • In a 2003 study, it was found that illness and disability reduces total work hours by approximately 8.6%, with nearly 8.7 million Americans unable to work. The loss to the U.S. economy represented about $468 billion.(2) In 2006, over $2 trillion was spent on health care with three-fourths of that amount focused on treating chronic conditions.(3)
  • In a multi-employer study by ACOEM, IBI and Dr. Kessler of Harvard Medical School, Loeppke, et.al., reported that for every dollar of medical and pharmaceutical costs spent an employer lost an additional $2.30 of health-related productivity costs. Health-related presenteeism was shown to have a larger impact on lost productivity than absenteeism, with executives and managers suffering higher losses. Co-morbidities demonstrated the largest effects on productivity loss.(4) 

These facts led to a hypothesis: Companies that envelope their employees and dependents in an environment that reinforces conscious and unconscious lifestyle choices as well as more effective accessing of healthcare, i.e. surround them with a “culture of health,” should be more productive and that productivity should be reflected in the price of their stock.

To test the hypothesis, we turned to the American College of Occupational & Environmental Medicine’s corporate health awards (http://www.chaa.org/). The Corporate Health Achievement Award (CHAA), established in 1997, recognizes organizations with exemplary health, safety and environmental programs. Participating organizations submit a comprehensive application about their program and undergo a rigorous review by an expert panel to assess four key categories:

  1. Leadership & Management
  2. Healthy Workers
  3. Healthy Environment
  4. Healthy Organization

Awards have been given to organizations in manufacturing and service sectors, including city health departments, federal agencies and healthcare systems. Most years since inception of the award there has been at least one recipient. Most recipients have been publicly traded companies.

Since these award-winning companies are recognized for their exemplary efforts in creating a healthy workforce and since a healthy workforce generates less health care costs and improved productivity, we tested the thesis that a portfolio of these companies would outperform the marketplace.

Our results strongly support the notion that focusing on the health and safety of a workforce is good business. Engaging in a comprehensive effort to reduce the health risks of a workforce and mitigate the complications of chronic illness within these populations, can produce remarkable impacts on health care costs, productivity and performance.

Dee Edington, Ph.D., has demonstrated that companies who do not pay any attention to elevating the health status of their workforce will see their employees developing increasing health risks and health care costs.(12) His results found that non-managed workforces acquire increased health risks and conditions resulting in increased costs over time. In fact, his research found that within non-managed populations the low risk cohort diminishes by roughly 5% while the moderate and high risk segments increase by roughly 8% and 11% respectively over a three-year period. He also demonstrated that it is possible to markedly reduce this trend through the execution of risk reduction programs at the workplace.(13)

Preventive services can stem the progression of health risks, chronic conditions and medical costs. RAND Corporation estimates one fifth of all healthcare expenditures will be devoted to treating consequences of obesity by 2020. Lowering obesity rates to 1998 levels could lead to annual productivity gains of $254 billion as well as the avoidance of $60 billion in annual treatment expenditures.

Seven chronic conditions (cancer, heart disease, hypertension, mental disorders, diabetes, pulmonary conditions and stroke) are currently costing the U.S. economy alone more than $1 trillion per year. Assuming the current trend continues to 2023, it would lead to a 42% increase in cases of the seven chronic diseases for a total of 230.7 million cases of these diseases with $4.2 trillion in treatment costs and lost economic output.

Plausible estimates of potential gains in 2023 associated with reasonable improvements in prevention, detection and treatment of just those seven conditions include:

  • Preventing 40 million fewer cases of illness
  • Cutting annual treatment costs in the U.S. by $217 billion
  • Reducing annual health-related productivity losses by $905 billion
  • Yielding more than $1 trillion in labor supply and efficiency(14)

Employers can realize similar results by implementing the best efforts in prevention, early detection and evidence based treatment for their workforce and covered lives.

A critical Meta-Analysis of 22 research studies in the scientific literature published in Health Affairs in February 2010 showed that medical and pharmacy costs fall by about $3.27 and absenteeism costs fall by about $2.73 for every $1 invested in wellness.(15)  This results in a return on investment of six to one.

Recognizing the merits of a healthy workforce even before this paper, ACOEM provided significant guidance. The College has stated that the marketplace has markedly underestimated the full impact of poor health in the workplace and on the economy. Employers would benefit by having a better understanding of the diseases and conditions that impact their employees and covered lives so that they could implement programs to mitigate their consequences. There is a connection between the health and safety and the productivity of workforces. Health care costs should be viewed as an investment in their employees rather than an expense. Health improvement strategies have proven to produce excellent returns. Comprehensive programs focus on primary, secondary as well as tertiary prevention.(16)

The workplace offers unique advantages for the implementation of health improvement initiatives. Roughly one quarter of our population is employed. When including retirees and family members this reach includes the majority of Americans. The workplace environment and the corporate culture can reinforce healthy behaviors. Powerful communication and educational assets can be leveraged. Incentives, penalties and mandates can be built into compensation and health benefits. Tenured employee relationships can promote sustainability. And finally employers possess the capability to measure the impact of health improvements on performance, productivity and business results.

The logic behind investing in workplace health is straight forward.

  • A large proportion of illness is preventable by reducing health risks. (17)
  • Health risks can be improved through workplace health programs. (18)
  • Reductions of health risks can lead to reductions in health costs. (19)
  • Worksite health programs can produce a positive ROI and VOI. (20,21,22,23,24)

Moreover, research supports a corporate-wide impact. Towers Watson has demonstrated that employers with highly effective health and productivity programs:

  • Generate 20% more revenue per employee
  • Realize a 16.1% higher market value and
  • Deliver 57% higher shareholder returns(25)

A recently published paper by Loeppke et al(26) emphasized the importance of integrating health promotion and health protection. This paper suggests that the CHAA assessment process should be realigned to follow the format of the DJSI. The CHAA’s current categories of measurement would be converted to mirror the DJSI’s categories, which include economic, environmental, and social metrics. This would result in an Integrated Health and Safety Index (IH&S Index).

Imagine a future scenario in which employers of sufficient size would be required or encouraged to publicly report on the degree to which they have achieved a culture of integrated health and safety. Those that report high Integrated Health and Safety Index scores could potentially be rewarded in the marketplace with greater investment as well as premium cost-reductions for group health and/or workers’ compensation insurance.

This would provide a major incentive for more companies to focus on the health and safety of their workforces and markedly aid in addressing many of the factors that are driving the American health care crisis—including the rise of chronic disease. If enough companies were able to improve and sustain the health status of their workforces, it could impact millions of Americans, providing a national tipping point in our effort to improve health outcomes and lower costs. The data in this paper suggest that such an effort might also contribute to investment-oriented opportunities and company differentiation in the marketplace.

Integrating health promotion (wellness) and health protection (safety) strategies creates synergy among these efforts, enhancing the overall health and well-being of the workforce, empowering employees to perform at the height of their potential and improving the organization’s bottom line.


References:

  1. Kessler et al. the Effects of Chronic Medical Conditions on Work Loss and Work Cutback. JOEM. 2001; 43(3):218-225.
  2. Berger, M, et al. Investing in Healthy Human Capital. JOEM. 2003; 45(12):1213-1225)
  3. Goetzel R. Do Prevention or Treatment Services Save Money? The Wrong Debate. Health Affairs. 2009; 28(1):37-41.
  4. Loeppke, R., et al., “Health and Productivity as a Business Strategy: A Multi-Employer Study”, JOEM, 51:4, April, 2009. pp 411-428.
  5. Peterson K W, Yarborough CM III, Ferguson EB, Matthew SJ. ACOEM Award: The American College of Occupational and Environmental Medicine’s Corporate Health Achievement Award.J Occup & Environ Med. 1996;38(10):969-972.
  6. Baldrige Award Winning Quality, 17th edition, by Mark Graham Brown, CDC Press, 2008.
  7. Malcolm Baldrige National Quality Award. [website]
  8. C. Everett Koop Award [website]
  9. Yarborough, CM. Administrative Track: What Constitutes Excellence for the Corporate Health Achievement Award. J Occup & Environ Med. 1998;40(4):381.
  10. Scope of Occupational and Environmental Health Programs and Practice. J Occup Environ Med. 1992;34:
  11. NCQA. Health Evaluation Data Information Set (HEDIS) 3.0. Washington, DC. National Commission on Quality Assurance. 1996.
  12. Edington, AJHP, May-June 2001, Vol 15, No. 5, pp-341-349. Research Overview of Natural Flow
  13. ZERO TRENDS by Dee Edington, 2009, published by the Health Management Research Center – University of Michigan
  14. Loeppke, R; Edington, D; Bender, J; Reynolds, A. “The Association of Technology in a Workplace Wellness Program with Health Risk Factor Reduction” Journal of Occupational and Environmental Medicine: March, 2013; Volume 55, Number 3: pp 259–264.
  15. Devol, R et.al, 2007, An Unhealthy America: The Economic Burden of Chronic Disease. Charting a New Course to Save Lives and Increase Productivity and Economic Growth, Milken Institute
  16. Baicker, K., et.al., Workplace Wellness Programs Can Generate Savings., Health Affairs, Feb. 2010, Vol 29, No. 2. pp: 1-8
  17. ACOEM Guidance Statement, Healthy Workforce/Healthy Economy: The Role of Health, Productivity and Disability Management in Addressing the Nations’ Health Care Crisis, JOEM, 51:1, pp 114-119, January, 2009.
  18. Healthy People 2000, 2010; Amler & Dull, 1987; Breslow, 1993; McGinnis & Foege, 1993; Mokdad et al., 2004.
  19. Loeppke, et al., 2008; Wilson et al., 1996; Heaney & Goetzel, 1997; Pelletier, 1999.
  20. Edington et al., 2001; Goetzel et al., 1999
  21. Aldana SG. Financial impact of health promotion programs: A comprehensive review of the literature. Am J Health Promotion 2001;15:296-320.
  22. Loeppke R. “The Value of Health and the Power of Prevention”. Int J Workplace Health Manage. 2008; 1(2):95-108.
  23. Serxner, S., et.al., Do Employee Health Management (EHM) Programs Work? Am J Publ Health2009; 23(4):
  24.  Goetzel, R; Loeppke, R, et al. “Do Workplace Health Promotion (Wellness) Programs Work.” J Occup Environ Med. 2014; 56 (9):927-934, September, 2014.
  25. National Business Group on Health/Watson Wyatt “Staying at Work Report” 2007/2008 from Survey of 355 Large Employers
  26. Loeppke, R; Hohn, T; et.al. “Integrating Health and Safety in the Workplace: How Closely Aligning Health and Safety Strategies can Yield Measureable Benefits.” Journal of Occupational & Environmental  Medicine 2015: 57 (5): 585-597. May, 2015.

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