Changes that Work The Healthy Worksite Initiative HWI Outcomes Conference Kathy Reims, MD September 23, 2009

Aim Develop and refine interventions that influence health behaviors and lifestyle choices, resulting in improved employee health status and eventually positively impacting the rising health care cost trend

Legislated Measures Reduction in % of population that is overweight or obese (HRA and biometrics) Reduction in risk factors related diabetes (biometrics) Reduction in high cholesterol (biometrics) Reduction in high blood pressure (biometrics) Reduction in risk factors related to absenteeism HRA and WLQ) Reduction in tobacco consumption (HRA and claims) Increase in appropriate use of preventive health services (claims)

Measures Identify agency policy, environment and “culture” changes that contribute to improved employee health status “What can the agency do?” Increase percentage of employees who are in the low risk category (0-2 risks from HRA) “Is the population getting healthier?”

Program Components  Onsite biometric screening and health risk assessment every six months  Individual, environment, and policy interventions  Focus on changes that the agency can make to improve employee health

Guiding Change  IHI Breakthrough Series  Expert Panel  Change Package  Results-oriented approach

HWI Change Package

Participation 38% of the eligible population screened at least once. (Range 23 – 76%)

Identified Risks: 3898 screenings

Demographics

Obesity Trends* Among U.S. Adults BRFSS, 2008 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Context to Consider Weight Trends  National statistics show that weight gain during adulthood has increased by > 50% in the past 30 years.  Weight gain in young adults 18 – 30 averages about 1 kg/year.

Overweight or Obese 31 % lost 6 or more pounds in one year!

Diabetes Risk Factors (Physical inactivity, Overweight, Hypertension, Lipid, FBG>100)

Cholesterol (Total, HDL, LDL, Triglycerides)

High Blood Pressure Systolic >120 and/or Diastolic > 80 decreased from 68% to 63% Physical Activity Those who were inactive decreased from 54% to 46%

Overall Risks (BP > 120/80, lipid, inactive, BMI>25, FBG > 100) 9% Decrease

Employees took Action

Affirmation of the Effort 69% agreed that “HWI provided new information about myself.”

Take Home Points  High level of risk identified  Early data encouraging that risks can be diminished  Employees took action to improve their health and felt supported by agencies