Wellness and Lifestyle: A Win, Win, Win Iowa Health Buyers Alliance Seminar October 25, 2006 Kerry Juhl, Executive Director Wellness Council of Iowa

Optimal Health “Optimal health is a balance of emotional, social, spiritual, physical and intellectual health.” Source: American Journal of Health Promotion

The Wellness Continuum

How Healthy Are We? About 108 million people in the United States have at least one chronic disease such as heart disease, diabetes, asthma, hypertension, or osteoarthritis. Five chronic diseases (cancer, heart disease, stroke, chronic obstructive pulmonary disease and diabetes) cause more than 67% of all deaths each year Chronic disease is not just an issue among older adults... 33% of the years of potential life lost before age 65 is due to chronic disease

Why Wellness = Win, Win, Win! Six Reasons

Reason #1: Our Citizens Are Not the Healthiest Almost 170 million Americans don’t get enough daily physical activity. Approximately 42 million Americans aren’t active at all. 64% of Americans are overweight or obese. Tobacco use continues to be popular even though a leading cause of death % of visits to primary care physicians are for stress related conditions.

Most Costly Risk Factors Health Enhancement Research Organization (HERO) (Percentage Differences In Average Annual Medical Expenditures For High-risk Vs. Lower-risk Employees.) Depression Stress High Stress High Blood Glucose Weight Former Tobacco Current Tobacco High Blood Pressure No Exercise

The Case for Low-Risk Maintenance “New evidence suggests that helping low-risk employees (the majority of any employee population) to maintain their low-risk health status has the potential to generate a major return on investment.” D.W. Edington, PhD University of Michigan Health Management Research Center

Reason #2: Much Illness is Preventable As much as 70% of illness and the associated costs are preventable. The leading causes of death in the U.S. are all related to lifestyle, yet little is spent on prevention: 95% of health expenditures are for evident illness. 400,000 deaths from smoking annually 300,000 deaths from poor nutrition and inactivity 100,000 deaths from alcohol related causes

“Each year in the U.S., 1.7 million people die of preventable chronic illnesses (like diabetes and heart disease). There’s no bioterrorism attack that would ever be that devastating.” Tommy G. Thompson Former Secretary, U.S. Health and Human Services

Reason #3: The Worksite is An Ideal Setting The majority of Americans work and spend most of their waking hours at the worksite. Employers have a vested interest in health- related issues. They and their employees are the primary purchasers of healthcare. Opportunity to partner: medical costs consume both corporate profits and employee paychecks.

Strategy for Change “The purpose of worksite wellness is not to change people, but to change the culture.” »D.W. Edington, University of Michigan

Reason #4: Wellness Works! There have been over 125 health enhancement research studies peer reviewed and published showing positive clinical, behavioral and/or ROI results.

Proof Does program participation have value? YES Participation has a significant impact on health risk for low and high risk employees (GM Lifestep, AJHP, 2001; J&J Pathways to Change, J Occup. Environ. Med., 2002) What happens when risk status changes? HEALTH CARE COSTS CHANGE Largest increases in average cost occur when employees move from low to high risk, greatest reductions in average cost occur when employees move from high to low risk status (J Occup Med., 1997) Does participation affect disability days and absenteeism? YES The more active participation, the greater the decrease in disability days (Dupont, AJHP, 2001) and absenteeism (HWP, AJHP, 2001)

Reason #5: More and More Employers Are Doing It! 90% of U.S. companies sponsor at least one health promotion activity. Innovative employers of all sizes and industries are seeing the value of proactively managing employee health and productivity: Investing in Human Capital. Wellness links a benefits strategy with a business strategy.

Reason #6: Healthcare Costs Are (still) Causing Concern Health care expenditures topped $1.9 trillion (NCHC) Annual premiums for family coverage reached $10,880 in 2005, eclipsing the gross earnings for a full-time, minimum wage worker ($10,712) (HRET) By 2017, it is estimated an employer will pay more in health/benefits than for wages/salary. (NCHC) This year, Starbucks will pay more for employee health insurance than they do for coffee (Starbucks) Experts contend that the only long-term solution to managing costs is to keep people healthy.

A Window of Opportunity The cost of health care is beyond what employers can afford and will increase exponentially over the next decade. Employers don’t know what to do. An unprecedented opportunity to establish the importance and effectiveness of optimal health as an investment in human capital.

In Order To Improve Health And Contain Costs, Worksite Wellness Programs Need To Be Carefully Designed

How do you build a healthy workforce? Results-Oriented vs. Activity-Centered –Activity-Centered: typically is short-lived and contributes little to the bottom line –Results-Oriented: success lies in constructing a firm foundation and making a long-term commitment Worksite health initiatives must be based on business outcomes Data collection is essential

The Seven Benchmarks 1.Capturing Senior Level Support 2.Creating Cohesive Teams 3.Collecting Data 4.Crafting an Operating Plan 5.Choosing Appropriate Interventions 6.Creating Supportive Environments 7.Carefully Evaluating Outcomes

Well Workplace University© 2000 Wellness Councils of America Why Senior Level Support? It’s essential for the integration of health promotion into the organization It’s necessary to secure financial resources It’s instrumental in implementing supportive corporate policies It’s key to tying health promotion objectives to business outcomes Benchmark #1

Role of The Wellness Team: What does the wellness team do? Establishes vision Collects data Determines goals & objectives Sets realistic timelines & budgets Communicates results Oversees the wellness program Benchmark #2

Well Workplace University© 2000 Wellness Councils of America Business Needs-Data Demographic Information Health Risk Appraisals Health Screening Data Medical Claims Disability Absenteeism Facility Assessment Culture Audits Benchmark #3

Why Plan? Forces you to consider your company’s needs, and strategic priorities Legitimizes and communicates your program to senior managers Gives your program continuity through personnel changes Provides energy to get your program moving Helps to stay focused. Benchmark #4

How Much Will it Cost? In health promotion, we often invest too little and expect too much. “Investing $100-$150 per employee, per year can generate $300-$450 ROI” Ron Goetzel, Director, Cornell University Institute for Health and Productivity Studies

Most Frequently Addressed Programming Areas Smoking Cessation Physical Activity Nutrition/Weight Control Hypertension Alcohol Seatbelts Mental Health Medical Self-care Stress Management Disease Management Personal Finance Immunization Ergonomics Work/Family Benchmark #5

Five big ideas for transforming your workplace into a supportive environment: Friendly facilities Proactive policies Consistent recognition and rewards for success Managers model and support healthy behavior Ongoing health promotion program Benchmark #6

Common Targets of Evaluation Participation rates Participant satisfaction Knowledge and skills Reduced risk factors Absenteeism rates Workers compensation claims Health care claims Turnover and ability to attract new employees Benchmark #7

Increased participation rates from 62% to 98% Absenteeism rates 28% less for wellness participants vs. non-participants Tobacco use decreased from 21% to 8% Elevated cholesterol levels decreased from 50% to 37% Weight decreased from 66% being overweight to 41% overweight

The Seven Benchmarks 1.Capturing Senior Level Support 2.Creating Cohesive Teams 3.Collecting Data 4.Crafting an Operating Plan 5.Choosing Appropriate Interventions 6.Creating Supportive Environments 7.Carefully Evaluating Outcomes

Be Healthy, Live Longer Steven Aldana, PH.D. People WhoLive an extra Are vegetarian1.5 years Exercise regularly2.4 years Eat nuts five times a week2.5 years Have normal blood pressure3.7 years Are not diabetic6.6 years Maintain normal weight11 years

8 Commandments for Living Long and Well (Dr. Edward T. Creagan, M.D.) Form stable long term relationships Maintain ideal body weight Eat a plant based diet Engage in regular physical activity Longevity does not allow for smoking Use alcohol in moderation, if at all Foster a sense of spirituality Find meaning and purpose in life.

Wellness and Lifestyle: A Win, Win, Win By investing in worksite wellness: Employee WINS: reduced risk, healthier, happier, longer lives Employer WINS: increased work performance, reduced health care utilization, moderation of costs, retention and recruitment Community WINS: reduced health risks, higher quality of life, economic impact

“ The function of protecting and developing health must rank even above that of restoring it when it is impaired.” Hippocrates