1. Healthy Business Bloomington Breakfast August 15, 2013

2.  U.S. has the highest level of medical care spending  U.S. ranks either all or below most other wealthy countries on many health indicators ◦ Life expectancy at birth ◦ Mortality rates among people aged <50 including rates of infant, maternal, and child mortality ◦ Rates of low birth weight and premature birth ◦ Prevalence and mortality rates for heart disease, diabetes, respiratory disease, infectious diseases, and both intentional and unintentional injuries ◦ Disability rates Source: RWJF Commission to Build a Healthier America, Overcoming Obstacles to Health in 2013 and Beyond, 2013

3. Source: America’s Health Ranking, 2012 Annual Report (http://www.americashealthrankings.org/IN/2012). High smoking rate (adults) High obesity rate (adults) High chronic disease rate One of the lowest amounts of public health funding Health disparities

4.  Most costly, common, and preventable  Obesity, Smoking, Diabetes, High Blood Pressure, High Cholesterol rates are higher than U.S. rates  Leading cause of death and disability  Heart disease leading cause of death  Almost half of adults reported history of at least one chronic disease (2010)

5. 1. Reduce Infant Mortality 2. Reduce Adult Smoking 3. Reduce Adult Obesity 4. Increase Childhood Immunizations (19-35 month-olds primary focus)

6. Total Infant Mortality Rates by State, 2010 Source: Murphy SL, Xu JQ, Kochanek KD: Final Data for 2010. National Vital Statistics Reports; vol 61 no 4. Hyattsville, MD: National Center for Health Statistics. 2013. =7/1000 LB

7. Black Infant Mortality Rates by State, 2010 No color: less than 20 deaths, rates unstable and suppressed Source: Murphy SL, Xu JQ, Kochanek KD: Final Data for 2010. National Vital Statistics Reports; vol 61 no 4. Hyattsville, MD: National Center for Health Statistics. 2013. =13/1000 LB

8. Smoking Prevalence Among U.S. Adults, BRFSS, 2012 Source: Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2012. =25%

9. Obesity Prevalence* Among U.S. Adults, BRFSS, 2012 *BMI=>30.0 - or a person 5 feet 6 inches tall weighing 186 or more pounds. Source: Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2012. =30%

10. Percent of Adults with >=150 Minutes of Physical Activity per Week, BRFSS, 2011 Source: Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011 >54.3% 48.2-54.2% <=48.1%

11. Adults Consuming Fruits/Vegetables Five or More Times per Day by State, BRFSS, 2009 Source: Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2009. 25.0-31.5% 20.0-24.9% 14.6-19.9%

12. Depression* Prevalence Among U.S. Adults, BRFSS, 2012 *Ever told you have a form of depression. Source: Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2012. 11.5-14.8% 15-19.9% 20-23.5%

13. Good or Better Health* Among U.S. Adults, BRFSS, 2012 *Adults reporting their general health status as excellent, very good or good Source: Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2012. 85.1-88.3% 80.0-84.4% 74.8-78.9%

14.  143,479 worksites in Indiana  85% have 50 employees  2,440,507 paid employees  Top industries (55% of worksites)  Retail; other services (except public administration); healthcare and social assistance; construction; and professional, scientific, & technical services Source: 2011 County Business Patterson (NAICS). http://censtats.census.gov/cgi-bin/cbpnaic/cbpsect.plhttp://censtats.census.gov/cgi-bin/cbpnaic/cbpsect.pl

15. Lost Productivity (Indirect Costs) Presenteeism Short-term Disability Long-term Disability Absenteeism Workers Compensation Healthcare (Direct) Medical Pharmacy Impact of Employee Health Visible Costs Non-Visible Costs Indirect costs represent 2-3 times direct health- care costs Source: Adopted from the CDC National Healthy Worksites Program.

16. For every wellness dollar spent, medical costs fall about $3.27, productivity increases, and absenteeism costs fall by about $2.37.  Increase health care costs  Most illnesses can be avoided  The work week is getting longer  Technology  Increased employee stress levels  Increased diversity in workforce Source: http://healthyamericans.org/assets/files/Provide%20Workplace%20Wellness%20Programs03.pdfhttp://healthyamericans.org/assets/files/Provide%20Workplace%20Wellness%20Programs03.pdf http://www.welcoa.org/6_reasons.html

17. Workplace Health Program Health- Related Program Health- Related Policies Health Benefits Environ- mental Supports Comprehensive Worksite Health Program = Results Evidence-based Strategies and Interventions

18.  Use multiple interventions, such as program and policy interventions, for a single health issue  Use interventions that address multiple health issues at the same time, which is more effective than addressing each single health issue separately

19.  Increases value of incentives from 20% to 30% (50% for tobacco cessation) in existing HIPPA nondiscrimination regulations  Separates worksite wellness into two categories  Participatory  Health-contingent ▪ Activity-only wellness program ▪ Outcome-based wellness program

20.  Employers and other community organizations/entities usually have a common goal of population health improvement  Health of workforce is affected by community dynamics/health  Potential for greater return on wellness investment if there is synergy and connectivity with community health initiatives programs  Community prevention can increase capacity to develop worksite wellness programs for small businesses

21.  Improve the health and productivity of current and future workforce  Control direct and indirect costs to the employer  Create image and/or reality of a healthy community that may help recruit and retain talented workforce  Increase the buying power and consumption level for business products (i.e., nonmedical goods and services) by improving the health and wealth of a community.  Channel corporate philanthropy in a direction that will improve community relations, goodwill, or branding with the potential for a positive return for the business enterprise itself  Creates public/private partnerships and a multi-stakeholder community leadership team that can become the foundation for collaboration, cooperation, and community-based problem solving for other issues affecting the business community, such as economic development and education  MORE JOBS for Indiana!!

22. William VanNess, MD State Health Commissioner 317-233-7400 wvanness@isdh.in.gov