1. Thursday, October 8, 2009 Marilyn Batan, MPH

2. Source: CDC Behavioral Risk Factor Surveillance System. 2 1999 Obesity Trends* Among U.S. Adults BRFSS, 1990, 1999, 2008 (*BMI 30, or about 30 lbs. overweight for 5’4” person) 2008 1990 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

3. 3 Annual Costs of Obesity $147 billion in medical costs (2008) $1,429 +healthcare costs/person (2008) (42% higher than normal weight person) 39 million work days lost (2003) -Finkelstein E. Annual medical spending attributable to obesity: payer- and service-specific estimates. Health Affairs 2009 Jul 29. 2. -Thorpe, KE, Florence CS, Howard DH, Joski P. The impact of obesity on rising medical spending. Health Affairs 2004; W4:480-6.

4. 4 CommunityMedical Schools Worksites CDC Settings

5. 5 Do Worksite Programs Help Employees Lose Weight? The U.S. Task Force on Community Preventive Services recommends: Worksite programs intended to improve diet and/or physical activity for reducing weight among employees. Programs include various approaches to support behavioral change: - policy & environmental - informational & educational activities - behavioral and social strategies Systematic review will be published in October issue of AJPM.

6. 6 How much savings? Results: –Average reduction in health care costs – 26% –Average reduction in absenteeism – 27% –Average ROI – $5.81-to-$1 savings- to-cost ratio Chapman, L. (2005). Meta-Evaluation of Worksite Wellness Promotion economic return studies: 2005 Update. The Art of Health Promotion. July/August, 2005

7. 7 More than Money Improves worker satisfaction and morale Demonstrates concern for your employees Provides social opportunities and source of support within the workplace

8. 8 Barriers to Implementation Cost Lack of understanding Lack of knowledge Lack of staff or capacity Lack of resources and tools

9. 9 Community Guide Recommendation Promising Practices (Literature) Translate Findings Expert Panels Promising Practices (Field) Focus Groups CDC’s Healthier Worksite Initiative

10. 10 LEAN Works! CDC’s LEAN Works! An interactive website Estimate workforce obesity costs Estimate cost:benefit of user-defined interventions Explore examples from other programs Download planning guides Slides to help you make the business case

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16. 16 Calculator Purpose Estimates workforce obesity costs Estimates cost:benefit of user-defined interventions

17. 17 Inputs Obesity Cost Calculator Worksheet –At a minimum: Type of industry (from a list of 12 industry categories) State or territory that best represents the location of the company Number of employees in the company

18. 18 Inputs Optional information: # of employees overall # of overweight or obese employees Average wage information for employees % of employees receiving benefits % of total compensation going to benefits By gender, age or both

19. 19 Datasets Data for the calculator - 6 nationally representative datasets. –Overweight and Obesity Prevalence National Health Interview Survey (NHIS) Behavioral Risk Factor Surveillance System (BRFSS) National Health and Nutrition Examination Survey (NHANES)

20. 20 Datasets Hourly Wages and Benefits –Current Population Survey (CPS) Medical Expenditures –Medical Expenditure Panel Survey (MEPS) Work Loss –National Health Interview Survey (NHIS) NOTE: All costs are reported in 2007 dollars using the Medical Care Inflation Index provided by the Bureau of Labor Statistics. All results generated from the tool are estimates. Actual results may be larger or smaller than those reported.

21. 21 Case Scenario You are a worksite coordinator of a 10,000 person healthcare company in Virginia with a small obesity prevention program that gets only minimal participation and attention. You want to build your company’s program, but don’t know where to begin. You’re looking for ways to get senior leadership more engaged in the program. You do not have information on employees’ BMI, average wages, or proportion receiving benefits.

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25. 25 Step 2: Employees’ BMI Do you want obesity prevalence estimation to be based on averages across your company’s industry or state?  Industry  State

26. 26 Step 2: Employees’ BMI Select the most detailed category for which you have an estimate of the number of employees in your company.  Total  By gender only  By age group only (18-44, 45+)  By gender and age group (18-44, 45+)

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30. 30 You may want to plug the numbers into a business case power point for senior management, but you don ’ t have one available.

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32. 32 Healthy food policy: meetings, vending, cafeterias Flextime for physical activity Coverage for obesity clinical screening, counseling, and treatment Enhancing access to physical activity: building walking trails, gyms, changing rooms/showers, stairwell enhancement Multifaceted physical activity and nutrition employee education programs Individually adapted physical activity programs Nutrition counseling Weight Management programs Team Competitions Incentives Interventions

33. 33 Weight Management Program, cost-effective? You would like to implement a weight management program for your employees. You’re unsure if such a program will be cost- effective.

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43. 43 Calculator will NOT… Tell you what intervention to implementTell you what intervention to implement Provide relevant intervention detailsProvide relevant intervention details

44. 44 Motivation, Behavior Modification, Program Development: Additional Resources 8 Tips for Exercise Motivation (Article from WebMD) http://www.webmd.com/fitness-exercise/guide/hate-exercise What you need to know about using incentives to change employee behavior (Article by president of Integrated Benefits Institute) http://eba.benefitnews.com/news/you-need-know-using-incentives- change-2668881-1.html Motivating Employees to Make Lifestyle Changes (PowerPoint from American Institute for Preventive Medicine) www.ehcca.com/presentations/cdhcsummit3/1_04.ppt

45. 45 Additional Resources CDC’s Healthier Worksite Initiative http://www.cdc.gov/nccdphp/dnpa/hwi/index.htm Weight of the Nation: CDC’s Inaugural Conference on Obesity Prevention and Control http://www.adph.org/ALPHTN/index.asp?id=3775

46. 46 Questions? www.cdc.gov/leanworks

47. 47 Thank You! Contact Information Marilyn Batan, MPH Division of Nutrition, Physical Activity and Obesity Centers for Disease Control and Prevention (770) 488-5287 FPL8@cdc.gov