Comprehensive Workplace Wellness
Programming
Jane Ellery, Ph.D.
Director of Wellness Management
Fisher Institute for Wellness and Gerontology
Ball State University
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jellery@bsu.edu
Focus of Presentation
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Doing Things Right vs. Doing the Right Things
Supporting Evidence and Current
Programming
Risk Reduction, Wellness, and Cost Sharing
Suggestions for Successful Programming
Reaching the “Hard to Reach” by Using Data
to Drive Decision-Making
Take Home Messages
Health Care Spending Rising
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Our nation spends more on health care
than any other country in the world.
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1980 health care costs totaled $245 billion
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average of $1,066/American
2003 total health care cost $1.7 trillion
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(CDC, NCCDPHP)
average of $5,805/American
Costs of Chronic Disease
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Over 90 million Americans live with chronic
illnesses
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75% of the Nation’s medical care costs
Annual cost of:
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(CDC, NCCDPHP)
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Diabetes – $132 billion
Arthritis – $22 billion (additional $60 billion in lost
productivity)
Smoking – $75 billion
All Cardiovascular Diseases – $300 billion
(additional $129 billion in lost productivity)
Physical inactivity – $76 billion
Percentage of Adults Who Are
Obese,* by State
(CDC, NCCDPHP)
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Causes of Death, IN Compared to
US, 2001
(CDC, NCCDPHP)
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Risk Factors and Preventive Services,
IN Compared to US, 2001 – 2002
(CDC, NCCDPHP)
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Health Care System or Sick Care…
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Health care spending:
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Treat the symptoms and ignore the underlying problem
Obesity epidemic… convenience and excessive
consumption (inactivity and overeating)
Lifestyle decisions and immediate gratification
Government agencies leading the health protection
charge
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Chronic Disease (75%)… $4,354/person
Prevention (2%)… $116/person
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CDC/National Center for Chronic Disease Prevention and
Health Promotion
Department of Health and Human Services: HP 2010
Read this sentence…
FINISHED FILES ARE THE RESULT
OF YEARS OF SCIENTIFIC STUDY
COMBINED WITH THE
EXPERIENCE OF YEARS.
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Why Offer Health and Wellness
Programs?
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Because it’s the right think to do
Keep workers healthy
Improve morale
Retain employees
Reduce medical care costs
Attract good employees
Improve productivity
Decrease absenteeism
Strength of Evidence for Worksite
Wellness
A
Major Cause of
Disease or Cost
B
Programs Alter
Behavior
C
Programs Reduce
Cost
Multi-Component
Very Strong
Strong
Very Strong
Hypertension Control
Very Strong
Very Strong
Strong
Tobacco Use
Very Strong
Strong
Strong
Medical Self-Care
Very Strong
Very Strong
Very Strong
Nutrition Education
Very Strong
Strong
Weak
Weight Management
Strong
Moderate
Weak
Physical Activity
Very Strong
Strong
Moderate
Stress Management
Very Strong
Moderate
Strong
Back Injury Prevention
Very Strong
Moderate
Strong
Cholesterol Reduction
Very Strong
Weak
Weak
Pre-natal Care
Very Strong
Strong
Strong
High Risk Intervention
Very Strong
Type of Program or
Target Behavior
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Very Strong
Strong
- Chapman, Proof Positive, 2002
Most Common Worksite Programs
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Smoking Cessation
Back Injury
Prevention
Violence Prevention
Blood Pressure
Screening
Stress Management
Fitness
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HIV/Aids
Nutrition/Cholesterol
Education and
Screening
Health Risk
Assessment
Alcohol and Drug
Abuse Intervention
Broad Approaches to Health in the
Workplace
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Health Promotion
Prevention, Early Detection, and Risk
Reduction
Wellness
Cost Sharing/Cost Containment
WHO Definition of Health
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Health is a state of complete physical,
mental, and social well-being and not
merely the absence of disease or
infirmity.
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Preamble to the Constitution of the World Health Organization as
adopted by the International Health Conference, New York, 19-22
June, 1946; signed on 22 July 1946 by the representatives of 61
states (Official Records of the World Health Organization, no. 2, p
100) and entered into force on 7 April 1948.
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The Definition has not been amended since 1948.
Merriam-Webster Definitions
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Health – The condition of being sound in body, mind, or
spirit; especially: freedom from physical disease or pain
Promotion – The act of furthering growth or development of
something
Prevent – to keep from happening or existing
Early – Near the beginning of a course, process, or series
Detect – To discover or determine the existence, presence,
or fact of
Risk – The possibility of loss or injury
Reduce – To diminish in size, amount, extent, or number
Wellness – The quality or state of being in good health
especially as an actively sought goal
Risk Reduction, Prevention, and
Early Detection Programs
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Taking steps to decrease the chance of developing a
disease or other health concern:
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Lowering your blood pressure
Losing weight
Stopping smoking
Focus on parts of self
“Normal” as a criterion
Professional directs action
Primarily “Physical” emphasis
Worksite Programs, revisited
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Smoking Cessation
Back Injury
Prevention
Violence Prevention
Blood Pressure
Screening
Stress Management
Fitness
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HIV/Aids
Nutrition/Cholesterol
Education and
Screening
Health Risk
Assessment
Alcohol and Drug
Abuse Intervention
Wellness
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An integrated method of functioning which is
oriented toward maximizing the potential of
which the individual is capable, within the
environment where he is functioning
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Halbert Dunn, 1977
Wellness
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Multidimensional and Interactional
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Variable, not static… and Ever-Changing
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Physical
Emotional
Social
Intellectual
Occupational
Spiritual
Environmental
Youth a Gift of Nature...Age a Work of Art
Focus on Promoting/ Protective
Factors
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What makes us strong?
What experiences make us more resilient?
What opens us to more fully experience life?
What in organizations makes us grow?
How can we give meaning to life?
What produces high level well-being?
Sense of Coherence (Antonovsky, 1979)
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Your world is understandable: Stimuli from
internal and external sources is perceived as
structured and predictable. (Comprehensible)
Your world is manageable: Resources exist
to meet demands posed by stimuli
(Manageability)
Your world has meaning: Demands are
challenges worth spending energy/effort on
(Meaningfulness)
Tasks that Should be Considered
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Manage the pace of life
Set priorities
Develop needed personal and occupational
skills
Connect people
As a manager, think about the needs of the
whole person… body, mind, and spirit
Wellness Programs
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Quality of life/life satisfaction monitoring
A holistic approach
Unique person directs action
Multidimensional expression across lifespan
Number and quality of friendships/social
support
Mental engagement
Environmental awareness
Basic Life Style Behaviors
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Get enough sleep
Eat a balanced diet
Think healthy… not thin
Lead an active life
Don’t smoke and avoid second hand smoke
Drink in moderation or not at all
Relax and avoid or control stress
Stay connected
Cost Sharing/Cost Containment
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Somewhat Newer Addition to the mix
Cost shifting: Employee pays a greater
portion of the health insurance premium
“Incentivizing”: Employee rewarded for
healthy lifestyle choices
Cost Sharing/Cost Containment
Programs
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$100 voucher to use toward December health
insurance premium for filling out an HRA
$500 check for participating in a smoking cessation
program and being smoke-free for 6 months.
Receives an additional $100 every year on smokefree anniversary
$200 shopping certificate for each 20 pound weight
loss
10% reduction in health insurance premium if 1 or
less “risk factor”
Pay higher percentage of health premium if noncompliant
Program Targets for Worksites… A
Balancing Act
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Remedial and rehabilitative
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Prevention/risk reduction programs
Life enhancing and growth producing
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Disability and illness specific
Work hardening
Social/fun
Financial planning
Leadership training
What Does it Take To Be
Successful in Worksite Health?
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Base programs on diversity of workforce and the
organizational culture
Communicate with your employees about health
related concerns and goals
Ask your employees about their lifestyle-decision
making interests
Implement programs that make sense for the size
and type of your workplace
Make a permanent commitment to improve and
maintain health of your employees… identify what is
valued and live those values
Toward Successful Programming…
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Individual behavioral change
Physical work environment
Organizational development & policies
Community collaboration and environmental
issues
Examples of Individual Change
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Work station stretching
Meditation and other Relaxation Techniques
Walking clubs
Self-care guide use and education programs
Healthy eating… when and where you eat,
as well as what.
Health risk appraisal and risk management
Personal/Professional Development
Examples of Physical Work
Environment
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Vending machines: snacks vs. low fat
Promoting walking by marking paths and
using signage to promote use
Posting/delivering health messages
Quiet room for relaxation
Personal control of workspace
Ergonomically correct workspaces
Workloads consistent with a normal work day
Organizational Development &
Policies
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Upper management buy-in
Commitment to wellness by including it in the
company’s vision
Health theme months
Subsidize fitness/health club memberships
Newsletters, emails, payroll inserts with health
tips
Departmental competitions: walking, weight, etc.
Special recognition of participants
Health and Productivity Management
Individual Elements
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Health Enhancement
Injury Prevention
Participation
Program Requests
Informal LeadersCommunication
Workplace Culture
Policy Enhancement
Workplace/job satisfaction
Management Support
Culture Change
Integration
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Organizational Components
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Disability Management
Health Promotion
Return-to-work programs and policies
Occupational Health
Regulations
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Incentives
Benefits
Needs Assessment
Evaluation Projects
Institute for Health and Productivity Management
Community Collaboration
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Advocating for sidewalks, bike trails and
health-related community planning
Health related speakers from community
Local restaurants sponsoring low fat foods and
cooking classes
Children of employees creating health posters
and messages
Sponsor parks and recreation programs
Involve health related organizations in
programs for employees
Audience Perspective
“You don’t build it for yourself. You find out
what the people want and you build it for
them”
- Walt Disney
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Healthy lifestyle strategy that encourages
an audience focus…
Wellness Marketing
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Wellness Marketing:
Distinctive Features
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Consumer orientation
Uses commercial marketing technologies
and theory (product, price, place, promotion;
exchange theory)
Voluntary behavior change
Data drives decision-making
Targets specific audiences
Creating the Competitive
Advantage
“Positioning our product relative to the competition”
 Increase the benefits of the target behavior
 Decrease the barriers (and/or costs) to the target
behavior
 Decrease the benefits of the competing behavior(s)
 Increase the barriers (and/or costs) of the competing
behaviors.
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The 4 Ps
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Product – Tangible items and services that
encourage individuals to perform the desired
behavior
Price – The cost that the target market associates
with the behavior
Place – Where and when the target market will
perform the desired behavior, acquire any related
tangible objects, and receive any associated
services
Promotion – Creating messages and selecting media
channels
Back to Worker Health
Beyond unintentional injuries…
 Relational Theory suggests social
connectedness is the primary determinant of
health (sign language interpreters and carpal
tunnel… nurses and back injuries)
 Gallop research in organizational
development suggests relationships are what
drive organizational health and vitality
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Resilient Employees…
(David Lee,
www.HumanNatureAtWork.com)
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Believe they are part of an organization that matters and is
worthy of pride
Have a chance to make a difference, a chance to matter
Experience self-efficacy
Experience control in their jobs
Have the chance to learn and grow
Are “kept in the loop”
Are treated with respect
Believe their manager, and management in general, cares
about them as human beings
Trust management’s ability and intentions
Believe they, and their work, are appreciated
Take Home Message
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Well designed workplace wellness programs can reduce medical
claims and worker’s compensation costs. ROI: about $3 for every $1
invested. (Goetzel, Chapman, Edington). But, wellness should be
considered an investment, not a cost
Interventions should follow a “systems” approach to changing
behavior, including individual behavior changes and organizational
policy, as well as workplace culture and community-level and “built
environment” issues. Collaborative efforts are important!
Programs should be tailored to the specific needs and wants of the
population served, and each workplace has unique challenges.
Overall, work toward having a fast, friendly, flexible, focused, and
happy workforce.
Buy-in from all “customers” (upper-management, “end users,” and
everyone in between) is key to the success of your initiatives.
WellForce Development Workshops
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Quarterly ½ day workshops to help HR
Managers and Wellness professionals with
Workplace Wellness programming
Visit www.bsu.edu/workplacewellness
Next workshop: October
Continuing Education…
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Graduate Degree Programs and Graduate
Certificates
Graduate Assistantships to support graduate
work
Working with partners to develop an
intensive workshop accompanied by
technical assistance and consultation
Workplace Wellness Resources
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Fisher Institute for Wellness and Gerontology
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Wellness Council of Indiana
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http://www.wellnessin.org/
Wellness Councils of America
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www.bsu.edu/wwrt www.bsu.edu/wellness
http://www.welcoa.com/
Comprehensive Workplace Wellness
Programming
Jane Ellery, Ph.D.
Director of Wellness Management
Fisher Institute for Wellness and Gerontology
Ball State University
45
jellery@bsu.edu