Healthcare is a $2.8 trillion a year industry in the United States, which is the highest spend per country in the world, but the U.S. is by no means the healthiest. In order to create a healthier nation and put those dollars to making a difference in society, your organization as well as the nation, needs to focus on creating a culture of health.
A culture of health helps people change their behavior and make healthier choices. As we all know, changing behavior is difficult, and it is nearly impossible if the person does not want to change. A good culture of health does not force an employee to comply, but rather guides them, and emotionally connects with them to join their peers in healthy behaviors.
As you will see, human connection is key. Employee health needs to be valued, supported and promoted within an organization. This means the environment and tools needed to make connections must be readily available.
While creating a culture of health sounds like a large and impossibly confusing concept, it doesn't have to be. In fact, creating and cultivating a successful culture of health can be as easy as following four simple tips:
- Use data to make a connection
- Design health policies and plans that make the right choice, the easy choice
- Support employees by allowing peer groups to connect and blossom
- Create opportunities for social relationships to positively impact employee health
Use Data to Make a Connection
Imagine you're at work, and your manager pulls you aside to tell you of a new healthcare policy. Your manager then strongly encourages you to get your teenage daughter mental health counseling. Now, imagine a second scenario where your manager tells you your company's benefits manager noticed stress levels of mothers in the company are higher than normal, and this increased stress can carry over into their relationships with children at home.
Your manager then describes her own challenges of balancing work while raising a 14-year-old daughter and asks you how you'd help her daughter and other girls like her. The first scenario presents a policy-dictated and extrinsically focused situation.
The second scenario is based on a story providing internal motivation to change employee behavior, context and an emotional connection. To create a positive culture of health, the first step is using stories to explain, generate support and gain compliance for policies. Start by collecting and sharing data.
As in the example, it is critical to leverage data in order to draw real conclusions on how employees are doing and what needs improvement. Data helps identify situations impacting the health, productivity and happiness of employees that can benefit from peer support.
It also creates an environment where employee problems and health issues are collectively dealt with. Stories and suggestions resonate more when they are based on reality and your credibility will be damaged if they are inaccurate. As every population is unique - in both demographics and the conditions that affect them - it is important to get access and understand your specific data set.
When risks and conditions that need addressing are discovered, find out the factors with your specific population. Is this impacting dependents or employees? Is this age or location specific? Is there a subgroup less impacted? Does it relate to the company mission, product or industry? Talk to employees about their experiences.
One person may have a story representative of the greater population that can provide insight into the issue. Employees have a unique perspective, and often others share their perspectives. Data-backed stories are so powerful; sometimes just sharing the stories in interesting ways is enough to influence change.
Opower, a power company, compared a customer's usage to their neighbors on the bill, and consumption dropped. DTE Energy asked spouses or partners to submit their combined weight as a target for weight loss, the partners kept each other on track.
Northern Illinois University simply published survey results that the students were moderate drinkers. This knowledge reduced consumption even further.
Design Health Policies and Plans that Make the Right Choice, the Easy Choice
Once you know your population's health stories, the next step is to identify what environmental and cultural factors would support the behavior changes you want to influence. Make sure the policies demonstrate leadership support and make the right choices, the easy choices.
Policies show the intent of company leadership and define important elements of the policy environment. Involving employees in policy development is necessary for cultivating a strong culture of health. When people feel they've freely and consciously made or supported a decision, they take ownership of it and tend to have a greater enjoyment of the outcome.
This self-attribution allows greater benefit to employees and overall culture.In essence, the role of policy is to make the right choice, the easiest choice. In the 2008 book Nudge, Cass Sunstein and economist Richard Thaler used the term "choice architecture" to describe the way decisions may be influenced by how choices are presented.
In policy writing and delivery, choice architecture is key to creating an intrinsically focused culture of health. Examples of choice architecture in policy include:
- Enrolling everyone and allowing participants to opt-out of programs versus making opting-in a difficult or confusing process.
- Placing healthy foods in a location for easier impulse-buys, and making it more difficult to purchase unhealthy snack options.
- Make the stairways more inviting so that people are less inclined to take the elevator.
In these examples, employees still have the choice, but are more motivated to make a good decision.
Support Employees by Allowing Peer Groups to Connect and Blossom
"Peer support is an important element in chronic condition management. Peer support is a system of giving and receiving help founded on key principles of respect, shared responsibility, and mutual agreement of what is helpful. It is about understanding another's situation empathically through the shared experience of emotional and psychological pain.
When people find affiliation with others they feel are "like" them, they feel a connection. This connection, or affiliation, is a deep, holistic understanding based on mutual experience where people are able to "be" with each other without the constraints of traditional (expert/patient) relationships." Mead S, Hilton D, Curtis L. Peer support: a theoretical perspective.
Peer support is the very foundation of a culture of health for chronic patients. Even if your organization is not large enough to sustain thriving patient peer groups, there may still be conditions prevalent enough to host peer groups (diabetes, stress and obesity for example).
Ask your medical carrier if they offer peer support programs, and if not there is also an online community that you can share with your employees with 250,000 people with more than 2,000 conditions called Patients Like Me. Inspired by a brother and friend's experiences fighting ALS, the co-founders and their team at Patients Like Me conceptualized and built a health data-sharing platform allowing patients to manage their conditions, change the way industry conducts research and improve patient care.
Peer support is where a culture of health really shines. People share stories, ideas, experiences and hope - without the constraints of the traditional medical establishment. In most contexts and for most objectives, peer support should emphasize:
- Empowerment and encouragement of self-sufficiency to adopt healthy changes.
- Participant and/or patient-centered approach that addresses health concerns within the context of individuals' interests and values and lives as they live them. For example, "breakfast, lunch and dinner" versus "carbs, fats and proteins."
- Attention to current concerns of the individual (e.g., current stress regarding problems with an adolescent child).
Create Opportunities for Social Relationships to Positively Impact Employee Health
"An important extension of the evidence linking social relationships to health outcomes is the growing literature on social capital and health. Social capital is defined as the features of social structures which act as resources for individuals, including interpersonal trust and norms of reciprocity and mutual aid both low social capital and uncontrolled blood pressure have been linked to cardiovascular disease morbidity and mortality."
Workplace Social Capital and Adherence to Antihypertensive Medication: A Cohort Study. Tuula Oksanen, et al.Social dynamics are being found to play a bigger part in the impact of health promotion then previously realized. Loyola's 2012 study found a person's circle of friends influences their weight and involvement in sports.
Gallup's Consumption survey showed if your friends and family engage in unhealthy habits such as drinking, smoking or being inactive, you are more likely to do so as well. A 2011 Dutch study found children excluded by their classmates, had elevated levels of cortisol at school.
Longevity, ovarian cancer, breast cancer, heart disease, stress and exercise have all been shown to be influenced by our friends and social group. The role of social acceptance and disapproval are the obvious cultural factors at work, but may not fully describe the dynamic.
It is important to tell your story well, and provide the social outlet to let employees simply relate to their friends and coworkers. Creating an environment for healthy social exchanges is important. This is good news; healthy social exchanges are a natural by-product of human interaction.
However, some organizations (deliberately or unintentionally) allow a culture where workers feel cut off or isolated from their colleagues. Adequate opportunities for social interaction and collaboration between working colleagues are not provided. So, how do you provide these opportunities? Start with places to interact, both physically and virtually.
The key is to provide a space where people from different groups and backgrounds want to be. It is a good idea to start where people tend to hang out naturally. Examples of virtual interaction include posting photos from events and hosting incentivized contests.
Asking open-ended questions about health preferences (for example, "What are your favorite healthy super bowl snacks?") and soliciting ideas and suggestions in open dialogue can also be effective. These methods should be targeted to involve employees and make them feel connected to their colleagues.
The next step is to turn the one-time engagement into an ongoing process. After initial involvement, it is important to start a dialogue. Engage participants using polls, and discussions. At this point, the employee is likely to ask friends to join him or her.
It is important to avoid broadcasting or one-way communication. In order to be engaging, communication should be two-way.
Create your Culture of Health
Creating a culture of health and making a change on the national scale starts with each company and the way they decide to deal with employee health. By using data to develop and design effective health policies that support employees and offer opportunities for social relationship building within organizations (and outside of), you are on the right track to having happier, healthier, more productive employees and making a huge impact on the U.S. healthcare industry.
About the Author
Sean Gallivan is the Chief Operating Officer at Healthentic. Sean is an expert on using big data as a way for employers to improve population health. He previously worked in the healthcare division of Thomson Reuters.
