Business of Well-being

Moving Employee Health into Action

It wasn't too long ago that C. Everett Koop, former U.S. surgeon general, challenged Americans to "create a smoke-free society in the United States by the year 2000."1 Boeing Co. stepped up to the challenge in 1984 and became the largest U.S. company to ban smoking in the workplace.

Since then, what began as an employer intervening on behalf of a specific group of employees has evolved into a data-based view of corporate wellness that emphasizes how a culture of health within an organization is crucial to the overall success of the company, starting a revolution in employee health.

Key drivers

Prior to Dr. Koop's challenge, early adopters of corporate wellness programs were influenced by the national campaigns and programs established by the newly-created Office of Disease Prevention and Health Promotion (ODPHP), which Congress established in 1976.

The ODPHP set benchmark goals for improving the health of U.S. citizens through national initiatives aimed to raise awareness about a specific segment of the population, or population health. The skyrocketing, double-digit health care premiums of the late 1980s and early 1990s2 no doubt helped further the movement.

The first results

By 1987, a study showed for the first time that health-risk factors such as smoking, obesity and not wearing seat belts were strongly linked to higher health care costs, proving that fitness centers and wellness programs were more than just perks. By 1990, the use of health-risk assessments to evaluate and track employee health became commonplace.3

A growing body of research indicates that these programs can change employees' behavior, helping to reduce health risks, increase productivity, decrease health care spending and boost return on investment.

Today: The shift in workplace wellness

Today's smart employers are addressing the variety of dimensions that influence health and productivity in the workplace, as they seek to re-define "health" to include more than just the physical component.Influenced by The World Health Organization's (WHO) definition of health as, "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity,"4 employers are looking at employee health from a whole-person view-recognizing the social, emotional, financial and environmental dimensions of employee health, as well.

Employers miss opportunities if they limit themselves to just the physical dimension of health. When we at HealthFitness develop a health management program, we focus on making healthy actions possible for more of the employee population; which we call Well-doingsm for more people. We do this by engaging individuals where they want support - whether it's social, emotional, environmental and/or financial factors.

Dimensions of employee health

In addition to physical health, examples of well-doing across the five dimensions of employee health include:

  • Social: Lack of social connectedness has been shown to reduce IQ and is a predictor for early death and dementia.5 Social bonds have also been shown to improve motivation to pursue and reach health goals.6

          Employers can support social well-being by providing opportunities for employees to become socially connected with others in the workplace, and by extending health .           management benefits to spouses and children.

  • Emotional: life with a clear sense of purpose or meaning is associated with lower risks of Alzheimer's disease, mild cognitive impairment, disability and death.7

          In addition to having a sense of purpose, this dimension includes resiliency-one's ability to bounce back from the inevitable ups and downs of life. Employers can address  . .           these areas by providing opportunities for employees to identify their values, connect with purpose, learn or improve healthy communication skills and build emotional  .           awareness.

          This can happen through traditional training programs and/or health coaching. Employers can also create an environment where re-charging activities are supported.           Examples are as simple as including "energy breaks" during long meetings and encouraging employees to take personal vacation time off.

  • Financial. A Harris Interactive poll found that 83 percent of Americans are stressed by at least one thing at work. The two top reasons respondents cited were low pay and an unreasonable workload.8 Another survey found 58 percent of workers don't have a financial plan in place to handle the unexpected.9

          To help employees address financial issues, employers are responding to an increased need for financial wellness benefits, financial education and financial wellness  . .           programs, including on-site money management and financial planning seminars.10

  • Worksite environment. Setting employees up for success through a health-aware and health-enhancing environment helps support healthy behaviors and goals.

          Company leaders who support or model healthy behaviors (such as using the fitness center, leading "walk & talk" meetings, or making healthy food choices themselves) send  .        a powerful message to employees that a culture of health is valued. A healthy culture translates into a competitive advantage with employees who are engaged and  .           energized.

Employers can help carry this even further and support individuals in creating healthy home environments through education and inclusion of spouses and family members in programming.

Well-doing in action: University of Louisville

Our client, the University of Louisville (UofL), is an example of well-doing in action; realizing that health is more than simply the absence of disease, UofL adopted a view of health with a whole-person orientation. UofL actively works to create a culture of health through its "Get Healthy Now" program, which started in 2005. With a 74 percent participation rate, the program is working to engage participants in healthy programming and activities including:

  • Health coaching for all participants, regardless of whether they are at low, medium or high risk
  • Bike share, team biking initiatives and a bicycle commuting group (University President Ramsey bikes to work on occasion)
  • Caregiving workshops (including legal, financial and social)
  • Smoke-free campus and free smoking cessation classes
  • Mindfulness, yoga and relaxation classes through the wellness center
  • Community partnership with the American Heart Association for support groups, and disease management partnerships with the Greater Louisville YMCA and the University of Louisville Hospital

A 2012-2013 return on investment for the "Get Healthy Now" program found the program returned a benefit cost ratio of 7.16 to 1 after four years. Program participants saw an average claims savings of $1,300; an estimated $4.3 million in reduced claims spending.

In 2013, the UofL used the cost savings to fund a "living wage" goal that increased the minimum salary for employees to $11 per hour-sharing in the wealth of good health. By offering a full range of well-being benefits, similar to the UofL, employers can help boost employee health and engagement by making healthy actions possible for more of their population.

About the Author

Tanja Madsen Director of Product Management, HealthFitness A veteran of health education and health management product development, Tanja Madsen is director of product management for HealthFitness. She is involved in the development of the innovative HealthFitness technology platform, the Personal behavior change model, a short, engaging health assessment and all national program content.

A certified health educator, Tanja works with a team that includes registered dietitians, health educators, exercise physiologists, and behavior change experts who are responsible for the development and management of national programs to improve population health.

Works Cited

1,2,3. Shaping Up: Workplace Wellness in the 80's and Today, July 18, 2012,

4. 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.

5. Walton G, Cohen G. Mere Belonging: The Power of Social Connections. Journal of Personality and Social Psychology, 2012, Vol. 102, No. 3, 513-532 2011 American Psychological Association 0022- 3514/12/. Accessed at Welcome_files/WaltonCohenCwirSpencer2012.pdf

6. Ibid.

7. Eric Kim, Ph.D. candidate, psychology, University of Michigan, Ann Arbor; James Maddux, Ph.D., university professor emeritus, psychology, George Mason University, Fairfax, Va.; Nov. 3, 2014, Proceedings of the National Academy of Sciences.

8. Workplace stress on the rise with 83% of Americans frazzled by something at work. (2013, April 09). The Street. Retrieved from

9. 2013 Aflac WorkForces Report conducted by Research Now on behalf of Aflac, executive_summary.aspx

10. "Five voluntary trends to watch in 2014," BenefitsPro, Dec. 13, 2013

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