Business of Well-being

Targeted Approaches Improve Company Health and Bottom-Line

A breadth of literature has clearly demonstrated the pivotal role of worksite wellness programs in improving health and capably suppressing healthcare costs.

When appropriately structured, wellness programs also offer lesser tangible, but undeniable benefits including the recruitment and retention of higher quality workers, curbing absenteeism and improving job satisfaction.

Based on a large body of published research, it appears clear that there are significant opportunities for employers to save on health-related expenditures by incorporating wellness strategies that target lifestyle behaviors.

For example, employees who smoke impose significant excess costs on employers. Smoking has been implicated in the advancement of neuromusculoskeletal pathologies and reductions in physiological functional capacity.

Research estimates the annual excess cost to employ a smoker is in the range of $3,391.00 to $5,816.00 per year. It's worth noting that tobacco related illnesses account for 25 percent of annual healthcare costs incurred by United States employers, amounting to $75 million.

The national rate of smoking has been estimated to be 16.8 percent. Socioeconomic status (income, education level) have shown to be strong determinants of smoking rates. As income and education level decline, there is a corresponding rise in smoking rates.

These estimates along with the aforementioned health and productivity costs associated with smoking reveal an opportunity to curtail an avoidable health-related expense-particularly among lower income and lower education sub-segments.

In addition to smoking, overweight and obesity may incur a sizable health-related cost to employers. Overweight and obesity are associated with numerous debilitating chronic diseases and even premature death.

In the US, one-third of adults are obese and two-thirds are overweight. The cost of obesity including lost productivity, absenteeism and medical expenditures has been estimated to be $2,770.00 per employee per year.

Collectively, the potential savings associated with reductions in smoking and obesity could be substantial. Therefore, engaging employees in lifestyle behaviors like healthy eating, increasing physical activity and avoiding tobacco may present long-term financial returns.

Targeted Strategies to Impact Health and Modify Behaviors

Address environmental and policy issues. Interventions with the greatest potential impact are those entailing efforts to make individuals default decisions healthy. These interventions tend to be more effective because they are less resource-intensive and influence larger population segments.

For example, increasing the availability of healthy foods through various environmental improvements can improve diet and decrease obesity. Modifying beverage vending and snack machines to reduce unhealthy foods, sodas and other sugar-sweetened beverages may present large scale benefits and create healthy default choices.

A recent audit of the nutritional value of snacks and beverages sold in a worksite's vending machines found average calories per vending item was about 15 percent of all the calories most adults need for an entire day. Snacks averaged 270 calories and beverages averaged 190 calories.

Some snacks rose to over 400 calories per package and beverages rose to over 300 calories per bottle (representing 20 percent of the calories most adults need in a day). In addition to being high in calories, average vending snack foods had high amounts of sodium and added sugars: 360 mg sodium (representing 15 percent of the daily recommended limit) and candy had 27 grams of added sugar or the equivalent of 7 teaspoons of added sugar (representing 100 percent of the daily recommend limit).

Other examples of how environment and policy may influence behavior are designating smoke-free worksites or enacting policies which deter tobacco use such as not hiring nicotine users. Studies have shown that those trying to quit smoking are more successful when their home and workplace are smoke-free.

Sedentary behavior has also been identified as a risk for chronic diseases such as obesity, diabetes, and cardiovascular disease. Technological advances have created a coinciding increase in workers employed in low activity occupations and resulted in many unfavorable health consequences. Thus, the worksite provides an opportune environment to avail interventions that reduce sedentary time and impact obesity and other negatively associated health outcomes.

Policies designed to encourage and/or incentivize the use of public transportation may serve as an effective countermeasure. Use of public transportation has been shown to help physically inactive populations attain the recommended level of daily physical activity. Transit users may achieve 30 minutes of physical activity daily solely by walking to and from transit.

Provide Leadership Support and Commitment

Changes in policy require the will and action of those in leadership and administrative positions in order to be successful. Employees are encouraged by policies, physical environments, and health-related resources that meet their needs.

Leadership support also leads to additional resources for programs and enabling of policies which promote healthier behaviors and wide-spread culture change.

Engagement, which is a key determinant of success, has been associated with leadership that has a strong desire to encourage wellness and improve health. Visible participation from leadership demonstrates a commitment to wellness that can influence universal participation throughout an entire organization.

Incentivize Participation

A direct correlation exists between program participation rates and financial returns.  Thus, without adequate incentives, participation rates may suffer.

According to a new employer survey conducted by Fidelity Investments and the National Business Group on Health, corporate employers plan to spend an average of $521 per employee on wellness-based incentives within corporate health care programs.

This marks an increase of 13 percent from the average of $460 reported for 2011, and is double the per employee average of $260 reported in 2009.

Activity-based incentives are generally more appealing because they are readily achievable for all individuals and therefore perceived as "fairer" since effort is rewarded, rather than inherent health factors.

In addition to premium reimbursements and cash incentives, employers may also consider offering intangible rewards such as time off and recognition awards.

Target Health Screenings and Tailor Follow-up Coaching

There is consensus that conducting health screenings in the workplace is helpful in detecting established health risk factors and preventing the development of non-communicable diseases. Screenings targeted towards higher risk individuals may be even more effective at identifying risk factors and providing better return on investment.

It has been revealed that targeted screening strategies are also less costly and capable of identifying up to 84% of high risk individuals. Literature has also suggested that targeting screenings based on gender and age would ensure more optimal utilization of resources compared to commonly- employed generic population inclusive screenings.

As a subsequent measure and to enhance the effectiveness of health screenings, tailored coaching may also be considered. Employees with cardiovascular risk factors experienced better outcomes when health risk appraisals were followed by personalized interventions versus information regarding resources and employee health programs.

Businesses comprise the largest sector of our nation's workforce, and the well-being of employees is inextricably linked to the success and competitive advantage of a company. Implementing policies and programs that promote health and wellbeing through strong leadership, appropriate incentives and cultural support may confer higher productivity and cost savings and raise a company's profile to attract and retain high-quality talent.


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About the Author

Victor Tringali is the founder and Managing Partner of Healthy Human Capital, a wellness consulting firm aimed at developing effective employee health promotion strategies that are tailored to the needs of client organizations.

Mr. Tringali currently serves as the Executive Director of University Wellness at Drexel University, where he innovated a nationally acclaimed wellness initiative aimed at improving the health and productivity among faculty and staff members in a large research institution embedded within a bustling urban landscape.

The initiative which garnered recognition from the American Heart Association, Wellness Counsel of America, and Philadelphia Business Journal was instrumental in helping curtail healthcare expenditures by an estimated 45 million dollars over a five year span while reducing Drexel's health care trend to zero. In 2014, Mr. Tringali was honored with the American Heart Association Innovation award for health promotion.

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