Why Wellness and What are We Doing to Improve It? Lydia Makrides, PhD Atlantic Health

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Why Wellness and What are We Doing to Improve
It?Lydia Makrides, PhDAtlantic Health
Wellness Institute

• Workplace Health Works!
• A Seminar on Innovative Workplace Health
  Practices
• Canadian Labour and Business Centre
• November 18-19th, 2003

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Agenda

• Why wellness
• Project Impact
• WIN
• Future plans

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The Business Case
Why Wellness

• RETURN ON INVESTMENT (ROI)
• Data from over 20 years in the US, Europe and
  Canada have shown
• Workplace health promotion programs can reduce
  absenteeism and employer costs and improve
  performance and productivity
• Workplaces are recognized as the single most
  important channel to reach the adult population
  through health promotion programs (WHO, 2001)
• A 1996 review of 10 major studies reported ROI
  ranging from 2 - 6 per 1 invested with two
  studies reporting as high as 10 - 20 per 1
  invested.

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The Business Case
Why Wellness

• HEALTH CARE AND INSURANCE COSTS
• Bank of America reported an average of 164 lower
  insurance claims in retirees who participated in
  a health promotion program. In non-participants,
  costs increased by an average of 15 / retiree.
• Pacific Bell reported 300 / employee lower
  claims resulting in 700,000 savings in one year.
• Coca Cola reported reductions in health care
  claims of 500 / employee / year.
• Prudential Insurance reported a drop in the
  companys major medical costs from 574 to 312
  for each participant in its wellness program.

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The Business Case
Why Wellness

• ABSENTEEISM
• A 2-year study by the DuPont Corporation of its
  comprehensive health promotion program reported a
  14 decline in disability days vs. 5.8 decline
  in the controls. They reported total of 11,726
  fewer disability days.
• Pacific Bell reported 3.3 days less on STD for
  employees who participated in their health
  promotion program, resulting in savings of 4.7
  million.
• A national manufacturing company reported that
  targeting of their wellness programs to high risk
  employees resulted in a 12.2 decrease in sick
  days.

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The Business Case
Why Wellness

• DATA FROM CANADA
• Canada Life (Toronto) reported ROI of 3.40 per
  dollar invested primarily due to reduced
  turnover, productivity gains and decreased
  medical claims.
• BC Hydro reported
• 1.2 million in reduced sick leave
• 97,000 in reduced accident costs
• 35,000 in reduced WCB claims
• Productivity gains of 919,000
• ROI of 2.74 per dollar invested.
• MDS Nordian reported
• significant decreases in annual grievances
• decrease in absenteeism from 6 days in 1993 to 4
  days in 1999
• decrease in injuries per 100 person years from
  2.5 to 0.5 in the same time frame.
• Husky Infection Molding System reported
• reduction in sick days lost of 2.5
  days/year/employee.
• reduction in drug costs of over 75 within 1 year
  after implementing comprehensive wellness
  program.

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The Business Case
Why Wellness

• THE PREVENTABLE COST BURDEN
• Established relationship between preventable risk
  factors such as smoking, inactivity and
  overweight that result in increased health
  claims.
• This increase in claims has been documented in
  the scientific literature

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The Business Case
Why Wellness

• THE PREVENTABLE COST BURDEN
• Using this relationship the amount of preventable
  claims can be estimated and the cost of doing
  nothing can be calculated.
• Realistic goals for workplace wellness in
  reducing the Preventable Cost Burden on a company
  can also be predicted.
• With no wellness interventions as employees are
  aging and likely to move up the risk ladder there
  is an exponential increase for the company in the
  Preventable Cost Burden.
• So it is true that
• HEALTHY EMPLOYEES
• MAKE HEALTHY COMPANIES.

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Why Wellness
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Project Impact
Overview

• 1st Study of its kind in Canada - Randomized
  Clinical Trial.
• Study on the effects of employee Wellness
  programs on cardiovascular risk factors.
• Cardiovascular Disease 36 of all deaths in 1997
  (Rank 1).
• AHWI Aventis Pharma Atlantic Blue Cross Care
  8 local employers
• Ocean Contractors
• NSLC
• NS Department of Education
• IWK Health Centre
• HRM
• MTT
• Nova Scotia Power
• Atlantic Blue Cross Care.

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Project Impact
Methods

• Participant requirements two or more modifiable
  risks
• 2,700 employees pre-screened - 1,656 (62) with 2
  or more risk factors.
• 556 employees randomly chosen to participate.
  Two groups
• Intervention Group (Wellness program)
• Control Groups (no intervention).
• Intervention education sessions, individual
  exercise programs, nutritional analysis and
  counselling, smoking cessation and stress
  management.

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OBJECTIVES
Project Impact

• To determine the impact of a 12-week primary
  prevention program on
• Modifiable cardiovascular risk factors
• Cardiac and stroke risk
• Cost-effectiveness
• Program satisfaction.

STUDY DESIGN
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Initial Findings
Project Impact

• Awareness 80 did not know their cholesterol and
  45 did not know their blood pressure.
• 61 of participants had at least 2 cardiovascular
  risk factors (smoking, obesity, high cholesterol,
  high blood pressure and lack of physical
  activity).
• More than half were moderately overweight or
  obese.
• 10 out of the 556 had serious medical problems
  (some resulting in surgery).

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Results
Project Impact

• All major risk factors decreased significantly.
• 40 of all smokers quit smoking.
• Control group also reduced their risk
  factorsshowing importance of awareness and
  prescreening.
• Number of events avoided over a 10 year period
• 1 cardiac event avoided for every 100
  participants
• 1 stroke event avoided for every 500 participants

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Cost Benefit Analysis
Project Impact

• Overall cost benefit analysis return of 1.64
  per 1 spent.
• Participants with 3-5 risk factors 2.04 per 1.
• Participants who are blue collar workers 3.98
  per 1.

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Conclusion
Project Impact

• 3-month primary prevention program, consisting of
  structured education and counseling, healthy
  eating, weight management, cessation of smoking
  and individual exercise prescription, is
  effective in decreasing major modifiable
  cardiovascular risk factors such as
• Obesity / overweight
• Physical inactivity
• Smoking
• These improvements lead to a decrease in
  projected cardiac and stroke risk factors based
  on 5-year Framingham risk estimates.

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Wellness Initiative Network (WIN)

• Joint task force throughout Atlantic Canada.
• Partner organizations with the AHWI
• Nova Scotia Heart and Stroke Foundation
• Abbott Laboratories
• Aventis Pharma
• Luedey Consultants Inc.
• Departments of Health
• Heart and Stroke Foundations
• Chambers of Commerce
• WIN - Phase I Perceptions of Workplace Wellness
  in Atlantic Canada.

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W I N - Phase I
Purpose

• Gain understanding of organizations perceptions
  and current involvement in wellness and
  dissemination of information.

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Methods
W I N - Phase I

• FOCUS GROUPS
• Five in Atlantic Canada
• St. Johns, Charlottetown, Halifax, Moncton,
  Sydney.
• ORGANIZATIONAL CHARACTERISTICS
• Generally larger with 200 employees
• Both public and private sectors
• Unionized and non-unionized workplaces
• Human resource staff
• Engaged in wellness.

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W I N - Phase I
Key Findings

• MEANING OF WORKPLACE WELLNESS
• Healthy Organizational Culture (valuing
  employees, job satisfaction, a balance of
  worksite demands vs. control, participatory
  approaches, supportive psychosocial environment)
• Connection to family health
• Individual health
• Safe and supportive physical environment

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W I N - Phase I
Key Findings

• BENEFITS OF A HEALTHY WORKPLACE
• Increased productivity and quality of service.
• Increased employee morale.
• Decreased absenteeism.
• Happier employees.
• A spirited, vibrant workplace.
• Improved retention and decreased turnover.
• Decreased sick time and disability.
• Decreased level of risk factors.
• Increased autonomy among employees.

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W I N - Phase I
Key Findings

• CURRENT WORKPLACE HEALTH ISSUES
• Stress due to increasing workloads.
• The aging workforce.
• Repetitive work.
• Safety issues.
• Level of education.
• The need for greater autonomy.

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W I N - Phase I
Key Findings

• CURRENT WORKPLACE HEALTH INITIATIVES
• Lifestyle initiatives.
• Needs and interest assessments.
• Workplace health committees.
• Occupational health and safety.
• Organizational health.

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W I N - Phase I
Key Findings

• RESPONSIBILITIES
• Shared between the employer and employee
• Support from stakeholders
• Government (provincial and municipal)
• Health care sector
• Business sector

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W I N - Phase I
Key Findings

• CHALLENGES
• Lack of access and coordination of resources.
• Lack of financial resources.
• Lack of management support.
• Lack of employee interest and time.
• Assuring and maintaining confidentiality.

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W I N - Phase I
Key Findings

• SUPPORTING EMPLOYERS
• How-to guides and best practice models.
• Resources to build awareness and commitment.
• Information on how to motivate employees.
• Resources to make the business case (ROI).
• Sharing / networking.
• Incentives and recognition.
• Build awareness, understanding and commitment.

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W I N - Phase I
Key Findings

• SUPPORTING EMPLOYEES
• Onsite programs and convenient times.
• Incentives.
• Recognition.
• Management support and participation.
• Charging nominal fee to ensure commitment.

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W I N - Phase I
Key Findings

• IMPLICATIONS
• Exploratory research.
• Perspective of large organizations.
• Seek small business perspective.
• Did not get complete picture - would require
  comprehensive survey.
• Interest and readiness in the business community.
• Need to network for sharing, building awareness
  and commitment.

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W I N - Phase I
Next Steps

• WIN PHASE II
• Comprehensive written survey.
• Report on Healthy Workplace services, resources,
  websites etc.
• Annual symposium and establishment of WIN as a
  sustainable network to share and learn.
• Further research on issues related to the
  established relationship between modifiable
  (lifestyle) risk factors and associated health
  costs and claims.

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• THANK YOU!
• Lydia Makrides, PhD
• Director
• Atlantic Health Wellness Institute
• 6960 Mumford Road West End Mall Suite 14
• Halifax Nova Scotia B3L 4P1 CANADA
• Telephone [phone]
• Fax [phone]
• Cell [phone]