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

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


1
Why Wellness and What are We Doing to Improve
It? Lydia Makrides, PhD Atlantic Health
Wellness Institute
  • Workplace Health Works!
  • A Seminar on Innovative Workplace Health
    Practices
  • Canadian Labour and Business Centre
  • November 18-19th, 2003

2
Agenda
  • Why wellness
  • Project Impact
  • WIN
  • Future plans

3
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.

4
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.

5
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.

6
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.

7
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

8
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.

9
Why Wellness
10
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.

11
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.

12
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
13
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).

14
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

15
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.

16
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.

17
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.

18
W I N - Phase I
Purpose
  • Gain understanding of organizations perceptions
    and current involvement in wellness and
    dissemination of information.

19
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.

20
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

21
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.

22
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.

23
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.

24
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

25
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.

26
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.

27
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.

28
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.

29
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.

30
  • 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 (902) 482 2494
  • Fax (902) 482 2501
  • Cell (902) 452 7181
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