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Food and the Bottom Line: Decreasing Health Care Costs and Increasing Productivity by Upgrading the Corporate Food Environment

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Title: Food and the Bottom Line: Decreasing Health Care Costs and Increasing Productivity by Upgrading the Corporate Food Environment


1
Food and the Bottom Line Decreasing Health Care
Costs and Increasing Productivity by Upgrading
the Corporate Food Environment
  • Karrie E. Bergman, MPH Student
  • Walden University
  • PUBH-6165-4
  • Instructor Dr. Stephen D. Arnold
  • Spring Quarter, 2010

2
What We Will Cover
  • Overview of the Issue
  • The State or Our Health
  • The Cost of our Health
  • Costs to Employers
  • Can Changes Improve the Bottom Line?
  • Upgrading the Food Environment
  • Why Upgrade Food?
  • What is a Food Environment?
  • Ideas for Upgrading the Food Environment

3
Learning Outcomes
  • Why Employee Health Matters to your Profit Margin
    and Stakeholders
  • Why Food is Key to Employee Health
  • Types of Upgrades

4
The State of Our Health
  • The Health of Adults in the U.S.
  • 2005 1 out of 2 adults had a chronic disease
    (CDC, 2009)
  • 2007-2008 33.8 of adults overweight, 68.0 of
    adults were overweight or obese (Flegal et al.,
    2010)
  • 2007 23.5 million adults had diabetes (CDC,
    2008)
  • 2003-2006 20 of adults had hypertension (CDC,
    2010)
  • Prevalence of Health Risk Factors (Food RDA)
  • In 2004 (CDC, n.d.)
  • Only 40 of people eat at least two daily
    servings of fruit
  • Only 4 of people eat three daily servings of
    vegetables (with 1/3 being dark green or orange)
  • Only 13 of people have a daily sodium intake
    less than 2,400 mg

References Centers for Disease Control and
Prevention. (n.d.). Focus Area 19 Nutrition and
Overweight. Retrieved from ftp//ftp.cdc.gov/pub/H
ealth_Statistics/NCHS/healthy_people/focus_areas/f
a19_2.xls Centers for Disease Control and
Prevention. (2008). 2007 National Diabetes Fact
Sheet. Retrieved from http//www.cdc.gov/diabetes/
pubs/estimates07.htm Centers for Disease Control
and Prevention. (2009). Chronic Diseases and
Health Promotion. Retrieved from
http//www.cdc.gov/chronicdisease/overview/index.h
tm Centers for Disease Control and Prevention.
(2010). Hypertension. Retrieved from
http//www.cdc.gov/nchs/fastats/hyprtens.htm
Flegal, K. M., Carroll, M. D., Ogden, C. L.,
Curtin, L. R. (2010). Prevalence and Trends in
Obesity Among US Adults, 1999-2008. The Journal
of the American Medical Association, 303(3), pp.
235-241. doi10.1001/jama.2009.2014.
5
The Cost of Our Health
  • Cost of Health Care in the U.S.
  • 2007 Total Health Expenditures - 2.2 Trillion
    (NCHS, 2010)
  • Expenditures have tripled since 1990 (CMS, 2008)
  • 75 goes to treat chronic disease (Anderson, 2004)
  • References
  • Anderson, G. (2004). Chronic conditions making
    the case for ongoing care. Baltimore, MD John
    Hopkins University
  • Centers for Medicare and Medicaid Services.
    (2008). National health expenditures aggregate,
    per capita amounts, percent distribution, and
    average annual percent growth, by source of
    funds selected calendar years 19602007.
    Retrieved from http//www.cms.gov/NationalHealthEx
    pendData/downloads/tables.pdf
  • National Center for Health Statistics. (2010).
    Health, United States, 2009 With Special Feature
    on Medical Technology. Retrieved from
    http//www.cdc.gov/nchs/data/hus/hus09.pdf123

6
Costs to Employers
  • Employee Health Care Costs
  • 1999-2009 Insurance premiums for family coverage
    increased 131 (Kaiser/HRET, 2009)
  • Being Overweight Males 170 more/year Females
    495 more per/year (Peng, 2008)
  • 2005 Cost of health care added 1,110 to 1,500
    to the cost of each of the 4.65 million vehicles
    sold (Appleby and Silke Carty, 2005)
  • References
  • Appleby, J. Silke Carty, S. (2005, June 24).
    Ailing GM looks to scale back generous health
    benefits. USA Today. Retrieved from
    http//www.usatoday.com/money/autos/2005-06-22-gm-
    healthcare-usat_x.htm
  • Peng, T. (2008, August 15). Five Financial Costs
    of American Obesity. Newsweek. Retrieved from
    http//www.newsweek.com/id/153309
  • The Kaiser Family Foundation and Health Research
    Educational Trust. (2009). Employer Health
    Benefits 2009 Summary of Findings. Retrieved
    from http//ehbs.kff.org/pdf/2009/7937.pdf

7
Costs to Employers, Cont.
  • Lost of Productivity
  • 2003 Lost productivity from seven chronic
    diseases totaled 1.1 Trillion (DeVol and
    Bedroussian, 2007)
  • Loss of Productivity By Disease
  • Hypertenstion - 280 Billion
  • Cancers - 271 Billion
  • Mental Disorders - 171 Billion
  • Diabetes - 105 Billion
  • Heart Disease - 105 Bllion
  • Pulmonary Conditions - 94 Billion
  • Stroke - 22 Billion
  • Absenteeism
  • Obese workers may lose a week of work a year due
    to illnesses related to their weight (Peng,
    2008).
  • Presenteeism
  • Results in a loss of productivity several times
    greater than absenteeism (DeVol and Bedroussian,
    2007)
  • References
  • DeVol, R. Bedroussian, A. (2007, October). An
    Unhealthy America The Economic Burden of Chronic
    Disease Charting a New Course to Save Lives and
    Increase Productivity and Economic Growth. Milken
    Institute. Retrieved from http//www.milkeninstitu
    te.org/pdf/ES_ResearchFindings.pdf
  • Peng, T. (2008, August 15). Five Financial Costs
    of American Obesity. Newsweek. Retrieved from
    http//www.newsweek.com/id/153309

8
Can Changes Improve the Bottom Line?
  • Changes in Prevention and Treatment (DeVol and
    Bedroussian, 2007)
  • Avoid 40 million chronic disease cases
  • Reduce disease impact by 27 or 1.1 billion/year
  • Lower obesity rate could mean productivity gains
    of 254 billion/year
  • References
  • DeVol, R. Bedroussian, A. (2007, October). An
    Unhealthy America The Economic Burden of Chronic
    Disease Charting a New Course to Save Lives and
    Increase Productivity and Economic Growth. Milken
    Institute. Retrieved from http//www.milkeninstitu
    te.org/pdf/ES_ResearchFindings.pdf

9
Why Upgrade Food?
  • Foods Affect on Health
  • Cardiovascular Disease and Diet
  • Study of Low-fat Plant Diet (Esselstyn, 1999)
  • Prior to study total cholesterol was 237mg/dl
  • At 5 years total cholesterol was 137mg/dl
  • At 10 years total cholesterol was 145 mg/dl
  • Hypertension and Diet
  • Dietary Approaches to Stop Hypertension (DASH)
    Trial (Svetkey et al., 2001)
  • Diet low in fat, sodium and full of fruits and
    veggies
  • In 3 weeks
  • Hypertensive patients Decrease of 11.6/5.3 mm
    Hg
  • Normotensive patients Decrease of 3.5/2.2 mm Hg
  • References
  • Esselstyn, C. B. (1999, August 1). Updating a
    12-Year Experience With Arrest and Reversal
    Therapy for Coronary Heart Disease (An Overdue
    Requiem for Palliative Cardiology). The American
    Journal of Cardiology, 84, 339-341
  • Svetkey, L. P., Simons-Morton, D., Vollmer, W.
    M., Appel, L. J., Conlin, P.R., Ryan, D. H.,...
    Kennedy, B.M. (1999, February 8). Effects of
    Dietary Patterns on Blood Pressure. Archives of
    Internal Medicine, 159, pp. 285-293

10
Why Upgrade Food, cont.
  • You Determine Availability and Access
  • Cafeterias
  • Vending Machines
  • Restaurants
  • Pricing

11
What is a Food Environment?
  • Vending Machines
  • What is in the vending machines?
  • Cafeterias or Restaurants
  • What types of food are they selling?
  • Refrigerators
  • Is there sufficient space for people to bring
    food?
  • Catering
  • Are you getting what you pay for?

12
Upgrade Ideas
  • Upgrading the Food
  • Upgrading Ingredients
  • Ex Pasture Fed Beef vs. Feedlot-Fed Beef
  • Ex Switching to Whole Grains
  • Upgrading the Menu
  • Ex No Fried Items
  • Ex Lots of fruits and vegetables fresh or
    cooked without oils
  • Make it Delicious

13
Upgrade Ideas, cont.
  • Make Healthy Food as Easy (or easier) to Access
    as Unhealthy Food
  • Physical Access
  • Pricing
  • Make it Easier to Bring Food From Home
  • Vending Machines
  • Creative Programs ex Farmers Market On Site

14
Upgrade Ideas, cont.
  • Education and Wellness Programs
  • Provide Nutritional Information
  • Wellness Programs
  • Pamphlets and Newsletters
  • Personal Lifestyle Change Classes
  • Nutrition Classes
  • Cooking Classes
  • Moral Events

15
Lets Review
  • State of our Health
  • The Cost of Health
  • Food and Health
  • Upgrading the Food Environment

16
References
  • American Dietetic Association. (n.d.). Boost Your
    Nutrition with Beans. Retrieved from
    http//www.eatright.org/Public/content.aspx?id644
    2452093termsbeansandlegumes
  • Anderson, G. (2004). Chronic conditions making
    the case for ongoing care. Baltimore, MD John
    Hopkins
  • University
  • Appleby, J. Silke Carty, S. (2005, June 24).
    Ailing GM looks to scale back generous health
    benefits. USA
  • Today. Retrieved from http//www.usatoday.com/mon
    ey/autos/2005-06-22-gm-healthcare-usat_x.htm
  • Centers for Disease Control and Prevention.
    (n.d.). Focus Area 19 Nutrition and Overweight.
    Retrieved
  • from ftp//ftp.cdc.gov/pub/Health_Statistics/NCHS/
    healthy_people/focus_areas/fa19_2.xls
  • Centers for Disease Control and Prevention.
    (2008). 2007 National Diabetes Fact Sheet
    Retrieved from
  • http//www.cdc.gov/diabetes/pubs/estimates07.htm
  • Centers for Disease Control and Prevention.
    (2009). Chronic Diseases and Health Promotion.
    Retrieved
  • from http//www.cdc.gov/chronicdisease/overview/in
    dex.htm
  • Centers for Disease Control and Prevention.
    (2010). Hypertension. Retrieved from
  • http//www.cdc.gov/nchs/fastats/hyprtens.htm
  • Centers for Medicare and Medicaid Services.
    (2008). National health expenditures aggregate,
    per capita
  • amounts, percent distribution, and average annual
    percent growth, by source of funds selected
    calendar years 19602007. Retrieved from
    http//www.cms.gov/NationalHealthExpendData/downlo
    ads/tables.pdf
  • Center for Science in the Public Interest. (2004,
    May). Dispensing Junk How School Vending
    Undermines Efforts to
  • Feed Children Well. Retrieved from
    http//www.cspinet.org/dispensing_junk.pdf
  • DeVol, R. Bedroussian, A. (2007, October). An
    Unhealthy America The Economic Burden of Chronic
  • Disease Charting a New Course to Save Lives and
    Increase Productivity and Economic Growth. Milken
    Institute. Retrieved from http//www.milkeninstitu
    te.org/pdf/ES_ResearchFindings.pdf

17
References, cont.
  • Flegal, K. M., Carroll, M. D., Ogden, C. L.,
    Curtin, L. R. (2010). Prevalence and Trends in
    Obesity Among
  • US Adults, 1999-2008. The Journal of the American
    Medical Association, 303(3), pp. 235-241.
    doi10.1001/jama.2009.2014
  • Jeffery, R. W., French, S. A., Raether, C.,
    Baxter, J. E. (1994, November). An environmental
    intervention to
  • increase fruit and salad purchases in a
    cafeteria. Preventive Medicine, 23(6), 788-792
  • Mayo Clinic. (2008, May 23). Three main sources
    of sodium. Retrieved from
  • http//www.mayoclinic.com/health/sodium/NU00284/NS
    ECTIONGROUP
  • Mayo Clinic. (2008, May 31). Top 5 lifestyle
    changes to reduce cholesterol. Retrieved from
    http//www.mayoclinic.com/health/reduce-cholestero
    l/CL00012
  • Mayo Clinic. (2008, August 7). High blood
    pressure (hypertension). Retrieved from
  • http//www.mayoclinic.com/health/high-blood-pressu
    re/DS00100/DSECTIONrisk-factors
  • Mayo Clinic. (2009, November 19). Dietary fiber
    Essential for a healthy diet. Retrieved from
  • http//www.mayoclinic.com/health/fiber/NU00033
  • Mikkelson, L., Erickson, C. S., Nestle, M.
    (2007). Creating Healthy Food Environments and
    Preventing
  • Chronic Disease. In L. Cohen, V. Chávez, S.
    Chehimi (Eds.), Prevention is Primary (pp.
    287-311). San Francisco Jossey-Bass
  • National Center for Health Statistics. (2010).
    Health, United States, 2009 With Special Feature
    on
  • Medical Technology. Retrieved from
    http//www.cdc.gov/nchs/data/hus/hus09.pdf123
  • Occupational Health Management. (2008, August).
    An Apple a day Workers eat healthy to stay
    healthy. Occupational
  • Health Management, 90-91
  • Park, M. (2009, June 3). Farmers markets bloom at
    hospitals. Retrieved from
  • http//www.cnn.com/2009/HEALTH/06/03/farmers.marke
    ts.hospitals/index.html

18
References, cont.
  • Svetkey, L. P., Simons-Morton, D., Vollmer, W.
    M., Appel, L. J., Conlin, P.R., Ryan, D. H.,...
    Kennedy, B.M.
  • (1999, February 8). Effects of Dietary Patterns
    on Blood Pressure. Archives of Internal Medicine,
    159, pp. 285-293
  • The Kaiser Family Foundation and Health Research
    Educational Trust. (2009). Employer Health
  • Benefits 2009 Summary of Findings. Retrieved
    from http//ehbs.kff.org/pdf/2009/7937.pdf
  • Time. (2006, June 11). The Grass-Fed Revolution.
    Retrieved from
  • http//www.time.com/time/magazine/article/0,9171,1
    200759,00.html
  • United States Department of Agriculture. (2005).
    Dietary Guidelines for Americans 2005. Retrieved
    from
  • http//www.health.gov/dietaryguidelines/dga2005/do
    cument/pdf/DGA2005.pdf
  • United States Department of Agriculture. (2009,
    October 1). Why is it important to eat grains,
    especially whole
  • grains?. Retrieved from http//www.mypyramid.gov/p
    yramid/grains_why.html
  • United States Department of Agriculture. (2009,
    October 1). Why is it important to eat
    vegetables? Retrieved from
  • http//www.mypyramid.gov/pyramid/vegetables_why.ht
    ml
  • United States Department of Agriculture. (2009,
    October 1). Why is it important to eat fruit?
    Retrieved from
  • http//www.mypyramid.gov/pyramid/fruits_why.html
  • Washington State Department of Health. (2006,
    August). Worksite Wellness and Chronic Disease
    Prevention Resource
  • Kit An Investment in Good Health, Improved
    Productivity and Lower Healthcare Costs.
    Retrieved from http//www.doh.wa.gov/cfh/Nutrition
    PA/our_work_sites/worksite_data/Worksite_wellness_
    toolkit.htm
  • Zank, D. and Friedsam, D. (2005, September).
    Employee Health Promotion Programs What is the
    Return on
  • Investment?. Wisconsin Public Health Health
    Policy Institute Issue Brief, 6(5)
  • World Health Organization. (n.d.). Cardiovascular
    disease prevention and control. Retrieved from

19
Additional Resources
  • http//www.fruitsandveggiesmatter.gov/ - A web
    site from the CDC promoting the increased intake
    of fruit and vegetables
  • http//www.mypyramid.gov/ - USDAs Food Pyramid
    web site
  • http//www.cdc.gov/chronicdisease - CDC web site
    with information on chronic disease
  • http//www.cdc.gov/obesity/ - CDC web site with
    information on overweight and obesity
  • http//www.eatright.org/ - Home Page of the
    American Dietetic Association where you can find
    registered dietitians
  • http//www.doh.wa.gov/cfh/NutritionPA/Documents/WA
    _Worksite_Wellness_Toolkit.doc - Worksite
    Wellness and Chronic Disease Prevention Resource
    Kit

20
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