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A New Approach to Wellness: Keeping the Healthy People Healthy!
According to population studies, a typical employee population is made up of 65% with 0-2 health risks (e.g., depression, stress, high glucose, weight, smoking, blood pressure and physical activity, etc.), 25% have 2-4 risks and 15% have more than 5 risks.1 The argument is that since the high risk population is so costly, namely, 20 percent of the high risk population is responsible for over 80 percent of an employer's healthcare costs2, it would seem to make sense to focus solely on this population and drive these costs down. However, this is a mistake. It is equally important to keep the healthy people healthy. Here are the facts: diabetes, heart disease, obesity, and other costly conditions can be prevented when people engage in healthy behaviors day after day, year after year. In fact, 87.5% of health care claims costs are due to an individual’s lifestyle3. Furthermore, research tells us that, our health, if ignored, deteriorates as we age; we lose muscle mass, our metabolism slows (so our weight increases), we lose bone mass and our blood pressure increases. But if you can keep people exercising, eating well and dealing with stress appropriately, you can very likely avoid or mitigate the ill effects of aging. This is why it is JUST AS important to focus your wellness program on engaging all employees, not just the high-risk ones. Another factor to consider is that there are over 80 million baby boomers that will hit 50/60 years of age this decade so we should try to reach out to them before they end up in the high risk category. In fact, a cost savings of $350/person/year is realized by organizations for each employee who, while they don’t improve their health, do not add any risk factors during that year!1 How do you develop a wellness program that keeps the healthy employees healthy while helping the unhealthy employees become healthy? You need to develop wellness programs that engage the entire employee population. Imagine your employees’ response when you announce that your entire wellness budget is going to a program that only targets the very overweight people in your population and ignores those that are already doing the right thing or even worse, ignores those that are at a healthy weight but who still smoke! "Hey! I want to win a iPad too!" If resources are limited (and whose aren’t?), the best plan is to design programs that can engage various segments of your population. By focusing on overall wellness, you can achieve several goals. You can create a culture of health in the workplace, promote personal responsibility, support the important relationship between lifestyle choice and good health, provide inspiration and modeling from the healthy employees and reward employees for maintaining as well as for striving for healthy lifestyle behaviors. For example, a team wellness challenge could reward non-smokers, but also provide incentives and rewards for those who are striving to quit. In this way, you are able to meet individuals where they are and thus more participants are likely to engage and feel connected to the program. Similarly, if you can design a wellness challenge that rewards those who are already at a healthy weight as well as those who are losing weight at an appropriate rate of weight loss (1-2 pounds per week), it is a win win for all. How do you get the most bang for your buck in addressing the various populations segments? Encourage weight management and physical activity. Helping individuals to learn to manage their weight over time and stay within a healthy range by adopting healthy habits including portion control, and regular physical activity may help both the weight loss group as well as the weight maintenance seekers. The 2010 Dietary Guidelines for Americans recommends individuals "maintain calorie balance over time to achieve and sustain a healthy weight. People who are most successful at achieving and maintaining a healthy weight do so through continued attention to consuming only enough calories from foods and beverages to meet their needs and by being physically active."4 Furthermore, the Guidelines suggest "maintaining a healthy body weight and preventing excess weight gain throughout the lifespan are highly preferable to losing weight after weight gain. Once a person becomes obese, reducing body weight back to a healthy range requires significant effort over a span of time, even years."5 Encouraging physical activity through ‘take the stairs’ campaigns, establishing walking routes around your workplace (indoors as well, if size allows) and via a pedometer or accelerometer based walking program, or a wellness challenge have all been proven successful in increasing physical activity in various populations. And the research also documents a financial gain – as if employee health wasn’t enough! Programs that motivate individuals to increase physical activity save organizations approximately $900/person/year in direct medical costs2 and regular physical activity can reduce medication use, hospitalizations, and unnecessary physician visits.1 Want to bring your walking challenge out of the dark ages? Go high tech and make it fun! Many employees embrace technology and this can be used to motivate people to increase their physical activity and/or track the food they eat throughout the day. There are apps available for iPhones, that include Map My Run or the Walk n’ Play app, which tallies a users’ every movement over the course of a day, including walking and climbing stairs, and translates it to calories burned. The game gives an accurate calorie count thanks to a biomedical calibration process applied on the iPhone’s accelerometer that senses motion and can be made to measure metabolic activity. (Of course, you have to keep your iPhone with you throughout the day in order for this app to be beneficial.) Going hand in hand with tracking physical activity is calorie counting. In order to lose weight, you need to consume fewer calories than you burn. There are several online sources for calorie counting, like CalorieKing (for a fee) or SparkPeople (free). An iPhone app, called LoseIt, is also available for free and is a nice app for people who are often travelling or away from their computer (or addicted to their Smartphone!). The blackberry has a similar app called FatSecret, which users can purchase. Ideally, though, you would like to offer your employees an opportunity where they can track, view and possibly have a coach monitor their calories consumed and calories burned, if resources allow. At Wellness Workdays, we use a Personalized Employee Dashboard (PED) (see screen shots by clicking on the following link - PED Dashboards) to do just that and are getting great results since we began using the technology 9 months ago. Participants wear an accelerometer, which is similar to a pedometer. However, instead of simply tracking steps, the accelerometer measures calories burned because it can sense motion in six different planes. You can wear it walking, hiking, biking, strength-training, etc and it will capture all of these movements and translate it to calories burned. You then upload this data to the PED and have the ability to view graphs of your activity levels throughout the day/week/month. Another feature of the dashboard is the option to track your food consumption throughout the day. There is an extensive database of food options from which to choose. At the end of the day, the employee is able to see how many calories they burned and, if they tracked their food intake, how many calories they ate. The PED can also be equipped with a workstation where employees can monitor body fat and weight. The dashboard makes it incredibly simple for employees to keep track of all of the necessary components for weight loss or weight maintenance. In fact, one employee at one of our clients, lost 75 pounds just by following the guidelines set up for him on the dashboard! Keeping employees at a healthy weight or moving employees to a healthy weight is an important part of a wellness program. High BMI (body mass index) individuals cost an average of $2326 (1996 dollars) more in annual health claims compared to healthy BMI individuals8. These types of technology can be incorporated into wellness challenges in order to provide verifiable data or they can be used as stand alone programs, where employees are asked to meet certain daily calorie burn goals or certain body fat goals. Whether you are just starting a wellness program or hoping to make improvements to the one you currently have, make sure you have programming that will appeal to and engage all of your employees. This means running different programs throughout the year and using different approaches (i.e. sometimes offering a program that incorporates technology and sometimes offering an onsite workshop). Just make sure you are focusing on keeping all of your employees healthy, not just the high risk ones! Your employees (many more of them) will thank you! About the Author Selected Sources: 2. Agency for Healthcare Research and Quality. Retrieved July 18, 2011 from http://www.ahrq.gov/research/ria19/expriach1.htm. 3. Schroeder S.A. Indiana University-Purdue University, Fort Wayne (IPFW) Study. NE Journal of Medicine. 2006 4. 2010 Dietary Guidelines for Americans Executive Summary. Retrieved July 18, 2011 from 5. Balancing Calories to Manage Weight. 2010 Dietary Guidelines for Americans. Retrieved July 19, 2011 from 2010 Dietary Guidelines. 7. Chronic Disease Prevention Overview. Centers for Disease Control and Prevention, 2005. Retrieved July 17, 2011 from http://www.cdc.gov/nccdphp/overview.htm#3. 8. Long DA, Reed R, Lehman G. The cost of lifestyle health risks: obesity. Journal of Occupational and Environmental Medicine, 48(3):244-251. 2006. |
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