TODAY S ALLIANCE MEETING

Transcription

1 TODAY S ALLIANCE MEETING Beyond Biometrics & The Bowers + Kubota Story As told by the CEO Dexter Kubota & HIPAA Privacy and Security for Workplace Wellness Programs Laura Anderson, Esq 1

2 HABITS AFFECT HEALTH OUTCOMES 10% 20% 50% 20% Habits Environment Genetics Sick Care 32

3 GENES VS INHERITANCE YOUR PARENTS HEALTH HABITS INHERITANCE GENES SPACES YOUR HEALTH 33

4 WHAT S FITNESS WORTH?! Cardiorespiratory fitness and metabolic risk! Cooper Center Longitudinal study! 60,000 men, 20,000 women! 1970 to 2009! Treadmill testing for fitness as well as reported activity levels 34

5 OBESE & FIT = THIN & SEDENTARY Hazard Ratio for Heart Failure Mortality Joint Association of CRF and BMI, CCLS Men, Normal Weight Overweight Obese ( ) ( ) ( 30) Source: hhtp://circheartfailure.ahajournals.org Fit BMI (kg/m 2 ) Unfit 35

6 HR for HF Mortality Hypertension WHAT ARE THE GREATEST RISKS? Hazard Ratios for Heart Failure (HF) Mortality in Men Based on Presence of Individual Risk Factors, CCLS Current Smoking Diabetes BMI 30 kg/m2 Unfit Family History of CVD Source: hhtp://circheartfailure.ahajournals.org Heart Failure Risk Factors *Numbers inside boxes represent HF deaths 36

7 Sitting Disease by the numbers

8 94SITTING DISEASE - IMPACTS The 2010 American Cancer Society study published in the American Journal of Epidemiology followed 123,216 individuals (69,776 women and 53,440 men) from The alarming results: Women who were inactive and sat over 6 hours a day were 94% more likely to die during the time period studied than those who were physically active and sat less than 3 hours a day. Men who were inactive and sat over 6 hours daily were 48% more likely to die than their standing counterparts. Findings were independent of physical activity levels (the negative effects of sitting were just as strong in people who exercised regularly).

9 EXERCISE MAKES YOU FIT! WOW Minutes/Week of Reported Vigorous Intensity Physical Activity Men Women Quintiles of Cardiorespiratory Fitness 39

10 FITNESS AND TRIGLYCERIDES Triglyceride (mg/dl) Unadjusted Adjusted for Body Weight CRF Quintiles 40

11 FITNESS AND GOOD CHOLESTEROL HDL-Cholesterol (mg/dl) Unadjusted Adjusted for Body Weight CRF Quintiles 41

12 FITNESS AND BAD CHOLESTEROL Non-HDL Cholesterol (mg/dl) Unadjusted Adjusted for Body Weight CRF Quintiles 42

13 FITNESS AND CHOLESTEROL RATIO TG/HDL Ratio Unadjusted Adjusted for Body Weight CRF Quintiles 43

14 FITNESS AND SYSTOLIC BP Men Women SBP (mmhg) CRF Quintiles 44

15 FIT AND FAT ARE CORRELATED *Body fat parameters for men and women plotted against quintiles of CRF 230 Weight (lbs) Men Women Waist Girth (cm) CRF Quintiles 45

16 FITNESS & METABOLIC SYNDROME Metabolic Syndrome (%) CRF Quintiles Men Women *Metabolic syndrome for men and women plotted against quintiles of CRF. 46

17 FITNESS AND DIABETES 6 Diabetes Mellitus (%) 5 Men Women CRF Quintiles 47

18 DIABETICS AND NOT DIABETIC! Over 90% of patients on oral diabetic medications and 75% of patients on insulin were able to get off their medications after 26 days on a proposed diet and exercise regime! Physicians Committee for Responsible Medicine 48

19 FITNESS AND SMOKING 30 Smokers (%) Men Women CRF Quintiles 49

20 FITNESS PREVENTS HEART DEATHS Relative Risk CVD CHD CRF Quintiles *Cardiovascular disease (CVD) & Coronary heart disease (CHD) Mortality Plotted Against Quintiles of Fitness (men) 50

21 FITNESS AND 10 YEAR CHD RISK 10-year CHD Risk (%) Men Women CRF Quintiles 51

22 50 40 THE VALUE OF FITNESS TO EMPLOYERS % Prevalence Unfit Fit Impotence Low Back Pain Problematic Snoring Depression Unexplained Fatigue Difficulty Sleeping Decreased Sex Drive Frequent Heartburn Chronic MS Pain Anxiety Sexual Problems Frequent Headaches Source: ACLS, The Cooper Institute, January

23 GETTING FIT REDUCES COSTS Average Costs of Admissions Years 4 and 5 (ZAR) The cost of hospital admissions in years 4 and 5 on the basis of changes in levels of engagement in fitness-related activities in years 1 to 3 Inactive - No Change Inactive - More Active Active - Less Active Active - No Change Active - More Active Not Enrolled 53

24 GYM A DAY KEEPS HOSPITAL AWAY Odds ratios and 95% confidence intervals for the probability of hospital admissions per number of additional gym visits per week Odd Ratio for Hospital Admissions every 2 weeks 1+ per week 3+ every 2 weeks 2+ per week 54

25 LOWER HOSPITAL COSTS Highly Engaged spend 30% less on hospitals in total per year 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% No Engagement Low Engagment Medium Engagement High Engagement 55

26 ENGAGED HOSPITALIZED LESS 100% 95% 90% 85% 80% 75% 70% 65% 60% No Engagement Overall Endocrine, nutritional and metabolic Mental Respiratory Kidney and urinary tract Cancer Nervous & muscularskeletal Digestive Cardiovascular Source: International data from Health at Work 56

27 VITALITY LONGITUDINAL STUDY A healthcare cost analysis showed a 28.7% cumulative reduction in healthcare trend for members initially inactive who became engaged versus those who remained inactive after five years. Cumulative Trend for Initial Population that Became Engaged vs. Remained Inactive Year 1 Year 2 Year 3 Year 4 Year 5 57

28 COST TREND AND PEPY PREMIUMS % $ Two-year trends 2008/09 High Effectiveness Medium Effectiveness Low Effectiveness 7,000 6,950 6,900 6,850 6,800 6,750 6,700 6, PEPY medical costs High Effectiveness Medium Effectiveness Low Effectiveness 58

29 EXPENSE CONTROL FROM HEALTH Average ROI 6:1 25% 25% 33% Sick time Health Plan Workers Comp 59

30 ENGLISH SCORES Number of Fitness Standards Achieved Grade 5 Grade 7 Grade 9 60

31 MATHEMATICS SCORES Number of Fitness Standards Achieved Grade 5 Grade 7 Grade 9 61

32 EXERCISE AND PRODUCTIVITY Decision Making Error Rates Executive Function Episodic Memory None Exercise 62

33 TURNOVER RATES % Voluntary Involuntary Total High Effectiveness Medium Effectiveness Low Effectiveness 63

34 ECONOMIC VALUE TO EMPLOYERS Health & Productivity Effectiveness Five year Total Return to Shareholders Average market premium (share price) versus industry average Revenue per employee High 14.8% 11.7% $483 Medium -8.2% 6.4% $445 Low -10.1% -15.8% $434 64

35 MORE EFFECTIVE HEALTH AND PRODUCTIVITY PROGRAMS DELIVER 1.3% lower medical trend > $1,000 lower medical costs per employee 2 fewer sick days per year per employee 39% higher revenue per employee 18% premium in share price over the market Source: 2011/2012 Towers Watson/NBGH Staying@Work North America 65

36 BLOOD SUGAR & PRODUCTIVITY STORING FAT & WIRED LETHARGIC & CRAVING FOOD

37 Savings Dead Sick Symptoms Risks Healthy

38 Productivity Dead Sick Symptoms Risks Healthy

39 UHA REAL BODY AGE FITNESS ASSESSMENT 69

40 BLOOD PRESSURE YOUR RESULTS Blood pressure is the measure of the force or pressure exerted by blood on your arteries. There are two different measures of blood pressure: systolic (higher number), and diastolic (lower number). The systolic pressure reflects the force on your arteries when your heart contracts forcing a large volume of blood into your arteries. The diastolic pressure is the measure of the force on the arteries when the ventricles are relaxed and your heart is filling with blood. Normal Prehypertension Stage 1 Hypertension Stage 2 Hypertension Systolic 101 < >159 Normal Prehypertension Stage 1 Hypertension Stage 2 Hypertension Diastolic 64 < >99 Hanlie, your blood pressure of 101/64 mmhg is within the Normal range. Keeping your blood pressure within this range will greatly reduce your chances of having a heart attack or stroke. The American Heart Association recommends having your blood pressure checked on a regular basis. BLOOD PRESSURE TIPS It's important to realize that changing your lifestyle or living habits could have a dramatic effect on your blood pressure. Therefore, to keep your blood pressure from becoming elevated exercise regularly, control your weight, limit alcohol consumption and avoid excess salt and dietary fats. 70

41 CARDIOVASCULAR Cardiovascular fitness is the ability of the heart, lungs and circulatory system to supply oxygen and nutrients to working muscles efficiently, and allows activities that involve large muscle groups (walking, running, swimming, biking, etc.) to be performed over long periods of time. From a health standpoint, cardiovascular or aerobic fitness is generally considered to be the most important of the fitness components. Cardiovascular Assessment Protocol: OwnIndex Max VO2: 40.0 Hanlie, from the results of the OwnIndex assessment, your maximum oxygen consumption is calculated to be 40.0 ml/kg min. Maximum oxygen consumption (abbreviated Max VO2) is a measurement of the maximum rate your body can consume and process oxygen during exercise. The higher your Max VO2, the better your cardiovascular fitness. YOUR RANKING 40.0 Very Low Low Fair Moderate Good Very Good Elite ml/kg min < > 38 Comparing your results with other females between the ages 40-49, places you in the 90th percentile and the Elite cardiovascular fitness classification. REGULAR CARDIOVASCULAR EXERCISE CAN Reduce your risk of heart disease Lower elevated blood pressure Reduce blood cholesterol Increase circulation and improve performance of your heart and lungs Help you look and feel better

42 STRENGTH Muscular strength is very important to your overall health and fitness. Adequate levels of strength are necessary to perform your daily routines at home and work, without excessive fatigue or stress. Higher levels of muscular fitness also reduce the incidence of lower back pain and injury to the musculoskeletal system. Strong muscles also assist your cardiovascular system in sustaining physical activity. Bicep Strength: 53 lbs Strength Assessment YOUR BICEP STRENGTH RANKING 53 Poor Fair Average Good Excellent lbs > 72 Hanlie, from the graph above you can see your strength classification when compared with other females your age. Ideally, you want to score in the Good classification or higher. Try the tips below to help maintain your strength. STRENGTH TRAINING TIPS A well-rounded strength training program includes at least one exercise for each of the major muscle groups in your body. Minimally, you should include one core exercise for the lower body and two core exercises for the upper body. To avoid muscle fatigue, you should arrange your program so that successive exercises do not involve the same muscle group. This principle may be applied by using the following order for weight training exercises: 1) Thighs and hips 4) Legs and ankles 7) Forearms 2) Chest and upper arms 5) Shoulders and arms 8) Wrists 3) Back and thighs 6) Abdomen

43 FLEXIBILITY Flexibility is the ability to move a joint fluidly through its complete range of motion and is important to general health and physical fitness. Flexibility is reduced when muscles become short and tightened with disuse causing an increase in injury and strains. Sit & Reach:12.9 in Flexibility Assessment Hanlie, your flexibility classification is calculated using the measurements from the above flexibility protocols and established guidelines and norms. YOUR MODIFIED SIT AND REACH RANKING 12.9 Poor Fair Average Good Excellent inches > 16.2 Hanlie, the graph shows your flexibility classification when compared with other females between the ages Ideally, you want to score in the Good classification or higher. Try the tips below to help improve your flexibility. STRETCHING TIPS The following is a good outline to follow when stretching: Choose at least one exercise for each of the major muscle groups (10-12 in all). Stretch slowly without bouncing. Hold each stretch just below the pain threshold for seconds. Perform 2-6 repetitions for each exercise. For improving flexibility the routine should be performed three days each week. For maintaining flexibility, 1 day each week.

44 Hanlie, you are in the Moderate percent body fat range. This is slightly over your ideal body fat which gives you a slightly higher risk for developing many serious health problems listed BODY COMPOSITION Body Composition refers to the relative proportions of body weight in terms of lean body mass and body fat. Lean body mass represents the weight of muscle, bone, internal organs and connective tissue. Body fat represents the remaining fat tissue. Body fat serves three important functions: 1) insulator to conserve heat 2) metabolic fuel for the production of energy 3) body fat serves as padding to cushion your internal organs It's essential to maintain some body fat, but an excess level poses a serious health risk. High levels of body fat are associated with high blood pressure, increased levels of blood fats and cholesterol, heart disease, stroke, diabetes and certain cancers. In contrast, very low body fat can cause the development of such medical conditions as heart damage, gastrointestinal problems, shrinkage of internal organs, immune system abnormalities, disorders of the reproductive system, loss of muscle tissue, damage to the nervous system, abnormal growth and even death. Body fat is expressed as a percentage of total body weight. Protocol: Impedance YOUR BODY COMPOSITION Total Body Water: 69 lbs., 51.5%, 31.3 Liters Fat: 38.9 lbs., 29% 29.0% Fat Mass 71.0% Lean Body Mass Body Weight: 134 lbs. Lean Body Mass: 95.1 lbs. Fat Mass: 38.9 lbs. Basal Metabolic Rate: 1347 Hanlie, your body weight of 134 lbs. is made up of 95.1 lbs. of lean mass (bone, muscle and connective tissue), and 38.9 lbs. of fat mass. BMR is the number of calories your lean tissue uses each day Low Optimal Moderate High Very High % fat < > 35.0

45 BodyAge Hanlie, your BodyAge is 42 compared to your chronological age of 46. BodyAge is calculated from the results of your assessments and how you compare with others of your same age and sex. Ideally, your BodyAge should be at least the same as your Chronological Age. Your obtainable BodyAge is what you can realistically reach with a well-rounded wellness program. Consult with your fitness trainer to set realistic goals in fitness and lifestyle changes to reach your obtainable BodyAge. Your Age 46 BodyAge 42 Obtainable BodyAge RECOMMENDATIONS Hanlie, the following are factors that will improve your BodyAge. By improving these factors and following a well-rounded wellness program, it is possible for you to reach a BodyAge of 33 Improving your Body Composition from 29% to 20.09% will improve your BodyAge by 5 years. Improving your Flexibility ranking from Average to Excellent will improve your BodyAge by 2 years. Improving your Strength ranking from Average to Excellent will improve your BodyAge by 2 years.

46 Worksite Wellness Workshop HEALTH AT WORK TRAINING PROGRAMS Health at Work Wellness Actuaries, LLC 76 May 2014

47 CASE STUDY Instructions 1. Review the case study with your group, together, discuss the questions below. 2. Select 1 person to report recommendations back to the large group at the end. 77

48 CASE STUDY Background! Industry: health! # Locations: 1! Total # employees: 128! Total employees Fitness Tested: 103 employees, 81%! Wellness program in place for 8 years! Goal: Increase participation in the wellness program from 60% to 70% as a way to increase engagement, morale, and productivity. 78

49 BLOOD PRESSURE- 60% OF EMPLOYEES HYPERTENSIVE/PRE-HYPERTENSIVE 79

50 CARDIOVASCULAR- 72% OF EMPLOYEES ARE GOOD OR BETTER 80

51 STRENGTH: 86% ARE FAIR TO GOOD 81

52 FLEXIBILITY: 49% ARE VERY POOR/POOR 82

53 BODY COMPOSITION: 54% ARE HIGH/ VERY HIGH PERCENT FAT 83

54 COMPANY AVERAGE AGES All 34 Chronological Age Body Age Obtainable Age 84

55 SUMMARY FINDINGS! Blood Pressure: 60% of employees hypertensive/pre-hypertensive! Cardiovascular- 72% of employees are good or better! Strength: 86% are fair to good! Flexibility: 49% are very poor/poor! Body Composition: 54% are high/very high percent fat! Ages:! Chronological Age: 44! Body Age: 46! Obtainable Age: 34 85

56 CASE STUDY Questions & Your Recommendations: 1. Which measures are the most IMPORTANT to address first (e.g. blood pressure, cardio, strength, flexibility, body composition lean vs. fat)? 2. Which measure would be the EASIEST to address? Why? 3. Pick 1 measure, and describe how you would structure a wellness program for this company. 86

57 RECOMMENDATIONS Questions 1. Which measures are the most IMPORTANT to address first (e.g. blood pressure, cardio, strength, flexibility, body composition lean vs. fat)? ANSWERS: blood pressure predisposition to heart disease, premature death 2. Which measure would be the EASIEST to address? Why? ANSWERS: flexibility because no cost, all levels of employees can participate 3. Pick 1 measure, and describe how you would 87

58 Mahalo nui loa!