ASTHO Annual Meeting September 20, 2013

Transcription

1 ASTHO Annual Meeting September 20, 2013

2 Session Goal: Discuss the value of state public health and business sector partnerships to improve health and wellbeing through worksite wellness initiatives. Panelists: Dr. Dee Edington (National Expert) Dr. Joseph Acierno (SHO- NE) Dr. Terry Dwelle (SHO- ND)

3 Smoking Policies 50/50 (100%) report they are in smoke-free buildings 40/49 (81.6%) report they have footage requirements for smoke-free areas around the DOH building Nutrition Policies 10/50 (20%) have formal healthy catering policies, but many more have informal guidelines 6/49 (12.2%) have healthy vending machine policies 30/49 (61.2%) have a Farmer s Market available for staff 6/49 (12.2%) have menu labeling in their cafeterias Maternity Policies 45/49 (91.8%) have healthy maternity policies 33/46 (71.7%) report that they promote/encourage breastfeeding in the workplace 47/49 (95.9%) have lactation rooms available to employees Employee Assistance 43/49 (87.8%) have insurance coverage for tobacco cessation for employees; coverage varies widely 46/49 (93.9%) have employee assistance programs 38/49 (77.6%) have stress reduction/mental health programs Activities 38/50 (76%) have weight loss/physical activity challenges for employees 22/40 (55.0%) have done evaluation of worksite wellness programs & policies; methods vary widely 30/46 (65.2%) are working with other state agencies to promote worksite wellness 27/45 (60%) are working with local government or community to promote worksite wellness 9/37 (24.3%) are tracking wellness indicators

4 Smoke-Free Venues for Offsite Meetings 2012: Do you have a policy for smoke-free venues for off-site meetings? WA CA OR NV ID UT MT WY CO ND SD NE KS MN IA MO WI IL MI OH IN KY WV PA VA NY VT ME RI CT NJ DE MD NH MA AZ NM OK AR TN SC NC Yes AK HI TX LA MS AL GA FL No No Response

5 Health Challenges or Incentives for Staff 2012: Do you have weight loss or physical activity challenges or incentives for Department of Health staff? WA CA OR NV ID UT MT WY CO ND SD NE KS MN IA MO WI IL MI OH IN KY WV PA VA NY VT ME RI CT NJ DE MD NH MA AZ NM OK AR TN SC NC Yes AK HI TX LA MS AL GA FL No No Response

6 Stress Reduction/Mental Health Programs 2012: Do you offer employees any program or strategy to reduce stress or promote mental health, apart from health insurance benefits? WA CA OR NV ID UT MT WY CO ND SD NE KS MN IA MO WI IL MI OH IN KY WV PA VA NY VT ME RI CT NJ DE MD NH MA AZ NM OK AR TN SC NC Yes AK HI TX LA MS AL GA FL No No Response

7 State-wide objective for wellness of state employees 2012: Is there a state-wide objective for wellness of state employees, such as specific performance indicators or metrics used? WA CA OR NV ID UT MT WY CO ND SD NE KS MN IA MO WI IL MI OH IN KY WV PA VA NY VT ME RI CT NJ DE MD NH MA AZ NM OK AR TN SC NC Yes AK HI TX LA MS AL GA FL No No Response

8 Zero Trends: Health as a Serious Economic Strategy Realizing the promise and Competitive Advantage of a: Thriving, Healthy, High-Performing and Sustainable Workplace and Workforce Edington Associates LLC 2013 Edington Associates September 20,

9 Estimated Prevalence of Health Problems Self -Reported Allergies Back Pain Heart Burn/Acid Reflux Arthritis Depression Migraine Headaches Asthma Chronic Pain Diabetes Heart Problems Osteoporosis Bronchitis/Emphysema Cancer Past Stroke Zero Medical Conditions Health Problems 33.2% 26.9% 15.2% 14.5% 10.7% 9.4% 7.0% 6.4% 3.8% 3.3% 1.8% 1.7% 1.3% 0.7% 31.9% From the UM-HMRC Medical Economics Report Estimates based on the age-gender distribution of a specific industry sector and employee population 2012 Edington Associates 9

10 Estimated Prevalence of Health Risks Health Risk Measure High Risk Body Weight Stress Safety Belt Usage Physical Activity Blood Pressure Life Satisfaction Smoking Perception of Health Illness Days Existing Medical Problem Cholesterol Alcohol Zero Risk 41.8% 31.8% 28.6% 23.3% 22.8% 22.4% 14.4% 13.7% 10.9% 9.2% 8.3% 2.9% 14.0% OVERALL RISK LEVELS Low Risk = Medium Risk = High Risk = 0-2 risks 3-4 risks 5 or more From the UM-HMRC Medical Economics Report Estimates based on the agegender distribution of a specific corporate employee population 2012 Edington Associates 10

11 Natural Flow by Risks-Costs-Age Decrease the Slope $12,000 $9,000 $6,000 $3,000 $0 $1,776 Annual Medical Costs $7,991 $10,785 $7,989 $5,710 $6,625 $8,110 $5,114 $6,636 $4,620 $3,353 $5,212 $2,565 $3,800 $5,756 $1,414 $2,944 $3,734 $4,613 $2,193 $2, $11,909 $11,965 $8,927 Low High Med Risk Non-Participant 2012 Edington Associates Age Range Edington. AJHP. 15(5): ,

12 Recommendations for the Population after 30 years of work (Zero Trends) Don t Get Worse Help the Low-Risk stay Low-Risk Help the High-Risk move to Low-Risk 12

13 What s Next? Change the questions Get to a new level of thinking Adjust our vision of the future Have courage to change our definitions Lead, follow or get out of the way 2012 Edington Associates 13

14 Health Strategies for 2013 and Beyond Integrate the Whole Person into the Environment and Culture: Engage in Population Health (Follow the lead of Safety and Quality) ( in Quality terms this strategy translates into fix the systems that lead to the defects ) (Deming, Drucker, Blanchard) 2012 Edington Associates 14

15 Vision from Zero Trends Zero Trends provides a transformational approach Populations throughout the world live and work within a thriving, healthy, high performing and sustainable workplace and workforce Based upon over 900 Publications and Presentations 15

16 Enterprise Problem and Solution An ENTERPRISE PROBLEM (Threats to the Enterprise) Requires an ENTERPRISE SOLUTION 2012 Edington Associates 16

17 Principles of Senior Leadership Pillar #1 Strategic Create the Vision Connect vision to business strategy Provide measures to get to vision Commitment to healthy culture Provide adequate resources Leadership ownership and engaged Establish the business value of a healthy and high performing organization and workplace as a worldwide competitive advantage 2010: Health Transformation Group, LLC 17

18 Principles of Operations Leadership Pillar #2 Systematic, Systemic Alignment of Policies with Vision Assess Organizational Health Fix the gaps in the environment and culture Train all employees in What, Why, How Conduct a wellness program audit Brand health management strategies You can t put a changed person back into the same environment and expect the change to hold 2010: Health Transformation Group, LLC Not for Distribution 18

19 Principles of Self-Leadership Pillar #3 Systemic Create Winners Help people not get worse Help health people stay healthy Train in basic concepts of living and Thriving Provide improvement, wellness and maintenance programs Create winners, one step at a time and the first step is don t get worse 2010: Health Transformation Group, LLC Not for Distribution 19

20 Principles of Positive Recognition Pillar #4 Systemic, Sustainable Reinforce the Culture of Health Alignment of recognition to the vision Reward champions Set incentives for healthy choices Reinforce at every touch point What is recognized is what is sustained 2010: Health Transformation Group, LLC Not for Distribution 20

21 Principles of Quality Assurance Pillar #5 Sustainable Measure Outcomes against Vision Integrate all data Evaluate program outcomes Provide feedback on how progress was obtained and steps to get to vision Feedback on leadership, culture, selfleadership, positive actions, economic outcomes Support decisions with evidence 2010: Health Transformation Group, LLC Not for Distribution 21

22 Vision for Your Organization Summary 2012 Edington Associates 22

23 Which Sustainability Level is for You Sustainability Rating Core to the Organization 3 Strategic Vision from Leaders Systematic & Thriving Culture Systemic Engage all in the Culture Recognize Positive Actions, WorkTeam Sustained Progress in all areas Comprehensive 2 Speech from Leader Internal Wellness Program Screenings & Reduce High-Risks Coaching Incent High-Risk Reduction Change in Risks, ROI Traditional 1 Inform Leader Out-source Wellness Screenings & Reduce High-Risks Incent High-Risk Reduction Change in Risks Do Nothing 0 Do Nothing Do Nothing Do Nothing Do Nothing Do Nothing Pillar 1 Pillar 2 Pillar 3 Pillar 4 Pillar 5 Five Pillars Senior Leadership Operations Leadership Self- Leadership Rewards for Positive Actions Quality Assurance

24 Phone: (USA) (USA) Thank you for your attention Website: Edington Associates LLC University of Michigan North Campus Research Center 1600 Huron Parkway Ann Arbor MI Edington Associates 24

25 Worksite Wellness. Healthier Lives! A Nebraska Perspective Joseph M. Acierno, M.D., J.D. Chief Medical Officer Director of Public Health Nebraska Department of Health and Human Services

26 Nebraska Snapshot 513 heart attack deaths (2012) 776 stroke deaths (2012) 115,000 Nebraskans diagnosed with diabetes (2011) 65% of Nebraska adults are overweight/obese (2012) 8,887 Nebraskans diagnosed with cancer (2010) (Sources: 2012 vital stats, 2011 & 2012 BRFSS, 2010 Nebraska Cancer Registry)

27 2010 Worksite Wellness Survey 1,512 businesses surveyed Small, medium and large 47% response rate

28 2010 Worksite Wellness Survey Results Fewer than 1 in 5 provide incentives to employees or have policies supporting physical fitness 1 in 6 has policies encouraging healthy food at company events 1 in 4 has smoke-free policy prohibiting smoking on entire worksite 1 in 6 has wellness coordinator 1 in 10 offer health screenings More than 75% provided health insurance Cost commonly reported as barrier to implementing worksite wellness programs

29 Worksite Wellness Councils Cover Entire State

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31 50 Award Winners This Year!

32 Evidence-Based Model Criteria: Leadership Data collection (20 indicators) Wellness plan/demonstrated outcomes Policies/Environment/Benefits Employee health education Screenings Opportunities for physical activity Community involvement/philanthropy

33 Results Fruit consumption 22% - 41% Cholesterol screening 72% - 86% Absenteeism 81% - 70% High risk for diabetes 54% % High stress at work 35% %

34 Results Some areas need additional work: Binge drinking 18% % Routine checkup 82% - 83% Smoking rate 14% - 9.9%

35 Nebraska State Employee Introduced in 2009 Award-Winning: Wellness Program 2012 C. Everett Koop National Health Award 2010 and 2012 Gold Well Workplace Award Wellness Councils of America 2011 Innovations Award Council of State Governments

36 Walk This Way Top Walkers 700,000+ steps

37 Walk This Way Top Walker 10.8 million steps 2 nd year in a row!

38 Nebraska State Employee Wellness Program Results: Comparing with % previously high risk for low levels of physical activity now exercising more than 2 days a week. 9.1% previously high risk for low fruit/vegetable consumption now eating more than 3 servings per day. Tobacco use 12% to 10% High risk for stress 1.8% to 1.3%

39 Results: Nebraska State Employee Wellness Program Overall number of individual risk factors 1.70 ( ) to 1.53 (2013) Participants at low risk status 73.9% ( ) to 78.6% in 2013 Preventive screening rate to 72.7%. 33% before program.

40 Employee Recognition Wall of Fame This has truly been a life changing experience for me.

41 Employee Recognition Governor s Wellness Luncheon

42 Employee Wellness Program ROI 2.70:1 For every $1 spent on the wellness program, $2.70 is returned in health care savings.

43 The Future in Worksite Wellness

44 Wellness Works!

45 Terry L Dwelle MD MPHTM FAAP CPH State Health Officer North Dakota Department of Health

46 Comprehensive Worksite Wellness Traditional Project approach Community Engagement

47 Faith Based Schools Workplace HC Rural Town HC HC HC HC Other Organizations Individual North Dakota Department of Health 47

48 Facilitating communities to own their problems and solutions Community Know each other by first name Sense of shared responsibility

49 Smoking prevention and cessation Physical fitness Nutrition Stress management Medical self-care High blood pressure control Cholesterol reduction Cardiovascular disease prevention Prenatal care Seat belt use Back injury prevention Back pain prevention Weight management Nutrition education Chapman LS, The Art of Health Promotion, July/August,

50 Absenteeism decreased 26% Healthcare costs decreased 26.1% Worker s compensation costs decreased 32% Benefit / cost ratio 5.81/1 Chapman LS, The Art of Health Promotion, July/August,

51 Decrease use of the medical system Decrease absenteeism Decrease injuries Increase morale Decrease stress 51

52 Focus on prevention and education reduce risk factors (Public Health) Health benefits links Targeted health interventions Cost-effective health care delivery Chronic disease management Case management Call a nurse services Onsite clinics 52

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55 $8.5 million savings for 37,000 employees Health risks improved Case management saved $890,000 or $390 / employee / year 55

56 Champion Best practices Adequate resources Part of the strategy of the Health Department Deals with the perceived needs of the workplace Health Departments must have a worksite wellness program

57 Grant inflexibility Misperceptions about medical and pharmacy costs vs absenteeism and presenteeism PH programs are siloed MPH training inadequate for WW Small business increased fixed costs

58 Presenteeism 35% Absenteeism 33% Clinical costs 24% Medications 8% Loeppke R et al., Health and Productivity as a Business Strategy: A Multi-Employer Study. JOEM. 2009;51(4):

59 30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 12.20% 6.20% 0.00% 14.70% 14.70% 14.70% Excess Productivity Loss Base Productivity Loss 0.00% 0-2 Risks 3-4 Risks 5+ Risks Burton, et. Al., JOEM. 2005;47(8):

60 Grant inflexibility Misperceptions about medical and pharmacy costs vs absenteeism and presenteeism PH programs are siloed MPH training inadequate for WW Small business increased fixed costs

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