What is the Latest Research in Workplace Health Promotion (Wellness)? 2017 Art & Science of Health Promotion Conference The Broadmoor Colorado Springs, CO -- March, 2017 Ron Z. Goetzel, Ph.D. Johns Hopkins University and Truven Health Analytics, IBM Watson Health
AGENDA Latest Data from the Kaiser HRET 2016 Survey of Employers Revisiting the Controversy (Again): Do Workplace Wellness Programs Work? Health Affairs American Heart Association Study Bi-Partisan Policy Center Study Nielsen Employer-Employee Survey Metabolic Syndrome (MetS) Prevalence Study Dissemination of Best/Promising Practices What s coming up?
The Headline 83% of Employers Offer Wellness Programs but only 13% Have Comprehensive Programs
Revisiting the Controversy Do Health Promotion Programs Work? 12
The Confusion
New York Times 9/11/14
A Review of the Evidence: Journal of Occupational and Environmental Medicine
The Issue: HR 1313
Sharon Begley s Article in STAT
Fortune Magazine Article
RAND Report RAND Corporation, 2013. http://www.rand.org/pubs/research_re ports/rr254.html. Also available in print form.
Sample Sizes
Weight Reduction Results (N=3,924)
Obesity Rates Over Five Years Participants: 36% 27% Non-Participants: 36% 40%
Smoking Results 8%-29% quit rate (N=746)
Exercise Results 2.5 4.0 Days/Week (N=2,303)
Cholesterol Results No Difference (N=1,341)
Cumulative Per Member Per Month (PMPM) Health Care Cost Differences: Partic Vs. Non-Partic = $65.50 Savings (N=12,127)
Media Report Rand Study
PepsiCo Study
Results
Media Report PepsiCo's workplace wellness program fails the bottom line: study Mon, Jan 6 2014 By Sharon Begley NEW YORK (Reuters) - A long-running and well-respected workplace wellness program at PepsiCo that encourages employees to adopt healthier habits has not reduced healthcare costs, according to the most compreh ensive evaluation of a such a program ever published. Released on Monday in the journal Health Affairs and based on data for thousands of PepsiCo employees over seven years, the findings "cast doubt on the widely held belief" that workplace wellness programs save employers significantly more than they cost, conclude Soeren Mattke of the RAND Corporation and his co-authors. "Blanket claims of 'wellness saves money' are not warranted."
New Research
American Heart Association Study Feb 2017
Research Questions What is the relationship between organizational health and individual employee health? Which culture of health elements (programs, policies and environmental supports) best predict heart health i.e., fewer health risk factors for cardiovascular disease (CVD), lower prevalence of heart disease, and reduced medical expenditures? 33
Data sources American Heart Association (AHA) Workplace Health Achievement Index* (WHAI) Survey (Organizational Health N=20) Truven Health MarketScan Database** (Individual Health N= 373,478 ) Seven health risks for heart disease Heart disease prevalence Medical and drug expenditures for CVD * AHA Index: http://www.heart.org/heartorg/healthyliving/workplacehealth/what-is-the-workplace- Health-Achievement-Index_UCM_481057_Article.jsp#.WJJx2TbhrB8 34
Descriptive Analysis Selected characteristics of 373,478 workers with employer benefits at 20 large U.S. organizations, 2015 35
Risk Factor Definitions Blood pressure (Systolic >120 mm Hg or Diastolic >80 mm Hg) Cholesterol (Total Cholesterol > 200 mg/dl) Blood sugar (Fasting Blood Sugar > 100 mg/dl) Activity (Moderate Intensity < 150 minutes) Diet and nutrition (Fruit and Vegetables < 4.5 cups/day) Weight (BMI > 25 kg/m 2 ) Smoking (Current Smoker) 36
Heart Health Risk Profile of Employees Variable No. with risk data No. at risk % at risk Unhealthy weight 366,521 263,455 71.9 Poor diet 236,913 167,277 70.6 High blood pressure 253,535 168,170 66.3 Physical inactivity 205,671 97,096 47.2 High cholesterol 196,811 55,729 28.3 High blood glucose 142,682 35,858 25.1 Tobacco use 325,524 17,948 5.5 Employees of 20 large U.S. organizations and their risk factors for cardiovascular disease in 2015, by risk factor 37
Descriptive Analysis Employees of 20 large U.S. organizations and their risk factors for cardiovascular disease in 2015, by risk factor 38
Regression Analysis Relationship between higher scores on the AHA Workplace Health Achievement Index (WHAI) of 20 U.S. employers and employee cardiovascular health measures ( + = Pos Relationship; - = Neg Relationship; NS (+/-) = Non Significant) 39
Results Health risks for heart disease are prevalent with overweight/obesity leading the way, followed by poor diet, high blood pressure and physical inactivity. Higher scores on the AHA Workplace Health Achievement Index (WHAI) are associated with lower health risks in four categories (high blood pressure, high cholesterol, tobacco use, and physical inactivity) but higher in one risk factor category (poor diet). Higher WHAI scores are associated with lower heart disease prevalence but higher costs for heart disease. No clear pattern (yet) as to which organizational health factors are associated with better outcomes. 40
Implications for Action Benchmarks and best practices are needed by businesses so they can structure workplace health promotion programs supported by a culture of health that lead to good health and financial outcomes. This is a snapshot view. Longitudinal/trend data will help determine causeeffect relationships between organizational practices and improved health, reduced disease prevalence, and cost savings. Employers act now! No need to wait for more research before implementing evidence-based health promotion programs proven to positively influence employee health and well-being. Measure and evaluate -- design dashboards to track key program structure, process, and outcome measures for the organization. Experiment with different health promotion design elements at different business units/locations and track the effectiveness of alternative models. 41
Percent of Employers with Comprehensive Programs 13.3%
80.6% of Employers Say They Offer a Wellness Program But, 45.0% of Employees Say Wellness is Available to Them
Employee Opinions
Best/Promising Practice Dissemination Robert Wood Johnson Foundation Promoting Healthy Workplaces Transamerica Center for Health Studies Employer Guide to Workplace Health Promotion American Heart Association -- Developing a Culture of Health Playbook Centers for Disease Control and Prevention Workplace Health Research Network Centers for Disease Control and Prevention Information Clearinghouse
Kent et al. JOEM Study
Harvard Business Review, March 2016
CDC Workplace Health Resource Center First stop online to help employers launch or expand a workplace health promotion program Evidence-based, credible resources all in one location Helps employers tailor workplace health promotion goals to their organization s needs
CDC WHRC Unique Features Easy-to-navigate website with robust search functions Reliable and relevant assessment tools and step-by-step resources All resources vetted by CDC and workplace health promotion experts Suited to any workforce s budget
Other Exciting Developments Pending Announcements and Manuscripts Department of Defense Healthy Base Initiative Pilot Study https://bipartisanpolicy.org/library/healthy-base-initiative/ Update of the CDC Worksite Health ScoreCard https://www.cdc.gov/dhdsp/pubs/docs/hsc_manual.pdf Ford UAW Trust -- Enhanced Care Program Evaluation (NIHCR) Pinnacol Health Risk Management Health Risk and Workers Compensation National Academies of Medicine Vital Directions for Health NIOSH Methods Meeting The Health Project Applications due May 2017 for the C. Everett Koop Award Winners Announced at the HERO Forum September 2016 in Phoenix AZ www.thehaelthproject.com
Moving from ROI to VOI Financial Outcomes Health Outcomes QOL and Productivity Outcomes Cost savings, return on investment (ROI) and net present value (NPV) Where to find savings: Medical costs Absenteeism Short term disability (STD) Safety/Workers Comp Presenteeism Adherence to evidence based medicine Behavior change, risk reduction, health improvement Improved functioning and productivity Attraction/retention employer of choice Employee engagement Corporate social responsibility (CSR) Corporate reputation
Learn More at. http://www.jhsph.edu/promoting-healthy-workplaces