State of Wellness: The Goods, the Bads & What s Next for Creighton

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Creighton University Organizational Health Report State of Wellness: The Goods, the Bads & What s Next for Creighton Presented by: Dawn Obermiller, MA Date: May 8, 2014

Presentation Overview 2012-13 Wellness Program Overview - 2012-13 Enrollment, Engagement, Completion Comparison Data 2013 Risk Data Summary & Opportunities

Wellness Program Overview

Creighton Wellness Goal Individual Organization Culture of Health Knowledge, attitudes & beliefs Skill building Behavior change Social Support Create a supportive environment Provide access & opportunity Reduce barriers Not just cope with disease, health & well being Build a thriving, flourishing, high performing, sustainable workforce!

Enrollment & Participation Statistics 2010-2014

Participation Review Past Three Years 80% Enrollment Engagement Completion 78% Those that earned 7,000 pts by June 30 earned $5 BONUS in the rewards store 70% 60% 50% 40% 30% 20% 10% 0% 60% 53% 50% Enrollment (HS & HQ) 29% 25% 21% Engagement (7000 pts by June 30) 15% 15% 10% 0% 0% Completion (10,000 pts by Aug. 31) Those that earned 10,000 pts by Aug. 31 earned $10 BONUS in the rewards store 2010-11 (n=1505) 2011-12 (n=1611) 2012-13 (n=1428) 2013-14 (n=1761) Source: SimplyWell Online Reports as of 12.19.13.

Total Enrollment Comparison by Year Year Employee Participants Men Women Participation Rate Incentive 2010-11 1505 (546 CCAP, 959 PPO & Waived) 33.4% 66.6% 49.9% (n-3020) CCAP = $750/$1000 PPO I & II = HS + $40 prize Incentive Store Added 2011-12 1611 (576 CCAP, 1035 PPO & Waived) 34.2% 65.8% 53% (n=3044) PPO I & II= $150 CCAP= $750/$1000 Waived = HS 2012-13 1428 (465 CCAP, 963 PPO & Waived) 42.8% 57.2% 60% (n=2384) PPO I & II= $250 CCAP= $750/$1000 Waived = HS 2013-14 1757 (493 CCAP, 1133 PPO & 135 Waived) 45% 55% 78% (n=1757) PPO I & II= Wellness Rate (discount 30%) CCAP= $500/$750 + discounted premium Waived = HS Source: SimplyWell Group Summary & Executive Summary 12.19.13

Enrollment by Department Combo= <50 employees -GENC -Graduate School -SRVP -University College -VPMN Source: SimplyWell Group Summary & Executive Summary 12.19.13

Comparative Risk Data 2009 v 2013 (5 year) 2012 v 2013 (1 year)

45% 40% 35% 30% 25% 20% 15% 10% 5% 0% Moderate Health Risk Trending- 1yr 2012 2013 Triglycerides 150-199 LDL 130-159 HDL 40-50 2012-2013 N= 1032 Total Cholesterol 200-239 Blood Pressure 120/80-139/892 Glucose 100-125 1 in 4 Americans have heart disease Source: SimplyWell Summary Report as of 12.19.13

80% High Health Risk Trending- 1yr 2012-13 vs 2013-14 N=1032 70% 60% 50% 40% 30% 20% 10% Glucose 126+ Total Cholesterol 240+ HDL <40 LDL 160+ Triglycerides 200+ Blood Pressure 140/90+ 0% 2012 2013 Source: SimplyWell Summary Report as of 12.19.13

60% Moderate Health Risk Trending- 5yr 2008-2013 N=351 50% 40% 30% 20% 10% Triglycerides 150-199 LDL 130-159 HDL 40-50 Total Cholesterol 200-239 Blood Pressure 120/80-139/89 Glucose 100-125 0% 2009 2013 Source: SimplyWell Summary Report as of 12.10.12

70% 60% High Health Risk Trending- 5yr 2009-2013 N=351 50% 40% 30% 20% 10% Glucose 126+ Total Cholesterol 240+ HDL <40 LDL 160+ Triglycerides 200+ Blood Pressure 140/90+ 0% 2009 2013 Source: SimplyWell Summary Report as of 12.19.13

Comparison Risk of Repeat Participants- BMI n=351 80% 70% 60% 50% 40% 30% 20% 10% 0% 29% 23% 39% 41% 27% Overweight BMI 25+ 39% Obese BMI 30+ $73 Billon Annual cost of obesity among full time employees 27% 25% 41% 39% 2009 2010 2011 2012 2013 Each unit increase in BMI is associated with higher healthcare costs and increased likelihood of having claims for most major diagnostic codes and for diabetes and heart disease. Obese (BMI 30+) Overweight (BMI 25+) Source: SimplyWell Repeat Risk Summary Report as of 12.19.13

2013 Risk Data

Type of Risk 2013 % of Participants with Risk (s) n= 1757 2012 % of Participants with Risk(s) n=1428 2011 % of Participants with Risk(s) n=1611 2010 % of Participants with Risk(s) n=1505 Weight Management 65% 62% 62% 61% Improving Fitness 60% 57% 58% 57% Managing Cholesterol Levels 44% 43% 40% 48% Cancer Risk Reduction 41% 39% 39% 40% Coronary Risk Reduction 40% 40% 40% 47% Better Nutrition 33% 32% 35% 33% Managing Stress 11% 12% 13% 12% Managing High Blood Pressure Top Health Risks For All Participants 8% 10% 9% 9% Alcohol Management 6% 6% 7% 7% Quit Smoking 5% 4% 5% 5% Source: SimplyWell Group Summary & Executive Summary 12.20.13

Ideal/ Normal Risks from Current Health Screening Data 90% 80% 70% 60% 53% 61% 62% 70% 71% 55% 55% 77% 76% 81% 85% 50% 40% 47% 2012 (n=1428) 30% 20% 10% 2013 (n=1757) 0% Blood Pressure <119/79 Total Cholesterol <200 LDL <130 HDL >50 Triglycerides <150 Glucose <100 Source: SimplyWell Group Summary & Executive Summary 12.20.13

Moderate Risks from Current Health Screening Data 45% 40% 44% 39% 35% 30% 29% 29% 28% 30% 25% 20% 15% 23% 21% 12% 14% 12% 11% 2012 (n=1428) 10% 5% 2013 (n=1757) 0% Blood Pressure 120/80-139/89 Total Cholesterol 200-240 LDL 130-160 HDL 40-50 Triglycerides 150-200 Glucose 100-126 Source: SimplyWell Group Summary & Executive Summary 12.20.13

High Risks from Current Health Screening Data 18% 16% 16% 17% 14% 12% 10% 8% 10% 10% 9% 9% 7% 8% 11% 12% 2012 (n=1428) 6% 4% 5% 4% 2013 (n=1757) 2% 0% Blood Pressure >140/90 Total Cholesterol >240 LDL >160 HDL <40 Triglycerides >200 Glucose >126 Source: SimplyWell Group Summary & Executive Summary 12.20.13

Body Mass Index Desired <25 Overweight 25-29 Obese 30+ Women Men N= 790 N= 979 31% 38% 28% 30% Employees with BMI >27 have an average prescription drug cost of $714 vs those with lower BMI whose average is $472. 70% 62% 42% 31% Nebraska 65% Overweight & Obese BRFSS 2012 2012 M= 67% & F=59% Source: SimplyWell Group Summary & Executive Summary 12.20.13 http://www.alerewellbeing.com/_assets/cms_uploads/weight%20talk%20business%20case.pdf

Obesity puts you at RISK! Researchers who reviewed past studies found that heavy people who didn't have high blood pressure or diabetes, had more heart attacks and strokes over time than healthy normal-weight people. (That runs contrary to the results of some recent shorter-term reports, which suggested people could be obese but heart-healthy.) Employees with 30+ BMI (Obese) Health Score Breakdown 80% 60% 40% 20% Still At Risk 10% 23% 66% Health Score Risks 79 & below = 3+ risks 80-82.5 = 2 risks 85 + = 1 risk 0% HS 85 HS 80-84 HS 79 and below Obesity researcher Dr. James O. Hill said, It made perfect sense to say there might be a group that have extra body fat but aren't necessarily at risk. I think what this study says is, they are. It's just the risk may be lower (than among obese people who also have other problems) and it might take a little longer to see it." Source: SimplyWell Group Summary & Executive Summary 12.30.13

Personal Wellness Score The overall wellness rating gives a comprehensive score based on the sum of the different major wellness factors. 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% N=1757 Opportunity 8% 48% Within Guideline s At 30% Risk Lifestyle Physical Metrics 44% Good to Excellent 14% Poor Fair Good Excellent Source: SimplyWell Group Summary & Executive Summary 12.20.13

Healthy Living Habits 2013 Healthy Living Habits 28% Less than 7-8 hours of sleep most nights 4% Use tobacco 65% Are overweight or obese 40% Do not get recommended daily exercise 12% Do not eat breakfast daily 7% Snack frequently (3+/day) 5% Report drinking in excess (3+ drinks) 30% Do not eat recommended number of vegetables per day (5% do not eat recommended servings of fruit)

Organizational Wellness 8 risks and behaviors 1. Diabetes 2. CAD 3. Hypertension 4. Back Pain 5. Obesity 6. Cancer 7. Asthma drive 15 chronic conditions 8. Arthritis 9. Allergies 10. Sinusitis 11. Depression 12. CHF 13. COPD 14. CKD 15. High Cholesterol accounting for 80% of total costs for all chronic illnesses worldwide The vast majority of cases of chronic disease could be better prevented or delayed through helping individuals improve these risk and behaviors. Organizations that target 3 major modifiable risk factors by changing individual behaviors can save an average of $700/employee/year in health care costs and productivity improvements Source: 2010 World Economic Forum

Health Score 2013

2013 Health Score Breakdown 60% 50% 40% 30% Average Health Score 2011-84.5 2012-85.5 2013-84.7 Improved Health Score by 5 points: 2011-88 2012-261 2013-259 56% N= 1757 20% 140 new 20% 16% 10% 9% 6% 0% 50-59 60-69 70-79 80-84 85-100 5 or more risks 4 Risks 3 Risks 2 Risks 1 Risk Source: SimplyWell Group Summary & Executive Summary 12.20.13

Glucose & Weight Diabetes Defense In a study looking at weight and diabetes, people who lost 10% of their body weight within 6 months of being diagnosed with pre-diabetes had an 85% lower risk of being diagnosed with diabetes over the next 3 years. Below is further breakdown of their findings: Lost 10 lbs = 85% risk reduction Lost 7-9 lbs = 66% risk reduction Lost 5-6 lbs = 54% risk reduction BMI Breakdown of Employees with Glucose of 117+ 69% 9% 23% 1 in 10 Creighton employees are at risk for pre-diabetes! Ideal/Desired (<25) Overweight (25-29) Obese (30+) Source: SimplyWell Group Summary & Executive Summary 1.7.14

Extra Questions

Participation Preferences Nutrition Physical Activity Stress Not Likely 42% 39% 54% Somewhat Likely 35% 39% 34% Very Likely 23% 22% 12% Individual health coaching in person or via phone Nutrition Physical Activity Stress 13% 11% 11% Online learning 62% 49% 64% Onsite educational classes 26% 39% 25%

Why? Over the past wellness year (September 2012 - August 2013) Creighton has offered numerous skill building challenges healthy lifestyle classes and guided exercise programs such as HealthyLife Weigh CUTT Weight loss Challenge Wake Up Workouts and urbanxcursion. If you haven't participated in at least one of these offerings why not? I did participate 26% I didn t know about the programs. 12% I don t like group activities. 13% Prefer to work individually. 19% My health is excellent and I don t need to participate. 10% Cost prohibited me. 2% The time overlapped with other things. 17%

Summary & Recommendations

Building a Thriving Workforce Premature Sickness Chronic Signs and Symptoms Feeling Ok High-Level Wellness Self-Leader Thriving, Sustainable, Energetic, Well-being Adapted from Edington Associates, 2012.

Individual Wellness Optimal wellness makes it easier for individuals to do what is really important in their lives. Job Family Community Ambitions Wellness is the fuel for prosperity. Dr. James Hill Anschutz Health and Wellness Center

WAKE UP WORKOUTS It might have been cold outside, but that didn t hold our employee back from getting in shape! 2014 Highlights The Wakeup Workout classes have been wonderful for me. I have never been a particularly active person and these classes really change not only my day, but my week. I wanted to thank you for offering this class. It is just great, and maybe the most effective program for me I have done since I have been at Creighton. ~ Maureen Waldron

Before & After of our Female winner! Registered: 126 Completed: 63 Total Weight Loss: 607.3 lbs Total % Weight Loss: 5% 2 Year Comparison 2013 2014 Winners: Male Lost 21% Female Lost 15.4% Everyone who lost at least 5% of their starting weight won a t-shirt! (28 ee s) Average Pounds Lost Per Person # People that Lost 4-5% GOAL (2013-4%, 2014-5%) 4.8 lbs 9.6lbs 12 people 28 people When participants were asked how confident they were to maintain their weight loss for 6 months: 2013 55% were confident 2014 91% were confident When asked how effective the weekly weigh ins were to their success: 2013 73% said somewhat or very beneficial 2014 84% said somewhat or very beneficial

16 Week Program designed to give participants the tools they need to improve their Health Scores (from the SimplyWell health screenings). Participants must have a Health Score of 84 or below 4 Big Picture Presentations Weekly Drill In Sessions Weekly Emails November 2013 April 2014 Registered: 13 Completed: 8 Total Weight Loss: 27lbs *Health Score improvements will be measured in Sept. Take the Stairs: Creighton Climbs the Big East March 2014

What s next? Our goal is to create a supportive environment that makes the healthy choice, the easy choice. ~Your Wellness Team, Dawn & Amber Partner PAC-- May 5 23 rd Best Bites - June 2 30 th Trek N Tone- June 3 July 29 th Corporate Cup Training Program- June 3 Sept. 10 th SHIFT Boot Camp mid July SimplyWell Screenings September Transforming Together Year 3 Focus Resilience

Discussion Q & A Thank you! Email questions or comments to: dawnobermiller@creighton.edu wellness@creighton.edu

Diabetes Marker Hba1c

HbA1c Test What it is? Blood test that gives information about someone s average levels of blood glucose over the past 3 months. Used to diagnose type 1 and type 2 diabetes (also key indicator of disease management) It is reported in a percentage. The higher the percentage, the higher the blood glucose levels have been. Why its important Reflects average blood sugar level for the past two to three months (instead of at a certain point in time) It is a better reflection of how well diabetes management is working Source: www.mayoclinic.com & www.americandiabetesassociation.org 12.12.11

Pre-diabetes Risk At Creighton: 1 out of 10 employees have a glucose level in the pre-diabetic category (100-125). People who are already on the way to developing diabetes could significantly reduce their risk of having a heart attack or stroke by walking for just an extra 20 minutes a day for a year. British Medical Journal findings estimate that replacing 3 servings of juice per week with whole fruit would reduce diabetes risk 7%. A large international study of people with a condition called impaired glucose tolerance (IGT) - a precursor to diabetes - found that taking an extra 2,000 steps a day over one year cut the risk of serious heart illness by 8 percent.

Obesity & The Bottom Line Number of Additional Workdays that Obese employees miss vs nonobese employees. Per day is the estimated cost of those missed days. 30% of Creighton Employees are Obese = 1,572 days missed = $378,852 Source: Gallup Healthways Poll 2013