Winston Salem WellnessWinston Salem Wellness – Winston Salem Health Promotion

Although Dr. Phil is a wildly successful talk show host, it doesn’t make him in expert in losing body fat. Honestly…if he really knew how to lose weight and get fit, don’t you think he’d look better? His weight loss book has been a huge seller, but I don’t believe it will help you get a sexy body.

Is Dr. Phil a Great Fitness Role Model?

No! Physician Phil is not in very good shape at all! You can tell by looking at the man, that he has a below typicalphysique. I don’t listen to people who just talk a good game…I like to chose mentors who are the best at what they do.

Would You Rather Learn Business from a Harvard Professor or Bill Gates?

I would chose Bill Gates. There is nothing wrong with a good teacher, but I like teachers that “walk the walk”. If I wanted to get really fit, I want to learn from someone who is “really fit”. Just because someone is a perceived expert in another field, doesn’t make them an expert in all fields.

There is a Ton of Fitness Advice Given by Out-of-Shape People!

In my gym, we have a very overweight aerobics instructor and several chubby personal trainers. I wouldn’t take advice from any of them. I only take advice from people who are in better shape and who have more muscle tone than me. You may consider doing the same! I really don’t care about certifications or anything like that…if that person can’t get their act together, why should you take advice from them?

How Do You Find a Good Fitness Mentor?

Unfortunately there are not that many fit people in this world…or many of the people who are fit are not interested in giving out advice. The great thing about the internet is you can go online and find these people. The thing you need to do is be certain they have pictures posted of themselves, because you need to insure you are taking advice from a fit person. Also…read their articles and see if their content is unique or just the same bland stuff you read everywhere else.

The program design options hinge upon the goals/objectives and desired outcomes of your program.  If your intention is to help employees make a change behavior, lower risk factors, or save healthcare dollars then your wellness program would be designed to accomplish those outcomes and a budget would be significant to support that design.  

Wellness program design options vary, depending on desired outcomes and budgets.  Each level has pros and cons.  The intentions or results are quite different, are not interchangeable in terms of obtaining similar results, and therefore ought not be confused.  For example, planning activities such as an employee wellness fair or lunchtime education sessions, or having brochures available do not usually result in behavior modification, but may expand awareness on a topic.  If the intention is behavior modification then a different design is required, such as Lifestyle/Behavior Change Programs and Organization Support.  The outline below describes the wellness design levels with a brief explanation.

Awareness Programs:  At this level a employer makes health information available and accessible to employees.  This type of program frequently includes handouts on a variety of issues, wellness articles in newsletters, bulletin board displays, e-mail health messages, etc.   Also, most health & wellness fairs are designed as awareness programs with vendors offering information and offering health screenings to employees.  

Awareness programs are cheap and do not require extensive employee or business time commitments.  Still, these programs do not usually result in behavior change.  Improving awareness isn’t usually sufficient to generate lifestyle changes for most Americans, unless used to innervate staff members to register for a program being available at the business or neighborhood on the topic.  An example of this would be offering information on the deleterious effects of smoking and inviting staff members who smoke to register for a tobacco cessation class.

Education Programs:  Educational programs often offer more information on a topic and are able to also provide time for Q & A, but are similar to awareness programs.  An example is lunch-n-learn sessions on a health related topic.  These cost the company a little more than awareness programs; however, they remain inexpensive and do not require much time for planning or attending a session.  Again, increasing awareness and providing information may not yield the desired behavior modification unless ongoing support or rewards and incentives are also planned.

Lifestyle/Behavior Change Programs:  These programs are designed as 4 to 12 weekly sessions or workshops to offer health and wellbeing education, address barriers and offer opportunities to practice the desired skills.  Behavior change programs therefore require additional employer resources, cost more, and also require additional employee commitment, time and effort.  The results are often the desired beneficial lifestyle change, which if sustained may lead to potential cost savings.  

Examples are smoking cessation classes, weight loss and weight management meetings, or an ongoing exercise program.

Environmental and Company Support:  Environmental reinforcement is frequently considered the highest and most valuable level to include when beginning your wellness program in order to support and maintain healthy behaviors.  These types of design options include policy changes such as:

• Creating a smoke-free workplace
• Designating a walking path,
• Organizing workplace fitness centers,
• Ensuring healthy snack machines choices,
• Offering healthy food choices in the cafeteria, and/or
• Creating flex-time policies.  

Other examples include subsidizing healthy snack machines or cafeteria choices; reimbursing gym or weight loss and weight management program memberships; or offering insurance rewards and incentives for healthy behaviors.

Ideally, the wellness program design would include some of all of these options.  The more comprehensive the approach, the more successful the outcome will be.  For example, a company can have tobacco cessation information available; can schedule a one hour awareness session on the harmful effects of smoking and how to quit; can implement an onsite tobacco cessation program, supply self quit smoking kits, or support employees to go to a neighborhood program; and/or on an environmental reinforcement level can establish a smoke-free workplace and grounds, offer lower health insurance for non-smokers, or support pharmacological quit smoking aids for free.

Employee Health Promotion Program: Components for Success

There are several critical components that must be considered to see to the success of your Employee Health Promotion Program or Employee Health Promotion Program.  These include:  

• Senior Management Reinforcement & Employee Participation
• Active Corporate Health Promotion Program Committee
• Program is Based on Employee Needs & Interests
• Goals and Objectives are Determined
• Detailed Action Plan Based on Resources & Budget
• Program Implementation & Internal Marketing
• Assessment of Outcomes and Program

We have all been there. You have got the beach vacation, wedding, class reunion, old boyfriend or girlfriend in town….etc. There are a million reasons why someone may need to LOSE WEIGHT FAST!!!

In the past, I’ve wasted many an hour searching the web for diet, weight loss, and exercise ideas that would help me shed pounds quickly, but healthyly. You always find so called “experts” on message boards recommending that you lose no more than 1-2 pounds a week.

They say if it comes off slowly it will stay off. And if you have the time to do it that way (or you need to lose a significant amount of weight) then I wholeheartedly agree. HOWEVER, many of us have 10, 15, 20, 30 or 40 POUNDS to lose BEFORE A BIG EVENT OR OCCASION and we need to MAKE IT HAPPEN.

You have probably been counting down as the weeks or months have ticked by leading up to your big event. You have been feeling like you have plenty of time to lose the weight. “I will start tomorrow” is the oldest excuse in the book and pretty soon You will find that you’ve RUN OUT OF TIME.

I found a program that worked well for me and I’m going to share a sample chapter with you, it focuses on the benefits of beverages and how they are able to help you attain rapid, safe, and permanent weight loss.

Here’s the excerpt:

The single most important factor to your weight loss success will be drinking enough WATER.

In fact, you are likely carrying around a few extra pounds of water right now because you are dehydrated. The majority of American Citizens DO NOT DRINK ENOUGH WATER. Caffeine found in sodas and coffee (you know how we love our Starbucks!) exacerbate this problem. And, NO! I do not advocate drinking diet soda….it’s a NO NO on my plan.

When the body doesn’t get enough water, it holds onto what it has….ie. Water retention. Many friends who have used my plan (and who had been big coffee drinkers) found themselves losing up to 8 or 9 pounds in the first week!

The right combination of water, caloric intake, and exercise is powerful.

I am not saying that you can’t drink soda or coffee, but for each soda (please limit it to 1 a day….most have 100 calories or more) or coffee you consume please also consume at least four ounces of water. This means You will be going to the bathroom a lot (extra exercise..yay!) but everytime you go to the bathroom visualize yourself “peeing out the fat”…..I know it’s gross, but it kind of works for me!

Did you know that your liver converts stored fat to energy? Unfortunately, another of the liver’s job is to pick up any slack from the kidneys. Your kidneys need plenty of water to function properly. When you dehydrate yourself, the liver has to compensate, lowering it’s metabolic productivity. It can’t metabolize fat as quickly or as efficiently if it didn’t have to help out the kidneys. You’re setting yourself up to store fat.

I highly recommend getting yourself a BPA-free water bottle (aluminum or stainless steel is best) that clearly marks ounces on the side. You need to drink 64 OUNCES a day to achieve maximum weight loss and health benefits.

Important! Don’t drink this at all one time. Some folks might get to the end of the day and realize they haven’t made their daily quota and try to down a bunch of water at once. This is not healthy and can be dangerous. It is important to spread out your water consumption throughout the day, not all at once.

I’m recommending that you to switch back and forth between hot water (w/ lemon, herbal tea (caffeine free) or lime) and icy cold water. This revs up your metabolism in different ways and forces your body to work a little harder to metabolize the water and your own body temperature….this in turn leads to more calories burned, and that is what weight loss is all about.

Bottoms up, BEVERAGES……..

The accepted rule of thumb for weight loss is to drink eight 8 ounce glasses per day or 64 ounces overall OR whatever amount feels comfortable for your body weight and height. (ie. A larger person in a warmer climate is going to need more water than a petite person in a moderate climate.) Alternate between warm/hot water and icy, cold water.

Be sure to get yourself a BPA free water bottle to track consumption.

**Feel free to add lemon, lime, caffeine freeherbal teas, or even a teaspoon of honey to your water.

Be cautious not to overdo it, there is such a thing as water intoxication and while very rare, it can kill you if you over-flush your system with liquids.

BONUS!! Fiber and Protein Waters

I highly recommend incorporating these into your diet. They are fairly new to the market, but I’ve had great success with them myself and they’ll help you burn fat even faster. And, it makes it easier to meet that 64 ounces a day when you are drinking something that has a little taste to it!

Top Three Recommendations

1. Kellogg’s Special K2O Protein Water Mix in Pink Lemonade: You can add this to your water bottle and sip it throughout the day or between meals. Each mix contains 30 calories and 5 grams of hard-to-come-by-when-you’re-on-a-calorie-restricted-diet PROTEIN!!

This really helps to fill me up and takes the edge off of cravings. I recommend no more than 1 packet a day.

2. All-Bran Fiber Drink Mix in Pink Lemonade: Fiber is great way to help you feel full and it moves waste through your system more efficiently.

I recommend drinking 1 packet daily for the first three days of this program. It will help flush out toxins and help your body to release waste more quickly and efficiently. Each packet contains 20 calories and 10 grams of fiber.

3. Carnation Instant Breakfast No Sugar Added Rich Milk Chocolate: This isn’t a water substitute, but rather a meal replacement. Whenever you are short on time or energy, drinking one of these will help you stay on track and they actually taste good.

Just replace one of your mini-meals with a shake. Each mix contains 5 grams of protein, 4 grams of fiber, and 150 calories w/ milk.

Major benefits of healthy workers include:

• Decreased Health Care expenditures
• Reduced Injuries
• Diminished Rates of Absenteeism
• Increased Morale and Loyalty
• Increased Productivity
• Reduced Use of Health Care Benefits
• Diminished Workers’ Comp/Disability
• Positive Image in Community
• Lowered Turnover
• Better recruitment for skilled employee

What is NOT Having a Company Wellness Program Costing Your Employer?  

Let us look at the health risk factors that are increasing chronic diseases for adults:

• 59% of American adults are overweight or obese
• Greater than 60 percent of American adults do not exercise regularly
• Greater than 75 percent of adults do not consume the minimum recommendations for fruits and vegetables
• Heart disease is the most common cause of death and the leading cause of death in smokers
• 26% of workers stated they were frequently or very frequently burned out or stressed by their job  

Medical Care expenditures are Rising:  Medical Care expenditures are at a record figure of $1.7 trillion with no signs of leveling out, let alone decreasing.  The average expense of yearly healthcare spending is over $5,000 per person and with dependents almost $10,000.  Recent data shows that healthcare related expenditures now cost North Carolina companies thousands of dollars per employee, each year.

Most Illnesses Can Be Prevented:  Although it sounds unbelievable, experts estimate that preventable illness makes up 60 percent – 70 percent of the entire burden of illness in the U.S..   In North Carolina, it is estimated that more than 53 percent of all deaths are preventable, and that 2/3 of all preventable deaths are due to tobacco use, a sedentary lifestyle, and poor diet.

Stress Levels are Rising:  As employer resources dwindle and corporations adopt less-costly work practices, the effects of absenteeism and lost productivity have an increased effect.  In a current national poll, 78% of the population described their jobs as stressful, and the majority believe that stress levels have increased over The previous ten years.  To make matters worse, high levels of employer stress have the potential to negatively affect a employer by increasing injuries, absenteeism, and medical costs while decreasing work rate.  Simple solutions such as stress management education, flexible work schedules, quality social interaction, and increased participation in employer decision-making have the potential to improve stress levels in the workplace.

What is the Upfront Cost and Time Investment for a Corporate Health Promotion Program?

The expenditure is dependent upon the type of Worksite Wellness Program implemented.  There are several options to reward employee health with advantages and disadvantages of each.  The program design is dependent upon the objectives and goals of the wellness program, the business resources, and the area resources available.  

Improving dietary practices, expanding physical movement levels, managing stress or approaching work life balance issues, and lowering/eliminating tobacco use, are primary strategies for preventing many of the most common preventable chronic diseases. The possibilities of how your organization deals with these issues are endless and can range from expanding employee awareness, which may include purchasing a few pamphlets on a variety of topics, and measuring walking distances around your facility, to starting organization support such as funding a full-time occupational health professional or building an workplace fitness center.  

When well-planned and based on your goals, any of these programs have the potential to help you succeed.  Refer below to Workplace Health Promotion Program Design Options for additional ideas.

A Corporate Wellness Program is an organized program to help and support employees in instituting healthier lifestyles.  This may include increasing employee awareness on health subject matters, scheduling behavior modification programs, and/or instituting employer policies that support health-related objectives.  Programs and policies that encourage increased physical activity, tobacco use prevention and cessation, and healthy meal selections are a few examples.  

Dimensions of Wellness

Wellness is much more than fitness alone.  In addition to physical fitness, the dimensions of good health include:

   • Spiritual Wellness,
   • Emotional Wellness,
   • Social Wellness,
   • Intellectual Wellness

These dimensions are frequently depicted as a “life wheel” with examples of health components that include fitness, diet, purpose in life, monetary planning, social connections & backing systems, stress management, mind-body health, career planning and continued learning.   The key to personal health is keeping the “life wheel” in balance.  A comprehensive workplace wellness program addresses most, if not all, of these dimensions.

Why Corporate Health Promotion Programs?

staff members invest a great deal of time working, and the bottom line is that our traditional work-week is growing.  In fact, the everyday American now is at work about 47 hours per week.  In addition, items such as modems, laptop computers, cellular phones, voice and email have confused the work-life boundary.  These realities cut down on the amount of time that the average person is able to devote to wellness and health pursuits, and yet staff members are expected to be extremely efficient when at work.

A current study from the American Association of Occupational Health Nurses saw that workplace wellness or Company Wellness Programs are efficacious in supporting staff members to make beneficial health changes due to several factors such as convenience, environmental backing, and co-worker or social acceptance.  

What’s the Link between Wellness and the Workplace?

Programs and policies that reward healthy lifestyles can make a tremendous difference on employee wellness AND have an impact on the employer’s bottom line.  Studies show that for every dollar invested by employers in Workplace Wellness Programs/wellness programs, there were savings from $1.49 to $4.91 with a average savings of $3.14*.  In employer terms, that’s more than a 3:1 minimum ROI – a number that is hard to disregard, and a best practice that ought to warrant serious consideration from employers.  In fact, a Workplace Wellness Program literature review published in Health Promotion Practitioner Journal found:

   • 19 research studies observed a 28.3 percent reduction in sick leave
   • 16 studies shown a 5.6:1 return on investment
   • 23 showed a 26.1 percent decrease in health care expenditures
   • 4 observed a 30% decline in direct medical and workers’ compensation claims

There is little doubt that a comprehensive wellness program designed to meet a organization’s specific needs can save money by lowering absenteeism, lowering medical care costs, lowering employee turnover, and expanding productivity.

• The U.S. Department of Health & Human Services, 2003

After cost, poor employee program engagement and inadequate communications and substructure are listed as the greatest challenges for businesses administering any health benefi t program.22

By law, businesses are required to explain any benefits or explicit conditions of employment to all employees – this is called “due process,” and it usually takes the form of a packet of information that new employees are asked to review and sign during orientation or, in the case of existing employees, a brief communication during open enrollment periods.

Employers that only engage in the minimally necessitated due process communication of a Workplace Wellness Program, however, do a disservice to the program and the corporation.

Opinions about Medical Care in employers represent one of the largest disjoins between management and staff members. In discussing the need for savings, most employers (70 percent) believe their company effectively communicates about increasing Medical Care costs, while only 34 percent of staff members feel increasing Medical Care costs effect their business’ ability to succeed.23 When it comes to behaviors, 74 percent of employers believe their staff members must be held largely accountable for improving, managing and maintaining health, yet only 4 percent of employers think that staff members participate in these activities.

Under the proposed rules, the four specifications to be a bona fide Employee Health Promotion Program are:

- The total reward that may be given to an individual is limited. The departments invited comments on the appropriate level of the reward, suggesting that a limit of 10% to 20% of the total cost of employee-only coverage may be appropriate.
- The program must be reasonably designed to promote good health or prevent disease for people in the program.
- The reward must be available to all similarly situated individuals. More specifically, the program must allow any individual for whom it is unreasonably diffi cult due to a medical condition to meet the Corporate Wellness Program standard (or for whom it is medically inadvisable to attempt to meet the Corporate Wellness Program standard) an opportunity to satisfy a reasonable alternative standard.
- All plan materials describing the terms of the program must disclose the availability of a reasonable alternative standard.
Source: American Department of Labor Employee Benefits Security Administration

As Northwestern Memorial’s Kathryn Krivy says, “The most fundamental failure in any Worksite Wellness Program is not communicating. You need to tell people what you’re doing and why you’re doing it. You have to get staff members engaged and teach them of what’s going on.”

A properly implemented Workplace Wellness Program is designed to save a company more money with improved participation. However, a company must match its focus on program design with an equally strategic investment in efforts to engage employees in the initiatives.

Lay out your case – Despite widespread recognition of increasing Health Care costs, workers remain skeptical that the problem affects employer operations. In fact, only 53 percent of workers even believe what their employer communicates about the subject.24 Businesses need to be more candid and forthcoming about the amount they spend on Health Care and how that relates to larger budgetary constraints and potential investments.

Says Motorola’s Saenz: “We share with staff members that we have been able to maintain Motorola’s Health Care spend trend below national average over the past several years due to their participation in our various Employee Wellness Programs. This transparency is necessary to keep reminding people the reasons for our behaviors.”

An effective strategy is to focus on the cost savings and central health benefi ts to the employee and not the corporation. By personalizing the information in this way, it produces a win-win scenario instead of presenting the program as a sacrifi ce on the part of the employee. Information must be presented through multiple channels, constructed in a way that makes sense to all levels of staff members, and provided to staff members, dependents and retirees.

Make it your own – Every Company Health Promotion Program will be different, and ought to reflect the culture of a company. While program areas will be determined by analyzing employee health risks, the actual offerings ought to be shaped by the nature of the company. Younger, more active employee communities may be attracted by different programs than an older or technicaloriented employee. Additionally, a global company with mobile employees will have different needs than a company with one central location.

As noted earlier regarding PepsiCo’s HealthRoads, one strategy is for companies to brand their Employee Health Promotion Programs. Union Pacifi c Railroad (HealthTracks), General Motors (LifeSteps) and Caterpillar (Healthy Balance) all adopted this approach to help create recognition and a larger meaning around their efforts. Having a branded plan helps staff members and other stakeholders see the larger objectives of the Employee Health Promotion Program, instead of focusing on isolated offerings.

Say it loud, say it proud – As a potential cost-saving plan, Corporate Wellness Programs ought to be given the same executive backing and internal responsibility as any comparable employer effort. Employers ought to not approach wellness as simply a preventive, financially-motivated program, but rather as an opportunity for the employer to distinguish itself and become more competitive.

Jeffrey Treem, analyst, Edelman Change and Employee Program Engagement Group, says that effective communication about Workplace Wellness Programs must be integrated into existing organization communication channels and vehicles. “This includes executive communication to external stakeholders,” he notes, “because this sends a powerful message back to staff members about the significance of the programs. Workplace Wellness Programs must not be treated as merely an additional employee perk, but rather an innovative and strategic effort to decrease costs and create a healthier work environment.” Talk among yourselves – The most powerful champions of any Workplace Wellness Program will be the participants.

Organizations ought to discover ways to facilitate discussions about the program among workers. This could take the form of support groups, interactive media and the sharing of success stories.

Nonetheless, since Company Wellness Programs touch on potentially private health topics, it is important communication remains positive and inclusive, while not pressuring workers. Discussion of wellness topics ought to be voluntary, though employers may consider providing rewards and incentives for those willing to contribute. Motivation and information from peers is likely to carry more credibility and significance than messages from management.

———-

Even in an at-will employment environment, people are still guarded from discrimination (including wrongful termination) by virtue of belonging to a protected class. Prior to beginning a Workplace Wellness Program, companies need to be knowledgeable about the relevant legal restrictions and the potential impacts these measures can have on benefi ts and employee behavior programs.

Title VII of the Civil Rights Act of 1964 – Prohibits employment discrimination based on race, color, religion, sex or national origin.

This means that standards and offerings need to be applied equally (or possibly proportionally) to all protected classes. In other words, if a employer is offering access to health clubs, it should make sure that men and women have equal access to facilities. Organizations should also consider whether a person who may live in areas heavily populated by one race, religion or ethnicity also have access to facilities and programs. The easiest way to address this concern is to support onsite Employee Wellness Programs whenever possible. This not only ensures equal access, but according to Northwestern Memorial’s Krivy, also expands participation.

Companies must also be aware that particular health issues may disproportionately affect protected classes. Health Risk Assessments and any incentives and rewards put in place may have to be personalized to account for non-lifestyle related differences.

The Equal Pay Act of 1963 (EPA) – Protects men and women who perform substantially equal work in the same establishment from sex-based wage discrimination. Benefits, rewards and incentives and programs need to be applied equally to men and women. A business can’t set a weight goal for men and not for women, even though a business can set health parameters by job function. The Age Discrimination in Employment Act of 1967 (ADEA) – Protects individuals who are 40 years of age or older from discrimination based on age.

Policies not only need to be available to people of all ages, but program goals/objectives, restrictions and incentives/rewards need to be designed with age appropriateness. While older workers (or retirees and dependents) may inherently pose a higher health risk, their behaviors must be judged in terms of demographically appropriate measures.

Title I and Title V of the Americans with Disabilities Act of 1990 (ADA) – Prohibits employment discrimination against qualified individuals with disabilities in the private sector, and in state and local governments. Similar to other workplace offerings, any Company Wellness Programs, such as a fitness center or health clinic, would have to make reasonable accommodations for workers with disabilities.

One area of equivocation is whether obese staff members qualify as disabled. The issue is complicated because weight is caused by several factors (genetics, environment, behavior), some of which may be out of the employee’s control. Generally, for staff members to qualify for disability based on weight, the condition must signifi cantly impair their physical or mental ability to perform their job. This determination would need to be made by a qualifi ed physician. Although this label may affect the types of rewards and incentives and program requirements provided, it likely would not affect the overriding implementation of behavioral-focused initiatives.

Civil Rights Act of 1991 – Provides monetary damages in cases of intentional employment discrimination.

This legislation permits people to sue corporations for improper treatment. Compensation can be in the form of actual damages such as lost or expected wages, compensatory damages for a postion that causes public embarrassment, or even punitive damages meant to send a message to a corporation for egregious or habitual violations.

While these laws govern all corporation activities, there are even more stringent restrictions with regard to Healthcare problems. Most policies, communications and data collection regarding employee health are governed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Under HIPAA corporations can’t deny eligibility for benefits or charge a higher premium on the basis of:

• Health status
• Health condition (including both physical and mental ailments)
• Claims experience
• Receipt of health care
• Medical history
• Genetic information
• Evidence of insurability (includes activities such as riding a motorcycle, skiing, snowmobiling and other similar pursuits)
• Disability

However, because wellness programs may not include medical treatment or be insurance related, and may instead be confined to behavioral initiatives, HIPAA’s nondiscrimination provisions do not fully apply. To address this, in 2001 the United States Department of Labor, the Internal Revenue Service and the United States Department of Health and Human Services jointly issued a proposed regulation to help clarify the lawful provisions of a “bona fi de Wellness Program” in the context of HIPAA’s existing language (See Box p. 14). Although the regulation is not yet final, companies that comply with the measure will be viewed by the government as making a good-faith effort to avert discrimination in wellness programs.

Robust Workplace Health Promotion Programs are still relatively new to corporate America and the legal implications of implementation and enforcement are not completely known. By their very nature, these programs potentially expose companies to discrimination lawsuits, disengaged staff members and detrimental public relations. Nonetheless, companies that make a good-faith effort to comply with current Healthcare-related laws, find ways to involve staff members, and communicate strategically, will be able to minimize these risks while finding plenty of room to develop a creative and effective Workplace Health Promotion Program.

For many employers, a smoking ban would not even apply to all workers. That is because currently 30 states and the District of Columbia prevent employers from banning off-duty smoking.21 Additionally, 13 states prevent employers from banning alcohol use away from work. Only six states have broad statutes that prevent employers from prohibiting any lawful behavior. Michigan is the only state that expressly prohibits discrimination on the basis of weight, however the cities of San Francisco and Santa Cruz, Calif., also have this provision (San Francisco makes exceptions for police offi cers, fi refi ghters and the San Francisco 49ers football team). When beginning Employee Wellness Programs, employers ought to keep in mind local statutes as well as established common law.

Savings of Voluntary Company Health Promotion Program = (number of participants x savings per participant) – (expense of program)
Savings of Incentive-based Employee Wellness Program = (number of participants x savings per participant) – (expense of program + expense of rewards and incentives)
Savings of Mandatory Worksite Health Promotion Program = (number of participants x savings per participant) – (cost of program + cost of policy-related turnover + cost of limited talent pool)

Constructing Employee Health Promotion Program policies in a company that employs unionized workers can pose unique challenges. Employee Health Promotion Programs may be perceived by some unions as a condition of employment and therefore would be subject to collective bargaining between the parties. However this postion can represent an opportunity for both groups, as a policy agreed upon between union leadership and management is likely to be received more favorably by workers. The United Auto Workers and General Motors worked together to create and position a joint Employee Health Promotion Program which has successfully reached more than 800,000 participants. (See Case Studies, UAWGeneral Motors LifeSteps Employee Health Promotion Program, p.21).

Unless specifically stated otherwise, most business-employee relationships in America are governed by the principle of at-will employment. Under this system a business, or the employee, can terminate the relationship without any required showing of cause. This at-will standard gives private companies substantial authority in governing the behavior of workers. In this environment, companies can Finding Wealth Through Wellness 10 creatively design Company Health Promotion Programs based upon their specifi c corporate culture. Company Health Promotion Programs generally take three main forms:

Voluntary Company Wellness Programs – The most popular form of employee Company Wellness Program, in most cases they are made available to workers but participation (or lack thereof) is not linked to any type of consequence. Due to ineffective communication, often workers are either unaware of these offerings or confuse them with insurance-based healthcare. Incentive-based – Company Wellness Programs based on incentives reward workers for participation in Company Wellness Program activities. Incentives frequently include lower Medical Care premiums, gym membership or customized support offerings. In these programs, employees’ behavior can be linked to a particular reward.

Mandatory Employee Health Promotion Programs – Some corporations require, or ban, certain health-related behaviors. These can take the form of mandatory Health Risk Assessments for staff members and restrictions on smoking or alcohol use. While mandating behavior is an effective method to eliminate high-risk behavior, the cost savings must be gauged against the potential message sent to existing and prospective staff members. Given that staff members are already under various levels of scrutiny in the workplace, individuals may resist attempts by corporations to regulate off-duty behaviors. Additionally, some staff members may fi nd it diffi cult to comply, forcing corporations into the uncomfortable situation of punishing an otherwise productive employee.

In the short-term a mandate-based Company Wellness Program can lead to an increase in turnover, as workers either choose to leave or are fi red for noncompliance. In the long-term, the policy may prevent the company from hiring an otherwise qualifi ed applicant, or may serve as a deterrent for individuals thinking of the company. Limits in recruiting, for instance, led CNN to rescind a 13-year ban on hiring smokers.18

Organizations need to make sure that Workplace Health Promotion Programs are aligned with the values and culture that lead corporation operations. If a corporation emphasizes trust and individual responsibility, then a mandate-based program will likely cause more dissension than it would in a corporation that already heavily regulates corporation behaviors. Moreover, a work environment with a large disengaged population will likely have poor participation in a voluntarybased program. When calculating cost savings, organizations need to take a wider view and consider the effects on long-term employee program engagement.

In 2005, Michigan-based insurance benefits provider Weyco instituted a smoking ban for all of its nearly 200 staff members. Workers are subject to random testing and if they fail a mandatory breathalyzer test, they will be fi red. It is believed that Weyco is the first business to use testing to enforce a smoking ban – most companies ask staff members to self-report behavior. Four staff members (more than 2% of the total labor force) left Weyco as a result of the policy. A year prior to the ban the business started a $50 smoking fee, which would be waived if a employee passed a nicotine test or agreed to take a smokingcessation class. Weyco’s president Howard Weyers announced that 20 staff members quit smoking through this program.20 Workers were told they had one year before the total ban would go into effect. Under the new Employee Wellness Program, Weyco does offer $35 a month for staff members who want to use a fi tness center and another $65 a month for staff members who meet fitness goals.

1. Undertake a utilization assessment – While companies can’t get medical information on individual employees, insurance providers will supply companies with reports that detail patterns and rates of employee use for things such as physician visits, hospital stays and prescription drug use. This information is vital for a employer to set a benchmark of its current health risk status. Data from human resources(HR) can be integrated with benefits information to provide a complete picture of employees’ health-related costs. Then, companies can determine the specific level of behavior transformation necessary to result in cost savings. The utilization assessment helps a employer identify the areas in which it ought to focus its Company Wellness Program to reap the greatest benefits.

2. Build a organization case – Once a utilization assessment is in place, employers are able to quantify the Healthcare cost savings that will result from specific levels of lifestyle modification and risk reduction. This can be done by setting goals in terms of reductions in identifi able insurance utilization, attendance or disability variables, or by aiming for reductions in health risks and projecting the associated cost savings. Effective estimates factor in the cost of the Corporate Health Promotion Programs as well as the necessary internal marketing efforts that will surround the program. Says Betty-Jo Saenz, U.S. Healthcare Strategy lead for Motorola, “When we started our programs, our focus was on the 20 percent of staff members that made up 80 percent of the costs. We’ve addressed that, and now we’re paying attention to those who are active and Finding Wealth Through Wellness 8 keeping them healthy. Wherever you are on the continuum, there are opportunities.”

3. Design a cross-functional wellness team – Businesses need to identify potential team members who can be champions of wellness within the organization. It is important that the team is representative of the demographic and functional diversity of employees so that it can credibly address any specific needs groups may have. This team will serve as the voice and face for the Corporate Wellness Program within the organization. Best practice organizations integrate members from human resources, communications, organization development and senior staff. Using the utilization analysis as a model, the wellness team should evaluate what programs would be most effective within each particular corporate culture, aligning health-risk priorities with initiatives that employees will be receptive to.

4. Build buy-in from management – The most effective Employee Health Promotion Programs have substructure from the highest levels of a corporation. Backing from management, both in words and in action, sends the message that Employee Health Promotion Programs are a priority for a corporation. The utilization analysis can be a powerful tool to build the corporation case for Employee Health Promotion Programs and convince executives that initiatives are worthy of investment and attention. Meaningful wellness-related messages are integrated into corporation talks and aligned with corporate objectives.

5. Organize a complete Employee Engagement plan – The most brilliantly conceived Employee Wellness Program is meaningless if no employees take part. Effective wellness talks emphasize both health and monetary benefits at the personal and organization level. According to a 2004 survey by Towers Perrin, only 28% of employees say their organization communicates about Healthcare topics other than cost. In addition, wellness-related information ought to be a part of existing organization talks efforts and not coupled solely with benefits talks. This helps elevate the importance of Employee Wellness Programs and align initiatives with organization objectives.

Additionally, discussions around Company Wellness Programs can share personal success stories and provide company progress updates. Successful corporations not only use existing communications channels to generate discussion around activities, but also consider more interactive tools like message boards, forums, blogs and wikis. This helps personalize initiatives and permits for the sharing of best practices within the company.

A lot employers engage healthcare experts to advise in the construction, communication and backing of the program. The use of outside authorities such as these will increase the credibility of the Company Health Promotion Programs as well as combat skepticism from staff members who may view the organization’s motives as merely selfserving.

Another strategy available to corporations is to brand their Worksite Wellness Program. This move can increase the visibility and acceptance of the offering. Branded wellness programs are most common when corporations are also promoting an external campaign around Worksite Wellness Programs. An example of this is PepsiCo, which launched its HealthRoads Worksite Wellness Program internally along with a consumer campaign, Smart Spot, that puts special labels on healthier food and drink options.

These efforts are more effective when they are not owned solely by the internal communications department, but rather when managers serve as leaders of, as well as participate in, Company Health Promotion Programs within employers. This creates more immediate accountability and motivation.

6. Measure constantly and consistently – At every step of implementation, a Workplace Wellness Program must be able to show its value to a employer. Workplace Wellness Programs ought to be designed to allow corporations to set benchmarks and evaluate behavior change. Assessment ought to consider not only quantitative health measures, but also qualitative measures of stress and employee engagement. Less than 10 percent of corporations do extensive management of healthcare cost, employee health risk status or employee satisfaction with benefit offerings, and less than half of corporations do any measurement in these areas at all.16

Measurement is only useful if a employer explicitly specifies what data would constitute success. Potential measures of success include:

• Participation rates
• Greater employee engagement
• Lowering of risk status
• Decrease of direct health costs
• Diminished absenteeism
• Reduced disability claims

Motorola’s Saenz advises administrators of Employee Health Promotion Programs to track as many measures as possible from the start, even if management only requires one, because it is very difficult to retrieve data later. She notes that even if leadership begins by looking at participation rates, they will eventually want to know about reductions in claims and costs.

Frequent assessment is the only way to build support among management and employees. Nearly half of corporations feel a lack of useful data is a top barrier to their ability to manage employee health, and at least 20% of corporations don’t know how effective existing Company Wellness Programs are regarding various outcomes. Companies must lead utilization analyses each year and reevaluate Company Wellness Program priorities based upon changes. In Addition, progress must be shared with the wider business community to build support for initiatives. Managers and executives throughout a corporation are likely to support a program that can prove increased work rate among employees. Effective Company Wellness Programs are designed to be fl exible so they can respond to changes in both corporation goals and objectives and larger health variations.