chapter 5

Workplace Health Ecosystem

• The workplace is a complex ecosystem with its own organizational structure, policies, culture, norms, and values.
• Effective communication is crucial within this ecosystem, emphasizing clear expectations, mutual trust, and transparent goals.

Workplace Health Communication

• Workplace health communication targets three audiences:
  • Business leaders: Emphasizes the "business case" for investment.
  • Employees: Focuses on health and well-being benefits.
  • Program planners, implementers, and evaluators: Involved in program development and execution.

Workplace Health Promotion Opportunities

• Employees spend a significant amount of time at work, making the workplace an ideal setting for health promotion.
• Focus areas include:
  • Promoting healthy behaviors
  • Preventing and reducing risk factors
  • Managing chronic diseases

Workplace Health Challenges

• Poor health affects individuals and employers:
  • Increases morbidity and mortality
  • Reduces quality of life
  • Contributes to increased healthcare costs, placing a financial burden on both individuals and businesses.
  • The Workplace and Health report reveals concerning statistics:
    • 44% of working adults have reported poor overall health.
    • 16-26% struggle with issues related to family and social life, stress, sleep, diet, and weight.

Workplace Health Programs

• Prevalence:
  • 83% of large companies with health insurance benefits offer at least one health and wellness program.
  • Common program activities include weight management, smoking cessation, and health coaching.
• Benefits:
  • Improve employee health:
    • Influences health behaviors, reduces disease risks, and improves overall health status.
  • Positive impact on organizations:
    • Reduces healthcare costs, absenteeism, and boosts productivity.
    • Improves recruitment and retention rates.
    • Fosters a positive organizational culture and employee morale

Benefits of Workplace Health Programs

• Collective benefit:
  • Workplace health programs benefit employers, employees, their families, and communities.
  • Contribute to the prevention of disease and injury, promoting sustained health and well-being.

Workplace Wellbeing and Health Programs

• Workplace health programs (WHPs) aim to promote and sustain the health and well-being of employees.
• WHPs encompass a wide range of programs, strategies, and activities.

Six Potential Objectives of WHPs

• Resource Provision and Health Education: Providing access to health awareness materials and educational resources.
• Healthy Lifestyle Promotion: Encouraging healthy habits to minimize health risks and promote well-being.
• Preventive Health Screenings: Implementing health risk appraisals (HRAs) and biometrics to identify specific risk factors within the workforce.
• Chronic Disease Management: Offering programs targeting conditions like hypertension, diabetes, and obesity to prevent worsening health outcomes, improve treatment, and enhance quality of life.
• Employee Assistance Programs: Providing confidential access to stress management, psychological counseling, and substance abuse treatment.
• Adjunct Well-being Initiatives: Implementing additional programs and strategies to improve overall well-being.

WHP Terminology

• WHPs are implemented with a comprehensive approach, covering chronic disease management, preventative screenings, health awareness, and more.
• Effective WHPs require leadership support, organizational level policies, and a supportive environment cultivating a culture of health.

WHP Evolution: Historical Context

• Lalonde Report (1970): The first government document acknowledging the significance of individual behavior in health.
• Six Dimensions of Wellness (1976): Developed by Dr. Hettler, this model recognizes six key areas of well-being:

  Physical Wellness

  • Encourages learning about diet, nutrition, tobacco cessation, moderate alcohol consumption, and the benefits of physical activity.

  Emotional Wellness

  • Emphasizes awareness and acceptance of emotions.

  Social Wellness

  • Promotes positive contributions to the environment and community through healthy living and environmental preservation.

  Intellectual Wellness

  • Encourages creativity, knowledge expansion, learning, curiosity, problem-solving, and exploration.

  Occupational Wellness

  • Recognizes personal satisfaction and enrichment in work life.

  Spiritual Wellness

  • Emphasizes searching for meaning and purpose, developing an appreciation for the depth and vastness of life, nature, and the universe.

Healthcare Strategies

• In 2013, 72% of employers focused on programs that improved employee health and reduced medical costs.
• Aon Hewitt is a consulting agency specializing in human capital.

Human Resource Responsibility

• The human resources department is responsible for choosing health insurance coverage and purchasing various benefits.
• These benefits typically include medical, pharmacy, dental, disability, and workers' compensation plans.

Healthcare Management Silos

• Healthcare costs, employee health and wellness, and occupational safety are often managed by three separate departments.
• The department for health insurance benefits manages health insurance coverage.
• Workplace health focuses on preventing illness and disease through initiatives like fitness programs, biometric screenings, and healthy food options.
• Occupational health and safety focuses on preventing injuries and illnesses by implementing safe practices and policies, such as OSHA trainings, CPR training, and ergonomic design.

Employer Responses to Healthcare Costs

• Employers employ various methods to manage healthcare costs.
• Some shift costs through increased employee contributions, higher out-of-pocket expenses, and high-deductible health insurance plans (HDHPs).
• Others focus on employee health and wellness.
• Some restrict or decrease health insurance benefits.

Cost Shifting Strategies

• Cost shifting involves strategies like increased employee contributions to healthcare premiums, higher out-of-pocket expenses, and employing high-deductible health insurance plans (HDHPs).

High-Deductible Health Insurance Plans (HDHPs)

• HDHPs have lower monthly premiums but higher out-of-pocket deductibles compared to traditional plans.

Self-Insured Health Plans

• These plans allow employers to pay for healthcare claims at a higher level than traditional health insurance plans.
• Self-insured plans provide better insight into actual healthcare costs.

Affordable Care Act (ACA) and Workplace Health Programs (WHPs)

• The ACA, enacted in 2010, significantly changed the landscape of health insurance coverage and care.
• The ACA encourages employers to adopt WHPs by providing financial incentives and funding opportunities.
• WHPs incentivize employees to engage in healthy behaviors through:
  • Providing financial incentives for participation.
  • Linking healthcare premiums and cost-sharing to individual health behaviors.
• WHPs protect workers from discrimination based on their health status or genetics.

Health Risk Appraisals (HRAs) and Preventive Screenings

• HRAs are a widely used component of WHPs, with 59% of large companies offering them.
• Biometrics are offered in 53% of large companies.
• Preventive health screenings can identify employees who might benefit from disease management programs.

Chronic Diseases and Workplace Health

• The leading preventable and costly chronic diseases include:
  • Cardiovascular disease (CVD)
  • Stroke
  • Cancer
  • Type 2 diabetes
  • Obesity
  • Arthritis
• The CDC has developed a chronic disease cost calculator to estimate the economic burden of these conditions.
• WHPs aim to offset risk factors and support healthy lifestyles to reduce the impact of chronic diseases.

Tobacco Use and Workplace Health

• Tobacco-related diseases significantly increase healthcare costs and decrease profits for employers.
• Employing a smoker costs approximately $6,000 more per year than employing a non-smoker.

Resources for Workplace Health Programs

• The CDC, CDC Foundation, and Business Pulse offer resources and tools for businesses to implement WHPs.
• These resources include free assessment, planning, implementation, and evaluation tools.
• Other organizations supporting WHPs include:
  • The National Business Coalition on Health
  • The American Psychological Association (APA)
  • Exercise Is Medicine
  • The Workplace Health Research Network

Chronic Diseases

• Chronic diseases can lead to a decline in overall health of employees in the workplace.
• 59% of adults with chronic diseases say their current job has a negative impact on stress.
• Job stress is estimated to cost U.S. industries more than $300 billion a year.

Health Coaching

• Health coaching is a self-paced process in which a health professional helps facilitate healthy lifestyle behavioral change.
• Health coaches utilize self-inventories, motivational interviewing, and goal setting to challenge clients.
• Health coaches provide a safe, nonjudgmental environment, enabling long-lasting behavioral change.
• Health coaching can be delivered in-person, face-to-face, telephonically, or via online wellness portals.

Workplace Health Programs

• Workplace Health Programs (WHPs) utilize data to track and evaluate progress.
• Data is crucial for guiding decision-making in WHPs.
• Smartphones, tablets, and wearable technology devices can be used to track participation and engagement in WHPs.
• Social media can be used to provide encouragement and disseminate health-related material in WHPs.

Telemedicine

• Telemedicine is a form of digital health that involves connecting employees with a health professional via audiovisual capabilities.
• Telemedicine allows employees to have immediate access to healthcare professionals regardless of location, time of day, or day of the week.

Workplace Health Model

• The Workplace Health Model is a coordinated and comprehensive approach to promoting employee health.

Workplace Health Promotion

• A coordinated approach to workplace health promotion involves a planned, organized, and comprehensive set of programs, policies, benefits, and environmental supports designed for the health and safety of all employees.
• Interventions address multiple risk factors and health conditions concurrently, aiming to influence various levels of the organization, including individual employees and the organization as a whole.
• The CDC recommends four steps for building a workplace health promotion program:
  • Workplace health assessment
  • Program planning
  • Program implementation
  • Impact determination through evaluation

Total Worker Health (TWH)

• Total Worker Health (TWH) is a program advocated by the CDC's NIOSH that involves integrating safety and health hazard protection with promotion of injury and illness prevention efforts to advance worker well-being.
• The design of the TWH program advocates for a holistic approach to understand the factors that contribute to worker health and well-being.
• This approach calls for integrating all organizational policies, programs, and practices that contribute to worker safety, health, and well-being.

Active Design

• Active Design tackles environmental design, organizational culture, and policy issues.
• It focuses on features in the built environment that are proven to support daily physical activity and healthy eating.

Employee and Community Involvement

• Employee and community involvement through a participatory approach is encouraged.
• Several tools, such as surveys, meeting agendas, informative guides, instruction manuals, and program flyers, exist to facilitate employee engagement in health program planning.
• Terms like corporate citizenship, corporate social responsibility, and corporate philanthropy are often associated with this approach.

Leadership and Management

• A key element for successful wellness programs is top-level leadership support.
• Leadership influence is more effective if leaders are accessible, visible, and participate in the wellness programs themselves.

Leadership Participation in WHPs

• Visible leader participation in workplace health programs (WHPs) encourages positive employee behavior.
• Leaders setting an example demonstrates the company values both employees and the WHPs.
• Leaders should focus on sustainability by incorporating healthy practices into company culture.

Building Trust and Confidentiality

• Workplace health initiatives are not always altruistic, as they often benefit the company as well.
• Effective communication is key for WHPs. Health communicators engage, inform, and persuade employees, navigating complex social dynamics.
• Managers at all levels must actively promote healthy values by setting an example, establishing norms, and sharing information.

Tailoring WHPs

• Tailoring WHPs to specific employee sub-populations increases their effectiveness and success.
• Programs incorporating leadership support, a positive work culture, health risk screening, and tailored programing improve employee productivity.

Resource Utilization

• Organizations can leverage free or low-cost resources from academic, non-profit, and governmental organizations to overcome challenges with WHPs.

WHP Benefits

• Common motivations for offering WHPs include improving employee health, controlling healthcare costs, enhancing productivity, and reducing absenteeism.
• The success and value of a WHP are often measured by its financial benefits, including return on investment (ROI).

Evidence-Based Strategies

• Healthy workplace practices should be informed by scientific evidence.
• Employers should create a workplace that encourages and supports healthy behaviors.
• A successful WHP requires an employer's belief in the importance of employee well-being and success.

Workplace Health Programs (WHPs)

• Visible leadership participation in WHPs sets an example for employees and demonstrates value for both the WHP and employees.
• Corporate leaders must prioritize sustainability.
• Trust and confidentiality are crucial in WHPs.
• Workplace health initiatives often have a dual purpose: promoting employee well-being and benefiting the organization.
• Engaging, informing, and persuading employees about workplace health requires a nuanced approach.
• Managers at all levels should actively communicate health and wellness values through role modeling, norm creation, and information sharing.
• Tailoring health information and resources to specific employee groups can enhance program effectiveness.
• Successful WHPs often include organizational leadership, a supportive work culture, health risk screenings, and tailored programs.
• Programs with these features are more likely to increase productivity at work.
• Utilizing free and low-cost resources from academic, nonprofit, and governmental organizations can be invaluable for WHPs.
• Common reasons for implementing WHPs include:
  • Employee health
  • Control of healthcare costs
  • Increased productivity
  • Decreased absenteeism
• The success and perceived value of WHPs are often linked to corporate financial savings and return on investment (ROI).
• Healthy workplace strategies should be evidence-based.
• Employers should provide a work environment that supports healthy behaviors.
• Successful WHPs require employer investment in employee well-being.