Dr. Moore of Nationwide maintains that immunization is the most cost-effective treatment in medicine. For example, vaccinating children against the influenza virus averages a savings (including health care costs, parents’ missed work, etc.) of up to $35 per vaccine recipient. And experts predict that estimate is low, because it doesn’t take into account the rapid spread of the flu.

The American Association of Family Physicians’ Web site, www.aafp.org, offers a recommended adult immunization schedule created by the Advisory Committee on Immunization Practices. This schedule, tiered by age and chances of exposure, recommends diphtheria, tetanus, influenza, pneumonococcal, hepatitis B, hepatitis C, measles, mumps and rubella, varicella and meningococcal vaccinations.

Ideas to incorporate prevention and early detection:

• Hold a wellness fair and invite companies that provide testing services for such conditions as blood pressure, blood iron, cholesterol, body mass index (BMI) and diabetes.
• Provide educational materials about well-baby care and vaccinations.
• Choose health care coverage plans that include wellness check-ups and vaccinations.
• Provide worplace mammograms for workers.
• Sponsor worplace flu shots to coincide with flu season.

Advantages of Stress Reduction Programs

While stress cannot be eliminated from life, or even from the worksite, coping skills can be developed with relative ease. Stress management skills lead to decreased rates of absence and more effective, more productive workers. Because stress has been shown to contribute to such physical conditions as ulcers, high blood pressure and stroke, stress reduction has a direct impact on improving physical health.

Studies have shown that heart patients who attend stress management initiatives have 42% lower health care costs. Other studies have documented a 50% reduction in medical services use when stress management initiatives are employed. Further, Employee Assistance Program (EAP) experts estimate that 20% of any workforce is affected by personal problems that can influence work performance.

Stress reduction tactics to consider:

• Provide worplace yoga or meditation classes.
• Organize support groups among workers.
• Sponsor stress management classes during the workday.
• Provide an employee assistance program that includes both counseling and referral.
• Provide worplace counseling for workers in the case of a work-related trauma, such as the death of a co-worker.

Advantages of Prenatal Care and Breastfeeding

The old adage “an ounce of prevention is worth a pound of cure” is particularly relevant to when applied to preventive measures taken during pregnancy, when a few extra ounces of birth weight can save a child’s life. During pregnancy, simple precautions can help avoid catastrophic results; giving up tobacco use, for instance, drastically reduces the risk of miscarriage and pre-term labor.

The March of Dimes reports that if all women took adequate folic acid before conception and during pregnancy, the number of babies born with a neural tube defect could drop by as much as 70%. The physical and emotional benefits of proper prenatal care to a mother and child are underscored by a strong organization case for offering prenatal wellness benefits. Nationwide’s Chief Medical Director, Dr. Michael Moore, estimates costs to care for one baby delivered prematurely could approach $500,000.

First steps in fostering a prenatal program:
• Invite the March of Dimes to present information about prenatal health at an worker brownbag lunch or breakfast meeting.
• Hold prenatal care information classes for interested workers at lunchtime.
• Provide educational materials about the effects of alcohol, drugs and tobacco use on an unborn child.
• Provide incentives for adopting healthy lifestyles during pregnancy.
• Provide prenatal initiatives and education as part of the organization health care package.

Advantages of tobacco use Cessation Programs

Instances of respiratory diseases, cancer and other illnesses can be decreased through tobacco use cessation efforts. tobacco use cessation initiatives can provide huge opportunities for enhanced health.

The American Cancer Society reports that tobacco use workers cost corporations an average of $1,429 per smoker per year in raised health care costs over non-tobacco use workers. Implementing a tobacco use cessation program costs an average of $45 per worker per year, saving corporations an average of $1,383 per year for each worker who quits tobacco use. Additionally, the American Cancer Society reports that smokers are absent from work 50% more frequently than nonsmokers. They are also 50% more likely to be hospitalized and have 15% higher disability rates. tobacco use decreases onthe- job productivity as well. Employees who take four 10- minute tobacco use breaks a day work more than a month less per year than workers who don’t take smoke breaks.

Places to start with tobacco use cessation initiatives:

1. Establish a organization policy prohibiting tobacco use anywhere on the property.
2. Provide prompts/posters to support no tobacco use policy.
3. Policy supporting participation in tobacco use cessation activities during duty time (flex-time).
4. Provide counseling through an individual, group, or telephone counseling program onsite.
5. Provide counseling through a medical plan sponsored individual, group, or telephone counseling program.
6. Provide cessation medications through health insurance.

Advantages of Nutrition Programs

Nutrition directly impacts nearly every aspect of physical and mental health. A healthy diet can help protect against such conditions as heart disease, diabetes, arthritis, stroke, certain cancers and depression. Obesity, which is among the most common conditions linked to diet, affects a record number of Americans.

The American Journal of Health Promotion estimates the cost of obesity to U.S. organization to exceed $12.5 billion in health care, sick leave, and life and disability insurance. Further, one research study reports that obesity raises health care costs by 36% and medication costs by 77%. To offset the health risks of obesity and poor diet, many corporations have committed to helping workers ensure proper nutrition and undertake weight control initiatives.

Popular nutrition initiatives:

Fruit and Vegetable Consumption
1. Provide healthy eating reminders and prompts to workers via multiple means (i.e. e-mail, posters, payroll stuffers, etc.).
2. Provide appealing, low-cost fruits and vegetables in snack machines and in the cafeteria.
3. Provide cookbooks, food preparation, and cooking classes for workers’ families.
4. Ensure onsite cafeterias follow healthy cooking practices and set nutritional standards for foods served that align with the U.S. Dietary Guidelines for Americans.
5. Provide healthy foods at meetings, conferences, and catered events.
6. Use point-of-decision prompts as a marketing technique to promote healthier choices.
7. Provide healthy cooking demonstrations that teach skills (i.e. fruit and vegetable selection and preparation).
8. Provide taste-testing opportunities at the worksite.
9. Provide worker-led campaigns, demonstrations or programs.
10. Provide local fruits and vegetables at the worksite (i.e. worksite farmer’s market or community-supported agriculture drop-off point).
11. Use competitive pricing (price non-nutritious foods in snack machines and cafeterias at higher prices).
12. Provide protected time and dedicated space away from the work area for breaks and lunch.
13. Make kitchen equipment available to workers.
14. Provide an opportunity for onsite gardening if possible.

Sweetened Beverage Consumption
1. Make water available throughout the day.
2. Provide appealing, low-cost healthful drink options in snack machines and the cafeteria.
3. Modify worksite snack contracts to increase the number of healthy options.

4. Price non-nutritious beverages at a higher cost.
5. Use point-of-decision prompts to promote healthier choices.

Portion Control
1. Label foods to show serving size and/or nutritional content.
2. Provide food models, food scales for weighing and pictures to help workers assess portion size.
3. Provide appropriate portion sizes at meetings, worksite events and in the cafeteria.

Nutrition initiatives in action

While many corporations address weight management through fitness initiatives, corporations are increasingly focusing on nutrition through separate programming. Recognizing the productivity boost and lowered medical expenditures that come with maintaining a healthy weight, many corporations may help pay for obesity treatments for workers. For example, to improve the health of dangerously obese workers, drug maker Wyeth reportedly pays for stomach-shrinking surgeries that carry price tags of up to $40,000.

A 2003 Society of Human Resource Management research study shows that 24% of corporations offer weight loss initiatives. In Ohio, Honda offers an onsite, registered dietitian who provides individual or group consultations on weight management. Body fat analysis and body mass index (BMI) measurements are available to workers at any time.

At Grange Insurance’s Columbus headquarters, the cafeteria chef analyzes meals and provides workers basic nutrition information, including Weight Watchers points. Many corporations partner with the American Cancer Society to offer nutrition information through the ”5-ADay” program, which provides corporations free signage and educational materials about the importance of eating five servings of fruits and vegetables a day. The program also offers a fruit and vegetable ”frequency card” that gives workers a free portion of fruit or vegetables after he or she has purchased a preset number.

Wellness programming means different things to different corporations. Effective wellness initiatives can be as simple as bringing bushel baskets of fresh fruit into break rooms to encourage better eating. They can be as extensive as building fitness facilities onsite or paying for obesity treatments.

A driving factor behind the push toward wellness spans corporations of all types, sizes and cultures: that is, health care expenses are spilling over the corporate belt buckle. The annual cost of medical services in the United States is increasing at seven times the rate of inflation. And the rise in medical costs is one boom pundits expect our economy to sustain.1

This trend makes it increasingly challenging for corporations to maintain current levels of insurance coverage. In 2003, health care inflation forced 65% of corporations to increase workers’ share of health costs.

Seventy-nine% of large firms said they will increase workers’ share of health costs in 2004.2 But with lost benefits and increased financial burdens come lost morale and productivity.

Employers are searching for another way. While corporations cannot control many of the supply-side elements contributing to increasing health care costs—malpractice insurance rates, the nursing shortage—they can help curb demand. That’s why efforts are being redirected from illness to wellness.

The case for Corporate Health Promotion Programs is supported by an ever growing body of evidence demonstrating the high costs associated with controllable health risks:

• One research study reports that obesity raises health care costs by 36% and medication costs by 77%.
• Michigan officials estimate physical inactivity cost the state nearly $8.9 billion in 2002, a cost estimated to be largely borne by corporations through insurance premiums and lost productivity.
• The not-for-profit National Committee for Quality Assurance reports that the estimated average cost for postnatal care for women who did not receive prenatal care was $2,341 more than for women who had. And the indirect costs of unhealthful behavior can be just as high.

Information shows that healthier workers are more productive, spending more time at work and showing increased “presenteeism,” or productivity, while there. Further, healthier workers use fewer medical services. The five leading causes of death in the United States — heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes — are directly linked to unhealthy lifestyles. Clearly, encouraging healthful habits presents an opportunity to improve workers’ well being, reduce the need for health care services and help control costs.

Offering worker wellness benefits — large or small — represents an intersection between corporate social responsibility and responsibility to stakeholders. Between worker health and corporate health. It’s frequently the right thing to do for workers and corporations.

Research by Traveler’s Corp. shows a $3.40 return for every dollar invested in Corporate Health Promotion Programs. For many corporations, the choice to offer worker wellness benefits is easy—one where conscience and pragmatism align.

The challenge arises in selecting the initiatives that will deliver the most impact based on trends in your workers’ health risks and medical claims costs. From large corporations to the corner deli, organization owners welcome ways to boost productivity, reduce rates of absence and cut costs. Likewise, Corporate Health Promotion Programs can range from modest to elaborate.

In determining where to focus a organization’s limited resources, looking at benefits, costs and best practices is a good starting point. This section profiles six aspects of wellness and explores their benefits to workers and corporations.

When it comes to working wellness into your workforce, you want someone who knows the ins and outs of health promotion, and who can counsel workers and provide primary care – all within the context of the current regulatory and legal environment.

AAOHN’s survey found that more than half of workers (61%) want to receive health and wellness information from a health care professional, such as a consultant or an worksite occupational health nurse (OHN), compared to pamphlets or brochures (18%) or human resources staff (15%).

OHNs can develop, begin and evaluate components of work site Corporate Health Promotion Programs such as testing initiatives, exercise/fitness courses, Stress management, tobacco use cessation, nutrition and weight control initiatives, and chronic illness management initiatives. Plus, OHNs can help workers navigate through complicated health plans and may even serve as a triage point between workers and their individual health care providers.

Employees might refrain from seeing their health care provider when it means time away from work, inconvenient parking, waiting time in the office and co-pays. In situations where workers are under treatment for chronic diseases like heart disease, worksite nurses can routinely monitor risk factors such as blood pressure or cholesterol on a regular basis.

It’s frequently easier for an worker to ask an worksite nurse for information about symptoms or prescription medication than it is to schedule a follow-up visit to a individual health care provider. Advantages realized by corporations include enhanced worker morale and retention, a recruitment advantage, raised productivity and decreased time away from work.

In corporations with a safety department, the OHN can evaluate and address work-related health issues, including participation in workstation evaluations to correct potential ergonomic problems, and proactively addressing muscle strains by developing stretching initiatives and involving workers in leading stretches.

Good for waistlines & your bottom line

By Sandra Simpson, APRN, BC, COHN-S, manager in Occupational Health Services at a Fortune 500 organization in Memphis, Tenn., and a member of the board of directors of the American Association of Occupational Health Nurses (AAOHN). For a copy of the AAOHN wellness survey, visit www.aaohn.org, or call (800) 241-8014, x0.

In today’s hectic world, the majority of of us are spending more time at work, and have increasingly less time to look after our health. For a long time, corporations have understood the benefits associated with keeping workers well – raised productivity from decreased rates of absence and lowered disability claims. For these reasons, coupled with the fact that many corporations realized double-digit health care costs last year, corporations should consider Corporate Health Promotion Programs as a way to keep workers healthy.

But just how important are these initiatives to workers? How frequently are they willing to take part in initiatives designed to positively impact their health and wellness? Who do workers trust to provide them with important information about their health?

Answers to these questions and more were recently garnered from a research study commissioned by the American Association of Occupational Health Nurses Inc. (AAOHN).

The AAOHN survey questioned 500 workers nationwide about their perceptions of Corporate Health Promotion Programs. More than three-quarters of all members indicated these initiatives are a good way to improve their overall health, and nearly 60% consider these offerings an incentive to remain with their current employer. worker retention and turnover impact the bottom line, so building Corporate Health Promotion Programs into the work site culture is a valuable way to help retain talented workers in addition to enhancing personal health and worksite productivity.

The Health wish list

Employees appear to have their own agenda when it comes to their health. With new national security threats, new economic pressures and work/balance issues, it’s not surprising that 85% of survey respondents cited Stress management as a priority topic for work site wellness.

In addition to stress, other preferred topic areas include testing initiatives (84%), exercise/physical fitness initiatives (84%), health insurance education (81%) and disease management lunch and learns (80%).

In addition to lifestyle and personal health issues, those asked expressed concern about work-related health issues, including strains and injuries resulting from lifting or task-oriented muscle repetition, exposure to harmful substances, personal injury, vision changes due to computer work and worksite violence.

What you should do

With such a broad range of health concerns, a primary goal for corporations is finding a way to proactively address the health and wellness needs of the largest number of workers, and effectively change unhealthy behaviors, promote wellness and ward off disease and illness.

Printed materials such as brochures, posters, fliers or pamphlets present an easy solution. But it’s important to remember that different employees require different formats for learning. A good rule of thumb: provide information in a variety of learning formats such as videos, pamphlets, health-related quizzes, display boards, Lunch-and-learn presentations and reimbursement or incentive programs.

This assumes you’ve overcome the first hurdle – getting employees to sign on to a Corporate Health Promotion Program. While survey respondents indicated health and Corporate Health Promotion Programs are important, just six out of 10 (60%) reported that they participated in the Corporate Health Promotion Programs at their corporations. The other 40% cited lack of interest and lack of time as deterrents.

This points to the need for a broad-based, structured Corporate Health Promotion Plan using a innovative approach, with an incentive for participation and effective program marketing.

By investing in an organized Corporate Health Promotion Plan headed by a qualified health care professional such as an worksite nurse, corporations can give workers the access to the health information they want, and increase participation and generate interest at the same time.

The result: workers become savvier health care consumers who feel more in charge of their individual health. And healthier workers make for a healthier bottom line.

Stress continues to drive workers’ work-related health concerns, which is probably why the majority of respondents (78%) in a recently published survey claim they would take part in a Corporate Health Promotion Plan to help their overall health and wellness.

In a recently published research study commissioned by the American Association of Occupational Health Nurses, Inc. (AAOHN), 500 full-time workers nationwide were interviewed telephonically.

“Today’s workers are clearly dealing with a lot of pressures such as the effects of 9/11, an unstable economy, national security threats and work/balance issues. There is a real opportunity for corporations to serve as an ally to their workers by providing them with resources to better manage their physical and emotional health – anything from stress management lunch and learns to nutrition and physical fitness counseling,” says Deborah V. DiBenedetto, president of AAOHN.

Nearly 80% of respondents believe their health would improve if they were offered the right information and tools through a viable Corporate Health Promotion Program.

Topping the list of most interesting Corporate Health Promotion Programs cited by workers is stress management (85%), closely followed by testing initiatives (84%), exercise/physical fitness initiatives (84%), health insurance education (81%) and disease management lunch and learns (80%).

More than half of workers (61%) would rather receive health and wellness information from a health care consultant or worksite nurse, compared to pamphlets or brochures (18%) or human resources staff (15%).

Effective Corporate Health Promotion Programs include the use of data sources in support of Corporate Health Promotion Plan planning, implementation, and evaluation. Information sources can be used to complete a community needs assessment, develop realistic Corporate Health Promotion Plan goals and objectives, and gain Senior Management support.

Centers for Disease Control and Prevention (CDC): Information and statistics
• http://www.cdc.gov/DataStatistics/
• Information and statistics are available by topic (i.e., asthma, injuries, MRSA).
• Information access tools are available to customize information tables and query datasets (i.e., Healthy People DATA2010, tobacco use-Attributable Mortality, Morbidity, and Economic Costs).
• Nationwide survey information is available (i.e., National Health and Nutrition Examination Survey (NHANES)).

CDC Behavioral Risk Factor Surveillance System (BRFSS)
• http://www.cdc.gov/brfss/index.htm
• BRFSS is the world’s largest, ongoing telephone health survey system. BRFSS has been tracking health conditions and risk behaviors in the US yearly since 1984.
• Chronic Disease Indicators are divided into seven categories: physical activity and nutrition, tobacco and alcohol use, cancer, cardiovascular disease, diabetes, overarching conditions, and other disease and risk factors.
• Prevalence information is also available (i.e., weight classification by Body Mass Index and age).