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Benefits 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. business to exceed $12.5 billion in health care, sick leave, and life and disability insurance. Further, one study reports that obesity raises health care costs by 36 percent and medication costs by 77 percent. To offset the health risks of obesity and poor diet, many corporations have committed to helping employees ensure proper nutrition and undertake weight control initiatives.

Popular nutrition initiatives:

Fruit and Vegetable Consumption
1. Provide healthy eating reminders and prompts to employees via multiple means (i.e. e-mail, posters, payroll stuffers, etc.).
2. Provide appealing, low-cost fruits and vegetables in vending machines and in the cafeteria.
3. Provide cookbooks, food preparation, and cooking classes for employees’ 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 workplace.
9. Provide worker-led campaigns, demonstrations or programs.
10. Provide local fruits and vegetables at the workplace (i.e. workplace farmer’s market or community-supported agriculture drop-off point).
11. Use competitive pricing (price non-nutritious foods in vending 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 employees.
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 vending machines and the cafeteria.
3. Modify worksite vending 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 employees assess portion size.
3. Provide appropriate portion sizes at meetings, workplace 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 employees. By way of example, to improve the health of dangerously obese employees, 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 study shows that 24 percent of employers 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 employees at any time.

At Grange Insurance’s Columbus headquarters, the cafeteria chef analyzes meals and provides employees 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 employers 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 employees a free portion of fruit or vegetables after he or she has purchased a preset number.

Benefits of Physical Fitness Programs

Exercise reduces weight, lowers risks of heart attack and stroke, helps to control blood pressure and diabetes, and improves mood. Studies increasingly show that physical fitness may also help reduce the occurrence of certain types of cancer. Researchers at the Centers for Disease Control and Prevention (CDC) recently documented another major advantage: physical fitness improves the health of the nation’s medical care expenditures.3 According to the CDC, physically active individuals incur $865 less per year in medical costs than inactive workers.

Dr. Michael Moore, vice president and chief medical director at Nationwide Insurance in Columbus, maintains that physical fitness is the most effective tool in health maintenance. “If you could prescribe exercise in a pill, it would be the number-one prescribed treatment in the world,” he said. In step with Dr. Moore’s prescription, nearly one-third of U.S. businesses help employees pay for gym memberships, according to an Associated Press report. Subsidizing gym memberships is just one way corporations promote active lifestyles.

Popular Physical Fitness Initiatives:

1. Allow access to on- and off- worksite gyms and recreational activities before, during, and after work hours.
2. Provide and promote participation in after work recreation or leagues.
3. Provide cash incentives or reduced insurance costs for participation in physical activity and/or weight management or maintenance activities.
4. Provide shower and/or changing facilities onsite.
5. Provide outdoor physical fitness areas such as fields and trails for worker use.
6. Provide bicycle racks in safe, convenient, and accessible locations.
7. Provide onsite fitness opportunities, such as group classes or personal training.
8. Provide an onsite physical fitness facility.
9. Establish initiatives that have strong social support systems and incentives, such as:
• Buddy or team physical activity goals
• Programs that involve workers and family
• Programs to promote physical activity, such as pedometer walking challenges
• Explore discounted or subsidized memberships at local health clubs, recreation centers, or YMCAs
10. Provide flexible work hours to allow for physical activity during the day.
11. Support physical activity breaks during the workday, such as stretching or walking.
12. Host walk-and-talk meetings.
13. Map out onsite trails or nearby walking routes and destinations.
14. Have employees map out their own biking or walking route to and from work.
15. Post motivational signs at elevators and escalators to promote stair usage.
16. Provide exercise/physical fitness messages and information to employees.
17. Provide or support recreation leagues and other physical activity events onsite or in the community.
18. Start worker activity clubs such as walking or bicycling clubs.
19. Provide onsite child care facilities to facilitate physical activity.
20. Sponsor a bike to work day and reward employees who participate.
21. Establish a box and solicit fitness and health tips.

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 U.S. is rising 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 employers to maintain current levels of insurance coverage. In 2003, health care inflation forced 65 percent of corporations to increase employees’ share of health costs.

Seventy-nine percent 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 rising 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 Workplace Health Promotion Programs is supported by an ever growing body of evidence demonstrating the high costs associated with controllable health risks:

• One study reports that obesity raises health care costs by 36 percent and medication costs by 77 percent.
• Michigan officials estimate physical inactivity cost the state nearly $8.9 billion in 2002, a cost estimated to be largely borne by employers 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 employees are more productive, spending more time at work and showing increased “presenteeism,” or productivity, while there. Further, healthier employees use fewer medical services. The five leading causes of death in the U.S. — 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 employees’ 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 employees and employers.

Research by Traveler’s Corp. shows a $3.40 return for every dollar invested in Workplace 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 employees’ health risks and medical claims costs. From large corporations to the corner deli, business owners welcome ways to boost productivity, reduce absenteeism and cut costs. Likewise, Workplace Health Promotion Programs can range from modest to elaborate.

In deciding where to focus a business’s limited resources, looking at costs, benefits and best practices is a good starting point. This section profiles six aspects of wellness and explores their benefits to employees and employers.

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 employees and provide primary care – all within the context of the current regulatory and legal environment.

AAOHN’s survey found that more than half of employees (61 percent) 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 percent) or human resources staff (15 percent).

OHNs can develop, implement and evaluate components of work site Workplace Health Promotion Programs such as testing initiatives, exercise/fitness courses, Stress Management Programs, smoking cessation, nutrition and weight control initiatives, and chronic illness management initiatives. Plus, OHNs can help employees navigate through complicated health plans and may even serve as a triage point between employees and their personal 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 employees 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 personal health care provider. Benefits realized by employers include enhanced worker morale and retention, a recruitment advantage, increased 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 employees 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 business 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, most of us are spending more time at work, and have increasingly less time to look after our health. For a long time, employers have understood the benefits associated with keeping workers well – increased productivity from reduced absenteeism 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 Workplace Health Promotion Programs as a way to keep employees healthy.

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

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

The AAOHN survey questioned 500 employees nationwide about their perceptions of Workplace 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 percent consider these offerings an incentive to remain with their current employer. worker retention and turnover impact the bottom line, so building Workplace Health Promotion Programs into the work site culture is a valuable way to help retain talented employees in addition to enhancing personal health and workplace productivity.

Health wish list

Employees appear to have their own agenda when it comes to their health. With new pressures resulting from an unstable economy, national security threats and work/balance issues, it’s not surprising that 85 percent of survey respondents cited Stress Management Programs as a priority topic for work site wellness.

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

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 workplace violence.

What you should do

With such a broad range of health concerns, a key goal for employers is finding a way to proactively address the health needs of the largest number of employees, 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 workers 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 workers to sign on to a Workplace Health Promotion Program. While survey respondents indicated health and Workplace Health Promotion Programs are important, just six out of 10 (60 percent) reported that they participated in the Workplace Health Promotion Programs at their corporations. The other 40 percent cited lack of interest and lack of time as deterrents.

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

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

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

Stress continues to drive employees’ work-related health concerns, which is probably why most respondents (78 percent) in a recent survey claim they would participate in a Workplace Health Promotion Program to help their overall health and wellness.

In a recent study commissioned by the American Association of Occupational Health Nurses, Inc. (AAOHN), 500 full-time employees nationwide were interviewed by phone.

“Today’s employees 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 employers to serve as an ally to their employees 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 percent of respondents believe their health would improve if they were offered the right information and tools through a viable Workplace Health Promotion Program.

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

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

Effective Workplace Health Promotion Programs include the use of data sources in support of Workplace Health Promotion Program planning, implementation, and evaluation. Information sources can be used to complete a community needs assessment, develop realistic Workplace Health Promotion Program goals and objectives, and gain Upper 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 data tables and query datasets (i.e., Healthy People DATA2010, smoking-Attributable Mortality, Morbidity, and Economic Costs).
• Nationwide survey data 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 data is also available (i.e., weight classification by Body Mass Index and age).

Workplace Health Promotion Program data collection and analysis is frequently avoided because of a perceived lack of resources for this very important Workplace Health Promotion Program component. Use the suggestions below to take advantage of a variety of resources available at your installation or in the local community.

Medical Interns and Residents

• If your Medical Center has an internship Workplace Health Promotion Program, get to know the Internship Director.
• Take advantage of these resources – including having the Director and/or interns/residents implement the outcome data collection plan for your Workplace Health Promotion Program.

Local college and graduate students

• Where appropriate volunteer agreements are in place, use local college/graduate students to help collect, input, and analyze Workplace Health Promotion Program data.
• Take advantage of the fact that these students are frequently looking for projects.
• If there are no “health-related” students/interns in your area, consider using business students. Let them calculate a cost avoidance or return on investment for your Workplace Health Promotion Program.

Other Medical Personnel

• Partner with other Medical Personnel. Find out who is collecting data, what data they are collecting, and how they are collecting it.
• If they are using a survey and the survey administration process is already in place, ask if you can add a question or two.
• Be aware of other research going on at your facility. They may already be collecting data you need OR may have analysis resources that can be shared.
• Ensure that other departments in the Medical center know you can always use some extra help if they have personnel with any down time. Use these resources for data entry or other administrative tasks.
• Make use of the volunteers at your Medical Treatment Facility to help collect and input data.

Past Workplace Health Promotion Program members

• Past Workplace Health Promotion Program members are also a good resource.
• They may be willing to lead a class session, provide encouragement to current Workplace Health Promotion Program members, or help collect data.
You can improve data collection and analysis by taking advantage of local resources. Using these resources expands the reach and impact of your Workplace Health Promotion Program.

Keeping Workplace Health Promotion Program data organized is essential in order to be able to determine Workplace Health Promotion Program impact and participant progress. Use the simple steps below to keep your data organized.

Manage Workplace Health Promotion Program data electronically.

• Storing Workplace Health Promotion Program outcomes data electronically is the best way to manage that information.
• An electronic system will enable you to review and analyze the data more efficiently.
• Scan old surveys and other Workplace Health Promotion Program information that exist only on paper into .pdf format for permanent storage.

Find the Workplace Health Promotion Program system that works best for you.

• Some workers are more comfortable with spreadsheet applications; others prefer to work with database applications.
• You will be more likely to use a Workplace Health Promotion Program that you are familiar and/or comfortable with.
• Standardize data collection and organization. Keep data columns/fields in the same order for all Workplace Health Promotion Programs.

Keep the Workplace Health Promotion Program as simple as possible.

• You do not have to be a Wellness Programming wizard or use complicated data entry interfaces in order to manage Workplace Health Promotion Program outcomes data.
• A simple spreadsheet is an excellent way to keep your data organized.

Store all Workplace Health Promotion Program data numerically.

• Using numbers (instead of words) will make the data much easier to enter and analyze. By way of example: use “1” for yes; “0” for no OR “1” for male; “2” for female.
• Number survey responses that contain strings of words. By way of example: instead of entering the responses: “patient education videos”, “news,” or “no TV,” number the responses so you only have to enter “1,” “2,” or “3.”

Label all Workplace Health Promotion Program data clearly.

• Ensure that all the data columns, rows, or fields are labeled. The data is worthless if you don’t know what data is in which column.
• The spreadsheet/database should include an explanation for column, row, field, and data abbreviations and a key for numbered responses.

Use consistent Workplace Health Promotion Program data units.

• Ensure that all data entered into a given column is expressed with the same unit of measure. By way of example, enter all heights as total inches, not as a combination of feet and inches.
Putting your data in order by using a simple system that works for you will enable you to track participant accomplishments. Keeping your data organized also makes it easier to communicate Workplace Health Promotion Program impact to leadership and make Workplace Health Promotion Program improvements as needed.

A gap analysis is an assessment tool that enables a business to compare its current capabilities and performance with industry benchmarks and expectations for performance. A gap analysis is used to identify areas that have room for improvement.

Gap analysis can also be used for your Workplace Health Promotion Program to determine where the program stands now and how the Workplace Health Promotion Program can better follow evidence-based recommendations.

To begin a gap analysis, ask these simple questions about your Workplace Health Promotion Program:
• What is the current state of the Workplace Health Promotion Program?
• How does the Workplace Health Promotion Program measure up to evidence-based practices? (i.e., the desired state)

The gap is the difference between the current and desired states.

After the gap has been identified, the next step is to determine the action steps that are needed to close the gap. These actions answer the question: “How can the Workplace Health Promotion Program move forward towards the desired state?”

Sometimes the gaps that need to be filled can be addressed through Workplace Health Promotion Program changes; other gaps might require policy changes. However, using a gap analysis will help you identify areas for Workplace Health Promotion Program improvement and the actions needed to make progress towards those goals.