Employee Health Screening

There are a number of reasons why a Employee Health and Wellness Program is beneficial.

1. Enhanced Morale – When the organizational culture begins to change as a result the Employee Health and Wellness Program, you and your employees may actually begin to see and feel a new level of energy within the company.  Ultimately, one of the most ambitious goals of any complete Employee Health and Wellness Program is to attempt to influence the attitudes and actions of the company’s most valuable resource — its employees.

2. Reduced Turnover – As we all know, employee replacement costs can be quite high for any kind of business.  The effort and expense associated with running employment ads, reading applications, checking references, interviewing qualified candidates, hiring and training a new employee can be a serious burden on any business.  In light of the challenges that high employee turnover pose, many businesses are looking to Employee Health and Wellness Programs as an additional perk that can help to prevent employees from jumping ship.

3. Increased Recruitment Potential – In the midst of a very tight labor market, businesses are forced to pull out the stops in order to recruit new talent.  In some instances, Employee Health and Wellness Programs can prove to be a very valuable tool in sealing the deal.

4. Reduced Absenteeism - When an employee misses work in a business setting, the entire company is forced to absorb his/her responsibilities.  Even in the event of the occasional absence caused by things like colds and the flu, work can back-up and tensions can build.

Even worse is a long-term absence caused by a major health event that requires hospitalization and/or rehabilitation.  By preventing certain types of illness caused by poor lifestyle habits, Employee Health and Wellness Programs can play an important role in decreasing absenteeism.

5. Healthcare Cost Containment - Most businesses don’t begin a Employee Health and Wellness Program with cost containment in mind.  However, cost containment for certain health problems should be considered a viable goal by many businesses.

6. Enhanced Employee Health Status - One of the greatest advantages of a well-designed Employee Health and Wellness Program is the promise of improved health.  There is a growing body of evidence that suggests well-designed Employee Health and Wellness Programs can successfully impact such behaviors as tobacco use, high-risk alcohol use, seatbelt use and more.

It is important to measure the effectiveness of all Employee Health and Wellness Programs. There are several very simple ways to measure Employee Health and Wellness Programs:

How many attended the corporate health and Employee Health and Wellness Program, and was there participation or a visible level of interest?

Use a short and simple pen and paper evaluation that people fill out at the end of the Employee Health and Wellness Program /seminar. Statements that are rated on a scale from 1 (strongly agree) to 5 (strongly disagree) will give valuable information. Ask about:
•    The value of the Employee Health and Wellness Programs to the individual
•    The style of the presenter
•    The presenter’s knowledge of the topic
•    The level of knowledge gained by the employee
•    Other areas that would be of interest for future Employee Health and Wellness Programs

Examples of Questions about Employee Health and Wellness Programs

•    This program provided me with information and/or skills I will use.
•    The presenter was knowledgeable about the subject matter.
•    There was adequate time for questions.
•    The methods used to present the information were effective.

Open-ended questions about Employee Health and Wellness Programs may include:

•    The best part of this Employee Health and Wellness Program was…
•    The part that needed improvement was….
•    I would attend another Employee Health and Wellness Program by this speaker…
•    Topics I would like to see included in other seminars or Wellness Programs…

This would be a process evaluation that examines how well the Employee Health and Wellness Programs were implemented. It is also important to look at health outcomes and cost outcomes of Employee Health and Wellness Programs.

More in-depth information about the cost-effectiveness of Employee Health and Wellness Programs can be found by analyzing data before and after Employee Health and Wellness Programs concerning healthcare claims, workers’ comp claims, sick time, productivity levels, etc. Health outcomes for Employee Health and Wellness Programs can be measured by looking at health claims and sick time.

It is also important to look at the impact of Employee Health and Wellness Programs on family members. For example, smoking by pregnant mothers may lead to the birth of a severely impaired child. This could cost an employer or health plan hundreds of thousands of dollars, an expense that could have been avoided with well-designed Employee Health and Wellness Programs.

You can also compare the cost per employee of running the Employee Health and Wellness Programs to the savings per employee. One evaluation of Employee Health and Wellness Programs involving 20,000 to 25,000 employees at New York City-based Citibank showed a return of $6.70 for every dollar the company invested in Employee Health and Wellness Programs. The findings were based on a study of medical costs and absenteeism.1

An ongoing evaluation of your Employee Health and Wellness Programs should be performed each year and additional periodic evaluations of Employee Health and Wellness Programs should be conducted on an ad hoc basis. An ad hoc evaluation of your Employee Health and Wellness Programs might be initiated by a variety of triggers. For example, at the end of flu season, a company might want to measure its flu shot program.

Employee retention is a challenge. Employee Health and Wellness Programs can help. offering perks such as incentives to exercise, healthy food, and stress management and weight loss programs at work is a way to keep your employees satisfied.

Attracting new staff members are also a challenge, and anything you can do to “stand out” from other employees is to your advantage. Remember, salary isn’t everything. Often, the possibility of flex hours or a discount at the local gym may be the deciding factor for a future employee. Once again, Employee Health and Wellness Programs to the rescue!

How Are Employee Health and Wellness Programs Administered?

Whether running small Employee Health and Wellness Programs in-house or using outside corporate wellness businesses to oversee the whole thing, program promotion is vital. You may have a great speaker come in to talk about a very “hot topic,” but if no one knew about it, it was a waste of the speaker’s time and your money.

Corporate Employee Health and Wellness Program setup and promotion go hand and hand. Depending on the size of your company, it may be handled by one person or an entire corporate wellness team. You may even have an employee who is interested in physical fitness and would love to organize some educational wellness seminars and programs.

Other employees may have areas of interest and would be willing to set up some educational programs. Especially for smaller businesses, once you have chosen your events and programs, it is best to set up a calendar with a schedule of events. Then publish the entire calendar as well as announcing each individual event as it comes up.

Access to Employee Health and Wellness Programs

To make access easy, offer a wide range of Employee Health and Wellness Programs and programs that can fit into everyone’s schedule. For example, some employees may find it difficult to get to a seminar at work or make a commitment for 8 weeks of the Weight Watchers at Work program. However, they will take advantage of a decreased rate at the gym and will borrow tapes from the health and wellness library.

If you have shifts, don’t forget to schedule events for the after 5:00 group. Nothing will undermine Employee Health and Wellness Programs more quickly than promoting great programs that are only convenient for first shift employees.

Sometimes, Employee Health and Wellness Programs can take advantage of “special situations” that occur and which offer an excellent opportunity for employee education and support, at little or no expense to the employer. Not only do these situations help employees personally, but also they are an opportunity for the employer to be seen in a positive light. For example:

A company had several employees with cancer, as well as a number of employees with family members with cancer. Their HR staff had received numerous questions about what to say to a coworker with cancer, as well as hearing about how difficult it was for the caregivers to manage work and home demands. They thought that it would be a great idea to initiate a lunchtime monthly “discussion/support group” to talk about the struggles, frustrations, and fears that people were facing. This activity was included under the umbrella of Employee Health and Wellness Programs that the company provided.

The group was facilitated by a rep from the Employee Assistance Program, but it was not a therapy group, nor was it promoted as such. It was informal and employees came as they could fit it into their schedules.

Did it solve all their problems? Of course not, but it did give them a place to vent, talk, and get some information and support. It was a powerful statement from the employer saying, “We care about you and we’d like to help you with this,” and the employees were very grateful. Effective Employee Health and Wellness Programs clearly convey this type of message to their employees.

Another employer had an employee who was autistic and frequently exhibited some odd or unusual behaviors. He had some significant difficulties and had to be out of work for several months. As time came for him to return, coworkers became anxious about what to expect.

The employer had someone come in to talk about autism and how best to deal with a person with the disease. It was a general discussion, and there was no discussion of the employee’s personal information. However, coworkers felt much more prepared to handle his return.

An employee with epilepsy told her coworkers about her condition in case she had a seizure. The employer then had someone from an epilepsy advocacy group come in and educate employees about the illness and what to do.

You may believe taking steps like this are not the responsibility of the employer, that it is not your business. But physical and mental illnesses affect just about everyone and are natural components of Employee Health and Wellness Programs.

Staff Members who are preoccupied and worried about someone having a seizure or catching HIV from a coworker are not focused and productive. When you spend time informing and supporting employees, you not only have productive employees, you also have their respect.

Employee Health and Wellness Programs are also an effective way to educate employees/parents about substance abuse, sexually transmitted diseases, pregnancy, depression, mental illness, learning disabilities, and other issues that affect adults, children, and teens. Arming parents, other relatives, and concerned friends with information is a way to prevent problems in the future, for themselves and their children.

Staff Members may not be comfortable attending Employee Health and Wellness Programs entitled “Substance Abuse and You” or “Dealing With Depression,” fearing they have “self-identified” just by their presence. However, when much of that same information is billed as “Teens and Substance Abuse” or “Recognizing the Signs of Depression in Teens,” there may be a full house for the seminar.

Once this occurs, the levels of awareness are raised. An employee who is concerned that he or she is actually depressed can attend and gain life-saving information. Using this type of approach in Employee Health and Wellness Programs goes beyond raising awareness among parents whose children are struggling with personal problems.

Mental health topics are frequently difficult to introduce. There is still some stigma attached to being “mentally ill” or having alcohol problems. A benign way to bring information into the worksite is to use Employee Health and Wellness Programs and the National Screening Day programs. These are dates that have been set aside annually to raise awareness about various problems. They include:

Alcohol Abuse and Addiction (April)
Anxiety Disorders (during Mental Health Month in May)
Depression (October)
Eating Disorders (February)

There is a wealth of information available internet-based that can be made available to your employees at no cost as part of your Employee Health and Wellness Programs. All it takes implement this into Employee Health and Wellness Programs is some type of notification in the form of an e-mail with an introductory statement and some links.

Local mental health clinics, medical schools, and hospitals usually provide free employee health screenings on designated days so that anyone can come in, take a test, and get information and a referral for care if appropriate. You could arrange with a local provider for a block of time for your employees to participate in the screenings, or talk to them about coming into the worksite to provide them.

What Are Employee Health and Wellness Programs?

Employee Health and Wellness Programs are designed to promote and support employee health and wellness through education and awareness programs primarily based at the worksite. The program is a win-win in that employees benefit from learning and staying well, and the employer has increased loyalty and less absenteeism.

As businesses become more aware of the importance of employee health on productivity, there is increased interest in encouraging and supporting healthy lifestyle choices. Employer costs for Employee Health and Wellness Programs may rapidly be offset with fewer work-related injuries, improved attendance, less turnover, and increased morale.

Types of Employee Health and Wellness Programs

Employee Health and Wellness Programs: Lunchtime Wellness Presentations

The simplest Employee Health and Wellness Programs are one’s where the employer arranges to have quarterly seminars during lunchtime on topics such as stress management, nutrition, and exercise. A local mental health clinic, hospital, or the Employee Assistance Program (Employee Assistance Program) may provide these. This type of corporate health and Employee Health and Wellness Program is usually arranged through HR, the medical department, or the safety manager. Participation is generally voluntary.

Before determining topics for wellness seminars, it is a good idea to do some type of employee polling to see what topics people are interested in. This may be as simple as an e-mail to all staff asking for suggestions or as formal as having an outside group come in to conduct interviews and design a complete corporate health and Employee Health and Wellness Program.

Employee Health and Wellness Programs: Health Risk Assessments

An employer can provide complete Health Risk Assessments for employees. Health Risk Assessments are detailed questionnaires that covers all areas of behavior (seatbelt use, tobacco use, alcohol use, frequency of exercise, family history of disease and illness, etc.). This is usually done in conjunction with employee health screening for things like cholesterol and blood sugar screening.

Once the Health Risk Assessments are scored, the results are shared with employees along with suggestions for changes. The employer is able to get aggregate statistics that will show trends that he or she may want to address. For example, if a lot of people have high blood pressure, the employer may consider an educational seminar, biweekly workplace blood pressure readings, and low-salt, low-fat selections in the cafeteria or snack machines as interventions to include in the corporate health and Employee Health and Wellness Program.

If the Health Risk Assessments show that there is a “trend” toward not wearing seatbelts, perhaps having the State police come in and give a seminar about what occurs in an accident when you don’t have a seatbelt on would change some behavior.

Employee Health and Wellness Programs: smoking Cessation

smoking cessation programs are very popular components of Employee Health and Wellness Programs. Often, the local chapter of the American Cancer Society or American Lung Association will come in to run a group. Another option is for employees to attend a smoking cessation group in the community. Costs for the smoking cessation group can be offset by the employer after employees complete the program.

Employee Health and Wellness Programs: Stress Management

Stress is a major area of concern for businesses. Stressed out staff members get sick more frequently, make more errors, and generally do not perform up to capacity. As a result, Employee Health and Wellness Programs frequently take steps to address employee stress. There are many ways to address stress within your Employee Health and Wellness Programs, and the beauty of these ideas is that everyone can benefit from them.

Certainly, stress management seminars are educational and informative and should be included in any corporate health and Employee Health and Wellness Program.

Employee Health and Wellness Programs and Work/Life Programs

Many businesses offer a work/life program that offers assistance with things from finding day care for a child or elderly parent and information on obscure college scholarship funds to information on which PC to buy and where to find someone to walk your dog. These programs fit into Employee Health and Wellness Programs because they help your employees handle many of the things that are taking up work time and increasing stress.

Employee Health and Wellness Programs and Employee Assistance Programs

An Employee Assistance Programs are integral parts of effective Employee Health and Wellness Programs. By helping employees address personal/mental health problems and concerns, an Employee Assistance Program can go a long way toward improving overall health and productivity. Representatives from your Employee Assistance Program can also work closely with you to design Employee Health and Wellness Programs that are integrated and effective.

Time Management and Employee Health and Wellness Programs

Time is one of our most precious commodities, and anything you can do as an employer to help your employees manage their time is going to be welcome. Although not traditionally thought to be part of Employee Health and Wellness Programs, offering flextime and telecommuting are two ways to reduce stress and raise productivity.

These programs take thought and planning and are not appropriate for all employees or all positions; however, in many worksites, they are underused. Either your HR manager or an outside consultant can help you design a program. If you belong to a business group or Chamber of Commerce, you may find assistance there. Also, talk to colleagues who are doing this in their businesses to see how it is working.

The Culture of Wellness

Employee wellness has to be part of your company culture, not just something you throw in as an afterthought. It isn’t a Band-Aid, but rather a thoughtful piece of your business strategy. For example, if productivity is down due to smoking breaks, offering smoking cessation classes can help. But it’s also important to establish a no smoking policy.

When employees feel valued, they are more loyal and tend to work harder. They take pride in their work and talk about what a great company they work for. A healthy workforce is a productive workforce.

Even the best and most innovative businesses are experiencing the impact worker well-being on their organizations’ performance.  The bad news is that many of these businesses are unaware of the extent to which less-than-optimal employee health and well-being is impacting workforce capacity and performance.  The goods news is that there is an increasing body of research and practice than may help businesses mitigate this frequently unseen issue and create significant opportunities for improved workforce attraction, retention and performance!  This article focuses on how companyal leaders may improve physical and financial employee wellness in the worksite.

The Problems of Chronic Disease

According to the World Health Organization (WHO), 60 percent of deaths in 2005 could be attributed to chronic disease (cardiovascular disease, cancer, chronic respiratory diseases, and diabetes).1  The largest attributing factors to the chronic diseases include tobacco use, physical activity, and diet.2  The costs of these diseases are staggering.  For example, if there were a 10 percent reduction in mortality from heart disease and cancer, it could save the US $10.4 trillion annually.3  Further the WHO projects that over 80 percent of the US population will be either considered overweight or obese by the year 2015.

The Problems of Financial Distress and Dissatisfaction

As hard as it may be to fathom, a 2004 study found that 67 percent of U.S. Workers are dealing with Personal Financial Issues.4 In another study, it was found that these issues may exist in all segments of any workforce, regardless of income, education, or position level.5 Couple these facts with our workforce reality:

* The workforce is aging and demand for professionals in many industries continues to exceed the supply – and will for the foreseeable future.
* Due to the shortages of quality personnel the stress on our current workforce is increasing.
* With these workforce shortages, most businesses cannot continue to pay spiraling market prices for professionals.
* Lastly, those personality attributes that make many professionals great caregivers or service-providers also tend to make them less apt to focus on matters of personal financial management.

The ROI

There are significant reasons why businesses should employ Procedures to implement Employee Health and Wellness Programs for their employees:

* Improve Productivity including reductions in healthcare and workers compensation claims, absenteeism, and presenteesism;
* Lower employer paid healthcare and re-insurances premiums; and
* Improve employee, physicians and patient satisfaction; and
* Improve staff retention and productivity.

A recent Towers Perrin case study6 found that a ten percentage point improvement on employee engagement was linked to a 4.6 percentage point improvement on customer satisfaction and revenue growth and labor cost improvements equal to a 2.8 percent impact on controllable margin.

What all this shows is that offering Employee Health and Wellness Programs and rewards is more than just “the right thing to do.”  Rather, there is a profound business case.  As workforce capacity and engagement increase, a bottom-up cultural change takes place in your company.  These changes drive improvements in customer satisfaction, productivity, absenteeism, and presenteesism – all of which drive improvements in profitability.

The Course of Change

As an employer, you may have a tremendous impact on the health of the community.  Here are a few suggestions on how you may engage your employees (possibly include flowchart):

1. Define the Plan – Determine if you have the internal resource availability and knowledge to develop a formal Employee Health and Wellness Program.  Many organizations, due to confidentiality legal and other reasons, pick to engage outside partners to manage these processes.
2. Communication – Once you have developed the plan, communicate the plan to all employees – using multiple media and approaches.
3. Lead by Example –Begin Employee Health and Wellness Programs at the top (walk the walk).  Give yourselves the opportunity to go through a health risk assessment and a financial assessment.  If you can, communicate your results and your action steps to staff.
4. Develop rewards for Staff Participation – Here are a couple of financial rewards you may provide staff that are low cost and optimally have a ROI:

1. Pay employees to take a risk assessment
2. Lower employee contributions to medical plan for those with decreased risk of chronic disease and correspondingly raise employee contribution to medical plan for those with increased risk of chronic disease

5. Make available Personal Risk Assessment Counseling – Make available resources that can meet one on one with each employee to understand their health risks and opportunities
6. Eliminate Trans-Fat from Your Dietary Offerings – if you have workplace food facilities, and haven’t been required by legislative statute, you should eliminate trans-fatty oils from the employee and customer meals
7. Eliminate Smoking Areas for Staff Members – More and more organizations, including large cities, are now banning tobacco use on their facilities.
8. Make available Proper Monitoring Programs – Probably the hardest part of the plan, the ongoing monitoring is critical.  Some organizations are large enough to own or build wellness centers – but even then, many employees feel uncomfortable in using them.  Typically the users of wellness centers are those least in need.  The good news is that there are many external and internet-based tools and options that are available today.
9. Encourage Other Local Businesses to Make available Employee Health and Wellness Programs.  In some cases (e.g. hospitals), there are options where this may even generate revenue and/or deepen relationships with the communities you serve.

Legal Concerns

When thinking about a Employee Health and Wellness Program, one must take into account certain requirements under ERISA, the Internal Revenue Code (Code) and the Public Health Service Act (PHSA). All three laws were amended by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to provide for improved portability and continuity of health coverage. HIPAA also added Code section 9802, ERISA section 702 and PHSA section 2702, each of which prohibits discrimination in health coverage based on health status.

To be a bona fide Employee Health and Wellness Program, the plan must satisfy the following requirements:

* An individual’s total reward must be limited. A limit of 10 percent to 20 percent of the total cost of employee-only coverage may be appropriate, according to the DOL.
* The program must be reasonably designed to promote good health or prevent disease.
* The reward must be available to all similarly situated individuals. The program must allow any individual for whom it is unreasonably difficult because of a medical condition to meet the Employee Health and Wellness Program standard (or for whom it is medically inadvisable to attempt to meet the Employee Health and Wellness Program standard) an opportunity to satisfy a reasonable alternative standard.

1 2005 Preventing chronic disease: A important investment. World Health Organization
2 2007 Working Towards Wellness: Accelerating the prevention of chronic disease.  World Economic Forum
3 2007 The Value of Health and Longevity. Kevin M. Murphy and Robert H. Topal, University of Chicago
4 2004 Employer/Employee Equation Research on Worker Types, Preferences and Engagement Issues – Concours Group, Age Wave and Harris Poll
5 1997 Neal E. Cutler, Ph.D
6 2003 Talent Report: New Realities in Today’s Workforce – Towers Perrin

Employee Health and Wellness Programs that support employees and the environment that they work in have been shown to be a good ROI. Employee Health and Wellness Programs may be extensive and sometimes expensive. However, there are ways for small businesses to make positive changes at little or no cost.

Employee Health and Wellness Program: Physical/Weight Management Programs

1. Give access to on- and off- worksite gyms and recreational programs before, during, and after work hours.
2. Make available and encourage participation in after work recreation or leagues.
3. Make available cash incentives or decreased insurance costs for participation in physical activity and/or weight management or maintenance programs.
4. Make available shower and/or changing facilities onsite.
5. Make available outdoor exercise areas such as fields and trails for employee use.
6. Make available bicycle racks in safe, convenient, and accessible locations.
7. Make available workplace fitness opportunities, such as group classes or personal training.
8. Make available an onsite exercise facility.
9. Set up programs that have strong social support systems and rewards, such as:
o Buddy or team physical activity goals
o Programs that involve staff members and family
o Programs to encourage physical activity, such as pedometer walking challenges
o Explore discounted or subsidized memberships at local health clubs, recreation centers, or YMCAs
10. Make available 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 workplace 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 encourage stair usage.
16. Make available exercise/physical fitness messages and information to employees.
17. Make available or support recreation leagues and other physical activity events onsite or in the community.
18. Begin employee activity clubs such as walking or bicycling clubs.
19. Make available workplace child care facilities to facilitate physical activity.
20. Sponsor a bike to work day and reward employees who participate.
21. Set up a box and solicit fitness and health tips.

Employee Health and Wellness Program: General Health Education Programs

1. Have a current policy outlining the requirements and functions of a broad-based worksite Employee Health and Wellness Program.
2. Have a wellness plan in place that addresses the purpose, nature, duration, resources required, participants in, and expected results of a worksite Employee Health and Wellness Program.
3. Orient employees to the Employee Health and Wellness Program and give them copies of the physical activity, nutrition, and tobacco use policies.
4. Promote and encourage employee participation in the physical activity/fitness and nutrition education/weight management program.
5. Make available health education information to employees.
6. Have a committee that meets at least once a month to oversee the Employee Health and Wellness Program.
7. Make available regular health education seminars on various physical activity, nutrition, and wellness-related topics. Ask voluntary health associations, healthcare providers, and/or public health agencies to offer workplace education classes.
8. Host a health fair as a kick-off event or as a celebration for completion of a wellness campaign.
9. Designate specific areas to support employees such as diabetics and nursing mothers.
10. Conduct preventive wellness screenings for blood pressure, body composition, blood cholesterol, and diabetes.
11. Make available confidential health rist assessments.
12. Make available workplace weight management/maintenance programs for employees.
13. Add weight management/maintenance, nutrition, and physical activity counseling as a member benefit in health insurance contracts.

Employee Health and Wellness Program: Tobacco Cessation

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

Employee Health and Wellness Programs that support employees and the environment that they work in have been shown to be a good ROI. Employee Health and Wellness Programs may be extensive and sometimes expensive. However, there are ways for small businesses to make positive changes at little or no cost.

Employee Health and Wellness Program: Nutrition Programs

Fruit and Vegetable Consumption

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

Sweetened Beverage Consumption

1. Make water available throughout the day.
2. Make available appealing, low-cost healthful drink options in vending machines and the cafeteria.
3. Modify worksite vending contracts to raise 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. Make available food models, food scales for weighing and pictures to help employees assess portion size.
3. Make available appropriate portion sizes at meetings, worksite events and in the cafeteria.

Breastfeeding

1. Support nursing mothers by providing them rooms for expressing milk in a secure and relaxed environment, a refrigerator for storage of breast milk, policies that support breast feeding, and lactation education programs.
2. Make available flexible scheduling and/or workplace or near-site child care to allow for milk expression during the workday.
3. Adopt alternative work options (i.e. teleworking, part-time, extended maternity) for breastfeeding mothers returning to work.
4. Educate personnel on the importance of supporting breastfeeding co-workers.

Television & Food Advertising

1. Place televisionss in non-eating areas of the worksite.
2. Limit food advertising in the cafeteria (i.e. print and other media).

(Adapted from The Health Promotion First Act prepared by David Anderson, Ph.D., StayWell Health Management)

Employee Lifestyles Impact Employee Health

•    Approximately 40 percent of all deaths in the United States are premature (at least 900,000 deaths annually) and are due to unhealthy lifestyle choices such as tobacco use, poor diet, sedentary lifestyle, misuse of alcohol and drugs, and accidents. Other contributors to early death include genetic predisposition (30 percent), social circumstances (15 percent), poor access to quality medical care (10 percent), and environmental  exposures (5 percent).
•    Unhealthy lifestyle is the primary contributor to the six leading causes of death in the U.S. – heart disease, cancer, stroke, respiratory diseases, accidents, and diabetes – which collectively account for over 70 percent of all deaths.
•    People with healthier lifestyles live an average of 6 to 9 years longer,  postpone disability by 9 years and compress disability into fewer years at the end of life.
•    The prevalence of obesity among U.S. adults rose to 30 percent in 1999-2000, a 33 percent increase from a decade earlier,  and the prevalence of diabetes also rose by 33 percent during approximately the same period (1990 to 1998).
•    About two-thirds of American adults are overweight or obese, 55 percent do not get enough physical activity,  26 percent are completely inactive,10 and only 25 percent eat recommended amounts of fruit and vegetables  If diet/physical activity patterns continue worsening at their current rate, these behaviors will soon surpass tobacco use as contributors to mortality.
•    Among young people, the prevalence of overweight has more than quadrupled in the past 20 years to 16 percent,  daily participation in high school physical education classes has dropped from 42 percent in 1991 to 28 percent in 2003,  more than 60 percent eat too much saturated fat, and almost 80 percent do not eat recommended amounts of fruit and vegetables.
•    Lifestyle diseases disproportionately affect women, racial and ethnic minorities, the poor and seniors:
•    The prevalence of diabetes among African Americans is about 70 percent higher than among white Americans, and the prevalence among Hispanics is nearly double that for white Americans.
•    Women comprise more than half of the people who die each year of cardiovascular disease.
•    Chronic conditions significantly limit daily activity for 35 percent of persons over 65 years of age.

Financial Impact of Lifestyle

•    It is estimated that lifestyle-related chronic diseases account for 70 percent of the nation’s medical care costs,  which translates to over 11 percent of the entire U.S. gross domestic product.
•    Two broad-based scientific reviews identified 83 peer-reviewed studies reporting that people with unhealthy habits have higher medical costs.
•    Research conservatively estimates that high health risks (high blood cholesterol, high blood pressure, etc) account for at least 25 percent of total medical costs.
•    Recent research indicates a direct relationship between modifiable lifestyle risks and reduced worker productivity, and relevant data suggest that the costs to businesses in lost productivity due to poor employee health may be substantially more than the direct medical and disability costs.
•    Unhealthy lifestyles frequently lead to chronic disease, many of which cannot be cured and require years or decades of expensive treatments. Below are estimated annual costs of selected unhealthy lifestyles and chronic diseases including obesity,  tobacco use,  hypertension,  diabetes,  stress,  and inactivity.

Employee Health and Wellness Programs Improve Health and Yield Major Savings

•    Comprehensive scientific reviews identified 378 peer-reviewed studies showing that Employee Health and Wellness Programs improve health knowledge, health behaviors, and underlying health conditions.
•    Research has demonstrated that lifestyle modification may frequently be more effective and cost-effective than medical intervention in decreasing morbidity  and mortality.
•    Several scientific reviews indicate that Employee Health and Wellness Programs reduce medical costs and absenteeism and produce a positive ROI.  The most definitive review of financial impact reported that:
•    18 studies indicated that these programs reduce medical costs, and 14 studies indicated that they reduce absenteeism costs.
•    13 studies that calculated benefit/cost ratios all showed the savings from these programs are much greater than their cost, with medical cost savings averaging $3.48 and the absenteeism savings averaging $5.82 per dollar invested in the programs.
•    Medical costs are expected to exceed 16 percent of U.S. gross domestic product (GDP) in 2005 and to grow at 7.2 percent annually through 2015, when medical expenditures will account for 20 percent of GDP:
•    Per capita medical costs in the U.S. are the highest in the world and more than double the median for OECD countries,  yet the United States ranks 26th in terms of healthy life expectancy.
•    Medicaid is the second largest item in most state budgets, and its portion of the total budgets is increasing each year.
•    Rising medical costs for U.S. businesses continue to outpace general inflation, averaging 12 percent per year for the past 10 years.   This trend is causing a tremendous financial hardship on U.S. businesses.