Carine Sakr, Wellness at Work Conference, June 14, 2010
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Transcript of Carine Sakr, Wellness at Work Conference, June 14, 2010
DELAWARE STATE CHAMBER OF COMMERCE
WELLNESS @ WORK Conference
Carine Sakr, MD, MPHClinical DirectorChristiana CareOccupational Health & Wellness
June 14, 2010
Outline
Current situationWork-related mortality and morbidityNon work-related risk factors
Poor health and workWellness programsHealth care reformTake home messages
3
Work-Related Mortality and Morbidity
Non-Fatal Occupational Injuries and Illnesses
00.5
11.5
22.5
3
2003 2005 2006 2007
YearC
ases
per
100
full-
time
wor
kers
Fatal Occupational Injuries
0
1
2
3
4
5
6
1995 2000 2001 2004 2005 2006 2007
Year
Dea
ths
per
100,
000
empl
oyed
wor
kers
4
No Data <10% 10%–14% 15%–19%
Health Risk FactorsObesity Trends* Among U.S. Adults 1994
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Behavioral Risk Factor Surveillance System
5
Health Risk FactorsObesity Trends* Among U.S. Adults 2008
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Behavioral Risk Factor Surveillance System
6
Health Consequences of Overweight and Obesity
Cardiovascular diseaseHigh blood pressureAbnormal lipids Type 2 diabetesOsteoporosisConstipationDiverticular diseaseIron deficiency anemiaOral diseaseMalnutritionSome cancers
7
Health Risk Factors
Diabetes
6
7
8
9
10
11
1988-1994 1999-2000 2001-2002 2003-2004 2005-2006
Year
% P
erso
ns 2
0 ye
ars
ofag
e an
d ov
er
Hypertension
20
25
30
35
1988-1994 1999-2000 2001-2002 2003-2004 2005-2006
Year
% P
erso
ns 2
0 ye
ars
ofag
e an
d ov
er
Cigarette Smoking Adults US (2007)
010203040506070
NeverSmoker
FormerSmoker
CurrentSmoker
Perc
enta
ge
MenWomen
8
Consequences for Employers
Non-smoker
Former Smoker
Current Smoker
Mean days missed from work due to health conditions per year 4.4 4.9 6.7Total cost of productivity due to health per employee per year $2,623 $3,246 $4,430
*Bunn et al. Effect of Smoking Status on Productivity Loss. J Occup Environ Med. 2006;48:1099-1108
Unhealthy workforceIncreased medical costDecreased productivity
Absenteism + Presenteism
9
Wellness Programs
*Baicker et al. Workplace Wellness Programs Can Generate Savings. Health Affairs. 2010;29
METHOD OF DELIVERY% of
FirmsHealth Risk Assessment 81Self-Help Education Materials 42
Individual Counseling 39
Classes, seminars, group activities 36
Added Incentives for Participation 31
FOCUS OF INTERVENTIONWeight Loss and Fitness 66
Smoking Cessation 50
Multiple Risk Factors 75
Health Risk Assessment: Survey gathers baseline self-reported health data from the employee which are in turn used by employer to tailor subsequent interventions
10
Wellness Programs Work!
*Baicker et al. Workplace Wellness Programs Can Generate Savings. Health Affairs. 2010;29
STUDY FOCUSAverage
ROI
Health Care Costs 3.27Absenteeism 2.73
Medical costs fall by ~ $3.27 for every dollar spent on wellness programs and absenteeism costs fall by ~ $2.73
11
HRA Example: Christiana CareProgram Overview
2010 2008Eligible 7,957 8,241
Participated 6,217 6,403
% Participated 78% 78%Spouses eligible 2,869 N/A
Spouses Participated
1,925 N/A
% Participated 67% N/A
12
HRA Example: Christiana CareModifiable Risks 2010
Modifiable Risks
2010%
*National Norms %
Very Obese, very high risk (BMI >35)
18% 12%
Obese BMI >30 37% 32%
High levels of stress at home
13% 3%
High levels of stress at work
23% 4%
Low physical activity(1-4 days/wk)
68% 56%
* National Center for Health Statistics. Health, United States, 2007. Centers for Disease Control and Prevention. Accessed January 25, 2008.
13
HRA Example: Christiana CareNumber of Health Risk Comparison
0%
5%
10%
15%
20%
25%
30%
0 Risk 1 Risk 2 Risk 3 Risk 4 Risk 5 Risk 6 Risk 7 ormore
20082010
14
HRA Example: Christiana CareHRA/Biometric Program Highlights
0 Risk category went up by 4%
3, 4, and 5 risk categories went down by a total of 5% equating to a savings of $3,699,062!
Our savings between 2008 and 2010 is $228/employee or a total of$4,900,919!
*Wright et al. Comparing excess costs across multiple corporate populations. J Occup Environ Med. 2004;46:937-945
15
Smoking CessationFinancial Incentives for Smoking
Cessation
Randomly assigned 878 employees of a multinational company based in the US
442 employees: information about smoking-cessation programs436 employees: information about programs plus financial incentives
Financial incentives: $100 for completion of a smoking-cessation program
$250 for cessation of smoking within 6 months after study enrollment (confirmed by a biochemical test)
$400 for abstinence for an additional 6 months after the initial cessation (confirmed by a biochemical test)
*Volpp et al. A randomized, controlled trial of financial incentives for smoking cessation. N Engl J Med. 2009;360:699-709.
16
Smoking CessationFinancial Incentives for Smoking
Cessation
*Volpp et al. A randomized, controlled trial of financial incentives for smoking cessation. N Engl J Med. 2009;360:699-709.
Smoking Cessation
Incentive Group
Information Group
9-12 Months 14.7% 5%
15-18 Months 9.4% 3.6%
17
Provisions in the Patient Protection and Affordable Care Act
Bring value of Primary, Secondary, and Tertiary prevention to workplace beyond traditional wellness programs
Provide culture of health to workplace as a complement to the culture of safety:
Increased Productivity (less abs; less pres)Decrease cost to employers
18
Provisions in the Patient Protection and Affordable Care Act
Workplace Wellness and Productivity
Grants for Small Businesses to provide Comprehensive Workplace Wellness Programs
Employer-Based Wellness Programs: Directs CDC to providing services in areas of employer-based wellness programs
Wellness at WorkTake Home Messages
Health risk factors are increasing in the US
A healthy workforce is more productive
Wellness programs work!