WORKSITEWELLNESSPOLICYBy Ju l i a Lang , A l l i son Th i r i on , andChe l s i e Todd

WH Y M I N N E S O T A N E E D S A

Workplace health promotion programs are effortsput forth by employers to improve the health ofemployees. These programs are not new to theworkplace as employers first began assisting theiremployees with health­related issues in the 1950sin the form of Employee Assistance Programs (1).In the present, approximately half of all USemployers offer some kind of employee wellnessprogram (2). 

The United States' workforce is becomingincreasingly less healthy, which has majorimpacts on both public and private sectoremployers. Poor health of employees is correlatedwith a 51% decrease in overall productivity,which is related to health complications that costcompanies an estimated $225.8 billion annually. This value translates to a cost of $1,685 peremployee per year (3).  Programs aimed attobacco cessation, eating habits, and physicalactivity in the workplace have been shown tocombat these issues. N O M A D I C | 2 4

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Introduction

While many states, including Rhode Island, Colorado, and California,have already written worksite wellness policies for their governmentemployees, Minnesota has yet to create any policies on the subject.Since Minnesota has been a leader in public health for decades, astatewide worksite wellness policy is a logical step toward continuingthis legacy and will benefit both state employees and all Minnesotans.Implementing workplace wellness policy and initiatives for insurancewill significantly lower healthcare costs for citizens and the state. Additionally, wellness policies will increase both employee healthand productivity.

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What Can Worksite WellnessPrograms Accomplish?

Lowering overall healthcare costs, which saves money for bothinsurance providers and businesses.Promoting healthy employee lifestyles, decreasing incidence ofchronic disease, and increasing employee satisfaction andworkplace production.Providing employees with health promotion resources like supportsystems, education, and access to discounted fitness centers andservices.Strengthening the message that institutions and businesses areconcerned with the health and satisfaction of their employees.

Worksite wellness programs have a number of benefits for bothemployers and participants.  These include:

WhyMinnesota?The state governmentis the second largestemployer inMinnesota withnearly 40,000employees (12).Minnesota has rankedas one of the Top 10healthiest states foralmost three decades(11), but still hasroom forimprovement.The MinnesotaDepartment of Healthhas alreadydeveloped a WorksiteWellness Toolkit tohelp organizationscreate their ownpolicies andprogramming (3).

Nearly half of Americans have at least one chronicdisease (5).

Worksite Wellness Issue: ChronicDisease Prevalence

Savings PotentialA nationwide cost­benefit analysis of wellnessprograms shows that for every dollar spent onwellness, medical costs fell by about $3.27. When accounting for absenteeism, the samestudy showed an additional savings of $2.73per dollar spent (4).A review of the Biltmore tourism enterpriseshowed a 10% decrease in turnover over fouryears since implementing their employeewellness program, saving money on hiring andtraining practices (8).

30% of health outcomes, including chronic diseasediagnosis, are related to health behaviors such astobacco use, unhealthy eating, lack of exercise, andexcessive alcohol intake (6).Of the top ten leading causes of death, seven arechronic diseases like diabetes, heart disease, andrespiratory disease (7).

The Facts:

Worksite Wellness Policy Benefits:Improved health outcomes ­ At Johnson andJohnson, half of employees who had high bloodpressure were able to decrease their bloodpressure to a normal level thanks to wellnessprogram interventions (8).Reduced health risk ­ In a study of 185employees and their spouses, over half ofworksite wellness program participants whobegan the study as high health risk were reducedto low health risk in six months (8).Increased health engagement ­ In companies witha strong culture of health, employees are 3 timesas likely as others to report taking action toimprove their health (9).

Health care premiums for employer­sponsoredfamily coverage have increased by 87% since2000 (10).

Worksite Wellness Issue: RisingHealthcare Costs

Nationally, employer health insurance claimsfor obesity and related chronic diseases amountto $93 billion per year (3).86% of all health care spending in 2010 was forpeople with one or more chronic medicalconditions (7).

The Facts:

Worksite Wellness Policy Benefits:

The annual return on investment for worksitewellness programs is $3­$6 saved for every $1spent after about 2 to 5 years (3).In a worksite wellness study of 185 employeesand their spouses, medical claim costs declinedby $1,421 per participant, compared with thosefrom the previous year (8).At MD Anderson Cancer Center, workers’compensation insurance premiums were cut inhalf within 6 years of establishing a worksitewellness program (8).

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Worksite Wellness PolicyOptionsThere are several policy options available tocreate a healthier workplace.  See the next pagefor specific policy options.

Worksite Wellness ProgramRecommendations

Look to the Minnesota Department of HealthWorksite Wellness Toolkit for guidance indeveloping and implementing a WorksiteWellness Program and writing organizationalpolicies.

Wellness Policy Options

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WorksiteWellness ProgramRecommendations,ContinuedSee the table to the rightfor ideas on how to trackand incentivize employeeparticipation.

Wellness Programmingand Offering Ideas

Establish Wellness Champions to lead employees in their efforts.Coordinate a cost-share gym network with employee discounts.Set guidelines for ordering food for company events.Offer access for all employees to onsite fitness centers.Host on-site nutrition classes and taste-testing.Host off-site nutrition lessons and classes - grocery store tours, health expos, cooking classes, etc.Arrange team walking challenges or weight loss competitions.Offer stress management activities and classes.Issue physical rewards: standing desks, exercise ball chairs, pedometers, gym memberships, etc.Coordinate bike safety classes and bike-friendly campus initiatives.

Some opponents of workplace wellness programming consider penalizing employees for nonparticipation inmedical exams and/or other wellness activities to be discriminatory (19).Other opponents state worksite wellness programs have the potential to violate the Americans with DisabilitiesAct (ADA), and the Equal Employment Opportunity Commission (EEOC) has already taken legal action againstseveral companies whose worksite wellness programs were deemed inaccessible to some employees (20).

Frequently Asked Questions1. How will we get employees to participate in a worksite wellness program?

2. Why might people oppose workplace wellness programming? 

 3. How do we design inclusive worksite wellness programs?

More employees will participate in wellness programs if an incentive is offered for participating (18).Incentivizing annual Health Risk Assessments (HRAs) or biometric screenings increases wellness programparticipation in those employees with a higher risk of chronic conditions like diabetes, elevated blood pressure,and high cholesterol (18).

A 2016 guidebook developed by Gallagher Benefit Services, Inc. explains legal guidelines for developinglawful and nondiscriminatory workplace wellness programs.  See the cited web link for program­specificinformation (20).

References1. Call, Catherine, Gerdes, Robyn, and Robinson, Kristen. Health and wellness research study: corporate and worksite wellnessprograms: a research review focused on individuals with disabilities. U.S. Department of Labor. 27 March 2009. 2. Mattke, Soeren, Hangsheng Liu, John P. Caloyeras, Christina Y. Huang, Kristin R. Van Busum, Dmitry Khodyakov and VictoriaShier. Workplace Wellness Programs Study: Final Report. Santa Monica, CA: RAND Corporation, 2013.http://www.rand.org/pubs/research_reports/RR254.html.3. Workplace Wellness. (2015, August 26). Retrieved November 27, 2016, fromhttp://www.health.state.mn.us/divs/oshii/worksite/about.html4. Baicker, K., Cutler, D., & Song, Z. (2010, February 14). Workplace Wellness Programs Can Generate Savings. Health Affairs,29(2), 304-311. doi:10.1377/hlthaff.2009.06265. The Growing Crisis of Chronic Disease in the United States. (2007, April). Retrieved November 27, 2016, fromhttp://www.fightchronicdisease.org/sites/default/files/docs/GrowingCrisisofChronicDiseaseintheUSfactsheet_81009.pdf6. Peterson-Hickey, M., & Ayers, J. (2014, February 1). Advancing Health Equity in Minnesota. Retrieved November 27, 2016,from http://www.health.state.mn.us/divs/chs/healthequity/ahe_leg_report_020414.pdf7. Johnson, N. B., Hayes, L. D., Brown, K., Hoo, E. C., & Ethier, K. A. (2014, October 31). CDC National Health Report: LeadingCauses of Morbidity and Mortality and Associated Behavioral Risk and Protective Factors—United States, 2005–2013. RetrievedNovember 27, 2016, from http://www.cdc.gov/mmwr/preview/mmwrhtml/su6304a2.htm8. Berry, L. L., Mirabito, A. M., & Baum, W. M. (2010, December). What’s the Hard Return on Employee Wellness Programs?Harvard Business Review. Retrieved from https://hbr.org/2010/12/whats-the-hard-return-on-employee-wellness-programs9. Anderko L, Roffenbender JS, Goetzel RZ, Millard F, Wildenhaus K, et al. Promoting Prevention Through the Affordable CareAct: Workplace Wellness. Prev Chronic Dis 2012;9:120092. DOI: http://dx.doi.org/10.5888/pcd9.12009210. Kaiser Family Foundation and Health Research Educational Trust. (2006). Employer health benefits survey. Retrieved fromhttp://www.kff.org/insurance/7527/11. 2015 Annual Report; Minnesota. (n.d.). Retrieved from http://www.americashealthrankings.org/explore/2015-annual-report/measure/Overall/state/MN12. Top Employers Statewide. (2016, July 8). Retrieved November 27, 2016, from https://mn.gov/deed/business/locating-minnesota/companies-employers/top-employers.jsp13. Virginia. Retrieved November 27, 2016, from American Lung Association - Fighting for Air:http://www.lungusa2.org/cessation2/statedetail.php?stateId=5114. State Employee Benefits. Retrieved November 13, 2016, from CMS:https://www.illinois.gov/cms/Employees/benefits/StateEmployee/Pages/WellnessProgram.aspx15. State Agency Worksite Wellness. Texas Department of State Health Services, 2014.16. University of Missouri. (2016, October 31). Wellness Incentive. Retrieved November 20, 2016, from UM System :https://www.umsystem.edu/totalrewards/wellness_incentive17. Case Western Reserve University. (2016). Wellness Premium Incentive. Retrieved November 20, 2016, from UniversityWellness: https://www.case.edu/wellness/the-wellness-program/wellness-premium-incentive/18. Fronstin P, Roebuck MC. (2015). Financial Incentives and Workplace Wellness-Program Participation. Employee BenefitResearch Institute Issue Brief, 1-20.19. Mitts, L. (2015, April 2). Trending: Employer Wellness Programs Must Preserve Workers’ Nondiscrimination Rights. RetrievedNovember 20, 2016, from Families USA: http://familiesusa.org/blog/2015/04/employer-wellness-programs-must-preserve-workers-nondiscrimination-rights20. Gallagher Benefit Services. (2016). Guide for Designing a Compliant Wellness Program.