Worksite Wellness

in Arkansas

Presented by

Helen Weir (ADH) & Rhonda Hill (ACHI)

October 21, 2010

Economic Burden of Chronic Disease

• U.S. spends $2.2 trillion on health care annually

• .75 cents of every dollar is spent on managing chronic conditions

• One-third of the cost aloneis due to obesity

Economic Burden of Chronic Disease

Reported Cases in Arkansas, (projected 2009

and as % of population) Cancers (all): 149,896 5.2%

Diabetes: 146,964 5.1%

Heart Disease: 249,276 8.7%

Hypertension: 470,771 16.5%

Stroke: 33,491 1.2%

Emotional Disturbances: 305,331 10.7%

Pulmonary Conditions: 542,322 19.0%

Economic impact in Arkansas, projected 2009

(Annual Cost in Billions)

Treatment Expenditures: $3.65

Lost Productivity: $17.2

Total Costs: $20.85

Economic Burden of Chronic Disease

Social Ecological Model

Collaboration & Partnership

Arkansas Department of Health

Arkansas Center for Health Improvement

Arkansas Coalition for Obesity Prevention (ArCOP)

Arkansas Coalition for Obesity Prevention

• Grassroots, statewide collaboration that stemmed from 2007 Southern Regional Obesity Summit

• Identified that we were all working toward the same goal – yet separately

• Pooled resources, work plans, and overarching goals and objectives

• 200 + members with over 75 partnering entities

ArCOP

Mission: to improve the health of all Arkansas communities by increasing physical activity and healthy eating to reduce and prevent obesity.

Vision: all Arkansans value and practice healthy lifestyles through created and supported opportunities of increasing physical activity and healthy eating.

Goal: Increase the percentage of Arkansans of all ages who have access to healthy and affordable food and who engage in regular physical activity.

Coalition Partners

American Cancer Society American Heart Association Arkansas Academy of Pediatrics Arkansas Advocates for Children and Family Arkansas Blue Cross and Blue Shield Arkansas Center for Health Improvement Arkansas Children‟s Hospital Arkansas Community Foundation Arkansas Coordinated School Health Arkansas Department of Education Arkansas Department of Health Arkansas Department of Human Services Arkansas Foundation for Medical Care Arkansas Governor's Office Arkansas Head Start State Collaboration Office Arkansas Head Start TA Network Arkansas Hunger Alliance Arkansas Injury Prevention Center, Arkansas Minority Health Commission Arkansas Parks and Tourism Arkansas State Highway and Transportation Department

Arkansas State & Public School Employee Life & Health Insurance Plan

Arkansas State University Baptist Health Blue & You Foundation for a Healthier Arkansas Central Arkansas Transit AuthorityClinton School of Public Service ComMetrics Inc.

Community Health Centers of Arkansas Daughters of Charity Services of Arkansas - SE ARDelta AHEC Delta OPRU, ARS, USDA Evangelistic Ministries Frueauff Foundation Heifer InternationalHendrix University JB Hunt Transport Services Kutak Rock Firm LifeSynch Metroplan Midwest Dairy Council North Arkansas Partnership for Health Education North Little Rock First United Methodist Church PE4Life Academy (Rogers, AR) Pfizer Phoenix Youth and Family Services Pulaski Technical College Results Fitness 24/7 Robert Wood Johnson Foundation, Center to Prevent Childhood Obesity Safe Routes to School Program St. Francis House Community Clinic (Northwest AR) United States Department of Agriculture, ARS University of Arkansas Division of Agriculture University of Arkansas at Little Rock University of Arkansas for Medical Sciences University of Arkansas at Pine Bluff

Examples of Non-Traditional Partners

• Metroplan

• CATA

• JB Hunt Transportation Services

• NLR First United Methodist Church

• Evangelistic Ministries

• US Department of Agriculture

• AR Hwy and Transportation

• AR Parks and Tourism

• AR Game and Fish

• AARP

ArCOP Workgroups

WO

RK

GR

OU

PS

Access to Healthy Foods

Determine existing needs statewide and among

various sub-populations regarding access to healthy foods

Identify existing programs that support access to

healthy foods and determine additional programming and service needs

Identify programmatic barriers and determine

strategies and resources needed for successful implementation

Built Environment Collaborate with city and town planners to

promote physical activity by developing pedestrian and bicycle friendly neighborhoods that offer convenient, pleasant, and safe non-motorized links between residences, schools, shopping, and recreational facilities

Encourage active lifestyles by incorporating well

designed, mixed-use development that permits high quality of life with reduced need for

vehicles to conduct daily activities

Worksite Wellness Empower employers to combat obesity in the

workplace

Collaborate with local, state, and national

resources to identify best practices for workplace obesity intervention programs in an effort to decrease obesity and other chronic diseases across Arkansas

Health Care Engage with providers and insurers to improve

quality of life and reduce total long-term costs of health care due to obesity and related chronic disease

Collaborate with health care providers, employers

and other organizations who are purchasers of coverage and insurance companies or other

payers to ensure coverage for obesity

Early Childhood and Schools Collaborate with parents and communities to create a unified environment that promotes

healthy eating and physical activity

ArCOP Workgroups (cont.)

• Policy Development

• Social Marketing

• Evaluation

• Executive Team

Worksite Wellness Work Plan

Goal: Increase the percentage of Arkansans of all

ages who have access to healthy and affordable

food and who engage in regular physical activity.

Strategy: Improve worksite health environments.

Worksite Wellness Work Plan

Objectives:

• Establish an electronic clearinghouse for model

worksite wellness programs and resources.

• Double the size of the Arkansas worksite

stakeholder group.

• Hold 5 regional worksite health summits.

• Create healthy worksite award.

• Encourage development of policy/system

change to support healthy worksite

environments.

Regional Summits

• Five Regional Summits+ one

• Marketing

• Partner involvement

• Lessons learned

• Evaluation results

ArCOP – Growing Healthy Communities

Resources

• AHELP New web site for State of Arkansas workforce

http://ahelp.arkansas.gov

• Sister web site for state employees, businesses and departments at worksites interested in establishing or enriching the programs for the health of the workforce. Partnership participation in setting up resources ArCOP.

http://worksitewellness.arkansas.gov

Arkansas Healthy Employee Lifestyle Program

(AHELP)

Comprehensive worksite wellness programWeb-tracking behavioral intervention (points assigned)

Cardiovascular, aerobic physical activity

Fruits and veggies

No tobacco

Act 724 of 2005 granted up to three days off with satisfactory participation per calendar yearUNC Centers for Excellence features AHELP as an “Emerging Intervention for Obesity Prevention http://www.center-trt.org

HRA Response Rates Across 5 Years

*ASE only

$1

,62

5

$2

,39

4

$2,7

38

$3

,59

8

$4

,52

2

$6

,39

8

$1

,63

0

$2

,29

1

$3

,07

8

$3

,93

6 $

5,6

15

$8

,26

1

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

$8,000

$9,000

18 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74

Non-tobacco user

Tobacco user

Average Annual Total* Costs Linked to Any Tobacco Use

compared with Non-tobacco Use by Age Group

*Includes medical (inpatient and outpatient) and pharmacy costs for state employees.

$1,863

(29%)

Average Annual Total* Costs Linked to 5+ days/wk of

physical activity compared with No weekly activity by Age

Group

$1

,57

8

$2

,04

5

$2

,63

1

$3

,33

6

$4

,38

9 $

7,2

43

$1

,08

6

$3

,12

7

$4

,10

6 $

6,8

38

$11,4

47

$1

2,7

89

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

18 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74

5+days/wk of physical activity

No weekly physical activity

*Includes medical (inpatient and outpatient) and pharmacy costs for state employees.

$5,546

(77%)

Average Annual Total* Costs Linked to Normal Body Mass

Index compared to Obese BMI by Age Groups

*Includes medical (inpatient and outpatient) and pharmacy costs for state employees.

$1

,62

2

$2

,30

2

$2

,50

4

$3

,20

0 $

4,7

62

$5,9

71

$1

,60

5

$2

,52

2

$3

,47

0

$4

,45

0

$5

,68

5

$8

,14

3

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

$8,000

$9,000

18 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74

Normal Weight BMI

Obese BMI

$2,172

(36%)

ROI of Worksite Wellness Programs in

Economically Challenging Times

Top 5 Strategies

1.Tap into your insurance plan‟s willingness to pay for wellness.

2.Create a benefit design so wellness can be cost neutral.

3.Implement worksite policies & environmental changes that support healthy living.

4.Use the right wellness messages to enhance engagement & increase participation.

5.Make use of your free community resources.

WELCOA-2009

Small Business Interventions

10 Essential Things That Small Business Leaders Can Do To Promote Better Health

1.Issue letter of support to employees

2.Designate a company wellness leader

3.Conduct employee health interest survey

4.Provide Health Screenings/Health Risk Assessments opportunities

5.Physical activity campaign

WELCOA-2009

Small Business Interventions (cont‟d)

10 Essential Things That Small Business Leaders Can Do To Promote Better Health

6. Hold Lunch „n Learns

7. Establish an in-house library or electronic resource center

8. Disseminate a quarterly newsletter

9. Implement health promoting policies

10. Promote community health efforts

Small businesses: Steps toward increasing the health &

well-being of their most valuable asset………..

Their employees and their families

The Power of Prevention

Epidemic of Unparalleled Proportions

________substantiated by hard facts

• More than 1.7 million Americans die of a chronic disease each year

Five chronic diseases

•Heart Disease

•Cancer

•Stroke

•Chronic Lung Disease

•Diabetes CDC-Chronic Disease

Reasons for Prevention

Cancer- $171.6 billion, of this amount, $60.9 billion was due to direct medical costs and

$39.8 billion to lost productivity

Obesity- estimated $117 billion, of this amount, $61 billion due to direct medical costs and

$56 billion to lost productivity

CV Disease and Stroke- $351.8 billion , of this amount, $209.3 billion due to direct medical costs and $142.5 billion to lost productivity

CDC

Prevention

Chronic disease risk factors also place huge economic demands on our nation and state

Lost Productivity:

Smoking-more than $80 billion

Poor Nutrition- $ 9 billion related to heart disease, cancer, stroke, and diabetes

What did it cost your business?

CDC

Prevention

Three modifiable health-damaging behaviors

Tobacco Use

Lack of Physical Activity

Poor Eating Habits

33% of all U.S. deaths can be attributed to these behaviors

ArCOP – Worksite Wellness

• Strategy– Improve worksite health environments

• Objectives– Establish an electronic clearinghouse for

model worksite wellness programs and resources (12/31/09)

– Double the size of the Arkansas worksite/employer stakeholder group from 10 to 20 members (6/30/2010)

– Hold 5 regional worksite health summits (6/30/2010)

– Create healthy worksite award (12/31/2010)

– IN PROCESS/ONGOING Encourage development of policy/system change to support healthy worksite environments.

Healthy Workforce 2010, Partners

for Prevention (2001)

Healthy Workforce

The workplace is an ideal environment for cultivating a healthy life style

45% of a persons waking hours are spent in the

workplace

82% of the U.S. population is linked in someway to a

worksite

Worksites can be environments that promote health or

that create barriers to health

Arkansas Worksite Wellness

Healthy Arkansas Initiative 2004

Arkansas Department of Health and Arkansas Department of Human Services pilot intervention Healthy Employee Lifestyle Program (HELP)

Arkansas Law, Act 724 of 2005

Arkansas Workforce Wellness

Representative Linda Chesterfield sponsored

Act 724 of 2005 giving an incentive for healthy

behaviors and actions for State of Arkansas

employees

- Up to 3 days leave for satisfactory participation in the

AHELP web tracking program of physical activity, fruits

and vegetables, and no tobacco use.

- In addition, annual HRA and age-appropriate screenings

give points in the system.

Arkansas Healthy Employee Lifestyle Program

(AHELP) Roll-Out to all state agencies, boards,

and commissions

Arkansas Workforce WellnessArkansas Worksite Wellness

• AHELP goals:

• Reduce the number of employees who use tobacco

• Improve the nutritional choices available to employees

• Increase the number of employees getting age-

appropriate health screenings

• Increase the number of employees who participate in

physical activity

• Increase the number of employees who are at healthy

weight

Arkansas Workforce WellnessArkansas Worksite Wellness

• Based on Health Risk Assessments (HRAs) completed between February 2005 and March 2006*:

• Cholesterol - 12% increase in percent of participating

employees in the lowest risk category

• Physical Activity/Exercise - 12% decrease in percent of

participating employees in the “high risk” or “borderline risk”

category

• Nutrition - 26% increase in percent of participating employees

in the lowest risk group

* Arkansas Department of Health and Human Services

Arkansas Workforce WellnessArkansas Worksite Wellness

• As of June 2008, there were 2427 registered participants in AHELP

• Since AHELP‟s inception in April 2005:

• 648 participants have earned and redeemed the

incentive of 1-hour off in time from work

• 39 participants earned 1-day leave

• 40 participants earned 2-days leave

• 108 additional participants earned 3-days leave

• 6 available passes for 2-days at an Arkansas

State Parks Lodge earned

• In 2006 alone, over 440 other prizes redeemed

Arkansas Workforce Wellness

Resources will be available soon on the New Website for Lifestage Health Branch

Adults in Worksites:

www.AHELP.arkansas.gov

Contact: Helen Weir, Administrator

Helen.Weir@arkansas.gov

Arkansas Tools for a

Healthy Workforce

Arkansas Department of Health with their multiple partnerships and collaborations

Other state partnerships through the guidance of Center for Disease Control and Prevention (CDC)

Proven strategies, promising strategies and expert opinion strategies

Healthy Workforce 2010; Partners

for Prevention (2001)

Tools

CDC Evidence-Based Focus Areas:

Increase fruit & vegetable consumption

Decrease sweetened beverage consumption

Decrease food portion size (portion control)

Increase physical activity

Increase Breastfeeding

Increase smoking cessation in adults

Increase the proportion of worksites with formal No-Smoking policies

www.5Aday.gov

Healthy Habits

Nutrition

Eat for Color: Green, Orange/yellow, Red, Blue/purple, and White

Eat 5 to 9 servings of fruits and vegetables every

day

May lower your risk of certain cancers, heart

disease, and stroke.

Helps manage your weight

cdc.gov/nccdphp/dnpa/physical

Healthy Habits for Arkansas

Physical Activity

Adults:

Moderate PA for at least 30 minutes on 5 or more days of the week or

Vigorous PA 3 or more days per week for 20 minutes or more each time

New Guidelines 2008

cdc.gov/dnpa

Physical Activity

Why is PA important?

Reduces your risk of:

Heart disease and stroke, cancer, diabetes and high

blood pressure

Helps control weight

Keeps bones, muscles and joints healthy

Reduces falls in older adults

reduces symptoms of anxiety & depression

Arkansas Department of Health

SOS Facts

Healthy Habits

Tobacco:

Don‟t Smoke, Chew, or Dip

There is no safe tobacco.• If you use tobacco QUIT

• If you don‟t….. don‟t start

QUIT NOW !

Call it quits

1-866-NOW-QUIT

Tobacco

Arkansas Statewide Tobacco Programs and Services (AR Stops)

SOS Quitline

SOS Works- Fax-back Referral Program

Arkansas Tobacco Cessation Network

www.cdc.gov/CVH

Resources

Heart-Healthy and Stroke-Free Worksites

Successful Business Strategies to Prevent Heart

Disease and Stroke

Reducing the Risk of Heart Disease and Stroke: A

six-step Guide for Employers

Arkansas Department of Health-

• Heart and Stroke Prevention Program

• Diabetes Program

Arkansas Department of Health

Lifestage Health Branch &

Heart Disease and Stroke Prevention Section

Adults in Worksites

Helen Weir, RN, BSN

helen.weir@arkansas.gov

Magnolia

+ Community response is increasing

+ Increase in individuals attending GHC Coalition meetings

+ Mayor and representatives for the Chamber of Commerce are participating

− GHC is a BIG project

− Keeping people engaged and enthusiastic

Suggestion: Look beyond traditional partners -youth groups and organizations, faith-based groups mission programs, 4-H programs, Future Farmers, etc.

Batesville

+ Water bottles are now included in park vending machines

+ White River Community Garden has been established and individuals are decorating plots

+ All plots were rented shortly after grand opening

+ Mayor was asked to participate in the national 2010 Obesity Conference (ATL)

− Keeping people involved and showing up for events

Suggestions: Look beyond traditional partners. Share in tasks.

Little Rock – Arkansas Baptist College

+ Menu policy has been developed for use in the Arkansas Baptist College (ABC) cafeteria to offer healthier options

+ A Fresh Market is scheduled to open in July

+ Partnering with AR Children‟s Hospital to implement a community garden

+ Hired a full-time gardener

− Getting community Health Advisory Board recruited and engaged. They have already enlisted some community members to serve on the board.

Harrison

+ City sponsored a community garden plot of land centrally located

+ Public declaration by Mayor

+ City will provide water to the site

+ Storage building was purchased to store our

tillers, gardening materials, etc.

+ Community champion identified

− Slow everyone down enough to establish and adopt policies and procedures that will help sustain the concept

− Find a long-term entity to take “ownership”