Preventing Obesity, While Treating Laziness
The stereotypical American is a sweaty, overweight man who just finished his 9 to 5 job and is now searching Walmart for the cheapest case of beer he can find. Let’s change that. I am not looking at solutions to revolutionize our country; however, there is nothing stopping this adjustment from doing that: Should we start allowing employees to exercise during their workday? This is an interesting idea that potentially affects workers in a variety of ways.
Quite a few companies have implemented physical activity into their employees’ day; some go all out and build gyms inside the office while others simply form running clubs to exercise during their lunch break. The new trend of adding exercise into the workday isn’t just to reduce obesity in America. While that is important, what CEOs and managers are finding most helpful is all the side effects that come along with a daily workout. In fact, studies show that workers who spend 30-60 minutes exercising during lunch see an average of a 15% performance boost (Holmes, 2015). For only an hour a day, we can fight obesity while also lowering the number of sick days. Along with the fewer number of absences, employees can expect to see a longer life expectancy when they add physical activity to their daily routine.
Chronic Disease
The primary goal of any wellness program is to reduce the risk of chronic disease, which is currently the leading cause of death in the United States. According to the American Institute of Stress, “high stress is the leading culprit (of all of the lifestyle factors) of chronic disease, and excess stress accounts for more than $300 billion annually in lost productivity, absenteeism, accidents, turnover, and health care costs for US businesses” (Soldano, 2016). With so much stress circulating around offices, workplace wellness provides CEOs with a way to relieve tension and lower the amount of money lost due to stress. In one of the studies analyzed in the Journal of Occupational and Environmental Medicine, workers reporting stress experienced a 46% increase in their health care costs while the ones reporting depression had a 70% growth in health care costs. These two conditions impact employee’ health care costs more than obesity, smoking, or high blood pressure combined (Goetzel, 2014).
Stress and depression may not be entirely preventable, but the impact they have on the employees’ wellbeing and healthcare costs can be significantly reduced. The Journal of Occupational and Environmental Medicine takes evidence about the effectiveness of these programs and combines it with a critical review of outcome studies to answer the question: “Do workplace wellness programs work?”. It also takes a look at newer studies which question the need for workplace wellness programs whatsoever. The evidence accumulated over three decades demonstrates how properly designed and executed programs that are founded on evidence-based principles can achieve positive outcomes.
The article, Physical Activity Interventions in The Workplace: The Rationale and Future Direction for Workplace Wellness, brings up the issue of obesity. Both developing and developed countries are both facing an epidemic with their workers getting more and more overweight.
“As demonstrated elsewhere in this issue, the individual and societal health and economic costs of obesity and physical inactivity are enormous” (Batt, 2008).
This provides the need for both local and global action introducing health programs that can be applied to children, adolescents, the workforce, and the elderly. The article uses case studies from London to display their main points.
One chronic disease which has impacted just about every single person in one way or another is cancer. The word alone can cause some to cringe, despite how terrifyingly common this illness is. One scholarly article in the Seminars in Oncology Nursing brings up the thought that these wellness programs can promote cancer prevention. This article focuses on the disease prevention side of the workplace wellness debate. It also concentrates on the best way to implement a health promotion program and describes ways for employees to become wellness advocates. The data used in this article is all relatively recent with the oldest being from 2010. “Employers who offer workplace wellness programs can contribute to the overall health and well-being of their employees, improve employee productivity and retention, and reduce absenteeism and health care costs.” (Soldano).
RAND Studies
The Workplace Wellness Programs Study analyzes just about every aspect of the “Workplace Wellness” concept. This study goes over the chronic diseases that lead companies to begin these health programs and then follows up with different methods used across the globe. The research provided by RAND, a nonprofit institution that helps improve policy and decision making through research and analysis, is perhaps the most thorough study conducted on workplace wellness programs thus far. All 25 pages of the final study are packed full of statistics and graphs related to the program.
The 5 Steps to a Successful Workplace Wellness Program is a toolkit to help small/medium-sized companies implement their workplace wellness program. It shows how a properly implemented workplace wellness program can reduce health risks, lower healthcare costs, and improve productivity. These programs are becoming common in benefits packages, but there are some differences amongst them: some focus more on saving money while others take a more health-oriented approach, and there are differences in the design and implementation in each.
“This toolkit synthesizes the lessons learned and best practices from multiple projects and many years of research into a five-step guide for the planning, implementation, and evaluation of a successful workplace wellness program” (Busum, 2014).
The steps in the guide are
“Step 1: Define your objectives. Step 2: Determine your pain points. Step 3: Develop your plan of action. Step 4: Follow best practices in implementation. Step 5: Measure program impact.” (Busum, 2014).
Each step uses evidence and examples to explain why it is important and then provides tools and resources to help as well.
The article, Is More Always Better in Designing Workplace Wellness Programs?, uses data from the previous RAND studies and compares the findings. The objective of this article is to assess whether adding more components to a workplace wellness program will lead to better outcomes. This was measured by the relationship of a program’s components amongst one another to employee participation and multiple characteristics of effectiveness. The data came from a 2014 survey of 24,393 employees about the different services offered, leadership, incentives, and promotion in their workplace (Batorsky, 2016). The researchers used logistic regressions to display the relationship between program characteristics and outcomes.
“Components individually are related to better outcomes, but this relationship is weaker in the presence of other elements and non-significant for incentives. Within components, a moderate level of services and work time participation opportunities are associated with higher participation and effectiveness” (Batorsky, 2016).
The conclusion of this study is that simply adding more of something good will not directly improve it.
Brain Enhancements
There is a direct correlation between exercise and the release of “happy chemicals” in the brain; this will naturally reduce stress, depression, and the risk of chronic disease amongst employees. The 2014 Annual Work Stress Survey found that
“83% of US employees report being stressed by at least one thing at work” (Soldano, 2016).
With over ¾ of workers at risk of chronic disease simply due to stress, employers and health care professionals are quickly taking note of how important personal health and accountability are.
The improvement in an employee’s physical health that comes with a wellness program is an obvious perk, but how does that benefit the workplace? There are a bunch of mental benefits that come along with a healthy lifestyle, each one helping to reduce the stress that seems to be so common in our workforce today. Physical activity increases the blood flow to the brain, which can sharpen awareness helping to stay on top of deadlines/projects.
We are overworking our employees and not allowing them adequate time to rest; this combination can turn very dangerous very quickly with minimal warning.
“What do the Exxon Valdez, Chernobyl, and Three Mile Island incidents have in common? Fatigue. Employee fatigue played a role in all three tragedies” (Severe Impact of Fatigue in the Workplace Examined, 2002).
Routine exercise will produce more energy in the body. This will lead workers to feel more awake and able to perform during the day (Boehkle, 2011). With over $77 billion being lost each year due to workers being too tired to properly carry out their jobs (Severe Impact of Fatigue in the Workplace Examined, 2002), this presents yet another unnecessary expense that fit employees could help solve. Another benefit of being in excellent physical shape is that employees’ cardiovascular health will improve, giving them more stamina to meet the demands of their jobs.
“Regular exercise that includes power walking, running, weight lifting, swimming, or jogging can help reduce your risk of… developing type 2 diabetes, obesity, hypertension, and heart disease – all of which can interfere with work productivity.” (Boehkle, 2011).
The healthier you are physically, leads to a stronger immune system and therefore fewer sick days. This improved immunity minimizes the chances of employees’ getting influenza and the common cold, while the risk of chronic disease also goes down due to physical training.
Workplace Wellness Increases Productivity
The claim that “a workplace wellness program will enhance the productivity of employees” is thrown around quite a bit, but what does that broad statement entail? The statement is general because the benefits of implementing health incentives into a company are diverse, affecting many areas of everyday lives.
Employees’ mental health will see many benefits from exercising, most notably increased happiness. Physical training of the body prompts the brain to release serotonin, a neurotransmitter that stimulates mood and emotion, making the stresses of a workday easier to cope with (Boehkle, 2011). Directly, the increased release of these chemicals are helpful to each worker individually; however, there are indirect benefits as well.
The saying “Couples who sweat together, stay together” is completely applicable to companies. This expression refers to couples who exercise as a pair, when employees work out with one another they grow stronger as a unit. When you work out your brain releases dopamine, which is the chemical that contributes to happiness. The body craves physical activity, so the brain releases dopamine and other positive chemicals to make it enjoyable. A group of fellow employees exercising together causes a lot of happy chemicals to flow, leading everyone to be more friendly and accepting of their surroundings. Business leaders are constantly trying to build their personnel into a team, and office fitness might just be the solution they are looking for. An active employee is very much like a student-athlete; the addition of physical activity to one’s schedule will improve time management skills.
Companies will frequently spend hundreds of thousands of dollars on retreats or team bonding trips just to help strengthen the unity of their staff. A workplace wellness program can increase the productivity of employees, without changing how they work at all.
I personally have found bonding with people through athletics and sports is much stronger than any team building game I ever played. In high school, I was an avid lacrosse player and dedicated countless hours to practice, games, and working out. As my teammates and I arrived at school early for morning lifts or stayed after practice to get some extra reps in, we felt our relationship strengthen each time we stepped on the field together. Exercise is breaking your body down so that it rebuilds itself stronger than before. The same formula applies when doing group fitness: when people give blood, sweat, and tears towards a particular goal their bond is reinforced.
This new phenomenon is reshaping insurance companies as well, with insurers such as Blue Cross Blue Shield creating new programs for themselves with a new focus on prevention and treatment. Their new program, Blue365, promotes fitness in a new way offering discounts on health services such as gym memberships, eDiets.com meal delivery, and Reebok running shoes to list a few (Beals, 2012). Other insurance companies are following in their footsteps, often partnering with a national gym to offer special deals. The Carrot and Stick method is a different tactic that requires preventative healthcare choices, and if they are skipped, the employees have to pay. The Cleveland Clinic had more than half of their 29,000 employees enroll in their Healthy Choice plan since 2010. This plan involves weight management seminars, yoga classes, and more (Beals, 2012). It is all very appealing unless you aren’t participating in which case you face a potential 21% increase in premiums for unhealthy employees (Beals, 2012).
Saving Lives, But Also Saving Money
Along with increasing health spending, the workplace is experiencing a growing interest in disease prevention and the implementation of wellness programs to promote health.
“In a critical meta-analysis of the literature on costs and savings associated with such programs, we found that medical costs fall by about $3.27 for every dollar spent on wellness programs and that absenteeism costs fall by about $2.73 for every dollar spent” (Caperchione, 2015).
Even though these results need to be tested further, it provides an appealing glimpse into the future of these programs.
Are Workplace Wellness Programs Even Legal?
The United States is seeing an increase in workplace wellness programs in recent years as a means to cut some health insurance costs, but a new question has been arising lately: are these programs even legal? The issue comes when companies implement programs that require employees to receive a health evaluation, then are monitored for improvement, and usually receive a financial reward or penalty based on the results. This leads to discrimination against obese or unhealthy employees, some of which may need reduced health insurance the most in the company. The article More Carrot, Less Stick analyzes the discriminatory effects of workplace wellness programs.
“Employers utilize wellness programs as a subterfuge for discriminatory cost-shifting-in violation of the Americans with Disabilities Act and Title VII of the Civil Rights Act of 1964-that decreases access to, and affordability of, quality health care services” (Koruda, 2016).
The question is up in the air about whether or not this counts as discrimination is still up in the air.
Recently, workplace wellness programs have been gaining attention across the globe as a way to lower insurance costs by rewarding those who improve their healthy behaviors and penalizing those who do not achieve measurable health outcomes. More Carrot, Less Stick: The Discriminatory Impact of Financial and Health-Based Incentives, argues that these programs go against the goals of improving the overall health of employees and instead pushes the health care costs onto the employees who need lower premiums the most (Koruda). One of the main focuses of this piece is the impact of programs on low-income individuals, people with disabilities, and racial minorities. It references how these programs are a violation of the Americans with Disabilities Act and certain Civil Rights Acts. The solution provided to reduce the adverse effects of the programs would require the Equal Employment Opportunity Commission to release explicit guidance and exercise its power effectively (Koruda).
The Participatory Workplace Wellness Programs: Reward, Penalty, and Regulatory Conflict is a journal that discusses how participatory programs reward the completion of a health risk assessment are now the most prevalent type of wellness program in the country. This is because in 2013 the Departments of Treasury, Labor, and Health and Human Services updated their 2006 framework.
“The 2013 regulations for participatory programs and employers’ current practices conflict with the Equal Employment Opportunity Commission’s prevailing interpretation of the Americans with Disabilities Act of 1990” (Pomeranz, 2016).
There are a lot of legal and ethical concerns about employers utilizing incentives that may raise questions about the “voluntariness” of said programs. At the core of the issue is that under the Americans with Disabilities Act of 1990, it states that employers could not require health-related inquiries and exams. This article analyzed numerous federal websites to correctly interpret the ADA. The conclusions of this were “Either Congress or the federal agencies should address the conflict among employers’ practices, the wellness regulations, and the ADA and also consider additional protections for employees. Employers can avoid ethical and legal complications by offering voluntary programs with positive incentives” (Pomeranz, 2016). The Boston College Journal of Law & Social Justice proposes a solution to this controversy:
In order to rectify the discriminatory effects of these programs, the Equal Employment Opportunity Commission must issue explicit guidance and exercise its power effectively as an enforcer of the anti-discrimination law (Koruda, 2016).
A good portion of workplace wellness programs relies on incentives to gain participation amongst employees. Financial incentives are the most common ones implemented, likely because they produce the highest participation.
“More than 80% of large employers offer financial incentives for health promotion to their employees to help them achieve health goals, which includes things like physical activity” (Weiner, 2016).
Companies will often order health-related products in bulk and distribute the gifts to those participating in the wellness program.
“Health Insurance Portability and Accountability Act must be modified to better define ‘voluntariness’ within the realm of incentives and penalties” (Koruda, 2016).
The University of Colorado Boulder provides its partaking staff with optional FitBits, scales, and weight watcher programs just to name a few (Benefits Enrollment Tool). Some companies will give out gift cards to sporting goods stores or organic grocery stores. The most affordable incentive frequently implemented would be making simple changes to policy, such as freeing up time in one’s schedule so that they can have a chance to run during their breaks or cook a healthy dinner. The New York State Physical Activity Coalition recommends
“encouraging employees to take time out for themselves; managers should encourage employees to attend company-sponsored fitness classes or nutrition seminars and adjust their schedules accordingly” (Stokes, 2015).
However, with all these different incentives floating around, are workers being treated equally? I wouldn’t think all the employees are being treated equally if I was an obese, pack-a-day smoking, diabetic because I could be looking at thousands of more dollars in health insurance costs than my coworkers. With obesity rates as high as they are, the number of Americans who could face financial repercussions because their health is extremely high.
The thought of working out while on the clock does not appeal to everyone either. Some CEOs argue that it could be counterproductive to start these programs, claiming they would make employees tired and less efficient during the day. There are plenty of studies showing the opposite, that exercise, in fact, increases productivity and energy. Greedy managers will criticize the loss of work time during the day if employees begin exercising. But the more covetous managers will see this as an opportunity to get even more results from their staff, without altering the company’s goals.
One common misconception about exercise in the workplace is how expensive it is. It isn’t cheap to add a large office gym and locker rooms, but luckily there are ways to keep your staff fit without breaking the bank. It is less about the facilities and more about getting as many of the employees involved as possible. For some companies, all it takes is a lunchtime running club and the next thing you know, everybody is full of energy and confidence. Once a workforce becomes active, their number of sick days will decrease due to a stronger immune system and increased morale.
In the small picture, this is a matter of a slight change to our daily routine. Yet in the bigger picture, it holds the concept that if we practice more prevention methods for our problems, we will spend less time and money trying to fix them.
References
Batorsky, B. (2011). Is More Always Better in Designing Workplace Wellness Programs?: A Comparison of Wellness. Program Components Versus Outcomes. Retrieved October 10, 2016, from https://www.ncbi.nlm.nih.gov/pubmed/27513171
Batt, M. (2008, October 8). Physical activity interventions in the workplace: the rationale and future direction for workplace wellness. Retrieved October 10, 2016, from http://bjsm.bmj.com/content/43/1/47.full.pdf+html
Beals, R. K. (2012, February 12). Employees Get Paid to Exercise, While Some Pay to Sit Out. Retrieved September 30, 2016, from
Benefits Enrollment Tool: Step-by-step instructions. (2016). Retrieved October 18, 2016, from http://www.cu.edu/employee-services/benefits-enrollment-tool-how-enroll
Boehkle, J. (2011, March 27). How Does Exercise Improve Work Productivity? Retrieved October 26, 2016, from http://www.livestrong.com/article/422836-how-does-exercise-improve-work-productivity/
Busum, K. (2014). Five steps to a successful workplace wellness program: A RAND toolkit. Retrieved October 8, 2016, from http://www.rand.org/content/dam/rand/pubs/tools/TL100/TL141/RAND_TL141.pdf
Caperchione, C. (2015, August). Workplace Wellness Programs Can Generate Savings. Retrieved October 8, 2016, from http://content.healthaffairs.org/content/29/2/304.full.pdf+html
Goetzel, R. (2014, September 1). Do Workplace Health Promotion (Wellness) Programs Work? Journal of Occupational and Environmental Medicine, 56, 1-8. Retrieved October 10, 2016.
Wellness program incentives: Despite the popularity of workplace wellness programs, the effectiveness of such efforts varies. (2016). HealthLeaders.
Koruda, E. (2016, March). More Carrot, Less Stick. Retrieved October 4, 2016, from http://jlsj.bclawreview.org/review/36_1/05_koruda/
Mattke, S. (2011). Workplace Wellness Programs Study. Journal of Occupational and Environmental Medicine, 8-30.
Pomeranz, J. L. (2014). Participatory Workplace Wellness Programs: Reward, Penalty, and Regulatory Conflict. The Milbank Quarterly, 93(2), 1-15. Retrieved June 1, 2016.
Severe Impact of Fatigue in the Workplace Examined. (2002, April 3). Retrieved November 03, 2016, from http://ehstoday.com/news/ehs_imp_35340
Soldano, S. K. (2016). Workplace Wellness Programs to Promote Cancer Prevention. Seminars in Oncology Nursing, 3, 1-10. http://dx.doi.org.colorado.idm.oclc.org/10.1016/j.soncn.2016.05.008
Stokes, A. (2015, August 24). The Best Incentives for Wellness Programs. Retrieved from http://www.livestrong.com/article/148779-the-best-incentives-for-wellness-programs/
Weiner, L. J. (2016). Wellness Program Incentives. HealthLeaders. Retrieved from http://www.healthleadersmedia.com/leadership/wellness-program-incentives