HealthWorksA National Strategy for Comprehensive Workplace Health A National Strategy for Comprehensive Workplace Health

PromotionPromotion

Why Wellness: An Integrated Why Wellness: An Integrated Approach to Workplace HealthApproach to Workplace Health

NS Safety Council ConferenceNS Safety Council Conference

March 25, 2004March 25, 2004

Mary-Lou MacDonald MSc.Director, HealthWorksHeart and Stroke Foundation of NS

ObjectivesObjectives

1. What is “HealthWorks” and why did Health Canada fund this project in Nova Scotia?

2. What is “wellness” and why is an integrated approach the only successful option?

3. Why is this initiative important to you?

Unique PartnershipUnique Partnership

Major Partners: Major Partners: -Health Canada-Health Canada-Heart and Stroke Foundation of NS-Heart and Stroke Foundation of NS-Metropolitan Halifax Chamber of Commerce-Metropolitan Halifax Chamber of Commerce-Capital District Health Authority-Capital District Health Authority

Supporting Partners:Supporting Partners:NSCC, WCB, Office of Health Promotion, AHWI,NSCC, WCB, Office of Health Promotion, AHWI,*National Quality Institute*National Quality Institute

HealthWorks Purpose

1.1. Work with business leaders/champions Work with business leaders/champions to create local case studies for workplace to create local case studies for workplace health health (3 pilot businesses selected) (3 pilot businesses selected)

2.2. Create a network of public and private Create a network of public and private organizations committed to sustaining organizations committed to sustaining workplace health in Nova Scotiaworkplace health in Nova Scotia

3.3. Develop national support networks for Develop national support networks for dissemination and sustainability.dissemination and sustainability.

The Pilot Sites: The Pilot Sites: Small/Medium Size BusinessSmall/Medium Size Business

1.1. Secunda Marine ServicesSecunda Marine Services2.2. Rideau ConstructionRideau Construction3.3. Page and WoodPage and Wood

– Developed awareness and commitmentDeveloped awareness and commitment– Developed and conducted health and organizational Developed and conducted health and organizational

culture assessmentsculture assessments– Developed tailored wellness program and Developed tailored wellness program and

interventionsinterventions– Assisted with the program roll-out and evaluationAssisted with the program roll-out and evaluation– Developed business case Developed business case

The Workplace ParadoxThe Workplace Paradox

““The workplace has become an The workplace has become an environment that both contributes to environment that both contributes to employee ill health, while simultaneously employee ill health, while simultaneously offering the most potential for improving offering the most potential for improving overall employee health and well-being”.overall employee health and well-being”.

Canadian Council on Integrated Health Care 2002Canadian Council on Integrated Health Care 2002

Elements of Comprehensive Workplace WellnessElements of Comprehensive Workplace Wellness

Healthy and Safe Workplace

Organizational Health

Environmental Health

Personal Health

What is a Healthy Workplace?

1.1. Occupational Health and Safety:Occupational Health and Safety: reducing work reducing work related injury, illness and disability by addressing related injury, illness and disability by addressing environmental hazards in the workplace, ergonomics environmental hazards in the workplace, ergonomics and air qualityand air quality

2.2. Leadership:Leadership: improving job satisfaction and productivity improving job satisfaction and productivity by changing worker attitudes and perceptions, by changing worker attitudes and perceptions, management practices and the way work is organizedmanagement practices and the way work is organized

3.3. Health Promotion:Health Promotion: reducing the risk or incidence of reducing the risk or incidence of worker illness by addressing individuals’ lifestyle worker illness by addressing individuals’ lifestyle behaviors through education, supportive environments behaviors through education, supportive environments and policy and policy

Workplace Workplace WellnessWellness

1.1. Environmental Wellness:Environmental Wellness: ergonomics, noise level, ergonomics, noise level, air quality, workplace design, work pace, safe air quality, workplace design, work pace, safe lifting, safety guidelines, physical demandslifting, safety guidelines, physical demands

2.2. Organizational Wellness:Organizational Wellness: work-family balance, work-family balance, flextime, morale, training/professional development, flextime, morale, training/professional development, recognition, supervisor communication/ feedback, recognition, supervisor communication/ feedback, social atmosphere, management style/skillssocial atmosphere, management style/skills

3.3. Personal Wellness:Personal Wellness: smoking cessation, physical smoking cessation, physical activity, healthy weight, shift work, alcohol/drug activity, healthy weight, shift work, alcohol/drug use, stress copinguse, stress coping

The health of workplaces has a determining The health of workplaces has a determining effect on the health of Nova Scotia and effect on the health of Nova Scotia and

Canada.Canada.

Cost of Unhealthy WorkplacesCost of Unhealthy WorkplacesIn Nova Scotia/National ComparisonIn Nova Scotia/National Comparison

Highest rate of deaths from cancer and breast Highest rate of deaths from cancer and breast cancercancerHighest rate of death from respiratory diseaseHighest rate of death from respiratory diseaseHighest rate of hospitalization for chronic Highest rate of hospitalization for chronic illnessillnessHighest percentage of smokersHighest percentage of smokers80% of NS have one or more of the major risk 80% of NS have one or more of the major risk factors for CVDfactors for CVD22ndnd highest spending rate of health $ per highest spending rate of health $ per capita on institutionscapita on institutions

Cost of Unhealthy WorkplacesCost of Unhealthy WorkplacesIn Nova Scotia/National ComparisonIn Nova Scotia/National Comparison

22ndnd highest rate of diabetes highest rate of diabetes

22ndnd highest psychiatric hospitalization rate in highest psychiatric hospitalization rate in Canada.Canada.

22ndnd lowest life expectancy lowest life expectancy

33rdrd highest percentage of heavy drinkers highest percentage of heavy drinkers

33rdrd highest percentage of overweight adults highest percentage of overweight adults

Highest reported use of disability daysHighest reported use of disability days

““A strong case can be made that a healthy A strong case can be made that a healthy workforce, a healthy and safe work workforce, a healthy and safe work environment, lead to optimal employee environment, lead to optimal employee productivity, higher quality of goods and productivity, higher quality of goods and services, and improved corporate services, and improved corporate performance.”performance.”

IHPM 2000IHPM 2000

The Human FactorThe Human Factor

Productivity cannot be reduced to simple Productivity cannot be reduced to simple accounting or presence on the job or volume of accounting or presence on the job or volume of work outputwork outputSimple representations of work and production Simple representations of work and production misrepresent the reality of work lifemisrepresent the reality of work lifeA simple dichotomous representation of work A simple dichotomous representation of work such as absent or not, injured or not, or flawed such as absent or not, injured or not, or flawed or correct, does not accurately reflect the or correct, does not accurately reflect the continuum of performance that extends beyond continuum of performance that extends beyond the absolute boundaries of these incident-based the absolute boundaries of these incident-based definitions definitions

Nova Scotia: Economic Losses

Work absences are increasingly due to personal reasons. Canada lost 82.2 million workdays for personal reasons in 2001, up from 65.6, 5 years ago

NS has more sick days than any other province (8.7 NS has more sick days than any other province (8.7 days per year)days per year)Ontario has 6 days per yearOntario has 6 days per yearCanada has 7 days per yearCanada has 7 days per yearIn Nova Scotia more than 400 million a year is lost to the In Nova Scotia more than 400 million a year is lost to the economy due to sickness and disabilityeconomy due to sickness and disability

GPI Atlantic 2003

Health and the Workplace and the Workplace

““While Canada’s health care system is While Canada’s health care system is under intense scrutiny, little attention is under intense scrutiny, little attention is being paid to the being paid to the role of role of workplace cultureworkplace culture on employee health”.on employee health”.

Canadian Council on Integrated Health Care 2002

Cost of an Unhealthy Workplace Culture

• Canada’s workforce is aging. Canada’s workforce is aging. Older workers (55-Older workers (55-64) average 2x number of sick days of younger 64) average 2x number of sick days of younger workers.workers. Benefit costs and absenteeism will Benefit costs and absenteeism will escalate if older workers don’t improve their escalate if older workers don’t improve their healthhealth

• Workers who have little Workers who have little input into decision-input into decision-makingmaking and how their job is organized were and how their job is organized were found to be 50% more likely to suffer from heart found to be 50% more likely to suffer from heart diseasedisease

• Mental and nervousMental and nervous conditionsconditions have replaced have replaced musculoskeletal conditions as the top conditions musculoskeletal conditions as the top conditions causing long-term disability. Estimate approx. 30 causing long-term disability. Estimate approx. 30 billion is lost to the Canadian economy annually billion is lost to the Canadian economy annually to mental health and addiction problems.to mental health and addiction problems.

Cost of an Unhealthy Workplace

• Canadians are experiencing extreme levels of stress due to work-life conflict. Workers with high work-life conflict registered 13.2 days absence/year vs. 5.9 days in those with low work-life conflict.

• Recent study of executives in Canadian public service showed that an individual’s lack of job control increased the likelihood of distress.

• High distress in turn was shown to increase the

likelihood of experiencing musculoskeletal problems by 90%; cardiovascular problems by 120%; gastrointestinal problems by 210%; coronary heart disease by 350%; and mental health disorders by 1740%.

Due DiligenceDue Diligence

By providing a healthy workplace environment employers By providing a healthy workplace environment employers protect themselves from liability charges related to protect themselves from liability charges related to exposure to an unidentified work hazard.exposure to an unidentified work hazard.

Employers may soon face litigation based on lack of due Employers may soon face litigation based on lack of due diligence that creates excessive stress for employees. diligence that creates excessive stress for employees. As well, unhealthy employees may threaten the health As well, unhealthy employees may threaten the health and safety of others.and safety of others.As employees become more stressed they become As employees become more stressed they become more likely to become involved in workplace accidents more likely to become involved in workplace accidents and sustain injuries.and sustain injuries.Employers are required to protect employees and the Employers are required to protect employees and the public from the unsafe actions of a worker.public from the unsafe actions of a worker.

““All effective interventions aimed at All effective interventions aimed at improving the physical work environment improving the physical work environment probably have some behavioral or social probably have some behavioral or social component, and rely on a component, and rely on a conducive conducive corporate culturecorporate culture to be effective.” to be effective.”

Institute for Heath and Productivity Management 2001Institute for Heath and Productivity Management 2001

More Research RequiredMore Research Required

Rather than a living representation of Rather than a living representation of mechanical performance, the human also mechanical performance, the human also experiences the effects of mental, motivational, experiences the effects of mental, motivational, emotional and social influencesemotional and social influences

Because of this strong association of productivity Because of this strong association of productivity with “softer” factors, researchers and with “softer” factors, researchers and practitioners often have difficulty identifying and practitioners often have difficulty identifying and describing exactly what it means, let alone what describing exactly what it means, let alone what should be done to optimize it.should be done to optimize it.

Choose Wisely-But Choose!Choose Wisely-But Choose!

Employers are now realizing that the Employers are now realizing that the astute selection of, and investment in, astute selection of, and investment in, these programsthese programs may be keymay be key in increasing in increasing worker performance and corporate worker performance and corporate productivity-essential factors in business productivity-essential factors in business success todaysuccess today

IHPM 2001

How Long for Return on How Long for Return on Investment?Investment?

within a few months: within a few months: – employees engaging in healthy activities during work employees engaging in healthy activities during work

hourshours

within 1 year: within 1 year: – your front-line managers see evidence of increased your front-line managers see evidence of increased

job satisfaction, commitment to work, improved job satisfaction, commitment to work, improved productivity among workers and an increase in productivity among workers and an increase in customer satisfactioncustomer satisfaction

within 3 years:within 3 years:– Significant quantitative improvements in health related Significant quantitative improvements in health related

costscosts

Source: CCIH, 2002Source: CCIH, 2002

Behavior Change ProgramsBehavior Change Programs

Behavior change programs typically Behavior change programs typically require 3-5 years of intervention require 3-5 years of intervention programming for cost-benefit to occurprogramming for cost-benefit to occurThis timeframe puts nutrition, smoking, This timeframe puts nutrition, smoking, and exercise programs outside the typical and exercise programs outside the typical short-term corporate business planning short-term corporate business planning cyclecycleHowever, the top four for short term However, the top four for short term outcomes…outcomes…

1.1. Exercise programs for low back pain problems –reduce Exercise programs for low back pain problems –reduce absenteeismabsenteeismEvidence on exercise and its impact on performance shows short Evidence on exercise and its impact on performance shows short term reductions in absenteeism and reduced turnover etc., etc., term reductions in absenteeism and reduced turnover etc., etc., etc. etc., etc.etc. etc., etc.

2.2. Depression detection and treatment: significant and immediate Depression detection and treatment: significant and immediate relevance in work setting. Few health issues take such a broad relevance in work setting. Few health issues take such a broad toll in cost, performance and quality of life.toll in cost, performance and quality of life.

3.3. Smoking cessation to reduce smoke breaks increases Smoking cessation to reduce smoke breaks increases productivity: (unscheduled smoke breaks cost NS employers productivity: (unscheduled smoke breaks cost NS employers $208 mil/yr; estimate smokers cost employers $2308-$2613 more $208 mil/yr; estimate smokers cost employers $2308-$2613 more than nonsmokers)than nonsmokers)

4.4. Vaccinations for influenza reduces both absenteeism and medical Vaccinations for influenza reduces both absenteeism and medical costcost

Pathways to Productivity

INTERVENTIONS RESULTS DESIRED OUTCOME

Disease Prevention,Health Promotion

Reduced Absenteeism

Acute & ChronicIllness Management

Improved Performance,Creativity, Motivation

Increased Productivity

EnvironmentalHealth & Safety

Reduced Accidents,Cost Savings

Healthy CorporateCulture

Reduced HealthCare Costs

Cost Reduction

IHPM 2001

A Healthy Workplace: Why is it Important?A Healthy Workplace: Why is it Important?

Employee:Employee:– Increased job satisfaction, health and productivity, loyaltyIncreased job satisfaction, health and productivity, loyalty

Employer:Employer: – Positively affects the bottom line of the businessPositively affects the bottom line of the business– Lower insurance premiums and benefit costsLower insurance premiums and benefit costs– Better able to attract and retain higher caliber employeesBetter able to attract and retain higher caliber employees– Lower absenteeism rates, disability costsLower absenteeism rates, disability costs

Community and Government:Community and Government:– Broad social and economic benefitsBroad social and economic benefits

Walk the Talk

If people are truly “our most valuable asset” why If people are truly “our most valuable asset” why aren’t more businesses and organizations in aren’t more businesses and organizations in Nova Scotia creating work environments that Nova Scotia creating work environments that contribute to the health and well being of their contribute to the health and well being of their workers?workers?

– EducationEducation– CostCost– SupportSupport

Social Marketing

Leverage

Leadership/Sustainability

Training/Education

Tools/ Supports

Incentives

Create Sense of Urgency

Create Awareness

ImpactLeadership

Identify Leadership

What, How, Who

Infrastructure

What, Who, How?

HealthWorks: A National Strategy for HealthWorks: A National Strategy for Comprehensive Workplace Health PromotionComprehensive Workplace Health Promotion

Leverage

WCB

Government

Health Insurers

Pharma

Chamber of Commerce

Policy

Programs

Legislation

Incentives

FinancialInstitutions

Prevention

Unions

Other

Tools and SupportTools and SupportDeveloped National and Provincial Model for WPHPDeveloped National and Provincial Model for WPHPNetwork of StakeholdersNetwork of StakeholdersHealthWorks WebsiteHealthWorks Website

Government of NS:Government of NS:Workplace Champions AwardWorkplace Champions AwardSupport development of provincial strategySupport development of provincial strategyCorporate strategyCorporate strategy

Metropolitan Halifax Chamber of Commerce:Metropolitan Halifax Chamber of Commerce:Healthy Business Award Healthy Business Award BusinessToolkit (posters, brochures, awareness campaign)BusinessToolkit (posters, brochures, awareness campaign)Sponsor National Policy at Canadian Chamber National MeetingSponsor National Policy at Canadian Chamber National Meeting

National Quality Institute: Framework for the National Quality Institute: Framework for the Development of a Healthy WorkplaceDevelopment of a Healthy Workplace

Small business assessment tool, recognition and rewardsSmall business assessment tool, recognition and rewards

““Nothing is more important to productivity than a Nothing is more important to productivity than a healthy, well-motivated workforce… So it is in healthy, well-motivated workforce… So it is in the economic interest of our business the economic interest of our business community to take a personal interest in the community to take a personal interest in the health and well-being of our employees… We health and well-being of our employees… We must be much more proactive than in the past.”must be much more proactive than in the past.”

- Metro Halifax Chamber of - Metro Halifax Chamber of CommerceCommerce

Health Care Task Force, 2001 Health Care Task Force, 2001

Metro Halifax Chamber of Commerce