city council feb. 5, 2013 wellness report
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TRANSCRIPT
City of San AngeloWellness Report
February 2013
San Angelo, Texas
Wellness Report
• 2012 shows improvement from 2011 in the overall health of employees.
• Weight and nutrition continue to be the most crucial and costly modifiable risk factors.
• There is opportunity to improve, however, the employees are to be commended.
Overall Wellness Rating
• Average wellness score for City of San Angelo employees is 69, compared to 67 last year. (out of 100)
• 47% have a “health age” younger than actual age, compared to 42%
last year• 53% have a “health age” greater than or equal to age, 58% last year
Needs Improving
(20-59)24%
Excellent(80-100)
16%
Doing Well (60-79)
60%
Needs Improving
(20-59)26%
Excellent(80-100)
14%
Doing Well (60-79)
60%
2011 2012
80/20 Rule• Generally, 80% of health care costs come
from 20% of the people.• As the number of health risks go up, so do
the health care costs.
• City employees with 5 or more risk factors decreased by 9%.
(Health claims are generally 3-4 times higher in people with 5+ risk factors)
Chronic Diseases
39%
20.9%
26.8%
38.6%
37%
15.8%
18%
23.4%
27% 23%
31.2%
21% 35%
40.8%
36% 45%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Diabetes
Heart Disease
Cancer
Metabolic Syndrome
Osteoporosis
at riskhigh risk
2011
2012
2011
2012
2011
2012
2011
2012
DiabetesDiabetes is increasing rapidly in the U.S. • One third of people do not know they are diabetic.• Type 2 diabetes is largely preventable.
Major risks: Obesity (BMI 30+ - 326 people); Nutrition (517 people); Low HDL (<39.9 – 299 people)
City of San Angelo employees• 19.9% compared to 19% last year have 0 - 1 risks – excellent, doing well
• 39.4% compared to 36% of employees have 3 - 4 risks – needs improving
• 40.8% compared to 45% of employees have 5+ risks – caution, high risk
Heart Disease70 – 80% of heart disease is linked to modifiable risks.• Actively eliminate any known risk factors.
Major risks: Obesity (BMI 30+ - 326 people); Low HDL (<39.9 – 299 people); Metabolic syndrome ( 3+ indicators – 298 people)
City of San Angelo employees• 47.9% compared to 43% last year have 0 - 1 risks – excellent, doing well
• 20.9% compared to 21% last year have 2 risks – needs improving
• 31.2% compared to 35% last year have 3+ risk factors – caution, high risk
CancerCancer is 2nd leading cause for death in US and is the leading
cause for persons of working age.• 2/3 of all cancer deaths can be prevented.• Get proper cancer checkups for age and gender.
Major risks: Smoker (96 people); Obesity (BMI 30+ - 326 people); No or low physical activity (<5 days.wk – 553 people)
City of San Angelo employees• 49.8% compared to 50% last year have 0 - 2 risks – excellent; doing well
• 26.8% compared to 27% last year have 3 risks – needs improving
• 23.4% compared to 23% last year have 4+ risks – caution, high risk
Cancer Screenings
In 2012, the City began paying all cancer screenings at 100% without a deductible. (Formerly at 80% after deductible had been satisfied.)
However, pro-active screenings did not increase overall.
21.6%
40.4%
46.3%
Mammograms
PAP test
Prostate Check
Colon Screening
9.9%
73.2%
84.5%
51.6%
47.2%
21.7%
40.5%
49%
17%
74.3%
83%
59.5%
51%
COMPLIANT NON COMPLIANT
2012
2011
Modifiable Risksof Chronic Diseases
Modifiable RisksTop Six Priority Health Recommendations
• Weight management (323 people overweight; 326 obese)
• Good nutrition (599 people have 6+ risk factors; 325 have 10+)
• High blood pressure (420 pre-hypertension; 160 high bp)
• Physical activity (553 less than 5 days/wk; 66 have no PA)
• Sleep (430 people get inadequate sleep - less than 7-8 hrs/night)
• Osteoporosis (380 have 2+ risk factors; 1 has 4+ risk factors)
City of San AngeloChronic Disease Risk Factors
(Smoking drops off list of being in the top 6)
43.4%
41.8%
44.3%
54.4% 20.7%
0 40 8020 60 100
22.4% 8.5%
38%
44.3%40.2%
54.7%
42.2%
44.3%
19.7%
21.5% 8.6%
55.7%
Nutrition
Weight
BloodPressure
Fitness
Sleep
Osteoporisis
at riskhighrisk
2012
2011
2012
2011
2012
2011
2012
49.2% 1% 2012
2011
2012
42.1%
Employee Weights
Obese45%
Overweight40%
Healthy Weight
15%
Under Weight
0%
BMIHealthy weight 18.5 - 24.9Overweight 25 - 29.9Obese 30 - 34.9Very Obese 35+
17.9% of emp (138 people) are very obese, above the national norm of 12%.
Obese42%
Overweight42%
Healthy Weight
16%
Under Weight
0%
20122011
Nutritional StatisticsChoosing unrefined, plant-based, low-calorie, low saturated-fat foods can greatly decrease risk of heart disease, diabetes, and many cancers.
In the City of San Angelo:•599 (77.6%) people compared to 675 (82.9%) last year are at increased risk with 6+ nutritional risk factors.
•325 (42.1%) people compared to 422 (51.8%) last year are at high risk with 10+ nutritional risk factors.
Employee Perception of Personal Health
89.3% think they are in good to excellent health
(compared to 90.5% last year)
47.6%
42.9%
8.7%
0.9%
2011 2012
Very good to excellentGoodFairPoor
49.1%
40.2%
8.3%0.5%
Economic ImpactEstimated Excess Health Claims Cost
# of employees
cost per
employee
no risks 77 67 $0
1 risk 137 168 $861
2 risks 214 166 $1,764
3 risks 159 164 $2,690
4 risks 105 96 $3,788
5 risks 61 61 $4,821
6 risks 34 29 $5,919
7+ risks 28 22 $6,995
14.5% of employees (112 people) have 5 + risk factors, influencing personal health for the individual, as well as
health care costs for the city. (15% last year)
2011 2012
Examples of Estimated Excess Cost per Risk Factor (5 of 15 risks reported)
2011 2012 Excess Cost
• Overweight (BMI >27.5) 515 502 $746,034• High BP* (140/90+) 309 282 $499,198• Low HDL (<40mg/dL) 326 300 $297,135• Smoking* (14 signed up for class) 100 96 $172,006• Seat Belt Use (<100%) 130 115 $149,438
Overall Estimated Excess Health Claims:Estimated excess cost for 2011 $1,993,176Estimated excess cost for 2012 $1,862,103Potential savings from 2011 $ 131,073 (goal of $199,317)
• Most expensive risk factor pp for excess health cost
Source: University of Michigan. Study of 205,000 employees showing relationship between risk factors and healthcare costs.
EMPLOYEES
• Improved average wellness score from 67 to 69
• Reduced obesity percentage by 3% (334 lbs lost)– 281 people lost 2+ lbs– 73 people lost 10–19 lbs– 29 people lost 20+ lbs
• Reduced employees with 5 or more risk factors by 9% (123 to 112)
• Reduced risk factors for diabetes, heart disease and osteoporosis
• Improved the nutrition of 249 people
ACCOMPLISHMENTS in 2012
Programs Implemented• Biggest Loser Contest• Diabetes Education Classes• Smoking Cessation Classes • Wednesday Walking Group• Label Reading Class with Dietitian• 30 Day “My Plate” Challenge (food pyramid)
• Fruit and Vegetable Challenge• Pedometer Challenge• Flu Shots
Suggested Programs for 2013• Wellness Incentive Program – initiate a point system• Biggest Loser Contest Quarterly for Employees• Programs
– Diabetes Education Classes– Smoking Cessation Class– Wednesday Walking Group
• Group Class Opportunities– Label Reading Class with dietitian– Eat This, Not That– Lifestyle changes to lower cholesterol– The DASH diet (help lower BP)
• Exercise– “Couch to 5K”– “Move for Life”– Pedometer Challenge– Wellness Challenge – 12 wk program
• Private fitness program for those at high risk• Weekly monitoring including exercise and nutrition tracking
Solutions: Health Management
• Utilize the city clinic, primary care providers and the wellness program to manage health of City of San Angelo employees.– Monitor employees with 5+ risk factors (112 employees)
– Develop clinical protocols/pathways for diseases. Referral to specialist if necessary.
– Encourage employees to get recommended
cancer checkups (mammograms, prostate, PAP, colon)