The Impact of Physical The Impact of Physical Activity on Workplace Activity on Workplace

WellnessWellness

Guy J. Scotolati, M.S.Guy J. Scotolati, M.S.DSCC Wellness @Work DSCC Wellness @Work ConferenceConference

UD, Clayton HallUD, Clayton HallJune14th, 2010June14th, 2010

CCHS Preventive Medicine and CCHS Preventive Medicine and Rehabilitation Institute (PMRI)Rehabilitation Institute (PMRI)

An Integrative Approach to the Management of An Integrative Approach to the Management of Health for our Communities ServedHealth for our Communities Served

Those Communities ServedThose Communities Served

In addition to preventive care, PMRI helps those In addition to preventive care, PMRI helps those with a wide variety of chronic illnesses, including with a wide variety of chronic illnesses, including those with or at risk for:those with or at risk for:

•• Cardiovascular diseaseCardiovascular disease•• DiabetesDiabetes•• Pulmonary diseasePulmonary disease•• Obesity/weight managementObesity/weight management

Exercise Services/Pulmonary Exercise Services/Pulmonary RehabilitationRehabilitation

Medically appropriate exercise for healthy and Medically appropriate exercise for healthy and high risk populations in an effort to improve the high risk populations in an effort to improve the individualindividual’’s function, (and as it applies) to s function, (and as it applies) to decrease symptoms, reduce dependence on decrease symptoms, reduce dependence on medications and costly interventions, and with medications and costly interventions, and with adherence to other healthful behaviorsadherence to other healthful behaviors---- slow slow down and perhaps even reverse the progression down and perhaps even reverse the progression of disease.of disease.

The Need to Manage our HealthThe Need to Manage our Health

•• Unhealthy lifestyle the primary factor to the six leading causesUnhealthy lifestyle the primary factor to the six leading causes of of death in the U.S.death in the U.S.-- heart disease, cancer, stroke, respiratory heart disease, cancer, stroke, respiratory diseases, diabetes, and accidents.diseases, diabetes, and accidents.

•• LifestyleLifestyle--related chronic diseases account for 70% of nationrelated chronic diseases account for 70% of nation’’s s health care costs, over 11% of the U.S. gross domestic product.*health care costs, over 11% of the U.S. gross domestic product.*

•• Conservative estimates that high risks (high blood pressure, Conservative estimates that high risks (high blood pressure, cholesterol, etc.) account for at least 25% of total health costcholesterol, etc.) account for at least 25% of total health costs.s.

**””Workplace Wellness Programs: Supporting Scientific Research Workplace Wellness Programs: Supporting Scientific Research and Wellness Statisticsand Wellness Statistics””, Health Promotion First Act, D. , Health Promotion First Act, D. Anderson, PhD., Stay Well Health ManagementAnderson, PhD., Stay Well Health Management

Where weWhere we’’re headingre heading……....

Medical costs expected to grow at 7.2% each Medical costs expected to grow at 7.2% each year through 2015, when health expenditures year through 2015, when health expenditures will account for 20% of the gross domestic will account for 20% of the gross domestic product.product.

Evaluating the Economics of Health Evaluating the Economics of Health Risk FactorsRisk Factors

IIn a crossn a cross--sectional analysis of 45,976 employees in a sectional analysis of 45,976 employees in a diversified industrial work force setting, E. I. du Pont diversified industrial work force setting, E. I. du Pont Nemours in Wilmington, DE found that employees Nemours in Wilmington, DE found that employees with any of six behavioral risks had significantly higher with any of six behavioral risks had significantly higher absenteeism (range = 10% to 32%) compared to those absenteeism (range = 10% to 32%) compared to those without risks.without risks.

These differences led to significantly higher illness costs These differences led to significantly higher illness costs (defined as compensation, health care, and non(defined as compensation, health care, and non--health health care benefits)care benefits)

The High Cost of Being UnhealthyThe High Cost of Being Unhealthy

Annual Annual excessexcess illness costs per person at risk**illness costs per person at risk**

•• Smoking: $960Smoking: $960•• Overweight: $401Overweight: $401•• Excess alcohol:$389Excess alcohol:$389•• Elevated cholesterol: $370Elevated cholesterol: $370•• High blood pressure: $343High blood pressure: $343•• Lack of exercise: $130Lack of exercise: $130

The total cost to du Pont of excess illness was conservatively eThe total cost to du Pont of excess illness was conservatively estimated at $70.8stimated at $70.8million annually. million annually.

****””The Effects of Behavioral Risks on Absenteeism and HealthThe Effects of Behavioral Risks on Absenteeism and Health--Care Costs in the WorkplaceCare Costs in the Workplace””, , Journal of Occupational and Environmental Medicine, Bertera, RobJournal of Occupational and Environmental Medicine, Bertera, Robert L., Dr. PH, 1991ert L., Dr. PH, 1991

Results of what some companies Results of what some companies have done ***have done ***

Well power of Unum Life Insurance Co.Well power of Unum Life Insurance Co.•• 2000 participants 2000 participants •• Evaluation period: 10 years beginning in 1985Evaluation period: 10 years beginning in 1985•• Comprehensive program incl. occ health/safety, health Comprehensive program incl. occ health/safety, health

educ., exercise and recreation opportunitieseduc., exercise and recreation opportunities•• Realized an est. savings of $132 to $237K for smoking Realized an est. savings of $132 to $237K for smoking

cessationcessation•• Cost benefit analysis of 1993 and 1994 medical claims Cost benefit analysis of 1993 and 1994 medical claims

indicated an ROI of 1:1.81indicated an ROI of 1:1.81

CompaniesCompanies’’ resultsresults……

CitibankCitibank

•• 22,933 in medical study and 21,749 in absenteeism study22,933 in medical study and 21,749 in absenteeism study

•• Evaluation period: median of 26Evaluation period: median of 26--38 months beginning in 199438 months beginning in 1994

•• Evaluated the financial impact of their health management prograEvaluated the financial impact of their health management program (initial m (initial screening of entire population followed by high vs. low risk screening of entire population followed by high vs. low risk intervention/education programs)intervention/education programs)

•• Realized an ROI of 6.47 to 8.81 for every dollar invested (reseaRealized an ROI of 6.47 to 8.81 for every dollar invested (research studies rch studies have shown an average health cost savings of $3.48 and rates of have shown an average health cost savings of $3.48 and rates of absenteeism absenteeism as $5.82 for every dollar invested in workplace wellness programas $5.82 for every dollar invested in workplace wellness programs)s)

CompaniesCompanies’’ resultsresults……

ChevronChevron

•• 950 participants950 participants•• Evaluation period: 2.5 yearsEvaluation period: 2.5 years•• Evaluate the impact of their Evaluate the impact of their ““Health QuestHealth Quest”” fitness program fitness program

(incl. weight control, nutrition, and stress management) on (incl. weight control, nutrition, and stress management) on medical expendituresmedical expenditures

•• Realized medical expenditures significantly lower for those who Realized medical expenditures significantly lower for those who used the fitness center at least twice weeklyused the fitness center at least twice weekly

*** *** ““A Review and Analysis of the Clinical and CostA Review and Analysis of the Clinical and Cost--effectiveness Studies of Comprehensive Health effectiveness Studies of Comprehensive Health Promotion and Disease Management Programs at the Worksite: 1995Promotion and Disease Management Programs at the Worksite: 1995--1998 Update1998 Update””, Pelletier, , Pelletier, Kenneth R., American Journal of Health Promotion, 1999, 13 (6): Kenneth R., American Journal of Health Promotion, 1999, 13 (6): 333333--345.345.

Exercise and Risk Factor ControlExercise and Risk Factor Control

•• High blood pressureHigh blood pressure•• High cholesterolHigh cholesterol•• Excess weight/obesityExcess weight/obesity•• Tension/anxiety/depressionTension/anxiety/depression•• Sedentary lifestyleSedentary lifestyle•• DiabetesDiabetes•• SmokingSmoking•• AgeAge•• HeredityHeredity

Revisiting Revisiting ““the High (the High (excessexcess) Cost of ) Cost of Being UnhealthyBeing Unhealthy””

•• Smoking: $960Smoking: $960•• Overweight: $401Overweight: $401•• Excess alcohol: $389Excess alcohol: $389•• Elevated cholesterol: $370Elevated cholesterol: $370•• High blood pressure: $343High blood pressure: $343•• Lack of exercise: Lack of exercise: $130$130

Total: $1,244*Total: $1,244*

* Savings with the addition of regular effective physical activi* Savings with the addition of regular effective physical activityty

Physical Activity Fundamental to Physical Activity Fundamental to Preventing DiseasePreventing Disease

Study by researchers at the Centers for Disease Study by researchers at the Centers for Disease Control and Prevention found that increasing Control and Prevention found that increasing regular moderate physical activity among regular moderate physical activity among inactive Americans over age 15 might reduce the inactive Americans over age 15 might reduce the annual national direct medical costs by as much annual national direct medical costs by as much as $76.6 billion in 2000 dollarsas $76.6 billion in 2000 dollars

Benefit to EmployersBenefit to Employers

Workplace physical activity programs can:Workplace physical activity programs can:

•• Reduce shortReduce short--term sick leave by 6term sick leave by 6--32 %32 %

•• Reduce health care costs by 20Reduce health care costs by 20--55%55%

•• Increase productivity by 2Increase productivity by 2--52%52%

How to Improve your CompanyHow to Improve your Company’’s s ““FiscalFiscal”” Fitness Fitness

•• Need to risk stratify your population (HRAs, biometric Need to risk stratify your population (HRAs, biometric screenings)screenings)

•• Education (handouts, company mailers, Education (handouts, company mailers, workshops/seminars, lunchworkshops/seminars, lunch--nn--learns)learns)

•• Determine internal/external resources to supply Determine internal/external resources to supply information and/or support your initiativesinformation and/or support your initiatives

•• Break down barriers to ensure easy accessBreak down barriers to ensure easy access•• IncentivizeIncentivize•• Measure outcomes!Measure outcomes!