Benefits Buzz

Calorie Counter Apps -- Making Thanksgiving Way Better (or Way Worse?)

Thanksgiving may be one of our favorite holidays, but it sure does nothing to help anyone trying to lose weight or stay on a diet. This year, your iPhone or Blackberry may be to the rescue (or, just may be the bearer of bad news). Lots of calorie-counter apps can help you (and your employees) keep on track with eating right.

Just in time for Thanksgiving, MobileHealthNews.com has a run-down of the top apps. Here's what they say:

In the coming years these calorie tracking applications will become far more user friendly by being coupled with wireless peel-and-stick sensors that automatically count a person’s calorie intake. Companies like Philometron are working on those sensors right now — until then we have to manually enter or look up our food’s calories, which makes tracking a chore.

A chore, yes, but way easier than any online method or paper and pen. Some of these apps were designed for managing diabetes or keeping up with a specific diet plan--all good stuff.

These are just a few of the countless mobile apps putting health and fitness info in your employees' hands. This is going to be a fun, fun space to watch as more and more wellness companies and health plans get in the game of mobile apps, making tracking health and wellness easier and more fun.

As for me, I think I'll start using these apps after Thanksgiving. 

Editor's Note - Jennifer Benz is founder and chief strategist at Benz Communications, a boutique consulting firm that focuses on employee benefits communication. You can reach her at jen@benzcommunications.com or via Twitter @jenbenz.

Do As I Say And Not As I Do When it Comes to Wellness?

Could research in ethics and management shed any light on the impact that culture can play with regards to wellness? 

Studies have shown that management behavior influences workplace ethics.  A Deloitte and Touche study showed that among working adults, the behavior of management (42%) and that of direct supervisors (36%) were considered the top two factors contributing to the promotion of an ethical workplace.  Ethics training ranked much lower (16%) as a factor.

Other studies have shown that corporate codes of conduct and the degree of "implementation strength and embeddedness" of such codes seems to deter self-reported unethical behavior in employees.


If it works for ethics, can it work for wellness?

If corporate code and management conduct are so influential when it comes to ethics, could their example also improve workplace health and productivity?  A new body of studies in health promotion seem to point in that direction. 

An article published in the Journal of Occupational And Environmental Medicine, looked at nine quality components of worksite health management programs and compared the results of those programs between best practice and common practice organizations.  Best practice organizations showed higher levels of program engagement than common practice organizations and were 1-2.3 times more likely to see population health improve.

Everyone wants to be the best
So what are some of the distinguishing characteristics of best in class programs?

• Comprehensive program design
• Integrated incentives
• Comprehensive communications
• Management support
• Dedicated onsite staff
• Multiple program modalities
• Health awareness programs
• Biometrics health screenings
• Vendor integration

The first step in really showing the value of any wellness program is always to form a cogent plan, make the case to management and then to execute that plan with enough discipline and flexibility to achieve results.  It's no small job, but what worth doing is?

Editor's Note - It's hard to be humble when you're bloggin' straight out of Portland, Oregon.  Tanya Barham is the Founder and CEO of Recess Wellness, a company where all the staff works like little elves at Christmastime to transform their client's workplaces into healthy, happy, productive places akin to Santa's workshop at the North Pole.  Seriously.  Of course, Santa's fat, so they still have work to do.

Doctors and Coke, sitting in the tree, k-i-s-s-i-n-g....

Two food and health partnerships really got under my skin this past month.
 
First, the American Academy of Family Physicians’ sponsorship deal with Coke for the AAFP’s consumer-  
facing website, familydoctor.org, where Coke will underwrite content development on beverages and sweeteners. This deal is the first for AAFP’s new Consumer Alliance, a corporate partnership that—and I’m quoting from the AAFP’s press release here— “allows corporate partners like The Coca-Cola Company to work with the AAFP to educate consumers about the role their products can play in a healthy, active lifestyle.”
 
Is it me, or do these two seem like strange bedfellows? This is the same organization that published a study linking soda consumption to unhealthy weight gain and, possibly, to diabetes, right? Who in an article, titled “Assessment, Prevention and Treatment of Childhood Obesity,” outlined these recommendations to their physicians counseling young patients and their parents:

· Drink less 100-percent fruit juice. While fruit juice contains many important nutrients, it is also high in calories. Drinking too much fruit juice may contribute to weight gain.

· Drinking too many sugar-sweetened beverages, such as soda or juice drinks, can contribute to weight gain. For example, drinking one soda each day adds enough extra calories to result in a 10-pound weight gain each year.

· Water is the most important nutrient. Pack water instead of juice boxes for lunches, sports or travel.

Maybe this alliance wouldn’t be so galling if it didn’t follow right on the heels of the beverage industry’s sharp attack on a potential soda tax and the launch of the Smart Choices Program™. The program’s simple. Companies pay up to $100,000 to display the Smart Choices seal of approval. Their products are given a nifty green check mark to signify they’re healthy choices and are identified on the Smart Choices website. Fruits, vegetables, whole grains, and low- and nonfat dairy are all included. So are full-fat mayonnaise, Froot Loops, Lucky Charms, Lunchables Chicken Dunks, and Fruit Roll-Ups Crazy Pix.
 
The problem is that the program’s too simple. It’s not a “smart,” “smarter,” “smartest” food labeling system. There’s no path—from Froot Loops to fruit and low-fat yogurt, for example—to help consumers make increasingly better choices. Buyers, like my kids or your employees, can now walk into the grocery store and—with a straight, validated face—tell themselves (or their parents) that they’re making a “smart” choice and go on their merry way.  
 
Look, Lucky Charms aren’t the devil. Neither are soda and fruit juice. My family’s the oddity in our group of no-dessert or dessert-once-a-week friends. We have dessert twice a day, and I don’t mean fruit. We also tip back a can of soda now and again. I also recognize that my disgust is preemptive. Nobody knows how this new alliance will play out.
 
It may go the way of the Smart Choices Program. The Friedman School of Nutrition Science and Policy at Tufts, the American Diabetes Association, the American Dietetic Association, and the Center for Science in the Public Interest—all original board members—have either dropped off or asked that their organizations be removed from the board, stating that individuals, not the institutions, are involved. Just last week, the Connecticut Attorney General announced he’s investigating Smart Choices, calling it “overly simplistic, inaccurate and ultimately misleading.”
 
But on the face of it, these deals and others like them make it increasingly difficult for consumers to make sound decisions and to know where to turn for reliable, unbiased information. They smack of trading a pound of flesh for our trust…and a ton of cash.

UPDATE: As of Friday 10/23, “Smart Choices,” a food industry labeling program that launched this summer and was backed by a bunch of food-business heavyweights will “voluntarily postpone active operations,” according to this statement. 
 
Editors Note: Fran Melmed is the owner of context communication consulting llc, an employee communication consulting firm. She blogs at free-range communication on communication, HR, and health and wellness. You can find her on Twitter @femelmed. (image credit: http://www.flickr.com/photos/coca-cola_art_gallery)

Flu Prevention--Mostly Common Sense, but Do Your Benefits Policies Support It?

The Chicago Tribune's cover of the Sunday business section has a story, like dozens we're seeing now, about Firms bracing for a rash of flu absences. While I hope the H1N1 flu season doesn't prove to be much worse than a typical flu season, most companies (and certainly the major media) are already assuming the worse.

What struck me from this Tribune article was the prevention advice: 

Tips for H1N1 flu prevention and treatment

-- Cover your nose and mouth with a tissue when you cough or sneeze.

-- Wash your hands often with soap and water, or use alcohol-based sanitizers, especially after you cough or sneeze.

-- Avoid touching your eyes, nose or mouth to limit the spread of germs.

-- Avoid close contact with sick people.

-- If sick, stay home for seven days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer.

-- Follow public health advice regarding school closings, avoiding crowds and other social-distancing measures.

-- Get both the seasonal and H1N1 flu vaccinations, when available. This is especially important for pregnant women, caregivers to infants and health care personnel.

-- If you contract swine flu, talk to your doctor about antiviral medications Tamiflu and Relenza, which can lessen the duration and severity of the illness.

-- For more information visit flu.gov.

Source: Centers for Disease Control and Prevention

Pretty much all common sense, right? The first 5 tips especially are behaviors that make sense ALL the time--not just when there's a pandemic. But, no matter how much the CDC says it, and no matter how much we all know it makes sense, how many people actually stay home when they are sick? (Let alone for seven days!?!!?)

This isn't all about company policy (it is also a lot about individual choices) but, there are a ton of benefit programs and policy factors at play here--time off programs, sick leave, coverage for preventive care, short-term disability policies, family leave, access to child care, the list goes on and on. A company can't be successful with the message "please stay home when you're sick" if they don't have the policies, business process and culture that allow for that.

While many companies have moved from separate sick, holiday and vacation banks to one single "Paid time off" for flexibility, those policies may unintentionally encourage people to work when they are sick. Would you rather come into the office with the sniffles or take a day off of your upcoming vacation to Maui?

What if furloughs have drained people's vacation and PTO banks this year? How will you encourage workers to stay home when they're sick if they are going to have to take a pay cut to do it? Do your policies support parents who may need to stay home with sick kids?

And, what about hourly and low-wage workers? How do you encourage them to take time off if being sick for a week may mean not being able to make rent that month?

Think about the business culture too. Do the work requirements of a specific line of business set the expectation that no one can ever miss a day? How many knowledge workers still come into the office when they're sick even though they have laptops and cell phones, because they don't have a good relationship with their manager? How many managers don't really understand the time off and benefit policies in the first place?

Lots of questions and no easy answers. And, much at stake as we know the cost of lost productivity and absenteeism. As you plan for the flu season, look deeper--beyond common sense communication and business planning--are your benefits programs, policies and business culture truly supporting the health of your workforce this flu season? Or, are they discrediting your message and encouraging exactly the opposite behaviors you need?

Editor's Note - Jennifer Benz is founder and chief strategist at Benz Communications, a boutique consulting firm that focuses on employee benefits communication. You can reach her at jen@benzcommunications.com or via Twitter @jenbenz. 

The WWE has a Wellness Program?

I was as astounded as you were to learn last week that wrestler Oscar Gutierrez (Rey Mysterio) was suspended from wrestling for 30 days because he was in violation of the WWE’s Wellness Program.  I know!  Who knew the WWE had a wellness program?  When I read this, I wondered what their ROI is.  How are they keeping employees engaged?  What vendor have they partnered with to manage the program?  How exciting to have an organization so visible to the public out there championing the wellness effort!

So I Googled it.  “WWE Wellness Program.”  Sure enough, a press release for the WWE Wellness Program showed up at the top of the list.  From the program outline:

“NEWS ALERT -- Effective today, February 27, 2006, WWE is implementing a broad WWE Talent Wellness Program. The Program has two components: 1) an aggressive substance abuse and drug testing policy; and 2) a cardiovascular testing and monitoring program.”

As it turns out, the WWE “Wellness Program” is what the rest of us would call a drug policy.  But the press release is from 2006.  Let’s give WWE the benefit of the doubt.  Let’s check out the company’s official Talent Wellness Program Summary.  According to this website, key components of the program include:

• Comprehensive Medical and Wellness Staffing and Infrastructure
• Cardiovascular Testing and Monitoring Program
• Mandatory ImPACT™ Testing
• Substance Abuse and Drug Testing Policy
• Annual Physical Examinations and Blood Screening
• Referrals to Consulting Health Care Providers On An As Needed Basis

Maybe WWE deserves some credit.  While I suspect they aren’t aggressively managing health in the way a traditional wellness program might, one has to give them credit for implementing a program to monitor their talent’s cardiovascular, brain, and general overall health.  This would seem to be in line with how most professional sporting organizations would operate.  And it would appear that their drug policy makes up only a small portion of their overall wellness program (albeit a more visible portion of it).  But it doesn’t appear that the program focuses much on providing coaching or case management, perhaps because most of their wrestlers rely more heavily on their own personal trainers.

Food for thought: I wonder whether the WWE is tracking ROI the way the rest of us would to see whether they’re getting any bang for their buck from their wellness program.  I also wonder whether this program is specific to their wrestlers or if it applies to all employees.  If all employees, this would likely not fit the bill for an effective program. 

I suspect, like me, you think the WWE’s “Wellness Program” is more PR than effective health management.  But the next time you’re in a meeting with decision makers in your organization making the case for a company wide wellness program, be sure to point out that even the WWE has a wellness program.  Who knows?  Someone in your C-suite may be a closet wrestling fan.

Editor's Note - Greg Dagley is a Benefits Consultant for a large multinational employer in Houston, TX. While his company has employees all over the globe, his job keeps him focused on US benefits and spending a lot of his time managing external vendors.  Is there any doubt his Excel skills are more advanced than yours?

Who Would’ve Thought I’d Have Anything in Common With Whole Foods CEO John Mackey?

I have a confession to make.  I get my groceries at Wally-World.  There’s one near my house, their prices are lower than another nearby grocery store, and I don’t mind the inevitable overcrowding on Sunday afternoon.  Some of you will count this against me since, for years, this establishment was known to have had a less than stellar track record in the way it treated its workers, and it may be single-handedly responsible for ending the age of mom-and-pop stores of all varieties (grocery, specialty, you name it).  To the first issue, I would say that Wal-Mart heard your concerns and has made efforts to improve relations with its employees.  And to the second, if it hadn’t been Wal-Mart, it would’ve been someone else putting mom-and-pop out of business.  It’s called capitalism.

My second confession is that I don’t eat anything organic (unless by accident).  Only God (and perhaps the FDA) knows what sorts of chemicals I’m ingesting when I eat the food purchased at my local Wally-World.  It hasn’t killed me, yet, so I’m not terribly worried.  So, who would’ve thought I’d come down on the side of Whole Foods CEO John Mackey in the debate over health reform.

In a recent op-ed in the Wall Street Journal, Mackey makes his proposals for health reform, and I agree with most of them.  What I admire about him is that he puts his money where his mouth is.  Whole Foods rolled out a Consumer Driven Health Plan (CDHP) with a Health Savings Account (HSA) several years back and has been serious about promoting it with employees and teaching them how to use it.  Employees are educating themselves about the plan and are, in fact, doing what CDHPs are designed to encourage them to do: shopping for health care services.

To be sure, I’m not certain CDHPs are going to save our health care industry.  But I do think they encourage people to think more carefully about their health care decisions.  I think that CDHPs should  be carefully designed to cover preventative things like regular checkups at low or no cost (i.e., not subject to the deductible).  Otherwise, some people will be inclined to avoid checkups in order to preserve their HSA balance.  That said, putting more responsibility on consumers seems like something else I remember that made this country great.  Oh yeah -- now I remember.  It’s called capitalism.

Mackey’s other proposals?

• Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits.
• Repeal all state laws which prevent insurance companies from competing across state lines.
• Repeal government mandates regarding what insurance companies must cover.
• Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year.
• Make costs transparent so that consumers understand what health-care treatments cost.
• Enact Medicare reform.
• Revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren’t covered by Medicare, Medicaid or the State Children’s Health Insurance Program.

Enacting any one of these changes would be challenging (an understatement?) given the interests that would be affected.  Nevertheless, to me, these are reasonable proposals for health reform that would encourage market-based solutions and deserve as much discussion as the options currently being debated.

Editor's Note - Greg Dagley is a Benefits Consultant for a large multinational employer in Houston, TX. While his company has employees all over the globe, his job keeps him focused on US benefits and spending a lot of his time managing external vendors.  Is there any doubt his Excel skills are more advanced than yours?

Smoke 'em If You Got 'em - Unless We Have a Policy Against It....

A follow up to one of my first ever posts over at the HR Capitalist.  Scott Rodrigues had been working as a lawn-care employee for The Scotts Co. for only about two weeks when he was fired in 2006 after a drug test found nicotine in his urine, a violation of a company policy forbidding employees to smoke on or off the job. He promptly filed a lawsuit that argued, among other things, that the company violated his right to privacy.

As the Boston Globe reports, that case has made it through the courts, and the courts upheld the Ability of Scotts to terminate Rodriques for smoking:

"Now a federal judge has dismissed the Bourne man’s suit, ruling that Rodrigues’s smoking was not a protected privacy interest because he never kept his puffing a secret.

In granting Scotts’s motion for summary judgment, US District Court Judge George A. O’Toole Jr. said that Rodrigues admitted in a deposition that he smoked while walking down the street and in a restaurant parking lot and was caught by a Scotts supervisor with a pack of cigarettes on his dashboard.

“It is clear from those admissions that Rodrigues has not attempted to keep the fact of his smoking private,’’ O’Toole wrote.

The judge also rejected Rodrigues’s contention that his firing violated the 1974 federal law that protects employees’ rights to their benefits. O’Toole said that law did not protect Rodrigues because he was not yet a bona fide employee and was only working on the condition that he passed the urinalysis.

Jim King, a spokesman for Scotts, which is based in Marysville, Ohio, said the smoking ban has never been used to fire “an existing employee,’’ only to screen out applicants. Since the ban went into effect, he said, the percentage of smokers among the company’s roughly 7,000 employees has fallen from 28 percent to 7 percent.

“We’re obviously pleased with how [O’Toole] ruled,’’ he said. “We think the ruling speaks for itself.’’

Scotts’s smoking ban was announced in 2005 by chief executive Jim Hagedorn, a former two-pack-a-day smoker, and went into effect Oct. 1, 2006, giving the company’s employees nearly a year to prepare. Scotts has paid for employees and their families to take part in smoking cessation programs.

King told the Globe after Rodrigues filed his suit that the tobacco policy was intended to reduce medical costs for the self-insured company, which he described as deeply committed to promoting good health among employees. He pointed out that Scotts built a $5 million wellness center in Marysville and reimburses some workers for fitness club memberships."

Now for the big question based on the wording of the ruling.  What if the prospective employee had attempt to keep his smoking a secret?  Would the ruling have stood?

Interesting stuff.  I'm not sure we can get to wherever it is we are going in the healthcare debate (especially from a cost perspective) until employees have incentives or penalties to motivate them to live healthier.

Time Magazine - Exercise Doesn't Help You Lose Weight...

Weight Loss has long been thought to be a calories in, calories out type of thing that was aided by exercise.  Now, Time Magazine's throwing one of those cover articles out (titled, "Why Exercise Won't Make You Thin") that's sure to make a lot of people say "A-HA!!!"

More from the Time article:

"In general, for weight loss, exercise is pretty useless," says Eric Ravussin, chair in diabetes and metabolism at Louisiana State University and a prominent exercise researcher. Many recent studies have found that exercise isn't as important in helping people lose weight as you hear so regularly in gym advertisements or on shows like The Biggest Loser — or, for that matter, from magazines like this one.

The basic problem is that while it's true that exercise burns calories and that you must burn calories to lose weight, exercise has another effect: it can stimulate hunger. That causes us to eat more, which in turn can negate the weight-loss benefits we just accrued. Exercise, in other words, isn't necessarily helping us lose weight. It may even be making it harder.

Earlier this year, the peer-reviewed journal PLoS ONE — PLoS is the nonprofit Public Library of Science — published a remarkable study supervised by a colleague of Ravussin's, Dr. Timothy Church, who holds the rather grand title of chair in health wisdom at LSU. Church's team randomly assigned into four groups 464 overweight women who didn't regularly exercise. Women in three of the groups were asked to work out with a personal trainer for 72 min., 136 min., and 194 min. per week, respectively, for six months. Women in the fourth cluster, the control group, were told to maintain their usual physical-activity routines. All the women were asked not to change their dietary habits and to fill out monthly medical-symptom questionnaires.

The findings were surprising. On average, the women in all the groups, even the control group, lost weight, but the women who exercised — sweating it out with a trainer several days a week for six months — did not lose significantly more weight than the control subjects did. (The control-group women may have lost weight because they were filling out those regular health forms, which may have prompted them to consume fewer doughnuts.) Some of the women in each of the four groups actually gained weight, some more than 10 lb. each.

What's going on here? Church calls it compensation, but you and I might know it as the lip-licking anticipation of perfectly salted, golden-brown French fries after a hard trip to the gym. Whether because exercise made them hungry or because they wanted to reward themselves (or both), most of the women who exercised ate more than they did before they started the experiment. Or they compensated in another way, by moving around a lot less than usual after they got home."

The article's a good read, so give it a run.  The problem with mass media articles like this is that they tend to not change anything, with the exception of making those avoiding exercise feel emboldened like they are somehow doing the right thing.  I haven't been exercising, but guess what?  Time ran that big article that said exercise doesn't work - so there's no reason for me to start.

Meanwhile, regardless of the reality regarding exercise's impact on weight loss, that same group gets none of the other postive impacts of exercise in their daily lives.

Worse yet, their kids grow up with no exposure to exercise as a part of a healthy lifestyle.

Thanks Time...

Reconsidering Giving Away Soda At Work

What are YOU spending on Wellness?

• $200 per participant in incentives?
• $40-50 per participant for biometrics screenings?
• $6 per participant for a health risk assessment?
• $4-15 pepm for health coaching?
• $2 pepm for incentive management?
• $200 per on site class?
• Goodness knows how much on staff time and consultants and the like, on program administration, and measuring of your butt kicking wellness program.

BUT does it every worry you that the $.75 peps (yes, that's per employee per soda) that you spend on providing free pop is corroding the value of what you have been spending on prevention?

Glucose, Fructose, or Sucrose?  Whoknose?
Does a sugar by any other name taste as sweet?

Most of us forgot the difference between glucose, fructose and sucrose long ago while starring wistfully at our high school heartthrob during chemistry. It wasn't something we needed to know and, I mean come on, who can tell the difference right? All of them taste sugary.

So, what's the difference? Well, according to a new study published in the Journal of Clinical Investigation, researchers from the University of California, Davis discovered that people consuming fructose-sweetened drinks showed an increase in a particular kind of fat that embeds itself between tissues in organs. They were also less sensitive to insulin, showed elevated blood levels of lipids, increased fat production in the liver, and elevated LDL (so-called 'bad' cholesterol) and larger increases in blood triglycerides. Yikes!

According to the study, those drinking glucose-sweetened beverages showed none of these changes. Unfortunately for us, most of the sugars that are readily available in the store come in the form of high fructose corn syrup or sucrose (table sugar).

So, uh, skip the soda and maybe provide a fruit bowl instead?

Editor's Note - It's hard to be humble when you're bloggin' straight out of Portland, Oregon.  Tanya Barham is the Founder and CEO of Recess Wellness, a company where all the staff works like little elves at Christmastime to transform their client's workplaces into healthy, happy, productive places akin to Santa's workshop at the North Pole.  Seriously.  Of course, Santa's fat, so they still have work to do.

Is Coffee the Wonder Drug to Prevent and Treat Alzheimer's?

Sure I've got stained teeth and I'm more than a little hyper.  The good news about my fondness for coffee ALL DAY LONG?  It might help me prevent Alzheimer's disease has received an extra boost from two new studies.

From the Atlanta Journal Constitution:

"Florida researchers report that a daily dose of 500 milligrams of caffeine -- the equivalent   found in five 8-ounce cups of coffee -- reversed memory issues in mice bred to develop Alzheimer-like symptoms. After two months on the stimulant, the mice rebounded to score just as well on memory tests as normal mice of the same age that had never exhibited signs of dementia.

The studies, published in the July 5 online edition of the Journal of Alzheimer's Disease, also found that caffeine cut by half the mice's excessive blood and brain levels of beta amyloid, the protein linked to characteristic plaque found in human Alzheimer's disease.

"The new findings provide evidence that caffeine could be a viable 'treatment' for established Alzheimer's disease, and not simply a protective strategy," lead author Gary Arendash, a University of South Florida neuroscientist, said in a news release. "That's important because caffeine is a safe drug for most people, it easily enters the brain, and it appears to directly affect the disease process."

Studies to test whether caffeine can help people with mild cognitive impairment or early Alzheimer's disease are likely to follow, investigator Huntington Potter, director of the Florida Alzheimer's Disease Research Center, said in the news release."  In the most recent experiments, the researchers also found that caffeine did not improve the memory of normal mice as it did for the Alzheimer's mice."

Coffee (and other forms of caffeine) is looking more and more like a good thing.  Have a cup today.  Make it three, maybe five.

Not a problem for me...

Was Denis Leary Right About Preventative Care?

Denis Leary had a great line from his Broadway show/CD "No Cure for Cancer".  It goes a little something like this:

"I love these little facts. "Well you know. Smoking takes ten years off your life." Well it's the ten worst years, isn't it folks? It's the ones at the end! It's the wheelchair, kidney dialysis years. You can have those years! We don't want 'em, alright!?

The Leary premise is quality over quantity.  If the late years aren't good ones, the theory goes that you may as well do what you want.  No mention of the cost of health care during the late years.  That doesn't translate too well into comedy, especially the Leary version of comedy.

Not to worry.  Arthur Garson's got you covered in this column from Governing Magazine, where he and Carolyn Englehard argue that preventative care just doesn't pay out:

"If you're among those who think prevention saves money, and will help reduce the overall cost of medical care, you're not alone. But while an apple a day might keep the doctor away, at least for awhile, it also might cost more than you think. Preventive medicine can help avoid costly illnesses earlier in life, only to increase the population of elderly and infirmed people who will most likely require expensive treatments for other illnesses later.

Even worse, unhealthy habits such as tobacco smoking may actually save money in the long run as people who smoke die earlier and use fewer health care dollars. "This doesn't make sense," you say, "Smokers are less healthy than nonsmokers." That may be true, and smokers do use up to 40 percent more medical care while they are alive. A recent study from Holland showed that, on average, smokers die at age 77 and save $100,000 in lifetime medical care costs compared with non-smokers who die at 83.

The same is true for people who are obese. While obesity-related conditions such as Type-2 diabetes, high blood pressure and heart disease are associated with high medical expenditures, the costs that are saved by preventing obesity will only be offset later in life by diseases unrelated to obesity that accompany living a longer life. In the Dutch study, obese people die at 80 and save $50,000 compared with non-obese people who die at 83."

Wow, there it is.  It's cheaper to allow people to make their own decisions about lifestyles because we don't have to spend money on them once they're gone - it's cheaper overall to let them do what they want. 

What the column doesn't explore is ramifications of preventative care for employers.  The ten years at the end are largely funded by the government.  What about the 5/10 year ROI scenario for employers that invest in programs that get people to stop smoking or drop their blood pressure.  Is the ROI there for the companies that choose to do that?

That's the million dollar question (literally) for employers in America.

Discounted Health Care for Buying Local Veggies? Is this Heaven?

I live in the mecca of local and organic produce. There are so many farmer's markets to choose from on a given week that you could eat like royalty nearly year-round and hardly step foot in a grocery store. The daddy of them all, the Ferry Plaza Farmers Market, and my favorite low-key version, The Alemany Market, are bustling year round and have arguably some of the best coffee, specialty food, gourmet treats and, of course, produce in the country. (Not that I'm biased or anything.) 

But, one of my favorite treats of the summer is my Community Supported Agriculture (CSA) veggie box. Once a week I pick up a box of the tastiest just-picked fruits and veggies. I read the info sheet on all the obscure or not-so-obscure items inside and plot out what to cook, freeze or eat on the spot (the strawberries don't always make it all the way home). I'll be the first to admit I'm a bit of a geek about this but it is so much fun--kind of like Christmas morning once a week (plus supporting the community and all that good stuff too). Unless you threw in a chef to cook the veggies for me, I would never have thought a CSA could get better. Until now.

In Madison, people are getting rebates on their health care for joining a CSA! The Madison Area Community Supported Agriculture Coalition (that is a mouthful!) has a program called Eat Healthy Rebate where their CSA members get rebates on their health plans--up to $200 bucks! This info from the Minneapolis Star Tribune:

CSAs are particularly popular around Madison, Wis. There, Physicians Plus Insurance Corp. in 2005 began offering $200 premium rebates to member families who joined CSAs. The program appears to have been the first of its kind in the country. In 2006, the first full year of the program, 972 members got the CSA rebate; heading into this season, 1,460 will qualify, said Physicians Plus marketing manager Scott Shoemaker.

If people are motivated to eat "healthier foods, exercise and practice preventive health measures, they're going to be healthier in the long run and need less health management down the road," Shoemaker said. "They'll go in to the doctor less. And costs will go down."

This is pure brilliance in my opinion. Why not pair eating healthy with lowering your health care costs -- and supporting the local community all at the same time?

This could be a great fit for employer wellness incentives too. Employees are often offered reimbursements for gym memberships that go unused--maybe for some employees those incentive dollars could be better spent on healthy eating? 

Are there other examples of pairing local agriculture with health incentives? Please leave examples--or your ideas!--in the comments below. 

Jack of All Trades & Master of None

Poor focus hampers wellness implementation.

Are you updating your facebook status via Twitter from your iPhone as you apply your make-up or eat your burger on the driveto your next open enrollment meeting?  Many Americans feel as though they are good at multitasking and engaging in multiple activities simultaneously leads them to believe they are accomplishing more. 

In her book, Distracted: The Erosion of Attention And The Coming Dark Age, author Maggie Jackson points to a growing body of research studies that seem to suggest the opposite.  A flood of stimulation, interruption and fleeting human contact have created a culture of "diffusion, fragmentation."

She points out the consequencesof what most of us consider par for the course in our lives and working environments:

Interruption and the knowledge worker:

• Knowledge workers switch tasks every three minutes. And once interrupted, a worker takes an average 25 minutes to return to their original task, according to informatics scientist Gloria Mark.
• How often are we interrupted?  The average worker gets 156 emails a day, according to the Radicati research group. And that's just the beginning; instant-messages, phone calls, faxes and snail mail add to the influx.

Making a national habit of multitasking:

• Sixty-five percent of people eat while they drive.
• Sixty percent of kids age eight to 18 multitask some or most of the time they're doing homework.
• Twenty-five percent of restaurant meals are ordered from the car, up from 15 percent from 1988.
• American kids are exposed on average to nearly six hours a day of non-print media.
• Two-thirds of children under six live in homes that keep the tv on half or more of the time, an environment linked to attention-deficiencies.

Time and time again in the world of wellness we see this habitual tendency toward mindless overcommitment, interruption, and multitasking lead to programs that are too diffuse to do much good if the desired outcome is a healthier workforce and reduced health care costs.

Why wellness fragmentation does not equal results

How does ROI for wellness work?  It is more of a cost avoidance than an actual savings in most cases.  Here is a simple (and maybe a little too simplistic) example to help walk you through the "savings." 



Half of your workforce participates in a risk based population health strategy (wellness program) and the other half does not.

For the participating half of the population, whose risk is known, you are able to offer outbound (active) and passive programs that directly impact and address the risks you've identified as prevalent to this group. 

Let's say the programs you've implemented are effective, engagement in them is high, and you retain these employees.  Over a series of years you should see something happen that is counter to what will have happened with no intervention. 

That is to say, this group will not get sick as often as non-participants because your interventions were effective and employees stuck around long enough for you to see results.

The non-participants at your company, as an aggregate, are an unknown entity to you.  You have very little data on their risks and, as a group, they will most likely continue to use health care at the same rate as before. 

Yet, if your company-wide wellness communications are effective and appealing, your participant group is vocal and influential, and your non-participants stay at your company without developing any major illness then some studies indicate that your wellness program might actually have a halo effect. 

That is to say, even non-participants will learn a little more about self care whether they participate or not.  Sure, that could slow the rate of health care cost growth in that group, though probably not by a lot.

Both groups' cost trends together is your overall trend.  Both may continue to rise, but your participant group's trend over several years will rise more slowly - making your overall costs appear to grow more slowly. 

UNLESS.  Yes, there is an unless.  Unless, your participant group is so small and the growth in the cost of health care is so large that your non-participants' health care usage effectively nullifies any impact you had on participants.    

Wellness is not Wii Fit.  You need to focus.

As much as we know that on an individual level good health is as simple as: sleep well, eat right, and move more, achieving a successful organizational wellness strategy is as much an art as it is a science.  It takes focus, discipline and rigorous measurement to impact behavior, motivate and sustain participation, and to quantify results.

If your program is to be successful then you will need to engage a large chunk of your workforce, stratify their risks, and follow a disciplined series of stepsover several years in order to see return on investment.  Oh, and do all of this while simultaneously carrying out the core work of your company.

Fight the urge to multi-task

While multi-tasking may be transitioning out of vogue when it comes to work effectiveness, its cousin  - work sequencing - can help break large and complex tasks into more manageable pieces. 

Plan to succeed by drafting a multi-year strategy with a realistic timeline.  Schedule monthly (core team), quarterly (key shareholders and decision makers) and annual reviews (company wide) of a the wellness program before you even begin work.  This will hold you accountable for reporting progress toward implementing your strategy and plan. 

Build up to maximum efficiency by starting with only a few key program components that will get you the most bang for your buck.  Gradually add complexity as your initial program begins to show results. 

More often than not, companies initially underestimate how much time it takes to implement a strategic wellness program.  They allocate too few resources and take on too many program components to ever really get much traction.  As a result, their programs suffer from poor participation due to fragmented management and the overall program shows high attrition.  Plan intelligently and sidestep this common trap.

Editor's Note: By day, Kris Dunn is the VP of People at DAXKO, a cool software firm dedicated to providing solutions to the best membership-driven organizations in America. At night, he morphs into a blogger at The HR Capitalist and the Founder and Executive Editor of Fistful of Talent. That makes him a career VP of HR, a blogger, a dad and a hoops junkie, the order of which changes based on his mood. Tweet him @kris_dunn...

Sunscreen Arms Race - How About a 500 SPF Product?

For those of you who haven't met me, to classify me as pasty is fair.  Irish blood has made me that way, which means I need some sunscreen protection when it's beach or pool time.  I've long since given up on the bronze tan, I'll settle now for people not squinting if they look my way, as the sun deflects off of my skin like it was aluminum foil.

Given my history as pasty-man, I've grown skeptical of the need for even 50 SPF sunscreen.  After all, if I burn in 20 minutes without sunscreen, 50 SPF means I have the ability to stay out in the sun (properly applied with no water erosion) for 1,000 minutes, right? 

As it turns out, there's a SPF marketing arms race that's going on right now.  More from the New York Times:

"LAST year, Coppertone rolled out two easy-to-use sprays with its highest-ever sun protection factor: SPF 70+. Not to be outdone, Neutrogena offered its Ultra Sheer Dry-Touch lotion in SPF 85 strength, that year’s big gun.   This sun season, Banana Boat is retaliating with a pair of SPF 85 sprays, which it trumpets on its Web site as “our highest SPF level in a continuous spray formula.” 

But now, SPF creep has hit the triple digits with Neutrogena’s SPF 100+ sunblock, leading some dermatologists to complain that this is merely a numbers game that confuses consumers.  The parade of stratospheric SPFs is “crazy,” said Dr. Barbara A. Gilchrest, a dermatology professor at Boston University School of Medicine. “For a normal person who is fair-skinned and concerned about skin damage and photoaging,” Dr. Gilchrest said, “it’s really in my opinion tremendous overkill.”

But that’s not necessarily the case. No SPF, not even 100+, offers 100 percent protection. What’s more, both UVA and UVB radiation can lead to skin cancer, which is why dermatologists now advise using sunscreens with an SPF of at least 15 and UVA-fighting ingredients like an avobenzone that doesn’t degrade in light or Mexoryl SX.

The difference in UVB protection between an SPF 100 and SPF 50 is marginal. Far from offering double the blockage, SPF 100 blocks 99 percent of UVB rays, while SPF 50 blocks 98 percent. (SPF 30, that old-timer, holds its own, deflecting 96.7 percent)."

Good to know.  Remember, when you see me on the beach, be sure your sunglasses are on.  The glare can be blinding...

Editor's Note: By day, Kris Dunn is the VP of People at DAXKO, a cool software firm dedicated to providing solutions to the best membership-driven organizations in America. At night, he morphs into a blogger at The HR Capitalist and the Founder and Executive Editor of Fistful of Talent. That makes him a career VP of HR, a blogger, a dad and a hoops junkie, the order of which changes based on his mood. Tweet him @kris_dunn...

Fat Is the New Skinny - Trends in Classifying Yourself As Overweight...

That's right.  Our kids have been fat so long that our expectation of what fat is has started to shift.  See this research abstract from Burke, Heiland and Nadler and exhale:

"We test for differences across the two most recent NHANES survey periods (1988–1994 and 1999–2004) in self-perception of weight status. We find that the probability of self-classifying as overweight is significantly lower on average in the more recent survey, for both men and women, controlling for objective weight status and other factors. Among women, the decline in the tendency to self-classify as overweight is concentrated in the 17–35 age range, and, within this range, is more pronounced among women with normal BMI than among those with overweight BMI. Among men, the shift away from feeling overweight is roughly equal across age groups, except that the oldest group (56–74) exhibits no difference between surveys. In addition, overweight men exhibit a sharper decline in feeling overweight than normal-weight men.

Despite the declines in feeling overweight between surveys, weight misperception did not increase significantly for men and decreased by a sizable margin among women. The shifts in selfclassification are not explained by differences between surveys in body fatness or waist circumference, nor by shifting demographics. We interpret the findings as evidence of a generational shift in social norms related to body weight, and propose various mechanisms to explain such a shift, including: (1) higher average adult BMI and adult obesity rates in the later survey cohort, (2) higher childhood obesity rates in the later survey cohort, and (3) public education campaigns promoting healthy body image. The welfare implications of the observed trends in self-classification are mixed.

Hat tip to Marginal Revolution...

The Bun In The Oven & The State of Preventative Health Care...

Here are some snippets from an email I received from the US Department of Health and Human Services today:

"We know that the health care crisis impacts every American, but our mothers, daughters and sisters are paying a particularly heavy price. Today, 21 million women and girls are uninsured. Women who try to purchase insurance find that the private market is often stacked against them. Premiums in the private market for young women are often higher than they are for men. In some states, insurance companies can legally discriminate against women, and leave them with higher health care bills or inadequate coverage.

We know America's women can't afford to wait for comprehensive health reform. Roadblocks to Health Care reports:

• In the individual insurance market, women are often charged higher premiums than men during their reproductive years. Holding other factors constant, a 22 year old woman can be charged one and a half times the premium of a 22 year old man.
• In a recent national survey, more than half of women (52%) reported delaying or avoiding needed care because of cost, compared with 39% of men."

Why are women charged more?
Among other things, because we can get pregnant and pregnancy in the US is very expensive. We therefore use more health care and are charged more or denied insurance coverage. But here is the crazy part, folks: women cannot self-impregnate!

Not long ago, I received a very personal lesson on the wacky state of preventative health care for maternity. As an otherwise extremely healthy person with a good track record for taking care of myself and little in the way of worrisome health risks, I'd gone the way of financial prudence. I purchased a health plan with a high deductible, but with inexpensive co-pays on doctor's visits and alternative medicine as well as discounts on pharmaceuticals, should I need them.

This was all working out very well. I continued to do my part for the team by taking good care of myself, paying my insurance company dutifully and not using any medical care! I was mentally prepared should a catastrophe befall me. I figured, should that happen, my piddly $5k deductible would seem like chump change in comparison to what I would otherwise have had to spend out of pocket for catastrophic care. All those years of paying unused premiums to my carrier would have been put to good use!

Then, about 6 months ago I developed a small "medical" problem. That's right. I got pregnant. Ok, so this is no catastrophic illness or disease condition, right? I mean, there are more than 6 billion people on earth and, unless I am mistaken, pregnancy is the way we all got here. As a scientist, I will grudgingly agree that pregnancy looks suspiciously like a highly evolved parasitic infection. Yet, unlike malaria - for instance - my health plan wasn't ponying up any cash for pregnancy vaccines or other preventative measures against this "disease."

So, it was one $20 co pay with my primary care doc, the cost of a pregnancy confirmation test, and then I was on my own. At that point my options were to start clocking maternity care against my catastrophic deductible. After meeting that limit I'd pay 30-70%. After doing the math, I realized that if I ended up in a hospital for a routine, healthy birth, with no serious complications, that I would most likely end up paying $7,500+ out of pocket for my "disease."

Compare this to a $2000-2500 bill if I pay cash for a home birth with a certified nurse/midwife, including all prenatal scans and labs and two months of well baby care, and it left me scratching my head. Now if there were complications (need for surgery, premature birth, gestational diabetes, preclampsia, etc.) that led to a need for emergency medical intervention then, as I said, there is not much room to gripe over the deductible when so many dollars and someone's life are on the line. Yet when all signs in my case (and in the case of nearly 75% of pregnancies that come full term) point to a completely normal, healthy pregnancy and birth, I am perplexed about how this situation serves any sort of greater good.

In my case, I simply opted to pay the midwife out of pocket and should an emergency arise, well, it's an emergency - deductible be damned. Yet I think about all of the women whose partners may have left them; women whose partners lost their jobs; women who have lost their own job and are not sure how to afford COBRA, but would be denied individual coverage due to their "pre-existing condition"; women who are short on the cash to be able to afford the relatively less expensive but still cost prohibitive bill for good prenatal care and who end up with very costly bills later on down the line due to having delayed or avoided care.

And these mothers who were impregnated by partners who - in most cases - will not be denied coverage or see rate increases due to their partners' "disease," are left unable to pay and to pass on the costs to the remaining payers in the current insurance system - thus becoming contributors to the astronomical rise is insurance rates. These are not some handful of bad people "out there." If you are reading this blog, breathing and have a pulse right now then you have a pregnant woman to thank.

People are not going to stop making more people, people. It just isn't going to happen. So what are our options when it comes to taking pregnant women off of the bad apple list with regards to health care costs?

1. Provide safe, effective and affordable contraception and family planning services to women of reproductive age (yes, this means after menarche) .
2. Ensure that pre-natal care is covered as preventative care under health plans.
3. Stratify pregnancies by risk and ensure that health plans cover lower cost but safe and effective birth options such as licensed birthing centers and midwife assisted home births for low risk pregnancies.
4. Ensure that health plans rapidly identify and direct high risk pregnancies to maternity care and coaching programs that help manage behavioral risk factors and more closely monitor pregnancy through birth.
5. If you are an employer providing maternity benefits and health insurance for your employees and spouses, make sure you emphasize prental care and maternity benefits offered by your health plan. Consider setting aside lactation rooms to encourage breastfeeding mothers to pump so that they can continue to feed their babies breastmilk (which has health benefits for the mother and child).
6. Support legislation that accomplishes all of the above and funds community health education centers that provide outreach, education and services to uninsured populations - eliminating a cost barrier which might keep pregnant women from seeking care until it is too late.

If altruism isn't your bag, then consider that early prenatal care helps all payers in the health insurance game by lowering costs shared by the pool. And if you are still feeling the glow from that gift that had your mom in tears last weekend, then - hey - do it for the lady who loved you enough to endure nausea, swollen feet, ill-fitting clothes and a whole lot more to bring you into this world.

Editor's Note - It's hard to be humble when you're bloggin' straight out of Portland, Oregon.  Tanya Barham is the Founder and CEO of Recess Wellness, a company where all the staff works like little elves at Christmastime to transform their client's workplaces into healthy, happy, productive places akin to Santa's workshop at the North Pole.  Seriously.  Of course, Santa's fat, so they still have work to do.

Alabama Teachers - Wellness is Gone, and Don't Smoke 'em If You Got 'em...

When push comes to shove on the benefits front, what's the first thing to go?  Select from:

1.  No price increases;

2.  Nice to have things like wellness programs; or

3.  Allowing people to smoke without charging them more for benefits...

If you're the group that administers benefits to Educators in Alabama, you dump wellness and start charging the smokers more.  From the Montgomery Advertiser:

"The board of the Public Education Employees Health Insurance Plan de�cided Friday to maintain the same basic rates for active employees: $2 per month for individual coverage, $132 for dependent coverage and $134 for family coverage. The rates for retired education employees will also stay the same.

The board unanimously raised the surcharge for smokers by $2 per month to a total of $25 starting Oct. 1. That affects about 20,000 people.

As a cost-saving measure, the board voted to eliminate all of its wellness program except flu shots. Deputy Director Marc Reynolds said eliminating health screenings, osteoporosis screenings, Weight Watchers and other features of the wellness program should save $3.5 million in the new fiscal year. But he said it could be more costly in the long run if illnesses are detected later and the treatment is more expensive.

The board had to look for cost savings and revenue generators because the education budget passed by the Legislature on Thursday provided for no increase in funding for health insurance for the 284,655 active and retired employees and dependents who have coverage. The Legislature did that, at the request of the Alabama Education, to put as much money as possible toward maintaining school jobs during the recession."

Interesting to see if wellness comes back to this group or if it's gone forever.  Still pretty good monthly rates for gold plated coverage though...

What Would You Do If Your CEO Got Swine Flu?

Get Well Soon, CEO!

Finding an executive manager is never easy. And once you do find a fearless leader, myriad cultural, economic and - yes - even personal health issues can threaten to throw the whole situation off the rails.

"The impact of replacing senior managers, especially due to sudden health issues, is even more acute than normal turnover. A study by Deloitte shows that 47% of companies cite their biggest people-related challenge as leadership development and succession planning," says Candie Fisher,Director of Client Development for Generator Group, a talent management firm based in Portland, OR

Steve Jobs' much publicized cancer struggle sent off a flurry of speculation about Apple's readiness to replace him.  Last year,CFOs at nCipher and Servocell resigned due to ill health. In 2004 McDonald's CEO, Jim Cantalupo died at age 60 of a heart attack. Charles Bell, who replaced Cantalupo, was diagnosed with colorectal cancer only a month after being named chief executive. 

And while the press might not have noticed that your company's top brass was 'not strong enough' to attend a meeting, that's just the kind of news that makes fine grist for the company rumor mill.  If people are worried about your firm's financial performance, an ailing leader's plight isn't exactly the kind of news that will boost productivity. 

Executives Are People, Too!

Despite their strategic importance to an organization, executive leaders are in many other ways just like everyone else. They have bad hair days (case in point, get a load of Bill Gates and the Microsoft crew in this photo)!

They get sick - often due to preventable causes - just like the rest of us.

Sharon McDowell is an exercise physiologist for the Center for Creative Leadership's Leadership At The Peak Program. The program has looked at the overall health of senior executives and leaders with more than 15 years of management experience, in the top three tiers of the organization, with leadership responsibility for 500 or more people and/or executive staff functions. McDowell says that of the nearly 3,000 program participants screened 58% had high cholesterol; 60% are overweight or obese; and about 50% don't exercise regularly.

Executive managers lead high stress lifestyles and often lack the time for structured exercise. The World Heart Federation and the US Federal Centers for Disease Control say failure to exercise is as bad as smoking a pack of cigarettes every day.

Unexpected leadership transitions are costly, says Fisher, "At the top levels, many companies do not have a strong program in place to fill senior leadership positions from within. As a result, fully-loaded recruiting costs of 1.5 times the annual salary are commonplace."

Fisher recommends companies implement a two-pronged strategy of keeping their senior managers focused on both wellness and succession planning. "Executive level jobs can be stressful, reducing executives health risk through wellness programs can increase leadership productivity thus improving their ability to mentor, groom, and retain high potential talent," she states.

Increasing executives' personal well-being might also improve their effectiveness. McDowell's research has shown that executives that exercise are more likely to be perceived as more energetic and effective than their non-exercising peers in 360 degree management surveys.

Editor's Note - It's hard to be humble when you're bloggin' straight out of Portland, Oregon.  Tanya Barham is the Founder and CEO of Recess Wellness, a company where all the staff works like little elves at Christmastime to transform their client's workplaces into healthy, happy, productive places akin to Santa's workshop at the North Pole.  Seriously.  Of course, Santa's fat, so they still have work to do.

Alabama - Now Charging Obese Workers More For Benefits....

I've written a lot in the past about the continuing escalation of healthcare costs in the U.S. forcing companies into a corner, a corner which will force them to either penalize unheathly employees or reward healthy employees for their health metrics.

Whether you use the carrot or the stick will be up to you.  But employers are increasing their moves to link employee heathcare premiums to metrics like blood pressure, cholesterol, blood glucose, obesity, etc.

The state of Alabama recently annouced some changes that suggest you'll have your BMI memorized in 5 years.  From MSNBC....

"Alabama, pushed to second in national obesity rankings by deep-fried Southern favorites, is cracking down on state workers who are too fat. The state has given its 37,527 employees a year to start getting fit — or they’ll pay $25 a month for insurance that otherwise is free.

Alabama will be the first state to charge overweight state workers who don’t work on slimming down, while a handful of other states reward employees who adopt healthy behaviors. Alabama already charges workers who smoke — and has seen some success in getting them to quit — but now has turned its attention to a problem that plagues many in the Deep South: obesity.

The State Employees’ Insurance Board this week approved a plan to charge state workers starting in January 2010 if they don’t have free health screenings. If the screenings turn up serious problems with blood pressure, cholesterol, glucose or obesity, employees will have a year to see a doctor at no cost, enroll in a wellness program, or take steps on their own to improve their health. If they show progress in a follow-up screening, they won’t be charged. But if they don’t, they must pay starting in January 2011.

“It’s terrible,” said health department employee Chequla Motley. “Some people come into this world big.”  Computer technician Tim Colley already pays $24 a month for being a smoker and doesn’t like the idea of another charge.  “It’s too Big Brotherish,” he said.

The board will apply the obesity charge to anyone with a body mass index of 35 or higher who is not making progress. A person 5 feet 6 inches tall weighing 220 pounds, for example, would have a BMI of 35.5. A BMI of 30 is considered the threshold for obesity.  The board has not yet determined how much progress a person would have to show and is uncertain how many people might be affected because everyone could avoid the charge by working to lose weight."

Welcome to the brave new world.  I'm a proponent of rewarding employees who live healthy lifestyles that result in reduced risk.  Still, I wonder if $25 per month ($300 per year?) makes enough of a dent.  My take is that the psychological threshold for action is triple digits - $100 per month. 

Put the doughnut down.  Doughnuts are for closers people who exercise... Not for those who think the Wii Fit is a good exercise tool...

An Apple A Day or A Bad Apple? Where Health and Productivity Meet.

An Apple A Day or A Bad Apple?

I was recently listening to an episode of This American Life entitled, "Ruining It For The Rest of Us" where they featured stories about how easily one person's behavior can have a contaminating effect on others. One particularly haunting story covered the research of Will Felps, a professor at Rotterdam School of Management in the Netherlands, who placed a confederate in a group and observed the impact that this "bad apple" had on the rest of the group. In nearly every case, the influence of even one spoiler tarnished the productivity and the morale of the group.
One thing that the researchers in Felp's study didn't look at, however, is that poor health can impact mood. Could an apple a day and a brief jaunt outdoors help the bad apple get his mood back on track? Or could workplace health and wellness be a protective means of coping for those who might otherwise be affected by a bad apple?

How do health and mood interact in your workplace? Have you seen an instance where a bad apple lowered the productivity of a work group and subsequently led to more sick days or a reluctance of team members to show up for work?

Editor's Note - It's hard to be humble when you're bloggin' straight out of Portland, Oregon.  Tanya Barham is the Founder and CEO of Recess Wellness, a company where all the staff works like little elves at Christmastime to transform their client's workplaces into healthy, happy, productive places akin to Santa's workshop at the North Pole.  Seriously.  Of course, Santa's fat, so they still have work to do.

 

When High STD Rates Are a Good Thing...

Is the glass half-full or half-empty?  When you're a public health department, you take wins where you can get them.  Case in point, if your STD rate is high, you may as well point to the fact that you're more aggressive than your peers in implementing testing programs.

More on the "half-full" lens from Wellness.com:

"Blue Earth County continues to have one of the state's highest rates of a common sexually transmitted disease. But, in a strange twist, that might be good news.  A state health official said it's likely that more aggressive testing in Mankato catches more cases of chlamydia than elsewhere, leading to the higher rate.

The state saw a new high in an epidemic of STDs in 2008. The Minnesota Department of Health said there were 17,650 new cases of chlamydia, gonorrhea and syphilis last year, a 3.5 percent increase.

Blue Earth County had the fourth-highest rate in the state, behind Hennepin, Ramsey and Beltrami counties. Blue Earth County had 212 new cases of chlamydia, the most common STD, a rate of 379 cases per 100,000 people.

Peter Carr, head of the health department's STD division, said the county could have slightly higherrates because of a larger college -- age population. Most cases of STDs are in those younger than 25.

"But it's very likely that health- care workers there are doing a much better job of screening. Chlamydia, in women in particular, doesn't produce symptoms, so there has to be good routine screening," Carr said.

"By doing what they are supposed to do, it makes theproblem look worse than it is."

If left untreated, chlamydia can lead to infertility in some women and cause complications in giving birth and possible infections in newborns.

Note to reporter - check year over year trends next time around, or at least moving forward <sigh>.

Is It The Government's Job To Make You Aware of Calories?

Generally speaking, I like to know the nutritional data of the food I eat.  I'm more hung up on fat grams than I am calories, because generally I think my calories are under control for my activity level. 

With that in mind, I respond well to seeing nutrition information at fast food outlets, and I think it's good business for those outlets, especially for return business from me.  If I know I can get something I like that's relatively healthy, by sharing that data, those chains have generally won loyalty from me over time.

That's how I roll.  BUT, I'm not sure restaurants should be required to provide that data, because I think 80% of the folks ignore it anyway.  Here's a snapshot from Forbes of what's going on in West Virginia, not known as a health mecca, regarding the posting of calorie/nutrition data:

"West Virginia state Sen. Dan Foster should have known his bill to require restaurants to post calorie counts was in trouble Tuesday when he walked into a House of Delegates committee room and found lawmakers scarfing down doughnuts and breakfast sandwiches from fast-food locations.

Before Foster could defend the bill, delegates were asking questions with their mouths full of complimentary food from fast food restaurants that had been laid out on a committee table before the meeting.  Ninety minutes later, the committee voted to kill the measure, which was billed as a way to combat the state's obesity epidemic.

"It's disappointing," Foster said. "The industry certainly spread their message."

Foster, a Kanawha County Democrat and physician, had been one of the bill's most passionate supporters. He helped secure its passage in the Senate and attended the two House committee meetings on the bill, answering questions from delegates about its intent and provisions.

"They clearly don't want people to know the calories, otherwise they'd do it voluntarily," Foster said.

A call to the West Virginia Hospitality and Travel Association, which lobbies for restaurants and opposed the measure, was not immediately returned Tuesday.  In previous meetings, lobbyists from the group have said that most large chain restaurants provide nutrition information, whether on the Internet or at their physical locations.

The bill would have applied to restaurants with more than 15 locations nationally. The goal was to post calorie counts on menus or menu boards in a bid to steer West Virginians toward healthier food choices. West Virginia has the second-highest obesity rate in the country, and ranks high in linked ailments like diabetes and high blood pressure.

Members of the House committee said even the watered-down version created by the committee's amendment would hurt free enterprise.  "I worry that what's in here is blaming the cause of all obesity on restaurants," said Delegate Daryl Cowles, R-Morgan."

Would the bill have made a difference?  I doubt it.  I think the folks who are drawn to healthy lifestyles provide return business loyalty to outlets that provide the information, and the obese generally ignore calorie/fat data in the same outlets. 

If the obese ignore the data, there's really not an ROI for the burden of providing the data.

Sending Your Employees to Fat Camp...

Every kid can probably remember a schoolmate who was sent away to fat camp and forced to endure not only the mockery of fellow children, but also bland, paltry portions of undressed salad and other "diet" foods. Losing weight was never cool, but with the mercurial rise of reality shows, even fat camp has been buffed to a high gloss.

Shows like The Biggest Loser and other reality diet shows feature diehard trainers who effectively supplant the participants' "lack of will" with their own shrill and uberfit war cries. They harass participants through boot camp-like workouts (4-6 hours worth at a pop) and analyze their every bite. The results are - well - dramatic enough to capture the attention of a rapt television audience.

Corporate wellness programs seem to be picking up on the trend. Home grown Biggest Loser competitions are popping up all over in America's offices. Sure, this approach can work. Particularly when on someone else's dime and when exercising 4-6 hours a day, but for the average working Joe or Josephine, expecting dramatic weight loss can be a setup for disappointment.

And for the ambitious wellness program director? For starters, your program might not actually be reaching the least healthy among your workers. A skinny pack-a-day smoker who does not exercise (unless you count lifting beer to mouth) and has a family history of illness may not have a lot to lose when it comes to shedding pounds.

While it may be tempting to assume that we can look at someone who is obese or overweight and judge their level of health, studies show that a moderately active obese or overweight worker is at less risk of disease than a thin co-worker with high stress, sedentary lifestyle, poor sleep habits, and a lousy diet. Some of the more serious risk factors for cardiac conditions and stroke (think: cholesterol and high blood pressure) are not necessarily something you can determine by looking at a scale.

On top of that, making weight loss into a competition with big prizes on the line not only ignores the fact that healthy weight varies greatly for every body, but there are actually plenty of unhealthy ways to show dramatic weight loss (think: dehydration, binging, diuretics, stimulants). About 65% of the human body is made of water. Do the math on that. Ask any amateur wrestler (you know the guys who basically wear garbage bags as they run around the block prior to being weighed in).  They can give you a few easy hints for ways to manipulate scale weight. Such tactics can dramatically alter scale weight; however, they put unnecessary stress on the body (dehydration and muscle loss) and the results are typically temporary at best.

Additionally, men have an advantage in the weight loss game. Men's hormonal makeup and body composition allows their bodies to rev up the fat burning engines. Women, and particularly those undergoing hormonal changes such as menopause, can still see tremendous benefits from exercise, but thanks to their hormones and body composition will see more gradual weight loss than most men.

So to recap:

• 'Skinny smokers' have little incentive to get healthy - there's not much to lose and have you ever tried running a mile after a cig? It's not fun.
• Weight Loss competitions unnecessarily shame larger people. Health and its relationship to weight is complex. You could be singling out otherwise healthy people based mainly on their appearance, which is not exactly a textbook team building approach.
• The fix is in. Offering prizes can emphasize unhealthy weight loss methods and put men at an advantage over women.
• The graph below shows average excess medical cost per employee of various health risks. Do you think the Biggest Loser is going to do much to reduce the first two?

If your wellness goal is to improve the health of your workforce, emphasize friendly competition and team spirit, while improving productivity along the way, then is fat camp really for you?

Editor's Note - It's hard to be humble when you're bloggin' straight out of Portland, Oregon.  Tanya Barham is the Founder and CEO of Recess Wellness, a company where all the staff works like little elves at Christmastime to transform their client's workplaces into healthy, happy, productive places akin to Santa's workshop at the North Pole.  Seriously.  Of course, Santa's fat, so they still have work to do.

If Food Were Health Care, a Pound of Bacon Would Cost $122....

Would you pay $122.48 for a pound of bacon?

If food prices had risen at the same rates as medical inflation since the 1930's, we would be paying an astronomical amount for common grocery items:

1 dozen eggs $ 80.20
1 pound apples $ 12.23
1 pound sugar $ 13.70
1 roll toilet tissue $ 24.20
1 dozen oranges $ 107.90
1 pound butter $ 102.07
1 pound bananas $ 16.04
1 pound bacon $ 122.48
1 pound beef shoulder $ 43.57
1 pound of coffee $ 64.17
10 item total $ 586.56

Source: American Institute for Preventive Medicine, 2007

Would you say we are getting more for our money?
Tell us what you think.

Why aren't we tackling this problem in the forum where Americans spend the majority of their waking hours?

If corporate wellness programs help employees and employers then what is the hesitation?

When some companies spend hundreds of dollars per employee per year on parties and other goofy events why is it such a stretch to offer programs on a regular basis that help employees reduce stress and live healthier lives?

So what do you feel is keeping your company from offering wellness?

And if your company is offering a wellness program what impact, if any, has it had on you during these rough economic times?

Editor's Note - It's hard to be humble when you're bloggin' straight out of Portland, Oregon.  Tanya Barham is the Founder and CEO of Recess Wellness, a company where all the staff works like little elves at Christmastime to transform their client's workplaces into healthy, happy, productive places akin to Santa's workshop at the North Pole.  Seriously.  Of course, Santa's fat, so they still have work to do.

I'll Be Back for the Meeting, After I Stretch Carl Out Before the Start of His Shift...

I'm increasingly becoming convinced that the best way to win the wellness game is to go "all-in" with on-site staff, etc.  That's bad news for small companies that can't afford those types of services. 

The situation with medical costs has now escalated to the point where it now makes sense to bring the doctor, or at least wellness folks who can do a variety of things, back on the campus of big companies.  Some previous studies have shown that especially when it comes to an on-site doctor to cut down on primary care costs, absenteeism, etc., you need at least 1,000 employees at a location to pull it off financially. 

A recent case study indicates the FTE count necessary for a big on-site wellness team might work for companies with far less than 1,000 employees - especially if they are primarily blue collar, manufacturing/production line environments with lots of worker's compensation risk. 

From CNN Heath:

"Lincoln Industries looks like a typical blue-collar plant: workers cutting, bending, plating and polishing steel for products such as motorcycle tailpipes and truck exhausts amid the din of machinery.

But the 565-employee Nebraska company is different.

Lincoln Industries has three full-time employees devoted to "wellness" and offers on-site massages and pre-shift stretching.Most unusual of all: The company requires all employees to undergo quarterly checkups measuring weight, body fat and flexibility. It also conducts annual blood, vision and hearing tests.

The company ranks workers on their fitness, from platinum, gold and silver down to "non-medal." To achieve platinum, they must reach fitness goals and be nonsmokers -- and the company offers smoking cessation classes.

For the company, the payoff is significantly lower health-care costs. The company pays less than $4,000 per employee, about half the regional average and a savings of more than $2 million. That makes the $400,000 Lincoln Industries spends each year on wellness a bargain.

The investment in "wellness" pays other dividends, according to Orme. He says fitter workers are more productive, have better morale and are safer. As evidence, he points to worker's compensation claims. Ongoing safety training and an increasingly fit work force have pushed worker's comp costs down from $500,000 five years ago to less than $10,000 so far this year."

In reading about this plant, I can't get an old Michael Keaton movie named "Gung Ho" out of my mind, where a Japanese company buys a plant and tries to get hard-core blue collar workers like George Wendt to pick up exercising before the start of their shift.

While the prospect of stretching Carl from the drill press team out before the start of his shift is a little daunting, I'd gladly get out of my comfort zone for a 50% reduction in medical costs.

I suspect you would as well. 

Worker Productivity and "Miracle-Gro" for Your Brain...

Dr. John Medina is a developmental molecular biologist and research consultant. He is an affiliate Professor of Bioengineering at the University of Washington School of Medicine. He is also the director of the Brain Center for Applied Learning Research at Seattle Pacific University.

So what does this guy, who knows a lot about brains and not just because his is obviously pretty high powered have to say about how to optimize our brains for work, play and study? Exercise. Yes. Not only does Medina show that exercise is the number one rule for brain health (hint: when our brain was designed regular movement was a fact of life for humans), but he strenuously emphasizes that our modern, sedentary work environment is actually hurting brain performance.

The US's labor landscape continues to undergo dramatic shifts. Manufacturing jobs are fading fast as the rise of the service economy dominates the landscape.  Even in the current downturn, many of the jobs that will grow as a result of the stimulus plan are in clean power, health care and any number of other fields that continue to experience increased modernization and interface with both people and information systems.

"It's good for us to displace low-wage, manual kinds of labor with higher-skill, higher-tech, higher-education-content labor," says Federal Reserve Bank of St. Louis President William Poole, who compares what's happening with the decline in agricultural employment of the early 20th century.

The problem is we are treating service based workers like factory workers. Workers' brain capacity is - at its core - the very product most service based companies sell; however, the sedentary cube land structured like an automotive assembly line is one of the least conducive set-ups for brain function.

Creative, effective ways to mobilize wellness at work will be central to revolutionizing the effectiveness of the knowledge-based worker. Corporate wellness efforts for such companies cannot simply be seen as a small fluff program for the motivated few who thrill at the thought of spandex leggings, step aerobics in the lunch room, or a gym membership on the company dime.

Wellness, when done right, is a strategic, integrated, and systematic approach for improving employee health, but also key to unleashing the very engine of human creativity - the brain.

Editor's Note - It's hard to be humble when you're bloggin' straight out of Portland, Oregon.  Tanya Barham is the Founder and CEO of Recess Wellness, a company where all the staff works like little elves at Christmastime to transform their client's workplaces into healthy, happy, productive places akin to Santa's workshop at the North Pole.  Seriously.  Of course, Santa's fat, so they still have work to do.

Mommy's Little Angel (Due To Cardiac Arrest)?

Okay, wait, when we said we wanted health care for everyone, we didn't mean that we wanted everyone to desperately need health care. Here are a couple of headlines that scared the bejeesus out of me:

A Rise in Kidney Stones Is Seen in U.S. Children - NYTimes.com
Kidney stones, once considered a disorder of middle age, are now showing up in children as young as 5.

Child Obesity Seen as Warning of Heart Disease - NYTimes.com  A new study finds evidence that children who are obese or have high cholesterol show warning signs of heart disease. 

In the second article the study finds, "artery walls of children and teenagers who are obese or have high cholesterol resembled the thickness of artery walls of an average 45-year-old."   (Silent scream here).  The kids in the study ranged in age from 6-19 years old!

And it isn't as though this is a small portion of the United States we are talking about. The Centers for Disease Control and Prevention estimate that about 16 percent of children ages 2 to 19 are overweight. This tracks well with what we know about the growing prevalence of Type II Diabetes, but now it also appears as though these young people may be at early risk for heart disease as well.

Prevailing data shows that as people age they become medically more costly, but when our 6 year-olds have the arteries and cholesterol levels of 45 year olds, it is anyone's guess how long the middle aged population will maintain its hegemony on medical costs.

• What are you doing to encourage spousal and dependent participation in your wellness program? 
• How many spouses and dependents participate?
• Do you do outreach for parents and kids with high BMI or low activity and high risk for diabetes?
• What about other more common childhood ailments like asthma and coping with allergens?

In many cases, we see that spouses and dependents contribute just as much - if not more - to health care costs and absenteeism as employees themselves.  If we choose to care for the whole person, shouldn't some aspect of that care be targeted at impacting the general well-being of their family milieu as well?

Is Fast Food Nation Conspiring to Put You Out of Business?

British health experts have issued a health warning pertaining to the "Super Size" phenomenon in hospitality establishments. Yes, it has finally reached the UK. The World Cancer Research Fund (WCRF) states that 'two-for-one' or 'meal deal' offers encourage people to eat too much. Even though this super size trend is "old news" in the US, we have a headache that our buddies across the pond get to ignore - a hamburger today can equal a big fat medical bill for your company tomorrow.

When dining out, eating fast food or in a rush, the pressure to finish everything on the plate can lead to overeating. Most restaurants will serve more food than the body needs. When employees hustle back to their desks, take-out in hand, to tackle their afternoon work, their inattention to what's on their plate could easily lead to regular overeating and significant weight gain. 

Compare the difference in serving size (and calories) of some food and drinks 20 years ago versus today:

It doesn't cost a great deal to provide employees with quick handouts about smart tips for eating out, and most health carriers will offer you such materials for free.  Here's a classic: ask for a box before your food comes out. When your meal comes you can put some of the food in the box before you start eating and set it aside (out of sight, out of mind). When you finish the food on your plate, if you're still hungry, open the box and go for it. If not then you have some delicious leftovers for tomorrow.

Also, employees who haven't eaten breakfast may literally be starving by lunch - at least their body thinks they are in calorie deficit.  In addition, their lowered blood sugar is not exactly enhancing great brain or work performance.  When they do hit the cafeteria or the fast food cart down the street, their body will be crying out for calories, and their brain will undoubtedly give in to satisfy cravings for high sugar, high fat foods that will scratch the itch. 

So let's get creative here, which employees want to be the most well liked?  The dreaded candy bowl types.  What about an unusual perk where the company actually pays a fruit stipend to those employees - leaving little fruit bowls scattered around the office?  Also just plain old providing a bowl of fresh fruit at the front desk or in break rooms will allow employees' brains to stay powered up between breakfast and lunch and will satisfy their cravings in a much healthier fashion. 

Do you currently offer healthy alternatives in your cafeteria at a subsidized rate, or provide fresh and healthy snacks as alternatives to soda pop and high sugar drinks (yes, juice is high sugar)?

 

No?  Why not start now?

Editor's Note - It's hard to be humble when you're bloggin' straight out of Portland, Oregon.  Tanya Barham is the Founder and CEO of Recess Wellness, a company where all the staff works like little elves at Christmastime to transform their client's workplaces into healthy, happy, productive places akin to Santa's workshop at the North Pole.  Seriously.  Of course, Santa's fat, so they still have work to do.

Bariatric Surgery - Does it Really Pay for Itself in 2-4 Years?

Weight reduction surgery has long been controversial for employers, with healthcare insurers putting up multiple behavioral goals and other gates before providing access to extreme solutions like bariatric surgery to covered individuals.

Is that the right or wrong approach?  I've never had enough information to really have an opinion.

Here's the first research I've ever seen as a HR pro that talks about expected payback to the extreme weight loss procedures.  Follow me after the snippet from the article to talk about what it means for you and me as advocates of healthcare and retention.

From information provided in the Wall Street Journal:

"Health insurers can offset the cost of laparoscopic or traditional bariatric surgery as a weight-loss treatment for obese patients within two to four years as a result of savings on other medical costs, according to a study published this month in the American Journal of Managed Care, the Wall Street Journal reports.

For the study, Pierre-Yves Crémieux, a health economist and principal at Analysis Group, and colleagues analyzed health insurance claims data for 2003 through 2005 for 3,651 severely obese patients who underwent either laparoscopic or traditional bariatric surgery. The patients in large part were female, with an average age of 44; more than one-third of the patients had high blood pressure, and many of them had high cholesterol, diabetes and other health problems.

Researchers matched each patient based on age, gender, geography, health status and baseline costs with a patient who did not undergo either of the surgeries. Researchers tracked claims data for the patients who underwent either of the surgeries for six months of pre-surgical examination and care, the procedures themselves, and about 18 months of post-surgical care; tracked claims data for post-surgical care for some patients for as long as five years; and tracked claims data for the matched patients over the same period.

According to the study, health insurers that covered patients who underwent laparoscopic surgery, which has an average cost of $17,000, offset the cost in about 25 months. Health insurers that covered patients who underwent traditional bariatric surgery, which has an average cost of $26,000, offset the cost in about 49 months. Crémieux said, "The most cost-effective treatment for obesity is bariatric surgery," adding, "If you do that, within two to four years, you will get your money back." In addition, he said, "We have identified the break-even point for insurers."

The 2-4 year break even point is important to me, because it allows me to get my head around payback.  The thing that's confusing to me is that there's a lot of other research that talks about the failure rate of the surgery - meaning employees can have the surgery or procedure, then not do the things they need to do to keep the weight off.  I haven't read the study in full, so I also wonder if the cost of the medical complications so often written about is reflected here.

Still, the concept of payback is good to have.  We're talking about an investment in an employee to help them improve their life, much like tuition aid.  Many tuition aid programs mandate a payback agreement that an employee stay with the company for a year or two once the company has made the investment.

Now that we have payback numbers and companies have to bear the cost of this surgery, I wish companies could short circuit the red tape by allowing the employee to say, "I want to be at this company long term, and I'm willing to sign a payback agreement making that pledge as a part of this optional proceedure".

I know there are a million legal reasons why you can't do this, and I'm not looking to tie payback to other big ticket items. Medical necessity still rules the day on that end, but it seems like the big question with this one is medical necessity and payback.  That said, my take is that a lot of employees who want the optional surgery would be willing to fast track the process and would accept a payback agreement of 2 years for improved access.

It's The Little Things: When You Don't Measure Wellness, You Fail...

A lot of people think that being healthy is all about the stressful hour at the gym and an ascetic lifestyle/diet rivaling that of a cloistered monk (and not in one of those monasteries that brews yummy beer). The truth is actually a lot less likely to make it the stuff of a good television mini-series.

Small, intelligently thought out changes made consistently over long periods of time are much more likely to produce sustainable results than are heroic efforts that can only be sustained for a couple of months at a time. In wellness, it seems, pacing is key. This is true for both the individual wellness program and the corporate wellness program.

We will cover a corporate wellness example today.

When you don't measure, you fail.

True story. I talk to a lot of people about corporate wellness. Many people tell me they have a corporate wellness program in place. When I ask what program they have in place they typically rattle off one or all of the following answers: a wellness fair, an online portal offered for free or low cost by their health plan or Employee Assistance Program, a yoga class, on-site massage, a corporate gym membership.

My next question? "What is participation like in your {fill in random program here} program?"

The answer (normally a variation of one of two responses)

The truth: "I don't know," or, "It is pretty lousy - just a handful of people."

The euphemistic version of the truth cooked up to make the respondent feel better about spending money on this program:

Respondent: Well there are a couple of people here who seem to really like the program and {more totally anecdotal blah blah blah} there's been quite a positive response.
Me: So have you participated?
Respondent: ......
Me: So about how many people, would you say, have given you this positive feedback?
Respondent: A lot
Me: 5? 10?
Respondent: Well the Director's assistant...
Me: 2? 20?
Respondent: Maybe 3
Me: Out of how many employees?
Respondent: 2,000

Ok so the rosey assessment of their wellness offering is based on a sample size of less than 1% of their employee population??!?!?! I'm sorry, but in this economy please hope that I never am your manager. Because if I find out that you are justifying an expenditure with anecdotal feedback and a quantitative evaluation with a sample size of 0.0015% I will fire you.

Measurement helps you manage programs so that you get more for each $

When companies, consumers, the government, banks, and - hey - just about anyone who turns on the radio or TV these days is blowing a freaking gasket about the economy you need to be able to show that you are making effective use of your company's money.

Even if your company's cash position is solid, perception is reality and investors, managers and employers are taking this very grave moment in history as an opportunity for a little financial introspection. When the top brass turns its eye on your pet programs, you'd better show that they have value and that you are creatively exploring ways to get more for your money.

Today I will let sleeping dogs lie and side step the issue of how effective any of the specific programs mentioned above are likely to be outside the confines of a strategic, planned, well-measured and effective wellness program design. Let's just assume all of the programs are fantastic and each is amazingly effective at transforming the health of its participants {cough}.

But I do have to complain about the very minimum employers could do to ensure the effectiveness of wellness programs but often don't do: measure them. Data is one of those little things - those small, pesky continuous things that is not fun to collect, clean or analyze for most of us.

On the flip side, those who have meticulously gathered data around wellness have shown that well-rounded, multi-year, multicomponent wellness programs produce significant, positive return on investment (ROI). This is especially vital to businesses who shoulder the health care costs of employees - a cost that now makes up the lion's share of employer sponsored benefits.

The catch?

1. The average study length of effective, multi-component wellness programs is 3.6 years.
2. The average cost of effective, multi-component wellness programs is $150 (or more!) per employee per year.
3. The average participation in effective, multi-component wellness programs must be more than 40% in order to make a dent in health care costs.

If you are going to be allowed to manage a program that is responsible for that much in spending, for those many years, and touches half or more of your workforce, do you think anecdotal evidence is going to help this program survive the revolving door of HR Directors, C-Suite execs or directors at your company?
Take a minute to answer that.
No?
Oh really.

Measure measure measure.
Look at the data in excruciating detail. Get deep into it. Ask questions. Are you not a numbers person? Find someone who is. Hire someone who is. Make excel your Valentine. Ask all the questions that the CFO and shareholders will be asking you. Dissect the data 20 different ways until you feel satisfied that you understand. At a freaking minimum - measure program cost and participation and ask how and whether you can get more people to particpate for the same or less money.

When someone asks you how many people use your program and how much it costs per person, produce a cogent answer. If the number looks unimpressive present a convincing plan on how you will improve matters.

The easiest way to ensure you do this is to pick 6 key things to measure early on in your program. Define what you are measuring, how that measure relates to some of your company's strategic goals, where the data comes from and how often it needs to be collected, and some of the considerations and assumptions you are making when analyzing the data. Once you've pulled that together in a one page overview, simply filling in new data points should not be too difficult.

Editor's Note - It's hard to be humble when you're bloggin' straight out of Portland, Oregon.  Tanya Barham is the Founder and CEO of Recess Wellness, a company where all the staff works like little elves at Christmastime to transform their client's workplaces into healthy, happy, productive places akin to Santa's workshop at the North Pole.  Seriously.  Of course, Santa's fat, so they still have work to do.