The American Association of Family Physicians’ Web site, www.aafp.org, offers a recommended adult immunization schedule created by the Advisory Committee on Immunization Practices. This schedule, tiered by age and chances of exposure, recommends diphtheria, tetanus, influenza, pneumonococcal, hepatitis B, hepatitis C, measles, mumps and rubella, varicella and meningococcal vaccinations.

Ideas to incorporate prevention and early detection:

• Hold a wellness fair and invite organizations that provide screening services for such conditions as blood pressure, blood iron, cholesterol, body mass index (BMI) and diabetes.
• Offer educational materials about well-baby care and immunizations.
• Choose medical coverage plans that include wellness check-ups and immunizations.
• Offer worksite mammograms for workers.
• Sponsor worksite flu shots to coincide with flu season.

Studies have shown that heart patients who attend stress management programs have 42 percent lower medical costs. Other studies have documented a 50 percent reduction in medical services use when stress management programs are employed. Further, Employee Assistance Program (EAP) experts estimate that 20 percent of any workforce is affected by personal problems that can influence work performance.

Stress reduction tactics to consider:

• Offer worksite yoga or meditation classes.
• Organize support groups among workers.
• Sponsor stress management classes during the workday.
• Offer an employee assistance program that includes both counseling and referral.
• Offer worksite counseling for workers in the case of a work-related trauma, such as the death of a co-worker.

The old adage “an ounce of prevention is worth a pound of cure” is particularly relevant to when applied to preventive measures taken during pregnancy, when a few extra ounces of birth weight can save a child’s life. During pregnancy, simple precautions can help avoid catastrophic results; giving up smoking, for instance, drastically reduces the risk of miscarriage and pre-term labor.

The March of Dimes reports that if all women took adequate folic acid before conception and during pregnancy, the number of babies born with a neural tube defect could drop by as much as 70 percent. The physical and emotional benefits of proper prenatal care to a mother and child are underscored by a strong company case for offering prenatal wellness benefits. Nationwide’s Chief Medical Director, Dr. Michael Moore, estimates costs to care for one baby delivered prematurely could approach $500,000.

First steps in fostering a prenatal program:
• Invite the March of Dimes to present information about prenatal health at an staff member brownbag lunch or breakfast meeting.
• Hold prenatal care information classes for interested workers at lunchtime.
• Offer educational materials about the effects of alcohol, drugs and smoking on an unborn child.
• Offer incentives for adopting healthy lifestyles during pregnancy.
• Offer prenatal programs and education as part of the company medical package.

Instances of respiratory diseases, cancer and other illnesses can be decreased through smoking cessation efforts. smoking cessation programs can provide huge opportunities for improved health.

The American Cancer Society reports that smoking workers cost corporations an average of $1,429 per smoker per year in increased medical costs over non-smoking workers. Implementing a smoking cessation program costs an average of $45 per staff member per year, saving corporations an average of $1,383 per year for each staff member who quits smoking. Additionally, the American Cancer Society reports that smokers are absent from work 50 percent more often than nonsmokers. They are also 50 percent more likely to be hospitalized and have 15 percent higher disability rates. smoking decreases onthe- job productivity as well. Employees who take four 10- minute smoking breaks a day work more than a month less per year than workers who don’t take smoke breaks.

Places to start with smoking cessation programs:

1.    Start a company policy prohibiting tobacco use anywhere on the property.
2.    Offer prompts/posters to support no tobacco use policy.
3.    Policy supporting participation in smoking cessation activities during duty time (flex-time).
4.    Offer counseling through an individual, group, or telephone counseling program onsite.
5.    Offer counseling through a healthcare plan sponsored individual, group, or telephone counseling program.
6.    Offer cessation medications through health insurance.

Nutrition directly impacts nearly every aspect of physical and mental health. A healthy diet can help protect against such conditions as heart disease, diabetes, arthritis, stroke, certain cancers and depression. Obesity, which is among the most common conditions linked to diet, affects a record number of Americans.

The American Journal of Health Promotion estimates the cost of obesity to U.S. company to exceed $12.5 billion in health care, sick leave, and life and disability insurance. Further, one study reports that obesity raises medical costs by 36 percent and medication costs by 77 percent. To offset the health risks of obesity and poor diet, many corporations have committed to helping workers ensure proper nutrition and undertake weight control programs.

Popular nutrition programs:

Fruit and Vegetable Consumption
1.    Offer healthy eating reminders and prompts to workers via multiple means (i.e. e-mail, posters, payroll stuffers, etc.).
2.    Offer appealing, low-cost fruits and vegetables in snack machines and in the cafeteria.
3.    Offer cookbooks, food preparation, and cooking classes for workers’ families.
4.    Ensure onsite cafeterias follow healthy cooking practices and set nutritional standards for foods served that align with the U.S. Dietary Guidelines for Americans.
5.    Offer healthy foods at meetings, conferences, and catered events.
6.    Use point-of-decision prompts as a marketing technique to promote healthier choices.
7.    Offer healthy cooking demonstrations that teach skills (i.e. fruit and vegetable selection and preparation).
8.    Offer taste-testing opportunities at the workplace.
9.    Offer staff member-led campaigns, demonstrations or programs.
10.    Offer local fruits and vegetables at the workplace (i.e. workplace farmer’s market or community-supported agriculture drop-off point).
11.    Use competitive pricing (price non-nutritious foods in snack machines and cafeterias at higher prices).
12.    Offer protected time and dedicated space away from the work area for breaks and lunch.
13.    Make kitchen equipment available to workers.
14.    Offer an opportunity for onsite gardening if possible.

Sweetened Beverage Consumption
1.    Make water available throughout the day.
2.    Offer appealing, low-cost healthful drink options in snack machines and the cafeteria.
3.    Modify worksite snack contracts to increase the number of healthy options.
4.    Price non-nutritious beverages at a higher cost.
5.    Use point-of-decision prompts to promote healthier choices.

Portion Control
1.    Label foods to show serving size and/or nutritional content.
2.    Offer food models, food scales for weighing and pictures to help workers assess portion size.
3.    Offer appropriate portion sizes at meetings, workplace events and in the cafeteria.

Nutrition programs in action

While many corporations address weight management through fitness initiatives, corporations are increasingly focusing on nutrition through separate programming. Recognizing the productivity boost and lowered medical expenditures that come with maintaining a healthy weight, many corporations may help pay for obesity treatments for workers. For example, to enhance the health of dangerously obese workers, drug maker Wyeth reportedly pays for stomach-shrinking surgeries that carry price tags of up to $40,000.

A 2003 Society of Human Resource Management study shows that 24 percent of employers offer weight loss programs. In Ohio, Honda offers an onsite, registered dietitian who provides individual or group consultations on weight management. Body fat assessment and body mass index (BMI) measurements are available to workers at any time.

At Grange Insurance’s Columbus headquarters, the cafeteria chef analyzes meals and provides workers basic nutrition information, including Weight Watchers points. Many corporations partner with the American Cancer Society to offer nutrition information through the ”5-ADay” program, which provides employers free signage and educational materials about the importance of eating five servings of fruits and vegetables a day. The program also offers a fruit and vegetable ”frequency card” that gives workers a free portion of fruit or vegetables after he or she has purchased a preset number.

Exercise reduces weight, lowers risks of heart attack and stroke, helps to control blood pressure and diabetes, and improves mood. Studies increasingly show that physical fitness may also help reduce the occurrence of certain types of cancer. Researchers at the Centers for Disease Control and Prevention (CDC) recently documented another major advantage: physical fitness improves the health of the nation’s medical care expenditures.3 According to the CDC, physically active individuals incur $865 less per year in medical costs than inactive workers.

Dr. Michael Moore, vice president and chief medical director at Nationwide Insurance in Columbus, maintains that physical fitness is the most effective tool in health maintenance. “If you could prescribe exercise in a pill, it would be the number-one prescribed treatment in the world,” he said. In step with Dr. Moore’s prescription, nearly one-third of U.S. companyes help workers pay for gym memberships, according to an Associated Press report. Subsidizing gym memberships is just one way corporations encourage active lifestyles.

Popular Physical Fitness Initiatives:

1.    Allow access to on- and off- worksite gyms and recreational activities before, during, and after work hours.
2.    Offer and encourage participation in after work recreation or leagues.
3.    Offer cash incentives or decreased insurance costs for participation in physical activity and/or weight management or maintenance activities.
4.    Offer shower and/or changing facilities onsite.
5.    Offer outdoor physical fitness areas such as fields and trails for staff member use.
6.    Offer bicycle racks in safe, convenient, and accessible locations.
7.    Offer onsite fitness opportunities, such as group classes or personal training.
8.    Offer an onsite physical fitness facility.
9.    Set up programs that have strong social support systems and incentives, such as:
• Buddy or team physical activity goals
• Initiatives that involve workers and family
• Initiatives to encourage physical activity, such as pedometer walking challenges
• Explore discounted or subsidized memberships at local health clubs, recreation centers, or YMCAs
10.     Offer flexible work hours to allow for physical activity during the day.
11.    Support physical activity breaks during the workday, such as stretching or walking.
12.    Host walk-and-talk meetings.
13. Map out onsite trails or nearby walking routes and destinations.
14. Have workers map out their own biking or walking route to and from work.
15. Post motivational signs at elevators and escalators to encourage stair usage.
16. Offer exercise/physical fitness messages and information to workers.
17. Offer or support recreation leagues and other physical activity events onsite or in the community.
18. Start staff member activity clubs such as walking or bicycling clubs.
19. Offer onsite child care facilities to facilitate physical activity.
20. Sponsor a bike to work day and reward workers who participate.
21. Set up a box and solicit fitness and health tips.

A driving factor behind the push toward wellness spans corporations of all types, sizes and cultures: that is, medical expenses are spilling over the corporate belt buckle. The annual cost of medical services in the U.S. is rising at seven times the rate of inflation. And the rise in medical costs is one boom pundits expect our economy to sustain.1

This trend makes it increasingly challenging for employers to maintain current levels of insurance coverage. In 2003, medical inflation forced 65 percent of corporations to increase workers’ share of health costs.

Seventy-nine percent of large firms said they will increase workers’ share of health costs in 2004.2 But with lost benefits and increased financial burdens come lost morale and productivity.

Employers are searching for another way. While corporations cannot control many of the supply-side elements contributing to rising medical costs—malpractice insurance rates, the nursing shortage—they can help curb demand. That’s why efforts are being redirected from illness to wellness.

The case for Workplace Wellness Programs is supported by an ever growing body of evidence demonstrating the high costs associated with controllable health risks:

• One study reports that obesity raises medical costs by 36 percent and medication costs by 77 percent.
• Michigan officials estimate physical inactivity cost the state nearly $8.9 billion in 2002, a cost estimated to be largely borne by employers through insurance premiums and lost productivity.
• The not-for-profit National Committee for Quality Assurance reports that the estimated average cost for postnatal care for women who did not receive prenatal care was $2,341 more than for women who had. And the indirect costs of unhealthful behavior can be just as high.

Information shows that healthier workers are more productive, spending more time at work and showing increased “presenteeism,” or productivity, while there. Further, healthier workers use fewer medical services. The five leading causes of death in the U.S. — heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes —  are directly linked to unhealthy lifestyles. Clearly, encouraging healthful habits presents an opportunity to enhance workers’ well being, reduce the need for medical services and help control costs.

Offering staff member wellness benefits — large or small — represents an intersection between corporate social responsibility and responsibility to stakeholders. Between staff member health and corporate health. It’s often the right thing to do for workers and employers.

Research by Traveler’s Corp. shows a $3.40 return for every dollar invested in Workplace Wellness Programs. For many corporations, the choice to offer staff member wellness benefits is easy—one where conscience and pragmatism align.

The challenge arises in selecting the programs that will deliver the most impact based on trends in your workers’ health risks and medical claims costs. From large corporations to the corner deli, company owners welcome ways to boost productivity, reduce absenteeism and cut costs. Likewise, Workplace Wellness Programs can range from modest to elaborate.

In determining where to focus a company’s limited resources, looking at costs, benefits and best practices is a good starting point. This section profiles six aspects of wellness and explores their benefits to workers and employers.