1. Worksite Wellness in Arkansas Presented byHelen Weir (ADH) & Rhonda Hill (ACHI) October 21, 2010
2. Economic Burden of Chronic Disease • U.S. spends $2.2 trillion on health care annually • .75 cents of every dollar is spent on managing chronic conditions • One-third of the cost alone is due to obesity
3. Economic Burden of Chronic Disease Reported Cases in Arkansas, (projected 2009 and as % of population) Cancers (all): 149,896 5.2% Diabetes: 146,964 5.1% Heart Disease: 249,276 8.7% Hypertension: 470,771 16.5% Stroke: 33,491 1.2% Emotional Disturbances: 305,331 10.7% Pulmonary Conditions: 542,322 19.0%
4. Economic Burden of Chronic Disease Economic impact in Arkansas, projected 2009 (Annual Cost in Billions) Treatment Expenditures: $3.65 Lost Productivity: $17.2 Total Costs: $20.85
5. Social Ecological Model
6. Collaboration & Partnership Arkansas Department of Health Arkansas Center for Health Improvement Arkansas Coalition for Obesity Prevention (ArCOP)
7. Arkansas Coalition for Obesity Prevention • Grassroots, statewide collaboration that stemmed from 2007 Southern Regional Obesity Summit • Identified that we were all working toward the same goal – yet separately • Pooled resources, work plans, and overarching goals and objectives • 200 + members with over 75 partnering entities
8. ArCOP Mission: to improve the health of all Arkansas communities by increasing physical activity and healthy eating to reduce and prevent obesity. Vision: all Arkansans value and practice healthy lifestyles through created and supported opportunities of increasing physical activity and healthy eating. Goal: Increase the percentage of Arkansans of all ages who have access to healthy and affordable food and who engage in regular physical activity.
9. Coalition Partners American Cancer Society Community Health Centers of Arkansas American Heart Association Daughters of Charity Services of Arkansas - SE AR Arkansas Academy of Pediatrics Delta AHEC Arkansas Advocates for Children and Family Delta OPRU, ARS, USDA Arkansas Blue Cross and Blue Shield Evangelistic Ministries Arkansas Center for Health Improvement Frueauff Foundation Arkansas Children‟s Hospital Heifer International Arkansas Community Foundation Hendrix University Arkansas Coordinated School Health JB Hunt Transport Services Arkansas Department of Education Kutak Rock Firm Arkansas Department of Health LifeSynch Arkansas Department of Human Services Metroplan Arkansas Foundation for Medical Care Midwest Dairy Council Arkansas Governors Office North Arkansas Partnership for Health Education Arkansas Head Start State Collaboration Office North Little Rock First United Methodist Church Arkansas Head Start TA Network PE4Life Academy (Rogers, AR) Arkansas Hunger Alliance Pfizer Arkansas Injury Prevention Center, Phoenix Youth and Family Services Arkansas Minority Health Commission Pulaski Technical College Arkansas Parks and Tourism Results Fitness 24/7 Arkansas State Highway and Robert Wood Johnson Foundation, Center to Prevent Transportation Department Childhood Obesity Arkansas State & Public School Safe Routes to School Program Employee Life & Health Insurance Plan St. Francis House Community Clinic (Northwest AR) Arkansas State University United States Department of Agriculture, ARS Baptist Health University of Arkansas Division of Agriculture Blue & You Foundation for a Healthier Arkansas University of Arkansas at Little Rock Central Arkansas Transit Authority University of Arkansas for Medical Sciences Clinton School of Public Service University of Arkansas at Pine Bluff ComMetrics Inc.
10. Examples of Non-Traditional Partners • Metroplan • CATA • JB Hunt Transportation Services • NLR First United Methodist Church • Evangelistic Ministries • US Department of Agriculture • AR Hwy and Transportation • AR Parks and Tourism • AR Game and Fish • AARP
11. ArCOP Workgroups Access to Healthy Foods Built Environment Determine existing needs statewide and among Collaborate with city and town planners to various sub-populations regarding access to promote physical activity by developing healthy foods pedestrian and bicycle friendly neighborhoods Identify existing programs that support access to that offer convenient, pleasant, and safe non- healthy foods and determine additional motorized links between residences, schools, programming and service needs shopping, and recreational facilities WORKGROUPS Identify programmatic barriers and determine Encourage active lifestyles by incorporating well strategies and resources needed for designed, mixed-use development that permits successful implementation high quality of life with reduced need for vehicles to conduct daily activities Worksite Wellness Health Care Empower employers to combat obesity in the Engage with providers and insurers to improve workplace quality of life and reduce total long-term costs Collaborate with local, state, and national of health care due to obesity and related resources to identify best practices for chronic disease workplace obesity intervention programs in an Collaborate with health care providers, employers effort to decrease obesity and other chronic and other organizations who are purchasers of diseases across Arkansas coverage and insurance companies or other payers to ensure coverage for obesity Early Childhood and Schools Collaborate with parents and communities to create a unified environment that promotes healthy eating and physical activity
12. ArCOP Workgroups (cont.) • Policy Development • Social Marketing • Evaluation • Executive Team
13. Worksite Wellness Work Plan Goal: Increase the percentage of Arkansans of all ages who have access to healthy and affordable food and who engage in regular physical activity. Strategy: Improve worksite health environments.
14. Worksite Wellness Work Plan Objectives: • Establish an electronic clearinghouse for model worksite wellness programs and resources. • Double the size of the Arkansas worksite stakeholder group. • Hold 5 regional worksite health summits. • Create healthy worksite award. • Encourage development of policy/system change to support healthy worksite environments.
15. Regional Summits • Five Regional Summits+ one • Marketing • Partner involvement • Lessons learned • Evaluation results
16. ArCOP – Growing Healthy Communities
17. Resources • AHELP New web site for State of Arkansas workforce http://ahelp.arkansas.gov • Sister web site for state employees, businesses and departments at worksites interested in establishing or enriching the programs for the health of the workforce. Partnership participation in setting up resources ArCOP. http://worksitewellness.arkansas.gov
18. Arkansas Healthy Employee Lifestyle Program(AHELP) Comprehensive worksite wellness program Web-tracking behavioral intervention (points assigned) Cardiovascular, aerobic physical activity Fruits and veggies No tobacco Act 724 of 2005 granted up to three days off with satisfactory participation per calendar year UNC Centers for Excellence features AHELP as an “Emerging Intervention for Obesity Prevention http://www.center-trt.org
19. HRA Response Rates Across 5 Years *ASE only
20. Average Annual Total* Costs Linked to Any Tobacco Usecompared with Non-tobacco Use by Age Group $1,863 $8,261 (29%) $9,000 $8,000 $6,398 Non-tobacco user $5,615 $7,000 Tobacco user $4,522 $6,000 $3,936 $3,598 $5,000 $3,078 $2,738 $4,000 $2,394 $2,291 $1,630 $1,625 $3,000 $2,000 $1,000 $0 18 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74 *Includes medical (inpatient and outpatient) and pharmacy costs for state employees.
21. Average Annual Total* Costs Linked to 5+ days/wk of physical activity compared with No weekly activity by Age Group $12,789 $5,546 (77%) $11,447 $14,000 5+days/wk of physical activity $12,000 No weekly physical activity $10,000 $7,243 $6,838 $8,000 $4,389 $4,106 $3,336 $6,000 $3,127 $2,631 $2,045 $1,578 $4,000 $1,086 $2,000 $0 18 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74*Includes medical (inpatient and outpatient) and pharmacy costs for state employees.
22. Average Annual Total* Costs Linked to Normal Body Mass Index compared to Obese BMI by Age Groups $8,143 $9,000 $2,172 Normal Weight BMI (36%) $8,000 Obese BMI $5,971 $5,685 $7,000 $4,762 $4,450 $6,000 $3,470 $5,000 $3,200 $2,522 $2,504 $4,000 $2,302 $1,622 $1,605 $3,000 $2,000 $1,000 $0 18 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74*Includes medical (inpatient and outpatient) and pharmacy costs for state employees.
23. ROI of Worksite Wellness Programs inEconomically Challenging Times Top 5 Strategies 1.Tap into your insurance plan‟s willingness to pay for wellness. 2.Create a benefit design so wellness can be cost neutral. 3.Implement worksite policies & environmental changes that support healthy living. 4.Use the right wellness messages to enhance engagement & increase participation. 5.Make use of your free community resources. WELCOA-2009
24. Small Business Interventions 10 Essential Things That Small Business Leaders Can Do To Promote Better Health 1.Issue letter of support to employees 2.Designate a company wellness leader 3.Conduct employee health interest survey 4.Provide Health Screenings/Health Risk Assessments opportunities 5.Physical activity campaign WELCOA-2009
25. Small Business Interventions (cont‟d) 10 Essential Things That Small Business Leaders Can Do To Promote Better Health 6. Hold Lunch „n Learns 7. Establish an in-house library or electronic resource center 8. Disseminate a quarterly newsletter 9. Implement health promoting policies 10. Promote community health efforts Small businesses: Steps toward increasing the health & well-being of their most valuable asset……….. Their employees and their families
26. The Power of Prevention Epidemic of Unparalleled Proportions ________substantiated by hard facts • More than 1.7 million Americans die of a chronic disease each year Five chronic diseases •Heart Disease •Cancer •Stroke •Chronic Lung Disease •Diabetes CDC-Chronic Disease
27. Reasons for Prevention Cancer- $171.6 billion, of this amount, $60.9 billion was due to direct medical costs and $39.8 billion to lost productivity Obesity- estimated $117 billion, of this amount, $61 billion due to direct medical costs and $56 billion to lost productivity CV Disease and Stroke- $351.8 billion , of this amount, $209.3 billion due to direct medical costs and $142.5 billion to lost productivity CDC
28. Prevention Chronic disease risk factors also place huge economic demands on our nation and state Lost Productivity: Smoking-more than $80 billion Poor Nutrition- $ 9 billion related to heart disease, cancer, stroke, and diabetes What did it cost your business? CDC
29. Prevention Three modifiable health-damaging behaviors Tobacco Use Lack of Physical Activity Poor Eating Habits 33% of all U.S. deaths can be attributed to these behaviors
30. ArCOP – Worksite Wellness • Strategy – Improve worksite health environments • Objectives – Establish an electronic clearinghouse for model worksite wellness programs and resources (12/31/09) – Double the size of the Arkansas worksite/employer stakeholder group from 10 to 20 members (6/30/2010) – Hold 5 regional worksite health summits (6/30/2010) – Create healthy worksite award (12/31/2010) – IN PROCESS/ONGOING Encourage development of policy/system change to
31. Healthy WorkforceThe workplace is an ideal environment for cultivating a healthy life style 45% of a persons waking hours are spent in the workplace 82% of the U.S. population is linked in someway to a worksite Worksites can be environments that promote health or that create barriers to health Healthy Workforce 2010, Partners for Prevention (2001)
32. Arkansas Worksite Wellness Healthy Arkansas Initiative 2004 Arkansas Department of Health and Arkansas Department of Human Services pilot intervention Healthy Employee Lifestyle Program (HELP)
33. Arkansas Workforce Wellness Representative Linda Chesterfield sponsored Act 724 of 2005 giving an incentive for healthy behaviors and actions for State of Arkansas employees - Up to 3 days leave for satisfactory participation in the AHELP web tracking program of physical activity, fruits and vegetables, and no tobacco use. - In addition, annual HRA and age-appropriate screenings give points in the system. Arkansas Healthy Employee Lifestyle Program (AHELP) Roll-Out to all state agencies, boards, and commissions Arkansas Law, Act 724 of 2005
34. Arkansas WorkforceWellness Arkansas Worksite Wellness • AHELP goals: • Reduce the number of employees who use tobacco • Improve the nutritional choices available to employees • Increase the number of employees getting age- appropriate health screenings • Increase the number of employees who participate in physical activity • Increase the number of employees who are at healthy weight
35. Arkansas WorkforceWellness Arkansas Worksite Wellness • Based on Health Risk Assessments (HRAs) completed between February 2005 and March 2006*: • Cholesterol - 12% increase in percent of participating employees in the lowest risk category • Physical Activity/Exercise - 12% decrease in percent of participating employees in the “high risk” or “borderline risk” category • Nutrition - 26% increase in percent of participating employees in the lowest risk group * Arkansas Department of Health and Human Services
36. Arkansas WorkforceWellness Arkansas Worksite Wellness • As of June 2008, there were 2427 registered participants in AHELP • Since AHELP‟s inception in April 2005: • 648 participants have earned and redeemed the incentive of 1-hour off in time from work • 39 participants earned 1-day leave • 40 participants earned 2-days leave • 108 additional participants earned 3-days leave • 6 available passes for 2-days at an Arkansas State Parks Lodge earned • In 2006 alone, over 440 other prizes redeemed
37. Arkansas Workforce Wellness Resources will be available soon on the New Website for Lifestage Health Branch Adults in Worksites: www.AHELP.arkansas.gov Contact: Helen Weir, Administrator Helen.Weir@arkansas.gov
38. Arkansas Tools for a Healthy WorkforceArkansas Department of Health with their multiple partnerships and collaborationsOther state partnerships through the guidance of Center for Disease Control and Prevention (CDC)Proven strategies, promising strategies and expert opinion strategies
39. ToolsCDC Evidence-Based Focus Areas: Increase fruit & vegetable consumption Decrease sweetened beverage consumption Decrease food portion size (portion control) Increase physical activity Increase Breastfeeding Increase smoking cessation in adults Increase the proportion of worksites with formal No- Smoking policies Healthy Workforce 2010; Partners for Prevention (2001)
40. Healthy HabitsNutritionEat for Color: Green, Orange/yellow, Red, Blue/purple, and White Eat 5 to 9 servings of fruits and vegetables every day May lower your risk of certain cancers, heart disease, and stroke. Helps manage your weight www.5Aday.gov
41. Healthy Habits for Arkansas Physical Activity Adults: Moderate PA for at least 30 minutes on 5 or more days of the week or Vigorous PA 3 or more days per week for 20 minutes or more each time New Guidelines 2008 cdc.gov/nccdphp/dnpa/physical
42. Physical ActivityWhy is PA important?Reduces your risk of: Heart disease and stroke, cancer, diabetes and high blood pressure Helps control weight Keeps bones, muscles and joints healthy Reduces falls in older adults reduces symptoms of anxiety & depression cdc.gov/dnpa
43. Healthy HabitsTobacco:Don‟t Smoke, Chew, or DipThere is no safe tobacco. • If you use tobacco QUIT • If you don‟t….. don‟t start QUIT NOW ! Call it quits 1-866-NOW-QUIT Arkansas Department of Health SOS Facts
44. TobaccoArkansas Statewide Tobacco Programs and Services (AR Stops)SOS QuitlineSOS Works- Fax-back Referral ProgramArkansas Tobacco Cessation Network
45. ResourcesHeart-Healthy and Stroke-Free Worksites Successful Business Strategies to Prevent Heart Disease and Stroke Reducing the Risk of Heart Disease and Stroke: A six-step Guide for Employers Arkansas Department of Health- • Heart and Stroke Prevention Program • Diabetes Program www.cdc.gov/CVH
46. Arkansas Department of Health Lifestage Health Branch &Heart Disease and Stroke Prevention Section Adults in Worksites Helen Weir, RN, BSN email@example.com
47. Magnolia + Community response is increasing + Increase in individuals attending GHC Coalition meetings + Mayor and representatives for the Chamber of Commerce are participating − GHC is a BIG project − Keeping people engaged and enthusiastic Suggestion: Look beyond traditional partners - youth groups and organizations, faith-based groups mission programs, 4-H programs, Future Farmers, etc.
48. Batesville + Water bottles are now included in park vending machines + White River Community Garden has been established and individuals are decorating plots + All plots were rented shortly after grand opening + Mayor was asked to participate in the national 2010 Obesity Conference (ATL) − Keeping people involved and showing up for events Suggestions: Look beyond traditional partners. Share in tasks.
49. Little Rock – Arkansas Baptist College + Menu policy has been developed for use in the Arkansas Baptist College (ABC) cafeteria to offer healthier options + A Fresh Market is scheduled to open in July + Partnering with AR Children‟s Hospital to implement a community garden + Hired a full-time gardener − Getting community Health Advisory Board recruited and engaged. They have already enlisted some community members to serve on the board.
50. Harrison + City sponsored a community garden plot of land centrally located + Public declaration by Mayor + City will provide water to the site + Storage building was purchased to store our tillers, gardening materials, etc. + Community champion identified − Slow everyone down enough to establish and adopt policies and procedures that will help sustain the concept − Find a long-term entity to take “ownership”