Are Your Workers Safe Healthy and Engaged with Casey Chosewood


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Are Your Workers Safe Healthy and Engaged with Casey Chosewood

  1. 1. Safe, Healthy, and Engaged How Protecting and Promoting the Healthof Your Employees Can Build a Culture of Wellness Webinar with June 10, 2011 L. Casey Chosewood, MD – Sr. Medical Officer, Total Worker Health National Institute for Occupational Safety and Health Centers for Disease Control and Prevention 1
  2. 2. Disclaimer• The mention of organizations and commercial entities and products in this presentation is for illustrative purposes only and does not represent an endorsement by CDC or the US Department of Health and Human Services.• The views herein represent those of the authors and presenter. For official guidance from the Centers for Disease Control and Prevention, visit 2
  3. 3. The U.S. Has a Critical Shortage of Health The U.S. spends > $2 trillion every year on healthcare… more than any other country.• Yet, among all countries of the world, the U.S. ranks: • 35th in infant mortality prevention • 30th in life expectancy at birth 3
  4. 4. The U.S. Has a Critical Shortage of Health• The US is one of the leading countries for cancer risk-- largely due to tobacco• Coronary heart disease rates are high, diabetes rates and risk factors are increasing• High levels of violence-related death are present• Leading causes of premature death: tobacco, poor diet and physical inactivity, alcohol, microbial agents, toxic agents, motor vehicle crashes, firearm-related incidents, sexual behaviors, drugs 4
  5. 5. “We spend less than four cents of every health care dollar on prevention and public health even though eighty percent of the risk factors involved in the leading causes of death are behavior-related and thus preventable.” President Barack Obama 5
  6. 6. What’s Driving Up the Cost of Healthcare?• Increasing prevalence of disease Especially obesity, diabetes, and heart disease• Continuing technological innovations• Increasing treatment intensity and duration• Delivery system inefficiencies• Over- and under-utilization 6
  7. 7. Between 1987 to 2005, healthcare utilizationincreased significantly • Mental Health Conditions 242% • Elevated Lipids 860% • High Blood Pressure 62% • Diabetes 100% • Pulmonary Disease 94% • Back Pain 180% 7
  8. 8. Quick Quiz QuestionCompared to one generation ago, how muchwould a dozen eggs cost today if they had risenin price at the same rate as healthcare? 8
  9. 9. Quick Quiz Answer $80.25(that’s $6.69 per egg) 9
  10. 10. The Deadliest Threats Facing CDC Cardiovascular Disease CancerExtreme diet Extreme environment Diabetes Preventable Injury Extreme convenience Extreme aging 10
  11. 11. Obesity Trends* Among U.S. Adults, 1990 (*BMI 30, or about 30 lbs overweight for 5’4” person)No Data <10% 10%-14% 15%-19 20%-24% 25% Source: Behavioral Risk Factor Surveillance System, CDC 11
  12. 12. Obesity Trends* Among U.S. Adults, 2008 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) (*BMI 30, or about 30 lbs overweight for 5’4” person)No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Source: Behavioral Risk Factor Surveillance System, CDC 12
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  15. 15. Isn’t Behavior Change Enough?Sir Michael Marmot ― It is unreasonable to expect people to change their behavior when the social, cultural and physical environments around them fully conspire against them….‖Adapted from M. Marmot/Institute of Medicine Report 15
  16. 16. What is health? Am I healthy? Do I care if others in my life are healthy? What influences my health?Does this job help make me healthier? How can my workplace help me change my health? Does my boss care if I am healthy? 16
  17. 17. A comprehensive worksite health promotion program contains…o Strong senior leadership commitmento Worker protection and respect as the primary cornerstoneo High quality occupational health and safety programmingo Adequate social, technical and programmatic supporto A variety of opportunities for health enhancement for persons at all ages, interests, abilities, and health and fitness levelso Frequent, clear communication, marketing, and brandingo Strong evaluation and process improvement processo See all 20 at 17
  18. 18. Does Your Company Have These Policies to Support Health?• Tobacco-free campus• Flexible work/schedule policies o Leave, telework, job share, parental/dependent care• Nutritious foods-at-meetings policy• Healthy transportation policies• Smoke-free meetings policy• Time during work hours for wellness activities o Training or educational opportunities, health fairs, events o Screenings, health coaching, EAP o Physical Activity (efforts in progress) 18
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  20. 20. Key Work-Life Balance Truths• Workers Want, Need and Will Seek Out More Flexibility• Organizing Work around People Works Better than Organizing People around Work• Every workplace policy will have some effect on the health and wellbeing of workers—take steps to make sure it is a positive one• View every workplace decision through the lens of ―the health and wellbeing of the worker‖ 20
  21. 21. Work and Life: Acknowledge the Balancing ActProvide links to your community’s parentingand adult care resources: referrals, articles,podcasts, webinars, forums, list servs, blogs• Develop specific resource kits around critical topics o Autism Information and Resources o Prenatal period o Parenting Teens o Lactation o Family Wellness, Nutrition and o A New Parents Return to Work o Adult Care-giving o Child Safety o Grief and Loss o College: Decision support and Financing o Others from your own experiences o Children with ADHD
  22. 22. Designing Healthier WorkplacesCan You Become a “Choice Architect”?• Choice-making is never neutral• Directing default options toward health can be powerful• Subtle ―nudges‖ toward healthier choices can improve health outcomes• Policy interventions provide a strong basis for better choices• Incentives and spotlights can motivate• Providing structure around complex choices helps Themes from Thaler R, Sunstein, C: Nudge Improving Decisions About Health, Wealth, and Happiness, 2008. 22
  23. 23. Does Your Workplace’s Built Environment Allow Health to Thrive?• Safe, hazard-free workplace• Welcoming, user-friendly, ergo-appropriate workspaces• Commitment to employee respect, engagement, and input• Stairs, walkways, paths, trails that are safe and inviting• Onsite food choices that make eating healthier easy• Transportation and parking options that enhance health• Onsite or nearby health clinic or access to healthcare providers• Fitness facilities or opportunities for physical activity 23
  24. 24. Does Stress Affect Your Workplace? On the average workday in the US, how many employees are absent due to stress? 24
  25. 25. Address the Stress• An estimated 1 million workers are absent every day due to stress. 1• Job stress costs U.S. businesses of over $300 billion yearly due to absenteeism; employee turnover; diminished productivity; medical, legal and insurance expenses; and Workers Compensation payments. 1• Work stress vs home stress? o Craft a less-stressful workplace first o Build resilient workers second• Find out more at Source: 1. American Institute of Stress 25
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  27. 27. StairWELL ProjectSimple changes to dreary stairwells increase usage • Painting • Carpeting • Framed artwork • Motivational signs • MusicLow-cost, high-impact 27
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  33. 33. The Guide to Community Preventive Services (The Community Guide)• Summarizes what is known about the effectiveness, economic efficiency, and feasibility of interventions to promote health and prevent disease• 36
  34. 34. Community Guide Worksite Reviews Physical Activity and Obesity PreventionPromoting Physical Activity and Obesity Prevention o Worksite programs to control overweight and obesity (Recommended) o Point-of-decision prompts to encourage use of stairs (Recommended) o Creation of or enhanced access to places for physical activity combined with informational outreach activities (Recommended) 37
  35. 35. Community Guide Worksite Reviews Assessment of Health Risks with Feedback to Change Employees’ Health BehaviorsAssessment of Health Risks with Feedback (AHRF) o AHRF used alone o Insufficient Evidence o AHRF plus health education with or without other interventions o Recommended 38
  36. 36. Community Guide Worksite Reviews Decreasing Employee Tobacco UseIncentives and Competitions to Increase Smoking Cessation o Incentives and competitions when combined with additional interventions o Recommended, based on sufficient evidence of effectiveness in reducing tobacco use among workers o Incentives and competitions when used alone o Insufficient evidence was found to determine whether or not worksite-based incentives and competitions alone work to reduce tobacco use among workersSmoke-free policies to reduce tobacco use among workers o Recommended, based on sufficient evidence of effectiveness in reducing tobacco use among workers Soler, et al. American Journal of Preventive Medicine, February 2010 39
  37. 37. CDC LEANWorks! 40
  38. 38. CDC Workplace Tools and Resources 41
  39. 39. Total Worker Health• NIOSH is dedicated to the preserving and enhancing the Total Health of Workers• Total Worker Health is a comprehensive organizational strategy that integrates traditional occupational safety and health protection efforts with health promotion and other workplace activities to prevent illness and injury, regardless of cause, so that all workers have opportunities to achieve optimal levels of health and well-being. 42
  40. 40. Total Worker HealthExamples of Integrated Programs o Respiratory protection programs that comprehensively address tobacco abuse o Ergonomic consultations that also discuss arthritis management strategies o Stress management efforts that first seek to diminish workplace stressors, and only then work on building worker resiliency o Integrated training and prevention programs (falls, motor vehicle safety, first aid, hearing conservation, stretching, flexibility and lifting programs) o Comprehensive screenings for work and non-work risks o Occupational health combined with a workplace primary care home model o Full integration of: clinics, behavioral health, traditional safety, health promotion programs, coaching, EAP, nutrition, disability and workers compensation.
  41. 41. Total Worker Health• WorkLife National Centers of Excellence o University of Iowa Healthier Workforce Center for Excellence o Center for the Promotion of Health in the New England Workplace • University of Massachusetts, Lowell • University of Connecticut o Harvard School of Public Health Center for Work, Health and Wellbeing• Research partnerships and advisories with Veterans Administration, Office of Personnel Management, and other federal, labor and private sectors partners
  42. 42. Resources• Centers for Disease Control and Prevention • NIOSH: Worker Health and Safety• NIOSH WorkLife Initiative • Alliance to Make US Healthiest• Essential Elements of Effective Workplace • CDC’s Division of Nutrition, Physical Programs and Policies for Improving Worker Activity & Obesity Health and Well-Being • Smallstep• HHS Physical Activity Toolkit • Community Toolbox• CDC Healthier Worksite Initiative • APHA - Healthiest Nation in 1 Generation• OPM’s Site for Workplace Resources • CDC LeanWorks! althWellness/wellnessresources 45