Larry Chapman’s Blog

Results-Driven Worksite Wellness

HIPAA in the 21st Century

Source: JAMA Editorial

Author: Larry Chapman

HIPAA has been on the health care scene since 1996. It created some often-awkward change throughout our entire health care system when first introduced. Covered entities had new and fairly extensive requirements to protect the health care consumer from unauthorized disclosures of their personal health information. Now 22 years later we are realizing that with the advent of Facebook, Instagram, email, online marketing, and a myriad number of other communication devices and platforms we need to revisit HIPAA for the 21st Century.

Two well-known lawyer educators have weighed in on the challenges and needs surrounding health information protections post-HIPAA with a sensitive concern for not stifling the emerging utility of “Big Data” analysis potential and cooperating with consumer-directed disclosure.

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I hope this tool helps you reach your wellness programming goals!  Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].

Is Alcohol Safe to Consume?

Source: The Lancet

Author:  Larry Chapman

Almost every culture in human history has used alcohol in some way. But, what level of alcohol use is considered “safe” or “low risk” for us today? Each nation has adopted somewhat different guidelines for what constitutes a safe or low risk level of alcohol consumption. For Americans, according to the CDC, weekly consumption of alcoholic beverages should not exceed 1 drink a day for women and 2 drinks a day for men. That’s 7 drinks per week for women and 14 drinks per week for men to maintain a safe or low risk status regarding alcohol consumption.

Now, a landmark study has just been published in the British medical journal Lancet that examined 83 prospective studies on the effects of alcohol on human health, and particularly all-cause mortality, with 599,912 subjects and some 5.4 million life years of follow-up observations. All this data was then run through a meta-analysis process. They found that for every drink over 5 per week (about 100 grams of alcohol per week) was associated with an average loss of 40 minutes of life. This result has profound implications for the health of Americans and of American workers.

The next step is for the United States Preventive Services Task Force (USPSTF) to examine this evidence and formally weigh in on what new advice on alcohol use should now be given to U.S. citizens by health professionals and authorities. In the meantime, it is probably prudent for wellness programs in U.S. employer settings to share these new findings with employees and their family members.

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NOTE: You will need to have an active WellCert Membership in order to download this document.

I hope this tool helps you reach your wellness programming goals!  Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].

Declining Health-Related Quality of Life in the U.S.

Source: American Journal of Preventive Medicine

Author:  Larry Chapman

Unfortunately, some more bad news!  The health aspects of quality of life of Americans is clearly deteriorating.  This 10-year comparison showed a highly significant erosion of the perceived health-related quality of life ratings from a large national sample of adults (N = 79,402).  People are feeling worse about their health status and its impact on the quality of their lives.

This has relevance to our efforts in worksite wellness.  Many wellness programs have down-played their health emphasis and shifted to a “well-being” emphasis, but this national data questions the wisdom of that shift. The analysis of data from large national population surveys shows that for workers under the age of 55 approximately 22% of the erosion in their average rating of the quality of life was directly due to health or medical-related factors.  For those adults over the age of 55, fully 35% of the erosion was due to health or medical-related factors.

At a population-wide level, the major factors that have contributed to a perception of a lower quality of life by adult Americans were: medical (21.9%; obesity, cardiac disease, hypertension, arthritis, medical injury), economic (15.6%; financial crisis, job loss), substance use (15.3%; substance use disorder or marijuana use), mental health (13.1%; depression and anxiety disorders), and social (11.2%; partner, neighbor, or coworker problems) risks.

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NOTE: You will need to have an active WellCert Membership in order to download this document.

I hope this tool helps you reach your wellness programming goals!  Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].

The State of US Health: Diseases, Injuries and Risk Factors by State: 1990 – 2016

Source: JAMA

Author:  Larry Chapman

The health of the US population is a matter of great importance to our national future.  Few analyses document the patterns, as well as this particular article, does.  This state by state analysis covers the years 1990 through 2016 and includes: Prevalence, incidence, mortality, life expectancy, healthy life expectancy (HALE), years of life lost (YLLs) due to premature mortality, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 333 causes and 84 risk factors with 95% uncertainty intervals (UIs) identified.

Their primary findings reflect a wide difference in the burden of disease at the state level. Specific diseases and risk factors, such as drug use disorders, high BMI, poor diet, high fasting plasma glucose level, and alcohol use disorders are increasing and warrant increased attention. These data can be used to inform national health priorities for research, clinical care, and employer wellness program policies.

In this edition of our blog, we focus on the just-released JAMA article summarizing the state of the health of the US population on a state by state basis.  This data is valuable to employers who are concerned about the health and well-being of their employees and their family members, wherever they are located.

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NOTE: You will need to have an active WellCert Membership in order to download this document.

I hope this tool helps you reach your wellness programming goals!  Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].

CDC’s Built Environment Package

Author:  Center for Disease Control and Prevention (CDC)

The field of public health, over the past decade, has been developing and refining a perspective and technical approach to bring a health orientation to what is called the “built-environment.”  This approach encompasses all man-made environments and how we use them and specifically, public health research has expanded the definition of “built environment” to include healthy food access, community gardens, mental health, “walkability”, and “bikeability”. In public health, built environment refers to physical environments that are designed with health and wellness as integral parts of the communities. Research has indicated that the way neighborhoods are created can affect both the physical activity and mental health of the communities’ residents. Studies have shown that built environments that were expressly designed to improve physical activity are linked to higher rates of physical activity, which in turn, positively affects health and supports worksite wellness efforts.

In this edition of our blog, we focus on the just-released package created by CDC to help employers and communities create environments that help support personal wellness behaviors.

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NOTE: You will need to have an active WellCert Membership in order to download this document.

I hope this tool helps you reach your wellness programming goals!  Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].

Corporate Wellness Services Industry in the U.S.

Author:  Sarah Turk, IBISWorld

What services constitute the corporate wellness industry?  How big is our industry in financial terms?  How many are corporate wellness services vendors out there?  These are just a few of the answers you will find in this edition of the Connections newsletter.

Why is this important?
This 34-page report provides a concise summary of the size and major characteristics of the corporate wellness services industry in the U.S.    It is important because it is one of the few well-researched and quantitively strong examinations of the size, scope, characteristics and business performance of the corporate wellness industry.

The report provides a great deal of information about market size and the external drivers that are likely to shape the future growth of the industry.  The current overall size of the industry was estimated to be $7.8 Billion in 2016 and is projected to have a future annual growth rate of 7.8% for the next five years.  However, this growth will likely be affected in a major way by the level of corporate profits, the rates of growth in health plan coverage and cost, the number of employees in the labor force and the awareness of the prevalence of modifiable health risk factors.

The report provides validation and credibility of the size and importance of the industry to the U.S. employer community and identifies a range of key characteristics for industry analysis.

Click here to download this document

NOTE: You will need to have an active WellCert Membership in order to download this document.

I hope this tool helps you reach your wellness programming goals!  Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].

Physician Wisdom on Wellness and Well-being

Author:  Larry Chapman

Why is this important?
This short, 4-page interview is important because it includes some great wisdom from the physician’s perspective about how to help patients (aka “employees”) get on the wellness bus. It includes practical tips for anyone advising anybody about succeeding on their wellness journey. Fast, pithy and practical read.

The medical literature is pretty clear that our own doctor(s) have a lot of influence on our health decisions as patients. We hope that this influence will be supportive of the behaviors that our wellness programs advocate, but sometimes this is not the case. A physician may downplay the feasibility of making a major lifestyle health behavior change, suggest a prescription drug, undermining the effectiveness of our wellness program’s efforts with that individual.

Therefore, we need to have some way of helping our employee’s doctor(s) to be supportive of the lifestyle-oriented health improvements we advocate in employee wellness. This article is intended to help with this problem as well as help physicians be more effective in advising patients on wellness issues.

Click here to download this document

NOTE: You will need to have an active WellCert Membership in order to download this document.

I hope this tool helps you reach your wellness programming goals!  Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].

Are we doing enough about Cancer?

Author: Larry Chapman

Think about that employee of yours that this year will receive a diagnosis with the “C” word.  Pretty chilling huh!  Even with the steady improvements in cancer incidence and survivability, it is still a primary health concern for a major portion of your employees.  The American Cancer Society (ACS) just released its national cancer estimates for 2018 that puts some perspective around this powerful health and wellness issue.

Wellness program managers would do well to look for some meaningful opportunities to help inform and educate employees about the health risk factors and treatment issues associated with cancer diagnosis, treatment and prevention.  Here are some suggestions:

  • Examine your health/well-being survey for cancer risk related questions.
  • Make sure the personal reports you provide to participants address cancer-related risk reduction.
  • Create an opportunity to use some of the global data in this article to raise awareness about cancer risk.
  • Remind employees through wellness coaches to make sure they have a PCP and to ask about cancer prevention.
  • Make sure your health plan has resources and services to help those who are newly diagnosed find their way through the health care “maze” when it comes to cancer treatment.
  • Look for an opportunity to incent your employees and their family members to stay “current” on all preventive screening that is cancer-related.
  • Review how your employees can access health plan provided, consumer information on cancer treatment and services including price transparency and options.
  • Keep an eye on the patient cost-sharing load for cancer patients so that we don’t financially overwhelm our employee families during treatment and follow-up.
  • Consider doing a lunch and learn session on cancer risk reduction strategies and issues.
  • Explore the possibility of a lunch and learn session on what to do if you or a family member gets a cancer diagnosis.
  • Depending on your work culture consider addressing complementary and alternative medical options.
  • Examine the option of looking at the primary, secondary and tertiary prevention issues connected with cancer. (Hint: primary = precursors, secondary = early detection, tertiary = help after confirmed diagnosis)

Lots of different things that can be done to help your employees deal with cancer issues.

Click here to download this document

NOTE: You will need to have an active WellCert Membership in order to download this document.

I hope this tool helps you reach your wellness programming goals!  Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].

The CDC Worksite Health ScoreCard

Author: Larry Chapman

The CDC Worksite Health ScoreCard (HSC) is a tool designed to help employers assess whether they have implemented evidence-based worksite health promotion and wellness interventions or strategies in their worksites to prevent heart disease, stroke, and related conditions such as hypertension, diabetes, and obesity.

The tool was developed by the CDC Division for Heart Disease and Stroke Prevention in collaboration with the Emory University Institute for Health and Productivity Studies (IHPS), the Research Triangle Institute, the CDC National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) Workplace Workgroup, and an expert panel of federal, state, academic, and private sector. To ensure the validity and reliability of the tool, a validation study was conducted by Emory University’s IHPS on the tool’s original 12 modules.

This study involved a national sample of 93 employers of variable size who agreed to pilot test the survey and provide feedback on the survey’s content and structure. In 2013, four additional modules were developed and tested using a similar protocol as the original validation study. For more information on how the tool was developed and validated, refer to the Frequently Asked Questions (FAQs) in Appendix A.

The types of issues addressed in this document includes:

  • 126 questions that employers can ask of their comprehensive worksite health promotion programs.
  • Steps for use of the CDC Worksite Health ScoreCard.
  • Instructions for using the ScoreCard.
  • 16 health-related domains are included in the ScoreCard.
  • Active links to key health and wellness technical evidence sources.

Worksite Wellness professionals can use this information to:

  • Compare their own programming to evidence-based sources.
  • Educate management and employees about the technical soundness of their employee wellness programming.
  • Utilize these recommendations to help formulate additional organizational and wellness programming strategies.
  • Formulate an evidence-based organizational perspective on employee wellness programming.

In summary, this 81-page program management tool contains a survey and scoring process to help employers utilize evidence-based interventions and represents a thorough appraisal of current scientific thinking about worksite wellness programs, and therefore is of significant value to worksite wellness professionals.

Click here to download this document

NOTE: You will need to have an active WellCert Membership in order to download this document.

I hope this tool helps you reach your wellness programming goals!  Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].

Obesity in the Workplace: Impact, Outcomes, and Recommendations

Author: Larry Chapman

The American College of Occupational and Environmental Medicine (ACOEM) is the authoritative group that provides guidance to health professionals that serve and care for employee populations in work organizations.  This guidance statement provides a consensus among occupational health professionals about the impact, outcomes to be expected and recommendations for dealing with obesity in working populations.  Obesity status affects approximately 37.7% of the U.S. adult population and represents a major concern of virtually all employee and worksite wellness initiatives. A body mass index (BMI) of ≥ 30 kg/m2 is the generally accepted threshold for obesity.

Objective: To conduct a comprehensive literature review to develop recommendations for managing obesity among workers to improve health outcomes and to explore the impact of obesity on health costs to determine whether a case can be made for surgical interventions and insurance coverage. Methods: We searched PubMed from 2011 to 2016, and CINAHL, Scopus, and Cochrane Registry of Clinical Trials for interventions addressing obesity in the workplace. Results: A total of 1419 articles were screened, resulting in 275 articles being included. Several areas were identified that require more research and investigation. Conclusions: Our findings support the use of both lifestyle modification and bariatric surgery to assist appropriate patients in losing weight.

The types of issues addressed in this article includes:

  • Methodology used by ACOEM to weigh the evidence for evaluating the outcomes of employer efforts to reduce obesity.
  • Estimates of the economic burden associated with obesity.
  • Staging of obesity and its health and safety impact.
  • Impact of the workplace on obesity.
  • Social stressors and psychosocial work factors.
  • Recommendations for lifestyle modification interventions.
  • Pharmacotherapy recommendations.
  • Surgical interventions and emerging invasive therapies.
  • Recommendations for employers about obesity treatment and prevention.
  • Research gaps concerning obesity in the workplace.

Worksite Wellness professionals can use this information to:

  • Compare their own approaches to obesity with the ACOEM recommendations.
  • Educate management and employees about the economic and productivity costs of obesity.
  • Utilize these recommendations to help formulate organizational and wellness strategies.
  • Formulate organizational perspectives about obesity and overweight issues in their workforce.

In summary, this is an authoritative and recent source of information and consensus about the major problem of obesity among working Americans and provides summary information and recommendations that are useful for worksite wellness professionals.

Click here to download this document

NOTE: You will need to have an active WellCert Membership in order to download this document.

I hope this tool helps you reach your wellness programming goals!  Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].