Larry Chapman’s Blog

Results-Driven Worksite Wellness

Infographic on Mental Health Issues from COVID-19

Source: National Institute of Health Care Management (NIHCM)

What is this about?

This edition of Connections provides a very useful summary infographic on the effects of COVID-19 on the mental health of American workers.  It comes from a think tank funded primarily by the Blues. (NIHCM) The data insights provided in this infographic give tangible evidence for addressing more of the mental health and mental well-being needs of our working populations and can be used to make a stronger case for expansion of employer wellness efforts. This infographic also provides a number of practical suggestions on how our employee wellness programming can be modified to better address these growing needs.

Why is this important?

The significantly increasing mental health needs of our working population due to COVID really needs to be addressed by our wellness programming efforts.  This means that mental health and mental well-being related issues, such as:  depression, discouragement, emotional burnout, chronic excess stress, anxiety, feeling overwhelmed, fitful sleep or sleeplessness, fatigue, lowered resilience and presenteeism have been intensifying since early Spring of this year and our wellness efforts now need to more completely address these issues.  We need to adjust our behavioral and psychological targeting of our programming and design more interventions that are effective in minimizing these problems for employees and their family members.

The ability to address more of these mental health and mental well-being issues is important for four distinct reasons.  First, these mental health and mental well-being issues can act to significantly reduce employee productivity if they are not addressed.  Second, these issues can lead to more serious diseases and conditions including accidents that have both severe human and economic consequences for employers.  Some of the ways mental health and mental well-being issues show up include suicide, drug and alcohol abuse, homicide, homelessness, domestic violence, loneliness, sexual addictions, withdrawal from social life, family dysfunction and abuse. The third reason it’s important is that these mental issues, if left unaddressed are likely to seriously undermine our efforts to find an acceptable “new normal” for business and organizational operations that is sustainable in post-COVID work environments.  Finally, the fourth reason I believe this is important is that these types of issues may well act to obviate personal concern for many of the other related wellness issues, such as, nutrition choices, weight gain, sedentarism, sleep disruptions, apathy, use of preventive sevices and receiving social support.  I am afraid if we are not careful in addressing these mental health and mental well-being issues now we may find ourselves facing even higher percentages of unmotivated and apathetic employees about their personal health and well-being.

What can you do with this document?

  • First, download and read the infographic document to get a sense of the magnitude of the recent deterioration of mental health and well-being status and the recommended steps employers can take.
  • Explore with your health plan(s) wellness staff what services or help they can provide.
  • Next, develop a set of possible program targets and interventions to address these needs.
  • Next, determine who should receive the infographic along with a set of your recommendations for modifying your employee wellness program in this or the next planning/programming cycle.
  • Then, determine which mental health and mental well-being targets the program should address and the companion interventions you are recommending.
  • Then, don’t do too much but what you do, do well!
  • Then, plan your evaluation for how you are going to measure the mental health and mental well-being effects of these wellness interventions.
  • Then, carry out the evaluation plan and report back to senior management on the amount of programming activity conducted, number of participants and any survey or collateral data sources you have planned to use.
  • Finally, propose additional activities for the next program cycle.

In summary, this infographic document provides an overview of the emerging mental health and mental well-being needs of U.S. employees associated with COVID-19 along with a variety of useful suggestions for programming. For a number of important reasons, it is probably best that we begin to systematically address these targets and corresponding interventions with our employees and their family members.

(Everyone can now download this document)

Click here to download this document

If you have any problem downloading the document go to our website and submit a comment.

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

Wellness Programming after COVID-19

What is this about?

The document in this edition of Connections is the latest Solution Set and addresses options and alternatives for how wellness professionals might modify their programs after COVID-19.  A summary of current research on COVID-19 is provided along with an overall assessment of the “big picture.” A concluding excerpt is reproduced below.

“I believe we still need to be careful as individuals who may have significant susceptibilities to the disease, but we certainly don’t have to follow the wholesale and widespread distancing and work disruption that is in place in selected states. We also need to be sensitive to the short term and long term morbidity, pain, suffering, and health care use associated with COVID-19 infection, but I believe that it does not rate the extreme “lockdown” actions caused by a fear of specific disease-caused premature mortality.4  I also believe that future historians will essentially say that the weak and those in poor health were the first victims of the virus, but after they died, few were really at-risk for unexpected premature mortality and therefore the virus had largely run its most critical clinical course which should have led quickly to diminished “lockdown” practices.  I believe they may ultimately say that COVID-19 was somewhat of an over-reaction on the part of governmental authorities driven by fear and influenced by a largely national political calculus.”

A series of recommendations for how employee wellness programming should change are provided along with an emerging view of the overall health significance of the pandemic.

Why is this important?

This document represents the most complete summary of the probable overall significance of the pandemic and how it will likely change how workplace wellness programs are conducted in the months and years ahead.  Helpful suggestions are provided about how to navigate the transition from pandemic to post-pandemic to help wellness professionals navigate the challenge of adjustment to the post-COVID-19 “new normal.” Links are also provided to the source documentation.

What can you do with this document?

  • First, skim through the document to get a sense of what it is recommending.
  • Next, determine if the source documentation can be used in educating employees about the long-term implications of the pandemic.
  • Next, determine which of the recommendations you should adopt.
  • Next, share with the staff. volunteers and management, the major points and find out how they view the recommendations you have selected to implement.
  • Next, as you put your work plan and budget together for the next year of programming consider which recommendations will be addressed and plan accordingly.

In summary, we believe that the intensive acute stage of this current COVID-19 pandemic will be over soon leaving some residual changes and modifications to be made to employee wellness programming efforts.  The challenge moving forward will be to transition smoothly from the current disrupted state of programming to the “new normal” state which will require some thoughtful planning and more flexible programming.

(Everyone can now download this document)

Click here to download this document

If you have any problem downloading the document go to our website and submit a comment.

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

27% of All Health Costs Preventable

Source: Lancet Public Health

What is this about?

The document highlighted in this edition of the Connections newsletter is a newly published study from the British Journal Lancet Public Health.  The article reports on an extensive modifiable health risk analysis of U.S.health care costs using a cross-comparison technique on two very extensive claims databases.  The objective of this study was to quantify health care spending attributable to modifiable risk factors in the USA for 2016. 

In 2016, US health care spending attributable to modifiable risk factors was $730.4 billion corresponding to 27·0% of total health-care spending.  This “attributable” spending was largely due to five risk factors: high body-mass index, high systolic blood pressure, high fasting plasma glucose, dietary risks, and tobacco smoke.  Spending attributable to risk factor varied by age and sex, with the fraction of attributable spending largest for those aged 65 years and older.  The significance of this is that the cost of governmental health programs like Medicare and Medicaid can be significantly reduced by reducing key health risks among program beneficiaries.  Attributable health care spending was also identified for the top 16 health risk factors.

Why is this important?

The issue in this edition of the Connections newsletter is important for 3 major reasons.  First, reducing the cost burden associated with major modifiable health risks is one of the most important goals of virtually all employee wellness programs.  Second, this study found that fully 27% of all health care costs are considered potentially preventable, which is a huge economic incentive for prevention and wellness among American employers and governmental health programs.  Third, this study provides very valid estimates of the potentially preventable conditions, diseases and costs that can be used by Wellness program managers to make a stronger economic case for funding employee wellness programs.

What can you do with this document?

  • First, read the document to get a sense of the methodology and results of the study.
  • Next, determine where in your current communications efforts this information can be used.
  • Then, determine which of your program interventions should include this information.
  • Finally, decide how else to use the information to plan and justify your annual program budget.
  • In summary, this document describes a study that found that fully 27% of U.S. health care costs were preventable in 2016.  Employee wellness programs play a major role in reducing these health risks and costs for employers and for governmental health programs like Medicaid and Medicare.

In summary, this document describes a study that found that fully 27% of U.S. health care costs were preventable in 2016.  Employee wellness programs play a major role in reducing these health risks and costs for employers and for governmental health programs like Medicaid and Medicare.

(Everyone can now download this document)

Click here to download this document

If you have any problem downloading the document go to our website and submit a comment.

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

Average Costs of Health Conditions

Source: JAMA

What is this about?

The document in this edition of Connections is a comprehensive 22-page article from JAMA that provides a great deal of health care cost summary information for the period 1996 to 2016 and a great look at condition-specific average cost information and patterns that can be linked back to targeted wellness program interventions.  The information also provided help by capsulizing the pattern of health costs for various populations to help reflect their cost patterns which is very helpful when you do not have actual claims data for your population.

Why is this important?

This document represents one of the most authoritative national sources available for condition-specific average health care costs.  This data allows us to show senior management credible national data on likely average costs of various medical conditions that are directly related to health habits among employees and their family members and that are usually addressed by employee wellness programs.  This data is critical for the preparation of economic-based budget appeals for program funding and expansion post-COVID.

What can you do with this document?

  • First, skim through the article to get a sense of what types of data are provided.
  • Next, identify the specific medical conditions or diagnoses that your program addresses through it’s behavior change and risk reduction interventions.
  • Next, for each of these specific medical conditions determine what the most recent average cost is likely to be. You can update them from 2016 by adjusting them annually for medical trend inflation rates.  (These are usually in the range of 4% to 8%) The adjustment sources can include the Bureau of Labor Statistics, Employer Cost Index.
  • Next, If you have any health condition prevalence information before and after data for your program/population, make an estimate of what the economic effects of the reduction of medical conditions are likely to be.
  • Next, if you can identify the age and gender-related factors associated with the medical conditions that are relevant to your population you can possibly make an economic estimate of the amount of potential economic savings that is present in your population.
  • Finally, you can use the 2016 average costs multiplied by actual medical trend (for example, 5% to 8%) to estimate the cost of doing nothing versus the costs of various levels of anticipated program effectiveness.

In summary, this article provides very useful data on the average cost of selected medical conditions that can be used to help make projections about the potential economic trends associated with wellness program targets and interventions to senior management.

(Everyone can now download this document)

Click here to download this document

If you have any problem downloading the document go to our website and submit a comment.

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

Healthy Life Years Gained from a Healthy Lifestyle

What is this about?

The document in this edition of Connections is a recent article from the British Medical Journal that uses 2 major American long-term epidemiological studies (The Nurses’ Health Study – N= 73,196 and the Health Professions Follow-up Study – N= 33, 366).  These 2 landmark prospective cohort studies are used in this study to document the healthy years gained from a healthy lifestyle.  A healthy lifestyle was defined as five low-risk lifestyle factors: never smoking, body mass index 18.5-24.9, moderate to vigorous physical activity (≥30 minutes/day), moderate alcohol intake (women: 5-15 g/day; men 5-30 g/day), and a higher diet quality score (upper 40%). The summary findings are highlighted below:

“The life expectancy free of diabetes, cardiovascular diseases, and cancer at age 50 was 23.7 years (95% confidence interval 22.6 to 24.7) for women who adopted no low-risk lifestyle factors, in contrast to 34.4 years (33.1 to 35.5) for women who adopted four or five low-risk factors. At age 50, the life expectancy free of any of these chronic diseases was 23.5 (22.3 to 24.7) years among men who adopted no low-risk lifestyle factors and 31.1 (29.5 to 32.5) years in men who adopted four or five low-risk lifestyle factors.”

This amounts to 10.7 more years on average for women who live a healthy lifestyle versus those that don’t (45.7% more life-years without chronic conditions) and 12.4 more years on average for men who live a healthy lifestyle versus those that don’t (54.0% more life-years without chronic conditions).  That’s a big difference in chronic conditions and morbidity, especially as we consider the risk of COVID-19 infections!

Why is this important?

This document represents one of the largest population studies on the healthy life years gained from healthy lifestyle choices. The five low-risk lifestyle factors are at the core of virtually all employee wellness programs and are also at the heart of risk factors associated with COVID-19. This study documents the quality of life advantages of a wellness-oriented lifestyle along with the reduced health care use and improvements in life expectancy or likely length of life.  You gain years of life and years of life without major chronic diseases: A pretty good trade-off for the pursuit of wellness.

What can you do with this document?

  • First, skim through the research article to get a sense of what findings and evidence it is presenting.
  • Next, determine if this information can be used in educating employees about the long-term implications of adopting a wellness-oriented lifestyle.
  • Next, determine where the findings should be used in your program.
  • Next, share with staff, volunteers and management, the major highlights of the study and how this information can be used with those that may be concerned about COVID-19 infection.
  • Next, as you put your work plan and budget together for the next year of programming consider how this information should shape your choice of targets and the corresponding interventions.

In summary, this study provides a quantitative estimate of the healthy years that can be gained from pursuing a wellness-oriented lifestyle.  The article provides recent and significant science-based proof of the value of adopting a healthy lifestyle.

(Everyone can now download this document)

Click here to download this document

If you have any problem downloading the document go to our website and submit a comment.

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

Employee Wellness Programming after COVID-19

What is this about?

The document in this edition of Connections is the latest Solution Set and addresses options and alternatives for how wellness professionals might modify their programs after COVID-19.  A summary of current research on COVID-19 is provided along with an overall assessment of the “big picture.” A concluding excerpt is reproduced below.

“This unprecedented global health crisis will likely become a historical phenomenon where it looked bad initially, but rapidly diminished as a health threat.  Unfortunately, the global community generally over-reacted to the threat and then for predominantly political reasons, failed to assess the change in its lethality and modify lockdown and social distancing procedures.”

A series of recommendations for how employee wellness programming should change are provided along with an emerging view of the overall health significance of the pandemic.

Why is this important?

This document represents the most complete summary of the probable overall significance of the pandemic and how it will likely change how workplace wellness programs are conducted in the months and years ahead.  Helpful suggestions are provided about how to navigate the transition from pandemic to post-pandemic to help wellness professionals navigate the challenge of adjustment to the post-COVID-19 “new normal.” Links are also provided to the source documentation.

What can you do with this document?

  • First, skim through the document to get a sense of what it is recommending.
  • Next, determine if the source documentation can be used in educating employees about the long-term implications of the pandemic.
  • Next, determine which of the recommendations you should adopt.
  • Next, share with staff, volunteers and senior management the major points and find out how they view the recommendations you have selected to implement.
  • Next, as you put your work plan and budget together for the next year of programming consider which recommendations will be addressed and plan accordingly.

In summary, we believe that the intensive acute stage of this current COVID-19 pandemic will be over soon leaving some residual changes and modifications to be made to employee wellness programming efforts.  The challenge moving forward will be to transition smoothly from the current disrupted state of programming to the “new normal” state which will require some thoughtful planning and more flexible programming.

(Everyone can now download this document regardless of membership status.)

Click here to download this document

If you have any problem downloading the document go to our website and submit a comment.

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

Clinical Treatment Guidelines for COVID-19

Source: National Institutes of Health (NIH) and New England Journal of Medicine (NEJM)

What is this about?
The 4-month-old COVID-19 Pandemic has directly affected virtually everyone in the world. The absence of science-based, consensus-mediated, clinical guidelines for its treatment has been a sore point with front line practitioners.  Now we have two major candidates for that definitive treatment guidance.  The “long” form (126 pages) version from the National Institutes of Health (NIH) and the “short” version from the New England Journal of Medicine (NEJM).  The document in this edition of the Connections newsletter includes both sets of guidelines.

Why is this important?
This document represents the best science we have on the issues of treatment for all COVID-19 cases.  Everyone wants to avoid the mortality and morbidity risks attached to infection with this novel Coronavirus.  In our collective role of providing health and wellness information to employees and their family members through workplace wellness programs, we need to maintain as much scientific accuracy and validity that we can.  These two sets of guidelines reflect the best current thinking of our leading scientists and clinicians.  That’s important for our individual peace of mind as well as for the treatment of family and friends that are unfortunate enough to contract the disease.

What can you do with this document?

  • First, skim through the two sets of guidelines to get a general feel for what they contain.
  • Next, determine if the NEJM version of the guidelines is appropriate to share directly with senior management, other major stakeholders, volunteers, and vendors.
  • Next, be ready to make available the long-form (NIH) guideline document for those wanting more.  Also, the NIH document includes updates right up to the date of this newsletter edition.
  • Next, consider if you should post this on your website as a resource for employees or on the FAQ portion of your website.
  • Next, working with your benefits administrator, you might consider how to make these guidelines available to selected clinicians that are serving your employees and family members.

In summary, we believe that these two sets of definitive current clinical treatment guidelines are important for all of us, and particularly that all COVID-19 clinical care provided to our beneficiaries is consistent with the best science and clinical consensus that is available.

(Everyone can now download this document.)

Click here to download this document

If you have any problem downloading the document go to our website and submit a comment.

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

Personally Navigating the Coronavirus Pandemic

What is this about?
I know we are all pretty sick of the word “Coronavirus”, but this edition’s document was too good to pass up.  The Wall Street Journal did an excellent 8-page special section on Navigating the Coronavirus that everybody needs to read.  The practical and thoughtful advice presented here is extremely useful.

Why is this important?
This special section offers thoughtful ways to protect yourself and prepare for re-entry.  Let’s finish this as strongly as we can and I believe this information can help us do just that.

What can you do with this document?

  • First, skim through the special section topics and read those that apply to your situation.
  • Next, determine if the document may be appropriate to share with staff, volunteers, vendors, senior management and others.
  • Next, consider if you should post this on your website as a resource for employees.

In summary, we believe that this very practical and helpful special section is valuable for all of us and deserves to be distributed widely. Hopefully, these insights and tips will help us prepare for re-entry.

(Everyone can now download this document.)

Click here to download this document

If you have any problem downloading the document go to our website and submit a comment.

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

Coronavirus Resource Kit

What is this about?
In this time of unprecedented global quarantine, everyone is rapidly becoming an expert on Coronavirus and this COVID-19 pandemic. New insights on the virus fill our media daily from all kinds of sources: some authoritative and many not so authoritative. The compendium document in this edition of the Connections newsletter puts together most of the authoritative information that has been disseminated to clinicians through the JAMA Network in March and April 2020 as well as other equally authoritative sources.  This compendium of authoritative articles has been developed with an eye to the details and technical issues that most employees in an employer wellness program may now want to know. It covers a wide range of technical issues including:

  • Predictive models of the pandemic
  • Patient risk factors and likely care outcomes
  • Care guidelines and advice for clinicians treating Coronavirus patients
  • Effects of the virus on body systems and degrees of resulting functionality
  • Details on the just-passed CARES Act legislation
  • The legality of governmental actions to control the pandemic
  • Patient education materials including face mask use for preventing COVID-19 infection
  • Examination of viral “hot spots” for patterns of patient characteristics and outcomes
  • Use of social media in preventing infection
  • Testing and diagnosis of the disease
  • Factors that will likely affect rationing of ventilators and ICU beds
  • Infectivity and lethality of the virus

Why is this important?
This compendium of articles and documents provide authoritative information that has been largely disseminated only to physicians to help them answer the questions that their patients are likely to ask.  This makes the information much more reliable and scientifically based than both mainstream and Internet-based sources of information on the pandemic.  This compendium is important because it brings together a large number of authoritative publications and resources to provide a more accurate and comprehensive picture of the pandemic. This information is geared to the actual clinicians that are providing care to the patients with the disease.

What can you do with this document?

  • First, read through the list of topics addressed in the compendium to get some perspective on what it addresses.
  • Next, identify which topics are of interest to you and read them.
  • Next, determine if the document may be an appropriate technical resource to share with staff, volunteers, vendors, senior management and others.
  • Next, consider if you should post this on your website as a resource for employees.
  • Next, consult the compendium when questions and issues come up.

In summary, we believe that this compendium of authoritative articles on the Coronavirus pandemic is a valuable resource for those who may be asked questions about the pandemic. Hopefully, accurate information about this crisis will be of value to all of us as we strive to protect our own health and the health of our employees and their family members.

(Anyone can now download this document regardless of membership status.)

Click here to download this document

If you have any problem downloading the document go to our website and submit a comment.

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