Abstract: Objective: To test the hypothesis that comprehensive efforts to reduce a workforce’s health and safety risks can be associated with a company’s stock market performance. Methods: Stock market performance of Corporate Health Achievement Award winners was tracked under four different scenarios using simulation and past market performance. Results: A portfolio of companies recognized as award winning for their approach to the health and safety of their workforce outperformed the market. Evidence seems to support that building cultures of health and safety provides a competitive advantage in the marketplace. This research may have also identified an association between companies that focus on health and safety and companies that manage other aspects of their business equally well. Conclusions: Companies that build a culture of health by focusing on the well-being and safety of their workforce yield greater value for their investors.

Abstract: Objective: To quantify and compare employee health- and productivity-related costs for current smokers versus nonsmokers for a large US employer. Methods: Multivariate regression models were used to compare medical, pharmacy, workers’ compensation, and short-term disability costs, self-reported absenteeism, and presenteeism by smoking status. Costs were aggregated over 3 years, from 2008 to 2010.Results: Controlling for demographic variables, smokers had significantly different health care utilization patterns, as well as higher absenteeism and presenteeism costs. Overall, employees who smoke were estimated to cost employers $900 to $1383 more than their nonsmoking counterparts. Conclusions: Current smokers experience incrementally greater lost productivity than nonsmokers, contributing to employer costs associated with smoking. Increased employer focus on smoking cessation may help mitigate these organizational costs.

Abstract: There is an increasing awareness among employers and health care providers that health care needs to be tailored to address the diversity of the workforce. Population-based data have shown significant differences in health behaviors and health risks among different racial/ethnic groups in the United States. The purpose of this study was to examine health risks and changes in health risks over time in an employed population at a financial services corporation. This large financial services corporation is naturally concerned about any disparities in health among employees. The study population consists of employees who participated in the organization’s medical plan and also the annual health risk appraisal questionnaire in both 2009 and 2010. Significant demographic differences exist among the four ethnic groups studied: whites, African Americans, Hispanics, and Asians. At baseline, African American employees had a significantly higher average number of health risks measured by the health risk appraisal, but they also experienced the greatest improvement in health risks by time 2. There were differences in the health risk profiles of the ethnic groups, with certain risk factors being more prevalent among some ethnicities than among others. The health care costs were not significantly different among the groups studied here. It is likely that other large employers may also find health risk differences among employees belonging to various ethnicities. Future research in this field should seek to understand the reasons behind differences in health among ethnic groups and how best to address them so that all employees can achieve a high level of health and wellness.

Abstract: Objectives: To investigate predictors of absenteeism and discuss potential implications for policy/program design. Methods: Health Risk Appraisal (HRA) data and self-reported and objective absenteeism (personnel records) were used to develop a structural equation model, controlling for age, sex, and job classification. A Medical Condition Burden Index (MCBI) was created by summing the number of self-reported medical conditions. Results: Higher MCBI and stress were direct predictors of absenteeism. Physical activity was not associated with absenteeism but mediated both stress and MCBI. Conclusions: Because stress impacted both absenteeism and MCBI, organizations may benefit by placing stress management as a priority for wellness program and policy focus. Physical activity was not directly associated with absenteeism but was a mediating variable for stress and MCBI. Measures of stress and physical health may be more meaningful as outcome measures for physical activity programs than absenteeism.

Abstract: OBJECTIVE: To develop, evaluate, and improve the reliability and validity of the CDC Worksite Health ScoreCard (HSC). METHODS: We tested interrater reliability by piloting the HSC at 93 worksites, examining question response concurrence between two representatives from each worksite. We conducted cognitive interviews and site visits to evaluate face validity of items and refined the instrument for general distribution. RESULTS: The mean question concurrence rate was 77%. Respondents reported the tool to be useful, and on average 49% of all possible interventions were in place at the surveyed worksites. The interviews highlighted issues undermining reliability and validity, which were addressed in the final version of the instrument. CONCLUSIONS: The revised HSC is a reasonably valid and reliable tool for assessing worksite health promotion programs, policies, and environmental supports directed at preventing cardiovascular disease.

Abstract: OBJECTIVE: Examine the influence of employee health management (EHM) best practices on registration, participation, and health behavior change in telephone-based coaching programs. METHODS: Individual health assessment data, EHM program data, and health coaching participation data were analyzed for associations with coaching program enrollment, active participation, and risk reduction. Multivariate analyses occurred at the individual (n = 205,672) and company levels (n = 55). RESULTS: Considerable differences were found in how age and sex impacted typical EHM evaluation metrics. Cash incentives for the health assessment were associated with more risk reduction for men than for women. Providing either a noncash or a benefits-integrated incentive for completing the health assessment, or a noncash incentive for lifestyle management, strengthened the relationship between age and risk reduction. CONCLUSIONS: In EHM programs, one size does not fit all. These results can help employers tailor engagement strategies for their specific population.

Abstract: OBJECTIVE: To understand risk factor modification effect on Type 2 diabetes incidence in a workforce population. METHODS: Annual health risk assessment data (N = 3125) in years 1 through 4 were used to predict diabetes development in years 5 through 8. RESULTS: Employees who reduced their body mass index from 30 or more to less than 30 decreased their chances of developing diabetes (odds ratio = 0.22, 95% confidence interval: 0.05 to 0.93), while those who became obese increased their diabetes risk (odds ratio = 8.85, 95% confidence interval: 2.53 to 31.0). CONCLUSIONS: Weight reduction observed over a long period can result in clinically important reductions in diabetes incidence. Workplace health promotion programs may prevent diabetes among workers by encouraging weight loss and adoption of healthy lifestyle habits.

Abstract: OBJECTIVE: Determine whether there is a relationship between level of engagement in workplace wellness programs and population/individual health risk reductions. METHODS: A total of 7804 employees from 15 employers completed health risk appraisal and laboratory testing at baseline and again after 2 years of participating in their personalized prevention plan. Population and individual health risk transitions were analyzed across the population, as well as by stage of engagement. RESULTS: Of those individuals who started in a high risk category at baseline, 46% moved down to medium risk and 19% moved down to low risk category after 2 years on their prevention plan. In the group that only engaged through the Web-based technology, 24% reduced their health risks (P < 0.0001). CONCLUSIONS: Engaging technology and interactive Web-based tools can empower individuals to be more proactive about their health and reduce their health risks.

Abstract: OBJECTIVE: To devise a methodology to create a single health risk–cost score that can be applied to health risk assessment survey data and account for the medical costs associated with modifiable risks. METHODS: We linked person level health risk assessment data with medical benefit eligibility and claims data for 341,650 workers for the period 2005 to 2010 and performed multivariate analyses to estimate costs associated with high risks. We used the estimated costs and risk prevalence rates to create a composite Workforce Wellness Index (WWI) score. RESULTS: Increasing obesity rates among employees was found to be the most important contributor to increased health care spending and the main reason the WWI score worsened over time. CONCLUSION: Employers that address employees’ health risk factors may be able to reduce their medical spending and achieve an improvement in their WWI scores.

Abstract: BACKGROUND: Workplace wellness programs have become increasingly popular despite large inconsistencies in the analyses of their ability to produce long-term medical care savings. OBJECTIVE: To clarify the aforesaid situation by estimating potential long-term medical care savings linked to chronic disease. METHODS: We combined data from the Global Burden of Disease Study and Medical Expenditure Panel Surveys to estimate the annual savings that would result from lowering risk factors typically managed by workplace wellness programs to their theoretical minimums. RESULTS: Lowering risk factors to their theoretical minimums, if this were possible, would reduce average annual costs per working-age adult by 18.4% and 28.4% for retirees. CONCLUSION: These findings have important implications for workplace wellness programs because they provide a robust estimate of potential savings.