Controlling health care costs is crucial for Iowa manufacturers to remain competitive. But a big question for many companies is whether investing in an employee wellness program will cut costs and improve productivity. To help answer that question, a team of Iowa State University researchers is conducting a pilot program with three Iowa manufacturers.
"All our evidence says there will be a net positive financial return for the companies," said Mike O'Donnell, program director for CIRAS, the Center for Industrial Research and Service at Iowa State. "While we're relatively sure helping employees become healthier will improve absenteeism rates, the real question is will it impact health care premiums?"
To gauge the potential impact, researchers had to first create a baseline for employee health. Ruth Litchfield, an associate professor in food science and human nutrition, and graduate research assistant Kayli Julander recruited 60 employees, at each of the three worksites, who volunteered to complete a health risk appraisal. Instead of just looking at a single indicator such as diet or exercise, the team took a holistic approach to assess physical, financial and emotional health.
Employees were then randomly assigned to a control group, which completed only the health risk assessment, or an intervention group, which completed a six-month program on nutrition, exercise, stress and finances. Future assessments will allow researchers to compare differences between the two groups and determine the benefits of offering a wellness program in the workplace.
"Americans spend a lot of time at work. If we can make it convenient for the employees to take a healthy lunch and learn how to improve their well-being or go for a walk during lunch, it's a great opportunity for the employee as well as the employer," Julander said.
After checking blood pressure, testing cholesterol levels and gauging body composition, researchers were most surprised by the lack of flexibility among employees. The majority -- as many as 85 percent when testing for the left arm -- had poor or low flexibility, which can have significant consequences.
"When you're dealing in a manufacturing environment, regardless of the task, dexterity and flexibility are always going to be important. You need to assemble things, you need to weld them, and some people need to lift things," O'Donnell said. "If you're not flexible, you're at risk for higher injury rates, at risk for not being able to do your job well enough."
The good news is this is one area, Litchfield said, that employers can easily address through a worksite wellness program. Improving flexibility not only has benefits within the workplace, but for the long-term health of employees.
"Flexibility is a key factor for long term quality of life and independent living in later life," Litchfield said. "In other words, can I still do my own laundry, and can I still open a can of vegetables for my lunch?"
The initial health assessment also found:
• More than 80 percent of employees were obese or overweight -- this was not determined by weight and height, but based on body composition which compares body fat to lean body mass. • Nearly 45 percent of employees were at high to very high risk for chronic disease, such as Type 2 diabetes, cardiovascular disease and hypertension as assessed by waist to hip ratio. • Only 26 percent smoke, but those who do smoke an average of 12 cigarettes a day.
Litchfield said results for high blood pressure and cholesterol levels are about what they expected. It is the flexibility and body composition that is most concerning.
"This really reinforces that if we're to look at the health of America as body composition, not just absolute weight, but actually looked at what is that weight made up of, we're in even bigger trouble. It's worse," Litchfield said.
It's all about self-control
One unique aspect of the pilot wellness program is the focus on financial well-being. There is a strong association between physical health and financial health, said Tim Griesdorn, an assistant professor of human development and family studies. It all relates to self-control.
"I believe one of the keys is self-control -- the ability to have control over what you eat or what you spend, how to use your time, and whether or not you exercise. Anything we can do to improve or strengthen someone's self-control muscle is going to have tremendous spillover effects through all areas of that person's life," Griesdorn said.
Employees completed surveys to assess their levels of financial stress and signed up to receive a free credit report. Nearly 60 percent had average levels of financial stress; nearly 15 percent were high. Griesdorn developed short courses to help employees understand their credit score and learn how to set financial goals, plan for retirement and eliminate debt.
Does intervention work?
Intervention programs were designed specifically for each worksite based on feedback from employees and employers. Researchers will revisit all three companies in January for another health risk appraisal to see if employees are making improvements. They will combine the health results with absentee rates and health care insurance claims for each company to calculate the effectiveness. Julander expects to see a range of results on an individual level.
"Participant A may have lost 30 pounds. Participant B may not have lost any weight, but they improved their cholesterol and they're eating more fruits and vegetables," Julander said. "Although Participant B might not be seeing the results they want on the scale, they are improving their health."
In 2014 companies can offer more incentives for wellness programs as part of the Affordable Care Act. Businesses can also increase health care premiums for employees who do not participate in a wellness program. The study will help companies make more informed decisions about employee health benefits as it relates to health care reform and their bottom line.
The Graphic Edge in Carroll, Timberline Manufacturing Inc. in Marion, and Rosenboom Machine & Tool in Sheldon are the three manufacturing companies participating in the pilot program.
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