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Institute for Health and Productivity Studies

Yet Another Reason to Build a Culture of Health at Your Company

For decades, proponents of workplace health promotion (wellness) programs have articulated the many factors justifying a business case for investment in these initiatives.  Among the arguments made in favor of building and sustaining a culture of health at work is that effective programs first and foremost improve workers’ health and well-being.  Beyond that, the spillover effect of having healthy workers is they consume fewer healthcare resources, are absent less often, have fewer accidents, and perform at optimal levels.  These outcomes are beneficial for the organization, for obvious reasons, but also good for the employees, especially when workplace wellness is embedded in a healthy company culture and valued by senior and middle management.

Along come three new studies suggesting that the benefits of workplace health promotion programs are even more far reaching.  The studies, published in the January 2016 issue of the Journal of Occupational and Environmental Medicine (JOEM), the official journal of the American College of Occupational and Environmental Medicine (ACOEM), trace the stock price of companies that have demonstrably excellent workplace health promotion and safety programs vs. the performance of average U.S. companies, operationally defined as the Standard & Poor’s (S&P) 500 Index.  In each of the studies, a hypothetical $10,000 was invested in companies with award-winning (or high scoring) wellness programs and their stock price was tracked over several years.  Results show that each of the portfolios containing companies with exceptional health promotion and safety programs significantly out-performed the S&P 500.  In one study that tracked the performance of C. Everett Koop Award winners, a portfolio made up of 26 publicly traded companies, the Koop winners achieved a 325% rate of return on their stock price from 2001-2014 compared to 105% for the S&P 500 Index companies.

Wall Street investors and chief financial officers do not typically subscribe to JOEM – why should they?  Their interests are squarely focused on making profits, at times at the expense of their workers.  Well, these studies should give them pause.  Perhaps corporate executives and investors should pay attention to workers’ health and well-being.  This is especially true because businesses continue to compete for talent – the best and brightest workers who will support the company’s mission and are willing to invest time and effort in their jobs.  Perhaps publicizing a company’s workplace health promotion programs is a way to attract and retain top talent.  Employees, especially millennials, are drawn to companies that offer a sense of purpose, are respectful of individual differences, and imbue a culture where workers’ health and well-being are highly valued.  Creating this culture ensures that workers remain committed to the enterprise because they believe the business is committed to them.

What’s the bottom line?  The three studies of companies with established cultures of health and safety do not “prove” that a health promoting culture guarantees good stock performance.  Certainly, the underlying principles of high-performing companies are still critical to positive financial performance – excellent leadership, innovation, high quality products and services, effective marketing, brand loyalty, reputation, and perceived value.  But, as these studies suggest, there may be another factor driving business success -- employing happy, healthy, and productive workers who care deeply about the success of their company – because their company cares about them enough to provide a world-class health and safety program.

To read the study, The Stock Performance of C. Everett Koop Award Winners Compared to the Standard & Poor’s 500 Index, click here.

Access the abstracts for the studies, Linking Workplace Health Promotion Best Practices and Organizational Financial Performance: Tracking Market Performance of Companies With Highest Scores on the HERO Scorecard, here; and Tracking the Market Performance of Companies That Integrate a Culture of Health and Safety: An Assessment of Corporate Health Achievement Award Applicants, here.

Designing Incentives for Wellness

When it comes to health promotion programs, it’s wise to avoid the “build it and they will come” strategy. A wealth of research tells us that people need motivation to adopt healthier behaviors and, especially in the early stages, they respond well to tangible incentives, such as prizes or discounts on insurance premiums. Incentives can jump-start participation in programs and can encourage workers to complete health risk assessments (HRAs), quit smoking, exercise more, or lose weight. At CitiBank, for example, employees receive a $150 cash incentive for filling out a yearly HRA; last year, some 85% of the company’s US employees completed the survey....Read More

Turck Industries: Where Wellness is “The Right Thing to Do”

An uncomfortable silence settles around the conference table when Turck Industries’ management team is asked what would happen to the company’s popular wellness program if CEO Dave Lagerstrom were suddenly to leave. After several minutes pass, Lagerstrom finally answers the question himself, “There’d be a mutiny if they tried to take it away.”...Read More

Overcoming Obstacles to Wellness: Reaching Call Center Workers at LL Bean

When we think about occupations that are hazardous to our health, steel worker, logger and jet pilot probably come to mind. But there is growing evidence that some jobs with far less thrill value are also linked to poor worker health—and higher medical costs for employers. In the case of call center workers—the growing cadre of employees who spend hours sitting at their desks, tethered to telephone headsets—a sedentary work environment significantly raises their risk for obesity, diabetes and other chronic illnesses. These jobs can also lead to a shorter lifespan, with research finding that people who spend 23 hours a week on sedentary activities have a 64% greater risk of dying from heart disease than those who are more active.

How can corporate health promotion programs impact the health and well-being of this growing segment of U.S. workers? Maine-based retailer L.L. Bean offers a promising model. The company’s Healthy Bean initiative used data collected from 4,000 employee health risk assessments (HRAs) and biometric tests to identify sites where health indicators were the most troubling. What they found was that the largest concentration of employees at greatest risk for medical and emotional problems worked at Bean’s three Maine-based call centers. At the Bangor call center, for example, the average age of the mostly female workforce was 54, 71.4% had elevated blood pressure, 67% were obese (BMI over 30), 11% were diabetic and almost 60% reported feeling emotional stress.

The challenge was designing a health promotion intervention that could really impact call center workers. At Bean, as at most companies, call center employees have difficulty accessing many of a company’s health promotion offerings. As lower-income shift workers, they are paid for the time they spend logged in and answering calls. Companies allow breaks for lunch and a few minutes to use the bathroom or get a cup of coffee. But the lack of flexibility in their schedules makes going to an exercise class, taking a walk or attending a wellness lunch session nearly impossible.

With this in mind, Bean ran a one-year pilot program in Bangor for 24 obese employees who had multiple health risks. The program included exercise, nutrition, and an emotional well-being component three times a week during work hours. What did they learn? There needed to be more emphasis on accountability for participants coming to class and keeping logs documenting their activity, according to Stephanie Harvie, Manager for Wellness Operations at Bean. Also, she says, “We greatly underestimated the importance of providing EAP services to address emotional well-being, financial stress and family difficulties the participants were dealing with” that addressed employees’ high rates of depression and emotional and financial stress.

A second pilot with 20 employees at Bean’s Lewiston call center took these lessons into consideration. This time, the wellness staff teamed up with the company’s Employee Assistance Program and conducted a baseline assessment of each participant to identify any mental health, personal and financial issues. In addition to nutrition and exercise programs, the Lewiston pilot also provided group and individual counseling to address issues such as body image, coping mechanisms and realistic goal-setting. If employees didn’t participate fully, staff worked with them to address barriers and make expectations clear, if participation and engagement levels did not improve, they were asked to leave the pilot. “We made it clear, you need to be accountable,” says Harvie. This time, results were encouraging: Average weight loss was 14.7 lbs. (ranging from gaining 12 lbs. to losing 66.3), cardiovascular fitness improved 25%, flexibility improved 20%, muscular strength increased 15% and muscular endurance was up 58%.

Of course, scaling up L.L. Bean’s pilot programs to reach all high-risk call center workers might be impractical—and expensive. But to really embrace the notion of a culture of health, it is vital that companies extend their health promotion programs to employees at all pay levels—including manufacturing line workers, call center staff and sales staff—who use tobacco, suffer from obesity, high blood pressure and/or depression. This includes providing healthy food and snack options at all facilities, having onsite fitness centers with extended hours to accommodate hourly workers who have to exercise either before or after their shifts, and incentives that take a bite out of monthly insurance premiums.

In many of the companies we visited, wellness was in fact trickling down to all levels and pay grades. We saw line managers leading regular stretching breaks at Turck. We heard about manufacturing workers at Janssen Pharmaceuticals (part of Johnson & Johnson) getting time off to attend a one- or two-day program to learn about optimizing their health and performance. We saw cardio equipment stationed right outside USAA’s call centers, where workers are encouraged to take a 10-minute active break. The financial services company also lets these shift employees combine lunch and break time into an hour-long period so they can attend a yoga class or train at the on-site gym. At Lincoln Industries we heard about how leadership offers a 10-week Fuel For Performance program for line workers; the program focuses on healthy food, physical activity and better sleep habits. Managers are rated on how well they implement this and other wellness programs and if they result in productivity gains.

Inactivity is a growing threat to the health and well-being of America’s workers. Best-practice companies recognize this and tailor well-designed health promotion programs to meet the needs of all employees—especially those shift workers who are at highest risk for injury and chronic illness.

Written with support by the Robert Wood Johnson Foundation

Factory worker

An Outcomes-Based Incentive Program That Works


CORRECTION: An early posting of this blog, using information gathered in interviews, misreported Graco healthcare spending. Those figures are corrected here.

At Graco, a Minnesota-based manufacturer founded in 1926 that employs about 2,600 workers, its outcomes-based incentive program works. Why? Because at Graco, senior leaders “walk the walk” not just “talk the talk.”

Graco is a publicly-held company, listed on the New York Stock Exchange, that manufactures pump and spray equipment for fluid handling in the construction, manufacturing, processing, and maintenance industries.  Pat McHale, the company’s CEO, worked his way up the corporate ladder, starting on the factory floor as a parts assembler. Because of his long tenure with the company, he possesses what is referred to as “street cred” among workers who view him as one of their own....Read More