Tools You Can Use: Reducing the Cost of Inactivity Natalie Clifton, M.Ed., CHES Physical Activity Coordinator Nutrition, Physical Activity and Obesity Prevention Program Texas Department of State Health Services

The Active Choice Should Be The Tools To Make The Case The Active Choice Should Be The Easy Choice At Work! Bikeability Walkability Cost of Inactivity ROI Cost of Obesity Employee Tools

What is Primary Prevention? What is Prevention? A systematic process that promotes healthy behaviors and environments and reduces the likelihood or frequency of an incident, condition, or illness occurring. What is Primary Prevention? taking action before the onset of symptoms

The Spectrum of Prevention Public Health Responsibility Influencing Policy & Legislation Changing Organizational Practices Fostering Coalitions & Networks Educating Providers Promoting Community Education Strengthening Individual Knowledge & Skills

Definitions Policy – laws, regulations, formal and informal rules and understandings that are adopted on a collective basis to guide individual and collective behavior Environmental change – something that alters or controls the legal, social, economic, and physical environment affecting health

Population versus Individual Patient Community Individual Intervention Assessment Policy Development Environmental Change Medicine Surgical treatment Health education Process System management Patient management Outcome Healthy community Healthy Patient Healing Advantage Radical Large potential for population Appropriate for individual who already has a problem Disadvantages Only a small benefit to each individual Cost of screening Interventions are palliative and temporary

Influences on population health

What P&E Change is Not… Health fairs Education Events Brochures Classes Other

I was able to get in one last lecture about diet and exercise.

The Four P’s Programs: Projects can be quick starting, low overhead, locally driven. require money and impact individuals Point of Decision Prompts: reminders for health can be easy to install Are sometimes ignored Projects the built environment strongly shapes behavior cost money Policies: create permanent change change the social norm require careful consideration

Physical Activity: What Works? Create or enhance access to places to be physically active: Building walking trails Providing public access to school gymnasiums, playgrounds, or community centers. Interventions to improve access should also include outreach that increases awareness of the opportunity to be active. Worksite activity programs that provide access to onsite or offsite fitness rooms, walking breaks, or other opportunities to engage in physical activity.

Alternative Transportation "Alternative transportation" modes are telecommuting, carpools, vanpools, public transportation, bicycling, walking, and running. These commute methods are relevant to employee health in two ways: A reduction in the use of single-occupancy vehicles helps reduce environmental fuel emissions. Employees who use "active transport" (public transportation, bicycling, and walking) to commute to work may increase their daily physical activity.

Economic benefits of Active Transportation : Increased productivity and a reduction of sick days and injuries at the workplace Reduction in road construction, repair and maintenance costs Reduction in costs due to greenhouse gas emissions Reduction in health care costs due to increased physical activity and reduced respiratory and cardiac disease Reduction in fuel, repair and maintenance costs to users Reduction of costs due to increased road safety Reduction in external costs of traffic congestion Reduction in parking subsidies Reduction of costs of air pollution Reduction of costs of water pollution Positive impact of bicycle tourism Positive impact of bicycle sales and manufacturing Increased property value along trails Economic Values Fact Sheet: http://www.rsa.cc/images/EconomicValueOfActiveTransportation.pdf

The Benefit-Cost analysis of Bicycle Facilities http://www.bicyclinginfo.org/bikecost/index.cfm

Commuting Expense Calculator Calculates commuting costs http://www.costofcommuting.com/

CycleFriendly Employer Cycle-friendly Employer Case Studies Employer Guide, Resources, Checklist http://fulltext.ausport.gov.au/fulltext/2003/nz/cycle_index.asp

Active Living Research Multi-use trails are associated with increases in walking and bicycling, especially in urban areas and among lower income populations. Sidewalks and bicycle lanes promote physical activity. Public transit use is linked with higher levels of physical activity and lower rates of obesity. Walking or biking to school can help kids be more active overall.

A Walkable Community Environment: Cars may be a leading cause of climate change. Your feet are zero-pollution transportation machines. Health: The average resident of a walkable neighborhood weighs 6-10 pounds less than someone who lives in a sprawling neighborhood. Communities: Studies show that for every 10 minutes a person spends in a daily car commute, time spent in community activities falls by 10%.

WalkScore.com What's your Walk Score? Get a Commute Report Explore Your Neighborhood 90–100 Walker's Paradise — Daily errands do not require a car. 70–89 Very Walkable — Most errands can be accomplished on foot. 50–69 Somewhat Walkable — Some amenities within walking distance. 25–49 Car-Dependent — A few amenities within walking distance. 0–24 Car-Dependent — Almost all errands require a car.

Worksite Walkability Audit Tool http://www.cdc.gov/nccdphp/dnpao/hwi/downloads/walkability_audit_tool.pdf

Quantifying the Cost of Physical Inactivity Developed by East Carolina University’s Department of Health Education and Promotion Provides an estimate of the financial cost of physically inactive people to a particular community, city, state or business. http://www.ecu.edu/picostcalc/ http://sao.hr.state.tx.us/Workforce/  

Return on Investment Calculator Three ROI calculators that look at: Changes in health care costs Absenteeism Presenteeism http://www.wellsteps.com/roi/resources_tools_roi_cal_health.php

Obesity Cost Calculator Provided by the Centers for Disease Control and Prevention (CDC)  An application for the workplace http://www.cdc.gov/leanworks/costcalculator/index.html

RealAge.com Sixty five Health Tests and Tools Health Assessment and Personalized Plan

Activity Zone http://www.dhs.wisconsin.gov/health/physicalactivity/pdf_files/ActivityZone3.pdf Please list walking “destinations” within 0-2 miles of your residence or work place Name Distance 􀂆 School __________________________________ 􀂆 Grocery store _____________________________ 􀂆 Convenience store __________________________ 􀂆 Retail shops ______________________________ 􀂆 Recreation facility __________________________ 􀂆 Dining __________________________________ 􀂆 Parks ___________________________________ 􀂆 Library __________________________________ 􀂆 Church __________________________________ 􀂆 Other ___________________________________ Please list biking “destinations” within 0-4 miles of your residence or work place Name Distance 􀂆 School____________________________ 􀂆 Grocery store _______________________ 􀂆 Convenience store ____________________ 􀂆 Retail shops ________________________ 􀂆 Recreation facility ____________________ 􀂆 Dining ____________________________ 􀂆 Parks _____________________________ 􀂆 Library ___________________________ 􀂆 Church ___________________________ 􀂆 Other ____________________________ 􀂆 Other ________________________ ____

Making the Case Benefits of Active Living to Employers: Next Steps: Share reports and data with leadership. Engage stakeholders & start the conversation. Prioritize needs and wants. A more productive workforce & cost savings Lower major medical & disability costs Reduced Absenteeism More Engaged Workers

More Resources Active Living Research: http://www.activelivingresearch.org/ National Society of Physical Activity Practitioners in Public Health (NSPAPPH): www.nspapph.org CDC Healthier Worksite Initiative: http://www.cdc.gov/nccdphp/dnpao/hwi/index.htm

Questions? Thank you!

Natalie Clifton, M.Ed., CHES Texas Department of State Health Services Nutrition, Physical Activity & Obesity Prevention  Tower Building 406 / Mail Code 1944 PO Box 149347  Austin, Texas 78714 P 512-776-3447 F 512-458-7618 Natalie.Clifton@dshs.state.tx.us