Nashville Area Chamber of Commerce’s Workforce Health Executive Roundtable Mary Yarbrough, MD MPH Executive Director Health and Wellness November 30, 2017 Confidential – do not distribute

Engaging in Health Risk Reductions and Disease Reduction Health in 5 Steps Engaging in Health Risk Reductions and Disease Reduction Confidential – do not distribute

Annual Cost of Lost Productivity due to Absenteeism (in billions) Absent Employee = Absent Dollars Occupation Annual Cost of Lost Productivity due to Absenteeism (in billions) Professionals $24.2 Manager, executives $15.7 Service worker $8.5 Clerical/Office $8.1 Nurses $3.6 Source: Gallup-Healthways Well-Being Index, 2012., survey of 303,625 employees Towers Watson Employer Survey: Top Priorities of Employers’ Health Care Activities in Next 3 Years Elevate Health and Pharmacy Plan Design Increase the focus on employee well-being Health Financial Workplace experience Develop/enhance a workplace culture where employees are responsible for their health Make changes to the excise ceiling tax Add or expand the use of financial incentive to encourage healthy behaviors Evaluate care management programs for chronic and acutely ill members Review health benefits in a total reward context Develop/enhance technology strategy including employee engagement and delivery of care Assess the viability of exchange models (private/public) Towers Watson: 2015 Best Practices in Health Care Employer Survey

Confidential – do not distribute Step 1 Identify the Problem Confidential – do not distribute

Global Economic Burden of Non-communicable Disease Prevalence of Disease Non-Communicable Disease Cardiovascular Disease Cancer Chronic Respiratory Diseases Other Chronic Diseases Communicable Influenza Driver of Lost Output Mental Health Cardiovascular Respiratory Diabetes Bloom, D.E., Ca ero, E.T., Jané-Llopis, E., Abrahams-Gessel, S., Bloom, L.R., Fathima, S., Feigl, A.B., Gaziano, T., Mowa , M., Pandya, A., Prettner, K., Rosenberg, L., Seligman, B., Stein, A., & Weinstein, C. (2011). The Global Economic Burden of Non-communicable Diseases. Geneva: World Economic Forum.

Nashville Chamber of Commerce Respiratory Asthma Chronic Obstructive Pulmonary Disease (COPD) Mental Health (Depression) Diabetes Cardiovascular (Hypertension)

Confidential – do not distribute Step 2 Pick a Strategy Confidential – do not distribute

Physical Health Targets for Intervention Modifiable Health Risks Poor Diet Physical inactivity Tobacco Alcohol Stress Conditions Overweight/obesity Elevated blood glucose High blood pressure High cholesterol Alcohol abuse Burnout Disease Mental Health Cardiovascular Cancer Respiratory Diabetes

Develop and Implement Your Plan Step 3 Develop and Implement Your Plan Confidential – do not distribute

Physical Work Environment Enterprise Community Involvement Avenues of Influence for a Healthy Workplace Physical Work Environment Personal Health Resources Enterprise Community Involvement Psychosocial Work Environment Reproduced from Healthy Workplaces: A model for action from the WHO

CDC Workplace Health Assessment: What is needed Planning/Implementation: What will be done Evaluation: Impact

Workplace Strategies by Condition Alcohol and Substance Abuse Blood Pressure Breast Cancer Cervical Cancer Colorectal Cancer Cholesterol Depression Diabetes Flu and Pneumonia Nutrition Obesity Physician Activity Tobacco Abuse Work-related musculoskeletal disorders and ergonomics

Healthier Tennessee

Health & Wellness Supporting the well-being and productivity of Vanderbilt Faculty and Staff

Comprehensive Programming* Health Awareness Motivation Skill Building Opportunities * Michael O’Donnell’s AMSO Framework to Guide the Development of Effective Health Promotion Programs

Awareness

Motivation and Skill Building

Opportunities

Evaluate Your Progress Step 4 Evaluate Your Progress Confidential – do not distribute

Wise Use of Resources Control health care costs Maximize productivity Health Plan Workers compensation Maximize productivity Minimize Absenteeism “Presenteeism” Maximize Retention Customer satisfaction Safety compliance

Prioritizing Daily Modifiable Lifestyle Risks Aerobic exercise Nonsmoking Low-fat diet and avoiding unhealthy snacks Adequate sleep (Other mental health and occupational risks)

Participation in Modifiable Health Risk Reduction Programs

Smoking Trend Percent Smoking

Percent Exercising ≥ 1 Day/wk Physical Activity Trend Percent Exercising ≥ 1 Day/wk

Normal Weight Trend

  Impact on Targeted Lifestyle Risks Stress Nutrition & Not improved Stayed the Same Improved Stress  Nutrition & food choices Smoking Obesity Activity/ Exercise 

Low Risk Individuals Have Lower Health Care Costs Medium risk 85% higher than low risk High risk 185% higher cost than low risk

Low Risk Proportion

Percent with >5 Sick days in Past Year Decreasing

Communicate, Communicate, Communicate Step 5 Communicate, Communicate, Communicate Confidential – do not distribute

Communicate Your Strategy: Culture of Wellness CREDO Goals Policies/Programs Workplace practices Health Care Benefits

Create Community Around Wellness Employee forums Managers meeting Newsletter Flyers Events Social Media Video Podcasts Email Community/National

Confidential – do not distribute Thank you Confidential – do not distribute