Fort Atkinson School District Wellness Program 2012 Program Summary February 16, 2019

Agenda Highlights Program Participation Wellness Evaluation Findings, Observations & Recommendations Top Risks Identified Lab and Biometric Results PHA Results Appendix

Highlights 32.8% PHA participation (Participants ÷Eligible Members) Top 5 Risks Overall BMI > 25 High LDL > 100 Sedentary Lifestyle High Systolic Blood Pressure >119 High Diastolic Blood Pressure >79 Fort Atkinson participants 10% less obese than National Average 40% answered in PHA that they do not exercise regularly, 15% worse than the National Average Tobacco use (smoking) better than the National Average Better than the National Average for elevated LDL Cholesterol for both men and women Men and women HDL Cholesterol worse than the National Average Fort Atkinson participants Triglycerides higher than the National Average for both men and women High Job Satisfaction

Participation Participation from 2/6/2012 – 3/6/2012 Total Eligible Participants: 302 (210 Female/92 Male) Total Enrolled: 99 (32.8%) (77 Female or 36.6%/22 Male or 24%) 32.8% of eligible participants Enrolled in the program, completed the PHA and labs The Purdy Elementary location saw the highest participation rate (40.5%) followed by the Middle School (39.4%).

Wellness Evaluation Findings, Observations, and Results

Top 10 Risks Identified Top 3 Risks Identified 61 Participants (61.6%) are overweight with a body mass index (BMI) 25 or greater 38 (38.4%) Participants generated a risk for Overweight with BMI 25-29.99 23 (23.2%) Participants generated a risk for Obese with BMI >= 30 46 (52.9%) Participants with high LDL >99 45 participants (45%) are considered sedentary because they Are doing 30 min of moderate exercise less than 3 times a week, OR Are doing 20 min of vigorous exercise less than 2 times a week

Body Mass Index BMI Ranges <18 is Underweight (0 members) >=18 and <25 is Normal (38 members) >=25 and <28 is Borderline (30 members) >=28 and <30 is Overweight (8 members) >=30 is Obese (23 members) High School and Purdy locations have the highest percentage of members overweight and obese (77% & 65%) 23% participants obese, less than the 33.9% national prevalence *(Centers for Disease Control and Prevention) Being obese puts you at greater risk for health problems such as heart disease, high blood pressure, stroke and more *According to the American Heart Association Recommendations: Low Calorie/Portion Control Diet At least 30 minutes of physical activity most days of the week

Systolic BP – Non-Hypertensive Members Systolic blood pressure ranges <120 Normal (44members) 120-139 is Borderline (28 members) 140-159 is High (7 members) 160-179 is Very High (1 members) >=180 is Extremely High (0 members) 36 participants with a systolic blood pressure reading >119 44% of Females & 50% of Males High blood pressure increases the risk of heart disease and stroke, which are the first and third leading causes of death among Americans *(Centers for Disease Control and Prevention) Contributing Factors: Stress, overweight, smoking, too much salt in diet, sedentary lifestyle Recommendations: DASH diet & At least 30 minutes of physical activity most days of the week

Systolic BP – Hypertensive Members Systolic blood pressure ranges <120 Normal (4 members) 120-139 is Borderline (6 members) 140-159 is High (7 members) 160-179 is very High (0 members) >=180 is Extremely High (0 members) 7 participants with a systolic blood pressure reading >139 38% of Females & 50% of Males High blood pressure increases the risk of heart disease and stroke, which are the first and third leading causes of death among Americans *(Centers for Disease Control and Prevention) Contributing Factors: Stress, overweight, smoking, too much salt in diet, sedentary lifestyle Recommendations: DASH diet At least 30 min. of physical activity most days of the week

Diastolic BP– Non-Hypertensive Members Diastolic blood pressure ranges <80 Normal (41 members) 80-89 is Borderline (23 members) 90-99 is High (12 members) 100-109 is very High (4 members) >=110 is Extremely High (0 members) 39 participants with a diastolic blood pressure reading >79 47% of Females & 56% of Males About one out of three U.S. adults, 31.3% has high blood pressure *(Centers for Disease Control and Prevention) Contributing Factors: Stress, overweight, smoking, too much salt in diet, sedentary lifestyle Recommendations: DASH diet At least 30 min. of physical activity most days of the week

Diastolic BP – Hypertensive Members Diastolic blood pressure ranges <80 Normal (6 members) 80-89 is Borderline (8 members) 90-99 is High (3 members) 100-109 is very High (1 members) >=110 is Extremely High (0 members) 4 participants with a diastolic blood pressure reading >89 21% of Females & 25% of Males About one out of three U.S. adults, 31.3% has high blood pressure *(Centers for Disease Control and Prevention) Contributing Factors: Stress, overweight, smoking, too much salt in diet, sedentary lifestyle Recommendations: DASH diet & At least 30 min. of physical activity most days of the week

Glucose - Blood Sugar Glucose Ranges Good <99 (82 members) Borderline >=99 & < 126 (17 members) High >=126 & <300 (0 members) Very High >=300 (0 members) 35% of U.S. adults age 20+ are pre-diabetic with a Glucose level between 100-125 *(National Diabetes Information Clearinghouse – NDIC and ADA) 17% of Fort Atkinson School District is pre-diabetic, better than national average Recommendations: Portion control/Limited carbohydrate diet At least 30 minutes of physical activity most days of the week

LDL: Bad Cholesterol LDL Cholesterol ranges <70 Very Good (11 members) 70-99 is Normal (30 members) 100-129 is Borderline (35 members) 130-159 is High (9 members) 160-189 is Very High (2 members) >=190 is Extremely High (0 members) National Avg. LDL > 130 = 33.5% *(Medscape) LMH Females LDL > 130 = 13% LMH Males LDL > 130 = 10% Both Females and Males better than the national average for elevated LDL Recommendation: Healthy Low Fat/Low Cholesterol Diet

HDL: Good Cholesterol Very Good; Males >60 & Females >60 (40 members) Normal, Males 40-59 & Females 50-59 (22 members) Low, Males <40 & Females <50 (37 members) Male National prevalence for HDL <40 = 24% 45% of Fort Atkinson Males with low HDL, worse than the national average Female National prevalence for HDL <50 = 27% 35% of Fort Atkinson Females with low HDL, worse than the national prevalence National prevalence figures obtained from National Health and Nutrition Examination Publication Recommendation: For those at risk, follow up with PCP At least 30 minutes of physical activity most days of the week

Triglycerides Triglyceride ranges <150 is Normal (66 members) 150-199 is Borderline (13members) 200-499 is High (19members) >=500 is Very High (0 members) National Avg. Triglycerides > = 150 = 31% of U.S. adult population *(American Heart Association) Females Triglycerides > = 150 = 32% Males Triglycerides > = 150 = 36% Fort Atkinson population worse than the national average for elevated triglycerides Recommendations: Diet – limit bad fats and increase omega-3 fatty acids Exercise – At least 30 minutes of physical activity most days of the week

Tobacco Frequency National Average of Smoking use is 20.6% of adults > 18 *(Centers for Disease Control and Prevention) 6% of participants are tobacco users, better than National Average 2.6% of females use tobacco 18.2% of males use tobacco

Activity Days Per Week 45% participants generated the risk for sedentary lifestyle 25.1% National Prevalence of adults who engage in no leisure-time physical activity *(Centers for Disease Control and Prevention) 40% Participants do not exercise regularly, worse than national prevalence Members who exercise for 30 min, 5 or more time a week have the lowest number of average risks, 2.1 Contributing Factors: Job type, overweight, and other health issues Recommendations: Identify one accountability/fitness partner Create a fitness plan with health or fitness professional Aerobic activity for 30-45 minutes 4-5 days per week

Risk Factors On the graphs, 0 through 8 represent the number of risk factors per person Risk Factors: High Systolic Blood Pressure >=120 High Diastolic Blood Pressure >=80 High LDL >=100 Low HDL < 40 (Male); < 50 (Female) High Triglycerides >=150 High Glucose >=99 Overweight BMI>=25 Tobacco Use: answered occasionally, weekly, or daily to tobacco use frequency question on PHA 33% of the population has 2 or less risk factors

Appendix

Top Clinical Risks Identified Clinical Risk Factors: BMI >25 High LDL Cholesterol Low HDL Cholesterol High Systolic Blood Pressure High Diastolic Blood Pressure High Triglycerides High Glucose Levels Tobacco Use 61 Participants (61.6%) are overweight with a body mass index (BMI) 25 or greater 38 (38.4%) Participants generated a risk for Overweight with BMI 25-29.99 23 (23.2%) Participants generated a risk for Obese with BMI >= 30 Target range for BMI = 18-24.9 46 (52.9%) Participants with high LDL >99 43 (44.3%) Participants with high systolic blood pressure >119 43 (43.9%) Participants with high diastolic blood pressure >79 37 (37.4%) Participants with low HDL Females <50 or Males <40 32 (23.7%) Participants with high triglycerides >149

Top Lifestyle Risks Identified Lifestyle Risk Factors: Sedentary Mammogram overdue Cervical Cancer Screening Overdue Sleep Apnea Symptoms Doesn’t have PCP At Risk for Depression Primary Care Appt. Needed Not Compliant with Meds Colon Cancer Screening is overdue Uncontrolled depression 45 participants (45%) are considered sedentary because they, Are doing 30 min of moderate exercise less than 3 times a week, OR Are doing 20 min of vigorous exercise less than 2 times a week 10 (10) participants do not have a primary care physician 9 (9%) participants need a primary care appointment 10 (10%) participants are at risk for depression Sub groups who need attention 16 (28.1%) female members >40 years old are overdue for a mammogram 12 (21.1%) female members >40 years old are overdue for a cervical cancer screening 6 (15.8%) members >50 years old are overdue for colon cancer screening 5 (5%) medicated members are not compliant with meds overall

Hypertension Medication Adherence Hypertension defined as combined blood pressure of 140/90 or greater 19 Participants indicated having High Blood Pressure (Hypertension) on their Personal Health Assessment 13 Participants, 68% always take medication and are controlling their condition based on their blood pressure reading 0 Participants, 0% taking medication did not have a controlled blood pressure reading 1 Participant who has not been prescribed any medications does not have a controlled blood pressure reading

Diabetes Medication Adherence Controlled Diabetes defined as Glucose<100 1 Participants indicated having Type I Diabetes; 0 with Type II Diabetes on their Personal Health Assessment 1 of 1 Type I individuals are controlled, and they mostly take their medication

Alcohol Frequency The majority of participants are limited alcohol consumers (75%) 10% of participants consume no alcohol 15% of participants consume 1-2 drinks per day

Caffeine Frequency The vast majority of Fort Atkinson School District participants consume caffeine daily (87%) 77% of participants consume 2 or less caffeine drinks per day 23% consume 3 or more caffeinated drinks per day 31% of males consume 3 or more drinks per day more than the 20% of females Caffeine frequency is highest in the age groups 40-49 and 50 to 59.

Chronic Back Pain See trend of participants with current or past back pain increase with age, while those responding never to back pain decreases with age 49% of participants self-reported current chronic back pain currently or in the past

Job Satisfaction Overall, 92% of participants strongly agree or agree their job is satisfying 7% disagree, and 1% strongly disagree The 60+ age group has the highest job satisfaction

Feeling down or depressed 10% of respondents indicated feeling down or depressed in the last 2 weeks 7.7% of females and 19% of males responding to this question answered feeling down or depressed in the last two weeks

Feeling bothered 4% of participants answered being bothered by things that usually don’t bother them in the last 2 weeks

Little interest or pleasure in things 9% of participants indicated having little interest or pleasure in doing things in the last 2 weeks

Trouble keeping focus 8% of participants indicated trouble keeping their mind on what they were doing in the last 2 weeks

Sources American Heart Association; www.americanheart.org http://www.heart.org/idc/groups/heart-public/@wcm/@adv/documents/downloadable/ucm_305059.pdf http://circ.ahajournals.org/content/123/20/2292.full CDC, Center for Disease Control; www.CDC.gov. http://www.cdc.gov/nchs/fastats/overwt.htm http://www.cdc.gov/nccdphp/dnpa/physical/stats/leisure_time.htm http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm#use http://www.cdc.gov/nchs/fastats/cholest.htm National Diabetes Information Clearinghouse (NDIC); http://diabetes.niddk.nih.gov/ http://diabetes.niddk.nih.gov/dm/pubs/statistics/#fast American Diabetes Association; http://www.diabetes.org/ http://care.diabetesjournals.org/content/28/11/2745.full National Health and Nutrition Examination Publication http://www.ncbi.nlm.nih.gov/pubmed/21881447