1. Health & Wellness Topics Myra Forrest

2. Reasons for Health & Wellness Programs Health Care Costs Health Care Costs Most illnesses can be avoided Most illnesses can be avoided Employees’ stress levels are increasing Employees’ stress levels are increasing Aging Workforce Aging Workforce

3. Health Care Costs Health Care Costs Average annual health care cost per American is $3,925. Average annual health care cost per American is $3,925. Preventable illnesses make up 70% of health care costs Preventable illnesses make up 70% of health care costs Preventable illnesses account for 8 of 9 leading causes of death. Preventable illnesses account for 8 of 9 leading causes of death.

4. BENEFITS Reduced medical claims Reduced medical claims Reduced absenteeism Reduced absenteeism Worth Every Dollar You Spend Worth Every Dollar You Spend

5. Reasons for Unscheduled Absences 2003 Source: 2003 CCH Unscheduled Absence Survey

6. Direct Benefits of Wellness Program Improves Employee Health Improves Employee Health Improves Productivity Improves Productivity Reduces Sick Leave Reduces Sick Leave Reduces Use of Health Insurance Reduces Use of Health Insurance Reduces Workers Compensation Reduces Workers Compensation

7. Indirect Benefits of Wellness Program Improves Employee Morale Improves Employee Morale Increases Employee Job Satisfaction Increases Employee Job Satisfaction Improves Corporate Image Improves Corporate Image Improves Benefit Package Improves Benefit Package

8. 5 Levels of an Effective Wellness Program 5 Levels of an Effective Wellness Program 5. Behavior Change Activities 4. Immunizations 3. Assessment & Screenings Educational Activities 2. 1. Awareness Activities

9. 2 Big Questions What’s it going to COST? What’s it going to COST? What’s it going to SAVE?

10. Higher Costs Preventable health risks are associated with higher corporate health care costs including workers compensation costs.

11. High Risk Criteria u Tobacco Use u Physical Activity u Medication/Drug Use u Absences Due to Illness u Drinking Alcohol u Seat Belt Use u Life Satisfaction u Job Satisfaction u Stress Signs u Depression u Blood Pressure u Cholesterol u Fasting Glucose u Weight è User of cigarettes, pipes, cigars, chewing tobacco è No regular exercise program è Sometimes or frequently è 5 days or more è More than 21 drinks per week è Only occasionally è Not too happy, very unhappy è Dissatisfied, very dissatisfied è 3 or more stress signals è Feel depressed most of the time è 160/100 or greater è 240 mg/dl or greater è 115 mg/dl or higher è More than 20% Overweight (Obese)

12. Costs of High Risk Behavior Unhealthy lifestyles (smoking, stress, obesity, high blood pressure, high cholesterol, poor nutrition, sedentary lifestyle, alcohol/drug usage) contribute to approximately 70% of health care costs. Unhealthy lifestyles (smoking, stress, obesity, high blood pressure, high cholesterol, poor nutrition, sedentary lifestyle, alcohol/drug usage) contribute to approximately 70% of health care costs. 1-pack/day smoker costs a company $1,902 more each year in medical costs than a non-smoker. 1-pack/day smoker costs a company $1,902 more each year in medical costs than a non-smoker. A person who drinks 3+ alcoholic drinks/day costs a company $814 more each year than someone who drinks 2 or less. A person who drinks 3+ alcoholic drinks/day costs a company $814 more each year than someone who drinks 2 or less.

13. First Year Treatment Costs Heart disease treatment can cost more than $30,000 in the first year. Heart disease treatment can cost more than $30,000 in the first year. Cancer - $29,000 Cancer - $29,000 Stroke - $22,000 Stroke - $22,000 Diabetes - $15,000 Diabetes - $15,000 Drug Abuse - $63,000 Drug Abuse - $63,000 Hip Fracture - $40,000 Hip Fracture - $40,000

14. SAVINGS The prevalence of preventable health risk factors can be reduced through a comprehensive worksite health promotion program The prevalence of preventable health risk factors can be reduced through a comprehensive worksite health promotion program

15. Worksite Wellness Most claim dollars are spent on high risk individuals Most claim dollars are spent on high risk individuals Goal - Keep employees healthy and don’t wait for problems before initiating wellness programs Goal - Keep employees healthy and don’t wait for problems before initiating wellness programs

16. Conclusion... Employees with modifiable health risks incur higher health care expenditures. Employees with modifiable health risks incur higher health care expenditures. Managing these modifiable risks provides opportunities to significantly reduce health care costs and improve quality of life. Managing these modifiable risks provides opportunities to significantly reduce health care costs and improve quality of life.

17. Steps to Reduce Risks and Reduce Costs  Determine prevalence of risk factors for your workforce. your workforce.  Invite and encourage employees at risk to make lifestyle changes. make lifestyle changes.  Provide opportunity and support for change. change.

18. The Aging Workforce 30% of present workforce is 45 30% of present workforce is 45 Influx of older women into workforce Influx of older women into workforce By 2015 – 40% or 50 million workers will be over the age of 60 By 2015 – 40% or 50 million workers will be over the age of 60

19. Aging Process Natural process Natural process Changes in strength, size and stamina Changes in strength, size and stamina Onset of diabetes, coronary artery, cancer, etc. Onset of diabetes, coronary artery, cancer, etc.

20. Impacts of Aging on the Body Skin Skin Ears Ears Eyes Eyes Respiratory Respiratory Cardiovascular Cardiovascular Musculoskeletal Musculoskeletal Central Nervous System Central Nervous System

21. Clinical Manifestations Bone density Bone density Weight gain Weight gain Skin shifts Skin shifts Habits Habits Sleep patterns Sleep patterns Hearing Hearing Smell Smell Temperature regulation Temperature regulation

22. 5 Aging Changes Balance Balance Flexibility Flexibility Attention, vision, and memory Attention, vision, and memory Strength Strength Reaction time Reaction time Age related changes can directly Age related changes can directly affect workplace safety affect workplace safety

23. What is Stress ? Events or situations that cause feelings of tension, pressure, or negative emotions such as anxiety and anger Events or situations that cause feelings of tension, pressure, or negative emotions such as anxiety and anger Physiological changes – increased heart rate and muscle tension Physiological changes – increased heart rate and muscle tension Emotional and behavioral changes Emotional and behavioral changes Person’s interpretation and response to a threatening event Person’s interpretation and response to a threatening event

24. Impacts of Stress Positive and Negative effects Positive and Negative effects Normal adaptive reaction to a threat Normal adaptive reaction to a threat Performance on work tasks or deadlines Performance on work tasks or deadlines Effects on personal relationships Effects on personal relationships Physical threats Physical threats

25. 3 Categories of Stressors Catastrophes Catastrophes Major Life Changes Major Life Changes Daily Hassles Daily Hassles

26. Ways to Reduce Stress Time management skills Time management skills Changes in lifestyle or how we look at things Changes in lifestyle or how we look at things Focus on good work habits and performance Focus on good work habits and performance Physical and health needs Physical and health needs Unmanaged stress leads to reduced sleep, increased anxiety, weakened immune system, and reduction in job performance Unmanaged stress leads to reduced sleep, increased anxiety, weakened immune system, and reduction in job performance

27. “ If I exercise today, I will be able to… ” “ If I exercise today, I will be able to… ”

28. What Can Exercise Do For Me ? Prevent or delay some diseases and disabilities Prevent or delay some diseases and disabilities Reduce stress and tension Reduce stress and tension Stimulates the mind Stimulates the mind Weight maintenance or loss Weight maintenance or loss Control appetite Control appetite Boosts self image Boosts self image

29. Improves muscle tone & strength Improves muscle tone & strength Improves flexibility Improves flexibility Lowers blood pressure Lowers blood pressure Relieves insomnia Relieves insomnia Increases good HDL cholesterol Increases good HDL cholesterol Quicker recovery after injury Quicker recovery after injury Provides enjoyment and fun Provides enjoyment and fun

30. Activities Improve Health & Ability Walking/Jogging Walking/Jogging Biking Biking Yoga Yoga Aerobics Aerobics Weight lifting Weight lifting Recreational sports – Golf, Volleyball Recreational sports – Golf, Volleyball Outside activities such as gardening, home improvement projects Outside activities such as gardening, home improvement projects

31. Four Types of Exercise Endurance – Increase breathing & heart rate Endurance – Increase breathing & heart rate Strength – Build muscles Strength – Build muscles Balance – Help prevent falls Balance – Help prevent falls Flexibility – Stretch muscles & tissues that hold your body’s structures in place Flexibility – Stretch muscles & tissues that hold your body’s structures in place

32. Rules for Stretching Stretch Both Sides Stretch Both Sides Avoid Bouncing Avoid Bouncing Stretch Until you Feel Slight Tension, NOT PAIN or DISCOMFORT Stretch Until you Feel Slight Tension, NOT PAIN or DISCOMFORT Hold for a Minimum of 10 seconds Hold for a Minimum of 10 seconds BE GENTLE BE GENTLE RELAX into the Stretch RELAX into the Stretch

33. Five Causes of Back Injuries Posture Posture Body Mechanics / Work Habits Body Mechanics / Work Habits Stressful Living Stressful Living Loss of Flexibility Loss of Flexibility Poor conditioning Poor conditioning

34. Spinal Anatomy

35. Back Injuries and How To Prevent Them Most back problems occur over a period of time. Most back problems occur over a period of time. Careful attention to lifting on the job and at home and regular exercise to maintain fitness, strength, and flexibility will help you maintain a healthy back. Careful attention to lifting on the job and at home and regular exercise to maintain fitness, strength, and flexibility will help you maintain a healthy back. Proper Lifting Techniques Proper Lifting Techniques

36. Proper Planning Is Important  Do you need to lift the item manually?  How heavy is it?  Where are you moving the item from?  Where does it have to go?  What route do you have to follow?

37. Mechanical Aids Dolly Dolly Handtruck Handtruck Forklift Forklift Assistance by another employee Assistance by another employee PUSH don’t Pull PUSH don’t Pull

38. Proper Lifting Techniques Squat to lift and lower. Do not bend at the waist. Squat to lift and lower. Do not bend at the waist. Keep your low back bowed in while bending over. Keep your low back bowed in while bending over. Keep the weight as close to you as possible. Keep the weight as close to you as possible. Bow your back in and raise up with your head first. Bow your back in and raise up with your head first. If you must turn, turn with your feet, not your body. If you must turn, turn with your feet, not your body. Never jerk or twist! Never jerk or twist! Put the weight down by keeping your low back bowed in. Put the weight down by keeping your low back bowed in. Keep you feet apart, staggered if possible. Keep you feet apart, staggered if possible. Wear shoes with non-slip soles. Wear shoes with non-slip soles.

39. Risk Factors for Back Injury during Lifting Lifting with your back bowed out. Lifting with your back bowed out. Bending and reaching with your back bowed out. Bending and reaching with your back bowed out. Slouched sitting. Slouched sitting. Twisting or jerking movements. Twisting or jerking movements. Lack of proper rest. Lack of proper rest. Obesity and poor nutrition. Obesity and poor nutrition. Stressful work and living habits. Stressful work and living habits.

40. Lifting Posture Wrong Way Right Way Lifting Posture Wrong Way Right Way

41. Promotional Ideas Newsletters Newsletters Smoking Cessation Smoking Cessation Health & Wellness Fairs Health & Wellness Fairs Stress Management Stress Management Fitness club discounts Fitness club discounts Blood drives Blood drives Health Screening Health Screening

42. Municipal Utilities Board of the City of Albertville M aking U s B etter Employee Wellness 2005

43. Our Employees 11 Females, 72 Males 11 Females, 72 Males 84 % Married 84 % Married 71% have children at home 71% have children at home 25% 10lbs or more overweight 25% 10lbs or more overweight 46% over 40, in five years 58% over 40 46% over 40, in five years 58% over 40 933 years of experience, 50% have 10+ years of experience 933 years of experience, 50% have 10+ years of experience

44. Attendance Program Implemented in 2000 Implemented in 2000 Total decrease in sick leave usage in Five years 26% Total decrease in sick leave usage in Five years 26% Usage in 1999 was over 6,000 hours, now is 4,500 hours a savings of 7,500 hours in five years. Usage in 1999 was over 6,000 hours, now is 4,500 hours a savings of 7,500 hours in five years. An increase of 3.6 years in productivity An increase of 3.6 years in productivity

45. Attendance Incentives Perfect attendance receives $120 gift certificate Perfect attendance receives $120 gift certificate 2000 7 people with perfect attendance 2000 7 people with perfect attendance 2001 9 2001 9 2002 8 2002 8 2003 16 2003 16 2004 17 2004 17 Employee with lowest usage in a group without perfect attendance receives $20. Employee with lowest usage in a group without perfect attendance receives $20. Group with overall lowest usage receives $20. Group with overall lowest usage receives $20.

46. Safety Program Last Lost Time Incident Last Lost Time Incident Electric 2003 Electric 2003 Wastewater 1999 Wastewater 1999 Water 1997 Water 1997 Total Days without lost time Total Days without lost time Electric 500 days Electric 500 days Wastewater 2000 days Wastewater 2000 days Water 2750 days Water 2750 days

47. Rewards for days without Lost time $25 meal gift certificates are given for every 250 days $25 meal gift certificates are given for every 250 days 1000 days $25 gift certificate 1000 days $25 gift certificate 1500 days $50 gift certificate 1500 days $50 gift certificate 2000 days $75 gift certificate 2000 days $75 gift certificate 2500 days $100 gift certificate 2500 days $100 gift certificate 3000 days $125 gift certificate 3000 days $125 gift certificate 3500 days $150 gift certificate 3500 days $150 gift certificate

48. Annual Safety Review 2000 11 claims 2 lost time 2000 11 claims 2 lost time 2001 15 claims 4 lost time 2001 15 claims 4 lost time 2002 7 claims 1 lost time 2002 7 claims 1 lost time 2003 9 claims 1 lost time 2003 9 claims 1 lost time 2004 2 claims 0 lost time 2004 2 claims 0 lost time Employee receives a $20 gift certificate for working incident free and an additional $20 if the whole group works incident free. Employee receives a $20 gift certificate for working incident free and an additional $20 if the whole group works incident free.

49. Workers Compensation Premiums 3yr Losses 1994 $62,409 1994 $62,409 1995 $58,106 1995 $58,106 1996 $68,065 1996 $68,065 1997 $51,236 1997 $51,236 1998 $60,362 1998 $60,362 1999 $72,455 1999 $72,455 2000 $77,904 2000 $77,904 2001 $84,736 2001 $84,736 2002 $64,036 2002 $64,036 2003 $70,473 2003 $70,473 2004 $64,929 2004 $64,929 2005 $68,943 2005 $68,943 2006 estimate $58,000 2006 estimate $58,000 1999 $281,125 2000 $319,512 2001 $303,028 2002 $112,486 2003 $ 79,777 2004 $ 73,663 2005 $ 55,479 2006 $ 4,507

51. Employee Rewards Luncheon Luncheon Employee Slide Show Employee Slide Show Door Prizes Door Prizes Trips to Gatlinburg Trips to Gatlinburg TV’s TV’s DVD Players DVD Players Computers Computers Rewards Rewards T-shirts T-shirts Stainless steel travel mugs Stainless steel travel mugs Beach towels Beach towels Coolers Coolers Fleece Blankets Fleece Blankets Golf Umbrellas Golf Umbrellas Stainless steel thermos Stainless steel thermos Emergency Car Kit Emergency Car Kit Gym Bags Gym Bags Gift Certificates Gift Certificates

52. Sucesses of Program In the five years of the program, MUB has given gift certificates totaling $17,840. In the five years of the program, MUB has given gift certificates totaling $17,840. MUB’s estimated savings in productivity, and workers compensation premiums $250,000. MUB’s estimated savings in productivity, and workers compensation premiums $250,000.

53. Current Activities Annual Safety & Attendance Banquet Annual Safety & Attendance Banquet Annual Health Screenings Annual Health Screenings Annual Flu Shots Annual Flu Shots Zoll AED units being placed in all locations (8 in place, 4 more ordered) Zoll AED units being placed in all locations (8 in place, 4 more ordered) On site Safety Classes 6 per year On site Safety Classes 6 per year Monthly Health & Safety Handouts Monthly Health & Safety Handouts

54. Proposed Activities Partnering with Occupational Health Group of Huntsville to provide Wellness Services Partnering with Occupational Health Group of Huntsville to provide Wellness Services Personal Wellness Profile Personal Wellness Profile In depth Health Screening In depth Health Screening Wellness Training Wellness Training Stress Management Stress Management Nutrition Nutrition Cancer Prevention Cancer Prevention Fitness & Exercise Fitness & Exercise

55. Gym Membership Paid Employee Gym Memberships Paid Employee Gym Memberships Local Gyms range from $15 to $30 per month. Local Gyms range from $15 to $30 per month. Employee joins gym of choice and MUB is invoiced monthly for membership. Employee joins gym of choice and MUB is invoiced monthly for membership. Estimated MUB monthly expense $1,000. Estimated MUB monthly expense $1,000.