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A healthy workforce: Prevention is key
to productivity

It's estimated that 60 percent of health care dollars are spent on preventable disease due to poor lifestyle habits. (1) With health care costs continuing to soar, the catalyst to help employees improve their health and, thus, reduce health care costs has taken on a higher degree of urgency and new complexity.

According to Kathy Parrish, manager of Ceridian's Health and Productivity Management program, "U.S. corporations need to be competitive in the global marketplace, retain valuable employees and contain health costs. It's a vicious cycle. The push for higher productivity increases stress, which can lead to health issues." Employees want more work-life balance, and yet companies need to compete in a global marketplace. The issue is complex, as is the solution.

Eliminate unhealthy behavior
Some companies have taken an aggressive approach to address the relationship between productivity and health care. Newsweek reported that one Michigan health industry company with about 200 employees went from a smoke-free workplace to a smokeless workforce in 15 months ("A job or a cigarette?", Feb. 24, 2005). Employees were given access to free smoking cessation programs and educational materials. Four of the company's employees continued to smoke and received termination notices. The high-profile terminations were reported by the national news media, including 60 Minutes.

The top executive at the Michigan company attributed the decision for a smokeless workforce to the need to reduce costs and increase productivity to stay competitive with healthy employees. The relationship to the bottom line is clear. A smoker will cost a company nearly $3,400 more in lost productivity and health care costs every year, according to the Centers for Disease Control and Prevention.

Other companies have taken a slightly different approach to eliminating tobacco in the workplace. According to the National Workrights Institute (NWI), an affiliate of the American Civil Liberties Union, an estimated 6,000 employers no longer hire smokers. NWI has conducted its own media campaign to keep companies from what they believe is "lifestyle discrimination," telling employees what they can do during their personal time.

Take a proactive, holistic approach
With human capital as their greatest asset and expense, companies need to find a way to leverage the asset while reducing the cost associated with it. Robert M. Kramer Ph.D., senior product manager for Ceridian, says that survival in today's business environment, where maximizing productivity is essential, requires that employers become more effective at managing absences.

Unscheduled absences have a major impact on workplace productivity. The 2003 Unscheduled Absence survey reported that the average cost of absenteeism was nearly $650 per employee. Such figures often include the replacement and retraining of employees and, what's more difficult to quantify, the "silent costs" of a decline in employee morale, sporadic work attendance and decreased job performance.

Described by Kramer as a "fresh approach" to the rising cost of health care and lost productivity, employers should consider how they can manage every area of employee absence, from presenteeism (being present at work, but not working at full effectiveness) to complicated disabilities. This holistic approach focuses on reducing employee absences through identifying high-risk employees, preventing absences and disability, reducing lengths of disability and returning to work successfully while minimizing relapse. These strategies also naturally result in reduced health costs.

"Before a solution can have any effect, it's important to identify the results the organization wants to achieve with an absence management or health and productivity program," Kramer explains. It's the first step to identify the "at risk" employees who could benefit from specific health services.

Health and productivity management: Ceridian style
Ceridian offers a comprehensive solution to help organizations manage the health and productivity of employees. Ceridian Health and Productivity Management provides employers with resources and tools to help promote a healthier workforce.

One such tool is the Life Health Assessment (LHA). This online assessment tool identifies and evaluates at-risk individuals based on their lifestyle behaviors and health conditions. The LHA goes beyond a traditional health risk assessment by globally integrating assessments of health and related psychological, interpersonal and life event issues, and then evaluating their impact on employee absences and productivity. A stage of readiness for change assessment also provides needed information for the intervention phase of the health and productivity management cycle.

In addition, the LHA generates data that profiles the health of a company's employee population and demonstrates the relationship between health and productivity. Population reports detail health status and risks, stages of readiness for change, the presence of chronic conditions and diseases and the levels of absence and productivity risks present in your population. Companies can then use the information gained from the health assessment to address the complexities and health issues that directly impact its workforce.

Once high risk individuals are identified, appropriate interventions can be implemented, such as Ceridian's Life Enhancement Program. The Life Enhancement program integrates health and wellness, psychosocial, behavioral and work-life balance coaching to help employees achieve a higher level of overall health and well being. It begins when a Life Enhancement coach calls and introduces the program to the employee.

Support is a critical component of successful health behavior change. Once an employee agrees to participate in the program, a coach begins the relationship building process. The coach works with the employee to set goals and create a plan that may include phone-based counseling and support, coordinating referrals for in-person counseling and support groups, providing educational self-help materials and coordinating solutions to everyday problems.

If an employee's assessment indicates an unhealthy lifestyle that may lead to more serious health problems, there could be a need to access wellness specialists. Ceridian also offers proprietary behavior modification programs that address issues such as weight management, smoking cessation, fitness and exercise, stress management, and pre and post natal care.

Motivating employees to participate is a critical component of a health and productivity management strategy and can be challenging. Whether or not participation is required or voluntary, it's a good practice to provide incentives. For example, incentives may be linked to employee participation in specific aspects of the program such as a health assessment. Rewards could be a deposit in an employee's flexible spending account or a reduction in health benefit costs. The use of appropriate incentives as well as education will help increase overall participation and acceptance.

The group approach to kicking off a health and wellness program is to host an in-house health fair. This provides a venue for a company to promote health and demonstrate the importance to all employees, not just those who are at risk. A health fair can help employees understand the importance of good health, encourage the adoption of improved health practices and connect employees with local service providers. It could include exhibit booths that focus on specific health issues and feature health practitioners, as well as benefit providers. Sometimes health screenings can be a good way to raise awareness among the employee population and be a motivation to take the first step.

Long-term outlook
A proactive approach takes time and commitment. Health behavior change is challenging. Healthy individuals are generally easily motivated, however, individuals who have less healthy lifestyle behaviors may be the least likely to take that first step. They're most successful with personalized attention, such as goal setting and behavior modification milestones, in a supportive, consultative environment. And, by taking a holistic approach, companies will likely avoid negative attention, such as the national press coverage of the smoking cessation approach by the firm in Michigan.

Holistic solutions to the health challenges faced today can help pave the way for a healthier and more productive U.S. workforce for generations to come. Contact your Ceridian representative to learn more about how Ceridian's Health and Productivity Management solution can benefit your organization.

Sources
(1) www.HealthDynamics.com
(2)USA Today, Oct. 3, 2005, "Percentage of Overweight Americans Stable."
(3) The Behavioral and Clinical Effects of Therapeutic Lifestyle Change on Middle-aged Adults, Center for Disease Control and Prevention
(4) Center for Disease Control and Prevention, www.cdc.gov