Monday, January 31, 2011

Employee Wellness Programs Should be Designed for All

Thank you John Commins from HealthLeaders Media , January 31, 2011...

The American Hospital Association issued a report this month on the status of wellness programs at the nation’s hospitals. It’s worth reading, even though the findings are less than encouraging.

As my HealthLeaders Media colleague Cheryl Clark notes, the AHA’s report, A Call to Action: Creating a Culture of Health, finds that most healthcare systems in the U.S. offer wellness programs of varying intensity and enthusiasm to their employees. Few, however, measure outcomes and fewer still have engrained healthy behaviors as part of their employees’ culture.
That sounds discouraging, but it shouldn’t be. The wellness movement in the workplace is a relatively new but simple concept: Improving employee health will reduce the growth of healthcare costs, and other ancillary costs, like absenteeism. The problem is not the wellness concept. That’s easy. Tens of millions of people who’ve tried to lose weight, or take up exercise, or quit smoking to improve their health understand the importance and desirability of wellness.

The problem is changing people’s less-than-healthy habits, like poor diet or sedentary lifestyle, learned over decades, and reinforced in everyday life – mostly during the two-thirds of the day that they’re away from work. (That’s why they’re called "habits," after all.) These habits took years to develop and it’s unrealistic to think that people will change their lives in the span of a few weeks or months with a "biggest loser" diet contest or discount rates at the local gym.

John Bluford, CEO of Truman Medical Center which has 4,000 employees in Kansas City, wrote the AHA report, and he was spot on when he told HealthLeaders Media: "This is not the program of the month. It’s a culture," and "You can’t do this for a year and think it’s a done deal."

In addition to the many suggestions that Bluford lists in his report – which you can read in Cheryl’s account -- I would also suggest that a little empathy goes a long way. If you are a hospital executive, not everyone on staff will have the same ability to embrace wellness.
Imagine how a low-wage, manual worker in environmental services at your hospital might view the idea. Maybe that worker has to get up at 4 a.m. every day to take a bus to work, where he’s on his feet all day wrestling with heavy objects. Maybe that worker has a second job to make ends meet, or he’s a single parent with two kids at home. That worker is probably not going to take advantage of your lunchtime Jazzercise class, or spend a couple hours after work running a treadmill.

Bluford talks about how important it is to have top leadership on board, leading your wellness program by example. He is right. However, I would suggest that while any wellness program should be led from the top, it should be designed from the ground up to be accessible for the lowest-paid employees.

Low-wage workers are often the ones who have the most to gain from wellness programs, because studies have shown that health issues like obesity – and all the ancillary problems overweight create -- disproportionately affect lower-wage workers. If you’re going to offer financial incentives for employees to get eat better, or exercise more, it’s unfair not to design programs readily available to everyone on your staff in a practical way.

You want staff to eat better, but do all of your workers have ready access to fresh fruits and vegetables, or even a decent supermarket? You’re offering a rebate to cover a partial cost of a health club, but what good is a rebate if you don’t live near a health club, or if you don’t make enough money to sign up for a health club in the first place?

That $60 a month for a gym membership might not seem like a lot to a hospital executive or clinician, but it can be out of reach for some folks on support staff. Exercise more? It’s hard to take a walk around the block if you live in a crummy neighborhood, or you don’t have sidewalks, or the streets aren’t lighted when you get home from work at night.

None of these problems is insurmountable, of course, and anybody who wants to improve his health has to take most of the initiative on exercise and diet. However, bad habits can be more easily overcome when everyone on staff feels a sense of ownership with the wellness movement.

If you want employees to embrace wellness, talk to them, all of them, including the environmental staff folks working the graveyard shift. Explain what you want to achieve with your wellness program, find out what is important to them, how they’d like to improve their lives, what they’d like to see in the program, and what limitations their lifestyle may impose. You probably won’t resolve all of their problems, but you’ve at least listened to their concerns, and made it clear to them what you’re doing. That’s a good start.

People want to be healthy. How many people enjoy being overweight, or enjoy smoking? If you want your wellness program to work for everyone, design it with everyone in mind.

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