To incent or not to incent
Originally posted October 18, 2013 by Rhonda Willingham on lifehealthpro.com
There is a lot of confusion and more than a few questions about the use of incentives in benefits these days.
What do the Health Insurance Portability and Accountability Act’s (HIPAA) new wellness regulations mean? How can we incentivize employees, without risking noncompliance with new regulations?
Incentives are an especially big question mark for employers because so many want to find ways to motivate, encourage and lower the health care costs for the 5 percent to 10 percent of their employee population that is driving 80 percent or more of their costs.
Often these are employees who have chronic conditions such as diabetes or heart disease, or who may be obese – a condition now classified by the American Medical Association as a disease. Often these are also valuable tenured employees who have the skills, knowledge and expertise a company may need; helping them helps the company.
Here’s what you can tell your group health employer clients about the complex issues surrounding incentives today:
1. Offer a health risk assessment
One of the first steps toward getting employees to improve their health is the health risk assessment (HRA), which is the entry point for most wellness programs. Employers frequently offer financial incentives, premium discounts, or even PTO to get people to take the HRA.
Yes, HRAs have come into question of late in benefits circles – but, despite the current controversy, they remain a very smart tool for employers. They provide important information about the health status of employees and what programs (based on aggregate, not individual data) could provide the most value to the organization.
But . . . and here’s where a lot of employers have gotten into trouble . . . you must fully explain their value, including how they work. Include the steps that need to be taken to protect privacy and ensure employees know they can opt out – preferably without penalties - if wanted.
2. Understand what new regulations do and don’t say
What employers can and can’t do with incentives is governed in part by the Patient Protection and Affordable Care Act (PPACA) and HIPAA.
One of the many provisions of PPACA is that it allows employers to link greater financial incentives to the achievement of predetermined health targets, such as smoking cessation or healthy weight. HIPAA also governs what group health plans can do with benefit programs.
Most importantly, HIPAA prohibits employers from charging different premiums based on health status. People can’t be penalized just because someone is overweight or has diabetes or heart disease.
HIPAA’s new wellness regulations, introduced in June of this year, state that:
…a group health plan…may not require any individual (as a condition of enrollment or continued enrollment under the plan) to pay a premium or contribution which is greater than [that] for a similarly situated individual enrolled in the plan on the basis of any health status related factor…
The other major component for HIPAA is guidance on the dollar amount allowed for incentives.
Health plans and insurers will be able to offer higher financial rewards to participants achieving healthy behaviors such as quitting smoking or reducing cholesterol. Specifically, as of Jan. 1, up to 30 percent of the total cost of health plan coverage (employer and employee cost of coverage with no cap) may be tied to an incentive. Tobacco cessation and usage reduction programs allow rewards to be increased to 50 percent. Now, in reality very few employers will go up to that 30 percent, but it is an option.
The real trick to compliance with HIPAA’s wellness regulations is that wellness programs will have to ensure they do not discriminate against people based on health factors. For example, if an employee is extremely obese and unable to participate in a walking program that provides financial incentives, there must be an alternative program for that employee.
3. Determine if you will use a carrot or stick
Employers have developed a range of approaches to incentives over the past few years. Most incentives today are based either on participation, outcomes or progress. Participation-based programs are simple.
You participate, sign a sheet that you came to the stop-smoking class or joined a gym, and you qualify for the incentive. Outcome-based programs usually include financial incentives.
Employers have learned over time that money is a great motivator for participation in either the HRA or a wellness program. The threshold for motivating employees seems to be right around $300 to $500 annually.
The key characteristic of an outcome incentive is that the employee doesn’t get that incentive unless he or she achieves a pre-determined goal or health standard, such as quitting tobacco use, losing 10 percent of body weight within six months, or bringing cholesterol levels within normal limits, etc.
Progress-based incentives are viewed as a “kinder, gentler” approach. They reward employees based on incremental, individually-attainable goals rather than a singular goal for all. In other words, you may need to lose 50 pounds, but the employer says, “We know losing even five pounds helps you and helps us, so you will still get the incentive.” (Studies show even small reductions in risk lower health care costs.)
Here again is where the incentive question gets tough and complicated. A Towers Watson 2012 survey reports that 62 percent of employers plan on switching from incentives for participation – which employees like – to incentives for improvements – which employers like – because it holds employees more accountable and the thought/hope is it will produce more tangible and measurable outcomes.
So what’s an employer to do when it comes to incentives? As we are learning from recent high profile news stories, employees will push back hard if they don’t support a wellness program and its goals (which typically happens if there is poor communication), or if they think non-participation penalties are too punitive. We all understand the need for accountability, but if that comes at the price of an unhappy employee population, what have you really won?
Every organization is different; I think it’s difficult to mandate you must do X, Y or Z. As part of my job with a leading health and wellness company and as a member of a number of key organizations evaluating worksite wellness programs and incentives, my recommendation is to consider a developing and evolving plan with incentives that engage, motivate and encourage all employees.
Start with simply incentivizing participation. Then as the program becomes better accepted with employees experiencing success – and as you do more education and communication – you can always migrate to the incorporation of a program that incentivizes progress.
Again, there is no one-size fits all, but we do know that what truly motivates people are programs that build intrinsic motivation. Program designs with the best chance of fostering such intrinsic motivation are those that use extrinsic tools (e.g., a weight loss program for employees) in a way that doesn’t make employees feel pressured but creates a supportive and empowering environment that promotes individual choice.
The last word on incentives is that the ultimate goal is not to get people to engage in behaviors for a short period of time just to get dollars. The objective is for employees to internalize the goal and learn how to make and sustain better lifestyle choices themselves.
Tips to help with negativity in the workplace
Originally posted on https://www.hr.com
Tips for solving negativity in the workplace
A lot of the time people feel that the workplace can be pretty stressful and they are not always so lucky to like every single one of their coworkers and not everyone has the most amazing boss. These are things you must be aware of in the workplace. You have to expect the negatives but to keep it from driving you insane, you have to at least try to keep a positive attitude and potentially come up with solutions to these negative attitudes.
1. Vent: Do not let your negative feelings about something build up, that could lead to a big explosive confrontation, which is obviously something you want to avoid. After work talk to a friend/spouse/ even a pet or anyone that will just sit and listen to your frustration. It gives you an opportunity to share all of your negative feelings, no filter involved and to possibly get some suggestions that might help with the issues you are dealing with. Writing it all down is also a good way to cope. It gives a chance to see them all in front of you, and can potentially give you your own insight on how to solve the negativity.
2. Come to terms: Keep in mind that you do not have the power to change everything that may cause negativity in the workplace. Focus on the things that are in your power and make the appropriate changes to make the negatives into positives. Coming to those terms will help you to further yourself instead of being stuck in a pit of negativity. Stay positive and keep moving forward and you will boost your potential to be successful.
3. Embrace what you have: Remember that things will not always go the way YOU want them to. Just know it isn’t just in your place of business, that’s life. It goes along with step number two where there is a point where you just have to learn to come to terms and accept that yes, there are some negatives you can change but for the ones you can’t, embrace them. It is the only thing you can do.
Stick with the positives and you will be much more likely to succeed. The negatives will be there, but if you learn to get past them or at least learn to work with them, then you will be in the right mind set to get what you worked for.
Bike and health expert advocates collaborative approach to wellness
Originally posted September 25, 2013 by Kathleen Koster on https://ebn.benefitnews.com
The workplace strategy for health improvement is easily expressed as a bicycling metaphor where bicyclists struggle with the uphill stretches and use caution to coast on downward slopes. Gary Earl, former vice president of benefits and health care for Caesars Entertainment Corporation, suggested employers could learn from the biking world when improving their wellness strategy, speaking during a panel discussion at the Benefits Forum & Expo in New Orleans on Monday.
“Our job [as HR professionals] is to improve the lives of human beings. We’re responsible for that,” explained Earl, founder and team captain of Journey for Health Tour, for which Earl and his team are riding a bicycle 3,000 miles across America to promote health improvement.
While working for Caesars, Earl transformed the company’s outlook on wellness programs and health benefits from a cost-only perspective to an asset for the workforce and business.
“[My employer’s] vision was the traditional vision: to offer affordable benefit plans to employees and to reduce costs. We turned that upside down. We wanted to move it from an expense to an asset,” he said.
He created an affordable equation to prove his strategy would improve the population’s health by developing a mathematic equation to show company executives the value in this paradigm shift.
That equation illustrated how employees’ positive health experience and positive attitude generates an increase in productivity, sustainability and satisfaction, which would lead to an improvement in company earnings.
“We have to look at health benefits as an opportunity, an asset,” Earl stressed.
Earl believes HR and benefits professionals need to hold themselves accountable to improving population health and always passionately advocate wellness—not simply view this responsibility as part of a dry job description.
Over time, we have created the problems afflicting our health system and it’s our responsibility as a community to fix today’s prevalent issues, said Dr. David Whitehouse, MD, chief medical officer, UST GLOBAL, a fellow panelist at the conference session.
“The ecosystem of health and the obesity endemic exist because of modernization. During World War II there were food shortages and we developed preservatives [to make our food last longer]. We then wanted to make our lives more convenient, so we developed transport and we stopped exercising and walking. We have, in fact, through modernization and our own design for comfort, created the epidemic,” said Whitehouse.
Earl seconded that point, adding that these health issues “can’t be viewed in isolation. They are systematic problems, which means that they are interconnected and interrelated. We need to approach this by connecting all aspects of the community, whether it’s faith, safety, education, business or economic development—there’s a real balance to be able to draw them all together.”
He added that business owners could drive this change. “They don’t own that change but they can be a catalyst. By coming together in uncommon ways but for a common purpose stimulates the change,” he said.
Employers and company leaders must connect with communities to make significant change. Applying the bike metaphor again, Earl said that we need to encourage each other when facing uphill challenges and learn from one another to find solutions. And for those downhill stretches, Earl explained that in biking, “you don’t ever coast downhill; you want to keep that leg-mind momentum going.” Employers must also use caution to stay in control of their initiatives and keep forward momentum, without swerving off the edge of the road.
“You’re not going to improve an individual’s health without understanding what those social and environmental elements are,” Earl said. “You have to put in the energy.”
Employers can align medical groups and local systems by working with the community. They can make a customized approach through patient-centered medical homes, on-site clinics or Accountable Care Organizations. Whatever employers develop with their local groups, they must work together to fix the dramatic health issues Americans face and struggle with.
“If we don’t overcome our shyness and work collaboratively then we will live with the misfortunes of our unintended consequences,” said Whitehouse.
Obesity’s disease label could spell trouble for employers
Originally posted by Andrea Davis on https://ebn.benefitnews.com
Earlier this year, the American Medical Association deemed obesity a disease. AMA board member Patrice Harris, M.D., said in a statement that “recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans.”
While there is still debate within the medical community as to whether obesity is a disease — the AMA’s own House of Delegates recommended the body not adopt the resolution declaring it a disease — there is speculation the AMA’s decision could open the door to more discrimination claims under the American with Disabilities Act.
EBN spoke to Jay Starkman, CEO of Engage PEO, about the AMA classification of obesity and how it might affect employer decisions.
What are the implications for employers?
Employers need to treat obese individuals like they would anybody else with a disability. … There was always an issue about whether or not an obese person was disabled under the Equal Employment Opportunity Commission guidelines. [Under the] ADA, “disability” is defined as an impairment that substantially limits a major life activity. … but there was always a question about whether or not obesity was one of those things.
One of the issues that existed for a long time was whether or not there needed to be some type of underlying disorder that caused the obesity, whether psychological or physical. By classifying obesity as a disease, it’s pretty clear that whether or not there’s an underlying disorder isn’t going to be a relevant inquiry any more. So that means that employers can’t make hiring decisions — hiring, firing, promotions, raises, compensation — based upon whether or not someone is obese.
Do employers need to consider any changes to their current employee policies?
The first is make sure you have very clear job descriptions — before hiring — that lay out any physical requirements of a position. The second thing is, if somebody is disabled, [because of] obesity or whatever, if it is possible to make a reasonable accommodation for them, that needs to be done.
What else might be important for employers to know?
The definition of “obese” is really in flux right now. A lot of the EEOC cases that existed prior to the AMA coming out with this defined it as “severely” obese or “morbidly” obese. … So nobody is sure what will constitute a disability, because the number of people that are 20% overweight in America is far different than the one for people that are double the standard weight. So I just think that it needs to be a very serious concern in people’s minds.
Top 10 Tricks for a Healthier, High-Energy Workday
Originally posted by Whitson Gordon on https://lifehacker.com
Working at an office can be surprisingly unhealthy. Between sitting all day, eating poorly, and enduring never-ending stress, your office can take a few years off your life. Here's how to stay healthy and energetic at the office (and make the day go by faster).
10. Eat Healthy, All Day Long
Ever have those days at work where you just feel exhausted and can't get anything done? There are a lot of ways to solve that problem, but the #1 fix is healthy eating (starting with breakfast). You should eat your most hearty meal in the morning, when you need the most energy, and continue eating healthily throughout the day to avoid crashes during your productive time. Eating lunch away from your desk can help, too.
9. Set Up a More Ergonomic Workspace
It may not seem like it, but sitting at your desk all day can wreak havoc with your wrists, back, neck, and other body parts if done improperly. Thankfully, it's really easy to set up an ergonomic workspace, without spending a ton of money. Most of it is practicing good posture and positioning your keyboard and mouse properly, though a good office chair is a good investment.
8. Get Up and Move
Having an ergonomic workspace isn't enough, though—all that sitting is still killing you. So, to keep yourself healthy and really avoid RSI injury, it's important to take frequent breaks. All you need is five minutes every once in awhile—in fact, we've created a schedule template that'll make sure you get enough time away from your workspace. If you really want to get out of that chair, a standing desk can be a really great solution too—many people, including Lifehacker's own founding editor Gina Trapani, swear by it.
7. Avoid Eyestrain at Your Computer
Ever get eye pain or headaches at the end of the day, but aren't really sure why? It's probably from staring at that computer all day. The aforementioned breaks can help combat eyestrain quite a bit, but a few of us at Lifehacker have also found that computer-oriented glasses likeGunnars can make a big difference, too.
6. Be Friends with Your Coworkers
Coworkers can be distracting and annoying, but being friends with them can actually make work a lot less stressful. In fact, one study even found that people who were friendly with their coworkers actually lived longer. Even if we're just talking productivity, knowing which coworkers will help you in a bind is incredibly useful, and easy to do with a single email. As long as you keep yourself from getting distracted, office friends can actually be good for your productivity and health.
5. Fit More Exercise Into Your Schedule
Getting regular exercise is one of the best ways to stay healthy and keep your energy level up, but getting regular exercise with a demanding job is tough. This 20-minute exercise plan is a good starting point, though you can also work small bouts of exercise into your day without a full "workout." Working out at work is possible, but tough, so it's up to you to try things out and see what works.
4. Cultivate Personal Rituals that Keep You Sane
It may seem silly, but little personal rituals during the day—whether it's a relaxing afternoon cup of tea or kicking back with the funnies—can really improve your mental and physical health. So don't neglect them! You should already be taking a few breaks during the day (see tip #8), so use them to your advantage. Having a good daily routine can go a long way. .
3. Get Better Sleep (or Sneak In a Nap)
You already know lack of sleep is bad for your work and health, but few of us actually do something about it. Well, it's time. Try sneaking in a nap at work if you can't force yourself to get enough sleep at night. Even a short power nap can keep you productive and creative. Justmake sure your nap isn't too short (or too long) and you'll be on your way to a more productive workday.
2. Work Smarter, Not Harder
Working yourself to the bone can create stress and really weigh on your health. If you're a regular reader of Lifehacker, you know our main philosophy is to work smart, not hard: that means using your time efficiently, doing your most important work during your body's high-energy hours, and avoiding the "cult of busy." The smarter you work, the less time you have to spend stressing out over everything you have to do.
1. Go Home
Building off the above: more hours does not equal more work. Ask yourself: how many hours do you work a week? Most research shows that if it's over 40 hours, you're hurting your productivity, your health, and your income (since you're working fewer hours for the same pay). The key? Stop working and go home at night. It's more challenging than it sounds, but it's well worth it.
Cost savings attributed to self-funding, wellness
Originally published September 6, 2013 by Tristan Lejeune on https://ebn.benefitnews.com
Dianne Howard has understandably made a number of changes during her tenure as director of risk and benefits management with the School District of Palm Beach County, Fla. - after all, she's been there for 18 years. One change in particular six years ago paved the way for many other beneficial ones: The district went self-funded. It's a shift that may not be an option for many employers, but Howard - winner of the 2013 Benny Award for Benefits Leadership in Health Care - says it allowed her to be more hands-on with internal policies and institute real, lasting improvements.
"I'm a big believer in self-insurance," Howard says. "I think you can buy excess insurance to protect yourself, you know, specific and aggregate. You can't be too small, but for groups of 1,000 or more, it's the way to go. You can control things, you can subcontract, you can get in there and say, 'Well, why is this costing us so much money?'"
She recalls an incident where MRIs - hundreds of them in total - were being paid for without having the deductible applied. Providers never informed them of this until the district took the reins themselves; they had just assumed that hospital stays were involved.
"And it was just a mistake - I'm not trying to throw anybody under the bus - but because we looked at it, we could fix it and change it so that the design as we negotiated [it] was in there, and we're getting the savings that we thought we would get," she says.
After going self-insured, the district used a data warehouse to analyze its claims and find ways to control costs. Estimated savings? At least $4 million. It also added a tobacco surcharge to insurance plans and helped write the Florida law banning smoking on school property. But the initiative Howard is most eager to talk about is one that has been widely embraced even as its financial efficacy has been increasingly questioned: wellness.
Not an easy sell
Many who have tried it will tell you that initiating a wellness program is not the easiest sell to an employee population. Just ask Howard: "People don't like being told what to do," she says, and she saw quite a bit of resistance. That's normal enough for a private company, but Howard's position comes with extra challenges.
"We're a public entity, so noise gathers," she says. "It doesn't just come to me and my staff. It goes to me, to my boss and maybe to our school board. You just want to be able to defend your position, get it well-communicated and get the unions on board to help you communicate. We told them, 'If it works and we keep our rates down, maybe we won't need rate increases every year.' And for 2014, we're not going to need a rate increase."
Marilyn Boursiquot, benefits manager for the district, agrees that wellness was not exactly a welcome change for employees, but she says the work is paying off.
"Our culture is slow, and some folks are still being dragged along kicking and screaming, but we can truly say that we're starting to see the light of creating a culture of wellness, which is really exciting," Boursiqout says.
Howard's "tenacity" and her "willingness to be on the edge" has helped steward the district through year after year of change, Boursiquot says. And she thinks that's what makes Howard worthy of her Benny Award.
"When we look at other school districts, and just other employers in general, they're willing to go to a point, but then when the rubber hits the road ... it's not always easy to introduce programs like this," Boursiquot says. "You take flak for it. And to actually keep moving forward in spite of all that - that's what I really admire about her."
Medical trends
The School District of Palm Beach County boasts an average five-year medical trend of 6% - 4% below the industry median of 10%. It also shed 1,000 dependents (estimated long-term savings: $4.4 million) after an audit found them ineligible - one of many reviews made possible through self-insurance.
Howard, however, believes the wellness program has been helping keep costs down for the district, which has 20,000 full-time employees. It was a slow road, she says, and the program "evolved" from weak to strong.
"We started out by saying, 'Here's a health assessment you could do.' In a district our size, we got 25 people to do it, and we gave gift cards at the time," she says. "And that really was poor. So about four or five years ago, we started talking with the unions, and we found a different way to negotiate with them and said, 'Let's bargain something two years out,' and that gave them time to think and to plan.
"We wanted to get to the point where employees have to get blood work, so they know their condition, and get a physical. ... More than half our employees never saw a doctor. So we said, 'OK, preventive stuff is what we should do,' so we had talks with our carrier about what's important, and we figured the health assessment was very important."
The district upped the reward for HRA completion substantially to a $50 premium reduction per month. "And that number," Howard says, "really was motivating to our employees." In its first year, the new program saw 85% compliance. And now, as she says, health insurance costs won't rise for workers next year. This, too, is a bigger deal for a public entity.
"We're government employees," Howard points out. "We haven't had raises in a few years."
Of course, even wellness programs' biggest proponents will admit they can only get you so far; the district has had to do its share of belt-tightening. Copays and premiums have risen in recent years, and there are newly designed pharmacy tiers, too.
Estimating in 2010 that diabetes accounted for 20% of its health claims, the district implemented a diabetes health plan. In its first year, the plan reduced total net costs by 9%, or around $2.9 million.
In another "self-funded only" gain, the district now gets 100% of its pharmacy rebates, which not only helps its coffers but also future plan design.
"Our rebates are approaching $5 million a year, and that's money that goes right back into the health plan," Howard says. "We had no idea it was so much money - only self-insured employers do."
Schools run mini-programs
But Howard again credits the district's wellness plans for starting long-term change. Schools, she says, can be excellent incubators for mini-programs that could work just as well at businesses with multiple locations. In addition to administrative offices, the Palm Beach County district runs some 180 locations, serving approximately 176,000 students.
"We had what we called 'wellness champions' at each school," Howard says. "What we said we would do is give them some resources so that they could run a program for their school - if they wanted to run a class on exercise or Weight Watchers or whatever. We have two big meetings a year with them, we give them a $500 stipend out of our health budget and for that they have to do a certain number of programs at their school. ... We went from 30 to 170 [wellness champions] in four years. And each of those people can [reach out] to the 200 to 400 people at their school and they know them."
Employees might be more amenable to such programs when they're initiated by a friendly co-worker and not some distant HR office. Making it personal and fun helps, too: In a different effort, called the Apple-a-Day Program, participants can submit photos of themselves eating apples while walking, reading medical care info or doing other healthy things. Howard says vendors donated prizes for the best photos, and local orchards even donated some apples. It's definitely a program she plans to repeat.
Kimberly Sandmaier, Palm Beach County wellness coordinator, admires Howard for her dedication and knows the district health plan is in good hands. "She's worked so hard with all our programs," Sandmaier says, and positive results are coming in on all fronts.
"I've always looked up to her and seen her as a leader. Whether it's meeting with a vendor or the unions, she gets a lot of respect from them. I think she does a great job, and she handles everything with grace."
As for what lies ahead, Sandmaier says, "We're trying to be proactive. We're trying to figure out the best thing out there to reduce our health care costs, especially in light of everything that's happening with health care reform and some of the additional charges that we may see in the future."
In the next phase of evolution, Howard plans to make her wellness programs results-based. Though she concedes it "may be not quite as successful," she remains optimistic.
"I think people are going to do it. I mean, you're taking the blood work anyways," she says. "Ideally people will say 'I've been doing the blood work for three years, I've had high blood pressure for three years - why don't I do something about it?' But that might not happen."
Whether self-insured or not, whether public or private, Howard recommends employers commit to wellness. "I really believe that you need a wellness component and work toward having your population having a little accountability in your health care," Howard says. "Don't give up when the noise gets a little loud. Use your data to show people, 'Look, this is what happening.' I just really believe in it; it's been good for us."
The numbers
Here are just a few of the results achieved by the School District of Palm Beach County under Dianne Howard's leadership:
2007: Switch to self-funded plan.
0: Cost increase in 2014 for self-funded medical plan.
6%: Average five-year medical trend.
100: Percentage of pharmacy rebates now received.
$4 million: Savings achieved from using a data warehouse to dig into claims to see where the school district was spending the most money and analyze what could be done to control those costs.
1,000: Number of dependents moved off the health plan thanks to a dependent eligibility audit.
$4.4 million: Estimated savings from dependent eligibility audit.
80%: Average participation rate in the wellness program.
$2.9 million: Estimated savings from the implementation of a diabetes health management program.
$600: Annual tobacco surcharge.
195: Number of wellness champions, up from 16 a few years ago.
Can Happiness Heal? How a positive attitude might save your life
Originally posted by Julia Perla Huisman on https://www.nwitimes.com
Health and happiness. Are the two linked? We can assume that those with good health are generally happy to be well. But what about the other way around? If someone is sick, can happiness make them feel better physically?
The answer is a resounding yes, according to recent research. Multiple studies have shown that a positive outlook on life reaps many tangible benefits: “‘Happy’ people cope better with stress and trauma, are more resilient, have stronger immune systems, and live longer,” says Barbara Santay, therapist for Franciscan Alliance’s Employee Assistance Program.
The statistics are staggering: according to Santay, two-thirds of female breast cancer survivors who attend support groups report that their lives were altered for the better after developing the disease. Women who have strong social connections live an average of 18 months longer than those who have little to no connections. Bereavement has been associated with stress hormones, and friendly social contact has been proven to decrease those hormones.
“One of the big ways we see [the correlation] clinically is with chronic pain,” says Michael Mirochna, M.D., a family medicine physician with Lake Porter Primary Care and Porter Physician Group of Porter Regional Hospital. “When a patient’s mood is good, they’ll be in less pain. If they start to feel worse and you dig into their psychosocial history, you find that something happened (their dog died, relationship problems, etc.). There’s a close correlation with mood and pain in that regard.”
It’s clear to see that happiness fosters good—or at least improved—physical health. But what, exactly, is happiness?
“I think we need to differentiate between happiness and joy,” says Tanaz Bamboat, certified laughter yoga instructor from Munster. “Happiness depends on things. Joy is unconditional.”
Santay adds, “People think they would be happy if only they were to get married, have a baby, get plastic surgery, win the lottery… These things do provide a temporary boost in happiness but after a certain time has passed, people return to their happiness set point.”
Experts agree that what leads to a continual state of happiness has nothing to do with circumstances or material possessions, which can be fleeting. Rather, it comes from one’s outlook on life.
Fortunately, such an outlook can be cultivated and exercised, so that even the biggest curmudgeon on the block can take control of his or her mental and emotional—and therefore physical—health.
We’ve outlined five ways to develop a positive perspective:
Be physically active. There is bountiful research backing the premise that exercise improves mood. “We strongly encourage physical activity with our patients diagnosed with depression,” says Mirochna. “If their depression is so bad that they don’t feel like doing anything at all, we encourage them to at least do some physical activity, and it immediately makes them feel better.” In fact, according to Santay, aerobic exercise is shown to be just as effective as depression medications.
Dawn Wood, certified therapeutic recreation specialist and instructor of the Benefits of Exercise class at Methodist Hospitals, says, “One of the emotional benefits of exercise is that you are doing good for your body and yourself. When you feel good about yourself, it gives you confidence to meet daily challenges, meet goals, and communicate with others.”
Meditate/Focus. Santay lists meditation, avoiding overthinking, and increasing “flow experiences” (activities that engage you, cause you to lose track of time) as ways to get the mind right. She also encourages two minutes of writing every day. “The immune system works better when we write,” she says. According to a study by the University of Missouri and Columbia, the psychological and physical benefits of two minutes of journaling are greater than those that come from writing in longer time segments.
Wood suggests “true relaxation… allow yourself to take a mental and physical break from your responsibilities from time to time, so when you return, you have a better frame of mind.”
Laugh. The phrase “laughter is the best medicine” isn’t just a euphemism. Laughter is proven to prevent heart disease, lower stress hormones, strengthen the immune system, and reduce food cravings. It also has anti-aging benefits.
While a comedy show or YouTube video provides a temporary laugh, the greater health benefit comes from intentional, continuous laughter that can be learned in a class like laughter yoga. In this practice, participants are taught to laugh from the belly, and for no reason, so they learn to laugh despite their circumstances. They’re also instructed to breathe properly, which improves blood flow.
Bamboat, who teaches laughter yoga classes throughout Northwest Indiana, works often with cancer patients. “Laughter brings movement up into the lymph nodes,” which play a big role in cancer care.
“Laughter brings you back to a childlike state,” Bamboat says. “We were born with a spirit of laughter but have forgotten it because of stress. If you condition your body to laugh unconditionally, you will relieve your social, medical and physical stress.”
Be social. When we’re not feeling well, we tend to isolate ourselves. In reality, that’s the worse thing we can do. Having social connections and a strong support system can greatly improve one’s health.
“We tell our patients it’s important to have a sense of community,” says Mirochna. “What kind of social support structure do they have in place? If they are elderly, we ask if they have kids or a family.” Mirochna points out that Porter Hospital has a group for senior citizens in which they can participate in lectures and trips and develop friendships with other people in their stage of life.
Santay also urges her clients to nurture social relationships, learn to forgive, and practice acts of random kindness. Wood adds that helping others has been “the biggest factor I have noticed with patients’ happiness. It helps them feel worthwhile, capable.”
Be spiritual. Getting in touch with your spiritual side can do wonders to your physical health. Those active in religion live longer, use drugs less often, have longer marriages, and are healthier in general, according to Santay.
Father Tony Janik of Franciscan St. Anthony Health-Crown Point explains spirituality’s medicinal qualities: “Those with a spiritual outlook can face the difficult parts of life by having a greater sense of value. They have a source of perspective and hope… They find strength in that hope and have better coping mechanisms.”
This is especially valuable for those going through the end of life. “Not everyone gets cured, but they can be healed, from a spiritual perspective,” Janik adds. “We believe that everyone is made in the image of God and that they can have a life beyond here. That gives our patients hope.”
Pedal Power - Wellness Infographic
Originally posted on https://onlinemastersinpublichealth.com/pedal-power/
No big surprise: Riding a bike provides more exercise than driving a car. But with cities embracing cycling by building bike trails and lanes and setting up bike-sharing stations, the general health effects of biking can now be studied en masse.
64%
Percentage increase in bike commuters from 1990 to 2009
54%
Percentage of all bike trips purely for transportation
47%
Percentage of Americans who want more bike facilities in their communities
Riding Healthy
The benefits to regular exercise are myriad and that includes cycling, which can have lifelong advantages.
Women who bike for 30 minutes a day have lower chances of developing breast cancer.
Adolescents who bike regularly are 48% less likely to become overweight as adults.
82%
Percentage of bike commuters who believe their health has improved since they began bicycle commuting
30-60 minutes per day
Length of time cycling takes to improve hypertension rates
We Need the Exercise
Why? Because …
- More than 1/3 of U.S. adults are considered obese.
- 18% of children ages 6-11 are obese.
- Less than 1/3 of Americans are getting 30 minutes of exercise a day, the CDC’s recommended minimum.
- For each hour per day someone spends driving, there is a 6% increase in the chance of obesity.
- Excess body weight is possibly responsible for more than 100,000 new cancer diagnoses in the U.S. each year.
- Exercising regularly helps stave off depression and raises self-esteem.
It’s Cost-Effective, Too.
Biking instead of driving is healthy for your wallet, but it may be even better for the health of cities and towns.
$11.80
Benefits for every dollar invested in bicycling and walking
$115 million
Annual healthcare costs saved in Portland, Oregon thanks to a regional biking trail network
Seeing Results
Let’s take a look at some cities where bike share stations and paths have been implemented and successful.
Midtown Greenway, Minneapolis, MN
Benefits: Home value increase, higher employment rate, number of cyclists increased to 3,500 per day
Jobs created: 700
Wonders Way Path/Ravenel Bridge, Charleston, SC
Benefits: 2/3 of path users get more exercise, connects East coast as part of 3,000-mile East Coast Greenway
Jobs created: 525+
Valencia Street Redesign, San Francisco, CA
Benefits: Bike traffic increased 144%, improved business in city, traffic collisions declined by 20%, motor vehicle traffic declined 10%
Jobs created: 218
Schuylkill River Trail/Wissahickon Park, Philadelphia, PA
Benefits: 58% of population uses the trail for exercise, cycling has prevented 47,450 tons of CO2 emissions each year, invasive plant removal due to trail construction
Jobs created: 745 volunteer jobs
Vera Katz Eastbank Esplanade, Portland, OR
Benefits: 220% increase in biking, bioengineered riverbanks reduce pollution
Jobs created: 1,050
A faster, cheaper way to wellness programs that work
Originally posted September 6, 2013 by Vlad Gyster on https://ebn.benefitnews.com
The debate over whether wellness programs "work" is becoming increasingly heated. Many question the validity of research demonstrating that wellness programs reduce health care costs. At the same time, others swear by their wellness provider. So, who's the liar?
As with most things, the truth is in the eye of the beholder. Wellness is a business, and it would serve us well - no pun intended - to consider this business formula as we attempt to determine where the truth lies and understand why this debate is so heated: Value = Benefits/Cost.
To begin with, we don't truly know the value of a wellness program. This formula helps quantify the importance of knowing value. When making a purchase, all of us have some understanding of a product's benefits, and in return we pay a cost. Together, those two factors create a value. If the benefits and costs are generally understood, then value is pretty predictable. But if there's a lack of agreement about the benefits, it's tough to come to consensus on value and cost. The result is very different calculations and a big debate about whether something is really worth it. This is what we're experiencing with wellness programs. The reality is that we don't really know all the benefits a wellness program provides, and, as a result, their value is up for debate.
This debate will eventually be resolved in one of two ways:
1. We come to a consensus that wellness programs deliver the stated benefits and continue to pay the current cost; or
2. We conclude the benefits are lower than initially thought, and adjust the cost accordingly.
I've got my money on option 2. Here's why:
Gartner - a research advisory firm that's been evaluating technology for more than 30 years - discovered a funny pattern: Every few years, a new technology emerges that gets a lot of people really excited. There's a lot of enthusiasm and promises, but, given limited use, no real data about the technology's actual benefits. This is the "peak of inflated expectations"; i.e., when we make statements like "This is going to change the world."
After a while, though, people realize that their perception of the technology's benefits are unrealistic; they feel they received bad value, get disgruntled and criticize the technology as worthless. This is the "trough of disillusionment." It occurs when the benefits are lower than originally assumed, and the cost is experienced as too high relative to the perceived lesser value.
It's reasonable to assume we are in the midst of a sober re-evaluation of the benefits of wellness programs, somewhere in the "trough of disillusionment." The good news is, as history has proven, that over time, the market comes to understand the technology's actual benefits, accepts them and broad adoption can occur. For this to happen, there needs to be a consensus about the benefits (aka ROI) and the price adjusted accordingly. This doesn't mean wellness programs are worthless, just that they may be worth less than the benefits declared during the "peak of inflated expectations."
Minimize cost
In a scenario where the value of something is unclear, it's wise to minimize - rather than wait for the market to drive down - cost, as cost is the variable you have control over. Traditional approaches to launching wellness initiatives come with huge overhead - strategy, vendor selection, implementation and vendor fees can easily run into the hundreds of thousands of dollars - and can take years before having any real impact on even a single employee. Cut as much of this overhead as possible. Vendor selections should come in the form of free trials with groups of employees. Vendor fees should be contract-free and have monthly options for easy exit. Strategy work should turn into small experiments with employees to identify what works and what doesn't.
In other words, spend less. But how do you drive a high level of engagement in wellness with limited resources? We suggest using the Lean Startup methodology used by startups to drive engagement in new products using limited resources. This approach advocates using small, inexpensive steps that lead to quick wins and continuous improvement. Its use could help HR quickly and cheaply differentiate what works from what doesn't, so HR can focus time and dollars on what's actually effective.
Four steps
Here's our version of the Lean Startup methodology adapted for HR:
Step 1: Think in terms of a "Minimum Viable Product". MVP is the smallest thing you can do to learn how to make progress toward your objective. For most employers, the objective of their wellness programs will be somehow tied to employee participation. Instead of spending limited resources on building business cases and other costly activities, pick something to do that is small and will help you learn what works to gain employee participation.
Step 2: Build something that's "good enough". Start with something easy, like an employee video testimonial about a benefit that's already available (but likely underappreciated), such as gym reimbursement. Upload the video to a video hosting tool for businesses so you can track how many people click the link and view your video. Send an email to employees inviting them to watch the video. Explain that this is a "beta" and you're testing concepts for a potential wellness initiative. Distribute it to a small group first to ensure everything is working.
Step 3: Measure. Measuring is essential. If you don't measure results you can't test your assumption about how a particular strategy will work or learn from it. Once the email is sent, you'll know how many people clicked the link and how many people viewed the video and for how long. These key performance indicators - KPIs - provide a baseline for identifying progress and future improvements.
Step 4: Learn. This is the most important step. By this point, you should have gained some idea of what's working well and what's not, and the data necessary to improve key metrics. These are the types of tangible outcomes necessary to propel any wellness initiative forward. What can you do to increase those numbers? The faster you can repeat this process and improve your KPIs, the more momentum you'll gain - and the sooner you can determine the potential effectiveness of wellness initiatives without a huge expenditure of scarce resources.
Debate will continue
Whether the results achieved with wellness programs are worth their cost is a debate that will likely continue. That said, there's little doubt that a key ingredient to achieving ROI on wellness programs - or any HR initiative - is employee participation. The HR-adapted Lean Startup approach lets you know whether you've got this key ingredient - before you've spent a lot of time and money hoping to get it.
Eating out may hurt work performance, study shows
Originally posted August 01, 2013 by Stephen Smith on https://www.cbsnews.com
Eating lunch outside the office will relax you - but it may also hinder your job performance, according to new research.
Scientists at Humboldt University in Berlin say that eating at a restaurant with a friend reduces "cognitive control and error monitoring." By contrast, workers who ate alone at their desk had no such adverse effects.
The study, published in the journal PLOS ONE, tracked participants who ate alone at their desk and those who walked to a restaurant to lunch with a friend. Each group consumed the same exact meal but the desk lunchers ate their food under time restrictions.
A mood rating questionnaire showed "a relaxation effect of the restaurant as compared to the plain meal situation," the study said.
Researchers also found that after the meal, those who ate at a restaurant were calmer and sleepier compared to those who ate solo at their desks. The restaurant eaters also demonstrated "reduced cognitive control" compared to the desk eaters.
The study's authors said it was impossible to gauge the impact of each variable in the study, such as the social context (alone vs. with a friend), availability of time (limited vs. plenty) and environment (small office vs. spacious restaurant).
The researchers suggested that accountants and scientists who eat out may see their work performance decline - but artists may actually see benefits.
"Reduced cognitive control is a disadvantage when close self-monitoring of performance and detailed attention to errors is required, such as in laboratory and factory work or numerical processing," they wrote. "In other situations, an attenuation of cognitive control may be advantageous, such as when social harmony or creativity is desired."