City Council Feb. 5, 2013 wellness report

City of San AngeloWellness Report

February 2013

San Angelo, Texas

Wellness Report

• 2012 shows improvement from 2011 in the overall health of employees.

• Weight and nutrition continue to be the most crucial and costly modifiable risk factors.

• There is opportunity to improve, however, the employees are to be commended.

Overall Wellness Rating

• Average wellness score for City of San Angelo employees is 69, compared to 67 last year. (out of 100)

• 47% have a “health age” younger than actual age, compared to 42%

last year• 53% have a “health age” greater than or equal to age, 58% last year

Needs Improving

(20-59)24%

Excellent(80-100)

16%

Doing Well (60-79)

60%

Needs Improving

(20-59)26%

Excellent(80-100)

14%

Doing Well (60-79)

60%

2011 2012

80/20 Rule• Generally, 80% of health care costs come

from 20% of the people.• As the number of health risks go up, so do

the health care costs.

• City employees with 5 or more risk factors decreased by 9%.

(Health claims are generally 3-4 times higher in people with 5+ risk factors)

Chronic Diseases

39%

20.9%

26.8%

38.6%

37%

15.8%

18%

23.4%

27% 23%

31.2%

21% 35%

40.8%

36% 45%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

Diabetes

Heart Disease

Cancer

Metabolic Syndrome

Osteoporosis

at riskhigh risk

2011

2012

2011

2012

2011

2012

2011

2012

DiabetesDiabetes is increasing rapidly in the U.S. • One third of people do not know they are diabetic.• Type 2 diabetes is largely preventable.

Major risks: Obesity (BMI 30+ - 326 people); Nutrition (517 people); Low HDL (<39.9 – 299 people)

City of San Angelo employees• 19.9% compared to 19% last year have 0 - 1 risks – excellent, doing well

• 39.4% compared to 36% of employees have 3 - 4 risks – needs improving

• 40.8% compared to 45% of employees have 5+ risks – caution, high risk

Heart Disease70 – 80% of heart disease is linked to modifiable risks.• Actively eliminate any known risk factors.

Major risks: Obesity (BMI 30+ - 326 people); Low HDL (<39.9 – 299 people); Metabolic syndrome ( 3+ indicators – 298 people)

City of San Angelo employees• 47.9% compared to 43% last year have 0 - 1 risks – excellent, doing well

• 20.9% compared to 21% last year have 2 risks – needs improving

• 31.2% compared to 35% last year have 3+ risk factors – caution, high risk

CancerCancer is 2nd leading cause for death in US and is the leading

cause for persons of working age.• 2/3 of all cancer deaths can be prevented.• Get proper cancer checkups for age and gender.

Major risks: Smoker (96 people); Obesity (BMI 30+ - 326 people); No or low physical activity (<5 days.wk – 553 people)

City of San Angelo employees• 49.8% compared to 50% last year have 0 - 2 risks – excellent; doing well

• 26.8% compared to 27% last year have 3 risks – needs improving

• 23.4% compared to 23% last year have 4+ risks – caution, high risk

Cancer Screenings

In 2012, the City began paying all cancer screenings at 100% without a deductible. (Formerly at 80% after deductible had been satisfied.)

However, pro-active screenings did not increase overall.

21.6%

40.4%

46.3%

Mammograms

PAP test

Prostate Check

Colon Screening

9.9%

73.2%

84.5%

51.6%

47.2%

21.7%

40.5%

49%

17%

74.3%

83%

59.5%

51%

COMPLIANT NON COMPLIANT

2012

2011

Modifiable Risksof Chronic Diseases

Modifiable RisksTop Six Priority Health Recommendations

• Weight management (323 people overweight; 326 obese)

• Good nutrition (599 people have 6+ risk factors; 325 have 10+)

• High blood pressure (420 pre-hypertension; 160 high bp)

• Physical activity (553 less than 5 days/wk; 66 have no PA)

• Sleep (430 people get inadequate sleep - less than 7-8 hrs/night)

• Osteoporosis (380 have 2+ risk factors; 1 has 4+ risk factors)

City of San AngeloChronic Disease Risk Factors

(Smoking drops off list of being in the top 6)

43.4%

41.8%

44.3%

54.4% 20.7%

0 40 8020 60 100

22.4% 8.5%

38%

44.3%40.2%

54.7%

42.2%

44.3%

19.7%

21.5% 8.6%

55.7%

Nutrition

Weight

BloodPressure

Fitness

Sleep

Osteoporisis

at riskhighrisk

2012

2011

2012

2011

2012

2011

2012

49.2% 1% 2012

2011

2012

42.1%

Employee Weights

Obese45%

Overweight40%

Healthy Weight

15%

Under Weight

0%

BMIHealthy weight 18.5 - 24.9Overweight 25 - 29.9Obese 30 - 34.9Very Obese 35+

17.9% of emp (138 people) are very obese, above the national norm of 12%.

Obese42%

Overweight42%

Healthy Weight

16%

Under Weight

0%

20122011

Nutritional StatisticsChoosing unrefined, plant-based, low-calorie, low saturated-fat foods can greatly decrease risk of heart disease, diabetes, and many cancers.

In the City of San Angelo:•599 (77.6%) people compared to 675 (82.9%) last year are at increased risk with 6+ nutritional risk factors.

•325 (42.1%) people compared to 422 (51.8%) last year are at high risk with 10+ nutritional risk factors.

Employee Perception of Personal Health

89.3% think they are in good to excellent health

(compared to 90.5% last year)

47.6%

42.9%

8.7%

0.9%

2011 2012

Very good to excellentGoodFairPoor

49.1%

40.2%

8.3%0.5%

Economic ImpactEstimated Excess Health Claims Cost

# of employees

cost per

employee

no risks 77 67 $0

1 risk 137 168 $861

2 risks 214 166 $1,764

3 risks 159 164 $2,690

4 risks 105 96 $3,788

5 risks 61 61 $4,821

6 risks 34 29 $5,919

7+ risks 28 22 $6,995

14.5% of employees (112 people) have 5 + risk factors, influencing personal health for the individual, as well as

health care costs for the city. (15% last year)

2011 2012

Examples of Estimated Excess Cost per Risk Factor (5 of 15 risks reported)

2011 2012 Excess Cost

• Overweight (BMI >27.5) 515 502 $746,034• High BP* (140/90+) 309 282 $499,198• Low HDL (<40mg/dL) 326 300 $297,135• Smoking* (14 signed up for class) 100 96 $172,006• Seat Belt Use (<100%) 130 115 $149,438

Overall Estimated Excess Health Claims:Estimated excess cost for 2011 $1,993,176Estimated excess cost for 2012 $1,862,103Potential savings from 2011 $ 131,073 (goal of $199,317)

• Most expensive risk factor pp for excess health cost

Source: University of Michigan. Study of 205,000 employees showing relationship between risk factors and healthcare costs.

EMPLOYEES

• Improved average wellness score from 67 to 69

• Reduced obesity percentage by 3% (334 lbs lost)– 281 people lost 2+ lbs– 73 people lost 10–19 lbs– 29 people lost 20+ lbs

• Reduced employees with 5 or more risk factors by 9% (123 to 112)

• Reduced risk factors for diabetes, heart disease and osteoporosis

• Improved the nutrition of 249 people

ACCOMPLISHMENTS in 2012

Programs Implemented• Biggest Loser Contest• Diabetes Education Classes• Smoking Cessation Classes • Wednesday Walking Group• Label Reading Class with Dietitian• 30 Day “My Plate” Challenge (food pyramid)

• Fruit and Vegetable Challenge• Pedometer Challenge• Flu Shots

Suggested Programs for 2013• Wellness Incentive Program – initiate a point system• Biggest Loser Contest Quarterly for Employees• Programs

– Diabetes Education Classes– Smoking Cessation Class– Wednesday Walking Group

• Group Class Opportunities– Label Reading Class with dietitian– Eat This, Not That– Lifestyle changes to lower cholesterol– The DASH diet (help lower BP)

• Exercise– “Couch to 5K”– “Move for Life”– Pedometer Challenge– Wellness Challenge – 12 wk program

• Private fitness program for those at high risk• Weekly monitoring including exercise and nutrition tracking

Solutions: Health Management

• Utilize the city clinic, primary care providers and the wellness program to manage health of City of San Angelo employees.– Monitor employees with 5+ risk factors (112 employees)

– Develop clinical protocols/pathways for diseases. Referral to specialist if necessary.

– Encourage employees to get recommended

cancer checkups (mammograms, prostate, PAP, colon)