Creating a Culture of Health

Creating a Culture of Health

Steven Aldana, Ph.D.CEO WellSteps

How Did This Happen?

Two Sides of the River Battle

• Capitalism• Employment• Politicians• Tradition• Greed

Follow the Money

50 Year Diabetes Prevalence in the U.S.

http://www.cdc.gov/nchs/data/nhis/earlyrelease/earlyrelease201206_14.pdf

USA

England

Canada

Austria

France

Korea

Percent Overweight

Milwaukee Health Report 2011 , WHO

USA

England

Canada

Austria

France

Korea

Milwaukee Health Report 2011 , WHO

Percent Overweight

How Did This Happen?

Two Sides of the River Battle

• Capitalism• Jobs• Politicians• Tradition• Greed

Follow the Money

Side Effect of Capitalism

Marketing Deception

IngredientsNonfat Yogurt (Cultured Pasteurized Nonfat Milk, Live and Active Cultures: S. Thermophilus, L. Bulgaricus, L. Acidophilus, Bifidus and L. Casei), Evaporated Cane Juice, Pomegranate Seeds, Pomegranate Juice Concentrate, Pectin, Natural Flavor, Locust Bean Gum, Fruit and Vegetable Juice Concentrate (For Color).

Health Claims Low fat Lowers cholesterol Part of a healthy diet Fat free Improves digestion Uranium free

Endorsements

Karachi, Pakistan

The Problem is: Food manufacturers: Salt, Sugar, Fat US Government Pharmaceutical companies Current health (disease) care system Technology, labor saving devices Greed

The Cavalry is NOT coming.

What is the Solution?

• Communities• Health Care Providers• Governments• Schools• Individuals• Businesses• Worksites

What is the Solution?

• Communities• Health Care Providers• Governments• Schools• Individuals• Businesses• Worksites

Employee-related

expenses

Unhealthybehaviors

Healthrisks

Chronicdisease

XAwareness

Motivation

Skills

Policy

=Effective WellnessPrograms

Reach Impact

Skills and Tools

Policy and Environment

Behavior Change Process

Motivation

Awareness and Education

Impact

Impact

Skills and Tools

Policy and Environment

Behavior Change Process

Motivation

Awareness and Education

Impact

5%

30%

25%

40%

Can Employees Improve Health Behaviors?

2.5

3.2 3.2

2

2.2

2.4

2.6

2.8

3

3.2

3.4

3.6

3.8

4

Baseline 1 year 2 year

Days of Exercise per Week (increase of 23%)

Popul Health Manag. 2012 Oct;15(5):261-6

120

198 193

100

110

120

130

140

150

160

170

180

190

200

Baseline 1 year 2 years

Minutes of Exercise per Week (increase of 53%)

Popul Health Manag. 2012 Oct;15(5):261-6

1.62

22.1

1.5

1.6

1.7

1.8

1.9

2

2.1

2.2

2.3

2.4

2.5

Baseline 1 year 2 year

Fruit Servings per Day(increase of 15%)

Popul Health Manag. 2012 Oct;15(5):261-6

2.05

2.4

2.5

2.0

2.1

2.1

2.2

2.2

2.3

2.3

2.4

2.4

2.5

2.5

Baseline 1 year 2 year

Vegetable Servings per Day(increase of 9%)

Popul Health Manag. 2012 Oct;15(5):261-6

Can Employees Improve Health Risks?

BMI

Merrill, et al, 2014 (JOEM)

Systolic BP

Merrill, et al, 2014 (JOEM)

Diastolic BP

Merrill, et al, 2014 (JOEM)

Cholesterol

Merrill, et al, 2014 (JOEM)

Glucose

Merrill, et al, 2014 (JOEM)

Can Employee Health Programs Prevent and Reverse Chronic Disease?

BD Medical

Diabetic

Pre- diabetic

Normal

Baseline 6 months 12 monthsAAOHN, 2006

BD Medical

Diabetic

Pre- diabetic

Normal

Baseline 6 months 12 monthsAAOHN, 2006

Can Employee Wellness Programs Lower Healthcare Costs?

• Self funded• Wellness program started in 2004• Behavior Change campaigns• Incentive program

Prev Med, 2011

Salt Lake County Wellness Program

$200

$300

$400

$500

$600

$700

$800

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Participants Non Participants

Ave

rage

Cos

t P

er C

laim

Prev Med, 2011

Salt Lake County Wellness Program

$200

$300

$400

$500

$600

$700

$800

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Participants Non Participants

Ave

rag

e C

ost

Per

Cla

im

Prev Med, 2011

Program Cost Program Savings ROI

$1,456,788($919,542 for incentives)

$4,841,898 $3,385,110

Cost Benefit Ratio of 3.32

Prev Med, 2011

XAwareness

Motivation

Skills

Policy

=Effective WellnessPrograms

Reach Impact

Employee-related

expenses

Unhealthybehaviors

Healthrisks

Chronicdisease

Summary

• Our poor health is caused by our unhealthy culture• Few organizations are motivated to change this

culture• Worksites are succeeding at improving population

health• Wellness efforts with both Reach and Impact

improve health and save money

Lifespan in years

Mor

bidi

ty

760

critical illness

Ann Intern Med, 2003:139:455-459

Lifespan in years

Mor

bidi

ty

0 ?76 86

critical illness

End of Life Benefits

Lifespan in years

Mor

bidi

ty

Lifespan in years

Mor

bidi

ty

10-20 Years

End of Life Benefits

Lifespan in years

Mor

bidi

ty

End of Life Benefits

Lifespan in years

Mor

bidi

ty

End of Life Benefits

Lifespan in years

Mor

bidi

ty

End of Life Benefits

Lifespan in years

Mor

bidi

ty