Experts discuss how culture changes can lead to weight loss and return on investments.
The Milken Institute School of Public Health practices what it preaches.
Architects designed the school’s 115,000-square-foot building, which opened last spring, with wellness in mind. It includes a centrally located staircase, faculty offices equipped with standing desks and kitchens on each floor. Instructors from the Department of Exercise Science teach free fitness classes for employees in the building’s studio spaces. Vending machines are stocked with healthy snacks.
The building served as a fitting setting for an event that focused on obesity prevention in the workplace, hosted Wednesday at the George Washington University. The program was sponsored by GW’s Office of Industry and Corporate Research within the Office of the Vice President for Research, the Milken Institute SPH and ICF International, a management, technology and policy consulting firm based in Fairfax, Va.
More than 35 percent of U.S. adults have obesity. Full-time workers in the United States who are overweight or obese miss an estimated 450 million additional days of work each year compared with healthy workers, according to a 2011 Gallup poll. This results in an estimated $153 billion in lost productivity annually.
“With the prevalence and the cost of obesity standing so high, we really need to marry that with real strategies that can bring to bear on this issue,” ICF International Vice President Nicola Dawkins-Lyn said. “Worksites are a primary setting where environmental and policy changes can help to move the needle to control adult obesity.”
While many workplaces have responded to the obesity epidemic by offering weight loss and wellness programming (often tied to monetary incentives), some experts have questioned whether these initiatives really improve health—or save companies money.
To test their effectiveness, the Centers for Disease Control and Prevention conducted a systematic review of 47 intervention strategies in 2009, measuring three outcomes: body mass index (BMI), weight and percent body fat.
The results, published in the CDC’s Guide for Community Preventive Services, indicate worksite nutrition and physical activity programs can increase physical activity, improve dietary choices and produce weight loss. But what’s the best way to implement those programs?
Bill Dietz, now director of GW’s Sumner M. Redstone Global Center for Prevention and Wellness, helped to conduct the review while he was a CDC official. He said this is one of the main questions that obesity experts are now grappling with.
“These conclusions are what to do. We think that workplace interventions are relevant particularly for obesity control. They don’t necessarily talk about how to achieve that,” said Dr. Dietz. “We know a lot about what we should do, but we know less about how we should do it.”
Bill Dietz, director of GW’s Sumner M. Redstone Global Center for Prevention and Wellness, helped to conduct a systematic review of workplace wellness programs while he was an official at the CDC. Dr. Dietz discussed the CDC's findings at Wednesday's event. (Rob Stewart/GW Today)
Experts at Wednesday’s event said that in order for employees to achieve measurable results, workplaces must create a “culture of health” starting from top leadership. Managers should set specific goals and expectations, ask for employee feedback, evaluate programs and provide “smart” incentives like pricing healthier menu items lower than unhealthy options.
Rather than only offering weight loss programs, speakers suggested that companies use a “systematic” approach to change unhealthy habits by making environmental and policy changes within the workplace.
“You’ve got to have a lot of things working in constant with one another, and they have to fit into the climate and culture of that organization,” said Ron Goetzel, vice president of consulting and applied research at Truven Health Analytics.
At Nike Headquarters in Beaverton, Ore., for instance, employees are allotted exercise breaks during the day, which they can take advantage of with the worksite’s 34-foot climbing wall, basketball and tennis courts, a swimming pool and even a “Tour de France” simulation spin studio.
The Return on Investment
For chief financial officers who may be skeptical about investing in healthier workplaces, evidence shows that wellness programs can actually be better for a company’s bottom line—if companies do them right.
Dr. Goetzel, an economist, presented data from a study that evaluated employees’ health at 12 Dow Chemical sites around the country. The researchers’ goal was to look at different levels of health improvement programs to see their effect on workers.
Low intensity sites had access to health education, added walking paths, weight management tracking programs and healthy food choices. The high intensity sites included all of those features plus increased accountability to senior management, site leader training, as well as regular training and feedback sessions for senior leaders.
“The idea was that if you involve senior management at these worksites—if they have skin in the game, if they are involved in crafting these programs and giving them greater accountability—then you would have greater success,” Dr. Goetzel said.
The hypothesis turned out to be true.
After collecting three years of data, both the low intensity and the higher intensity sites saw improvements in nutrition and physical activity. While weight increased over time at the lower intensity sites, weight remained constant at the higher intensity sites.
From 2004 to 2011, Dow saved about $120 million in health care costs as a result of these strategies.
“So, do these programs work? Yes, if you do them right, there is evidence out there that they can achieve good financial outcomes,” Dr. Goetzel.
But, he added, financial outcomes need to be tied to the notion of “value on investment.”
“Turns out most employers are humanistic,” he said. “They want to improve the quality of their workers’ lives. They know that attracts the best workers. People who like their company and have a supportive environment do more and perform better.”
This event was the first in a quarterly GW/ICF Research and Evaluation Forum, a speaker series to address issues impacting industry, academia and the public/private sector. The series is the result of a memorandum of understanding signed by GW and ICF in March 2014. GW and ICF jointly will pursue research opportunities in the areas of federal health programs including biomedical, bio-informatics, public health preparedness, genetics/genomics, survey methods and transportation.