This season, consider adding an already festive spice to foods and drinks. According to a study done by the American Journal of Clinical Nutrition, cinnamon lowered LDL cholesterol (that's the bad one) in patients with type 2 diabetes. In healthy patients, the study found that the addition of 6g of cinnamon to rice pudding lowered the glucose response in the body and slowed the rate at which food left the stomach, meaning subjects felt fuller for a longer period of time.
And chances are, you've already got some sitting in your spice rack right now! Mix ground cinnamon in your oatmeal, include it in your next stir-fry, or add a stick to a cup of eggnog. I mean, tea.
Warm up your wellness routine by bringing classes right to you!
US Workers put in the longest hours on the job in industrialized nations, clocking up nearly 2,000 hours per capita in 1997, the equivalent of almost two working weeks more than their counterparts in Japan, where annual hours worked have been declining since 1980.
One of the core beliefs at Recess is that life-long wellness is affordable and accessible to everyone. Between the tough economy and pressure to find holiday gifts for others, you may be way down the line on your own shopping list. But when the time comes to splurge, and you're thinking about buying something health-related, a little research can go a long way.
Take for instance, the unassuming pedometer. The Journal of American Medicinal Association recently pooled the results of 26 studies that measured the effectiveness of pedometers in motivating physical activity. Among the observational studies, pedometer users significantly increased their physical activity by 2183 steps per day (!) over the baseline. An important predictor of increased physical activity was having a goal such as 10,000 steps per day. Pedometer users also decreased their body mass index and lowered their systolic blood pressure.
Pedometers come in many affordable varieties and can be a great way to kick off a new wellness routine by keeping track of a daily, tangible goal. Stocking stuffers anyone?
But maybe a pedometer just doesn't ooze the charm or high fashion appeal you're going for. What about those shoes that promise to tone your legs and backside? Several varieties exist, and maybe you've seen the ads for the new EasyTone shoes. In the commercial, the camera continually drifts to well, the model's best asset. Do they work? Well, the jury's still out, but according to a recent New York Times article, trials done on the shoes and their toning efficiency involved a whopping five subjects walking on a treadmill.
Furthermore, "The shoes are designed only for walking, and because of the instability design, wearers are discouraged from running, jumping and engaging in other athletic activities while wearing them."
Wait, a sec, are these walking shoes or high heels we're talking about? Oh, they're walking shoes that promise to tone your booty, even though you can't participate in any naturally bootylicious-building activities while wearing them. Got it.
Hold on. Where have we heard this before? Something else that promises to burn more calories while you're doing something you do everyday, but ends up being a hindrance to just about everything. Oh yes, the Hawaii Chair.
Click the pic to see Ellen putting it to the test.
That's not to say the shoes don't make a difference for some people. But perhaps, like the increased awareness brought on by wearing a pedometer, you walk more in your souped up shoes because you're conscious that they're supposed to be making you look better. The only difference is about $80. That, and you can still jump while wearing a pedometer.
There's a lot out there you can buy for your health, but anything with the claim, "you just do what you normally do and you'll get thinner/faster/smarter/stronger" should be taken with a grain of salt (or cinnamon?).
Real change requires some kind, well, actual change, an awakening of mindfulness. If you can integrate wellness into your life in a meaningful, purposeful way, and the effects will deeper and longer lasting, rather than the by-product of a new health gimmick.
And you don't have to go it alone! You can even incorporate your holiday giving into bringing wellness to you and sharing it with others. Pack a picnic for you and a friend and head out on a hiking or snowshoeing adventure. Take your kids ice skating (but you've got to lace up your skates too!). Sign up you and your sweetie for a healthy cooking class. This way, you're sharing the goodness and creating memories--and those will last longer than even the most high-tech sneakers.
"Chopping up your carrots increases the surface area so more of the nutrients leach out into the water while they are cooked," said lead researcher Dr Kirsten Brandt.
Keeping them whole also preserves their natural sugars, so they taste better. During a blind taste test the research team found that eight out of ten people favored the whole cooked carrots to those that had been chopped and boiled.
Even if you can't live without those little orange medallions then, go ahead, and chop them, but do it after they are cooked. Eat your carrots whole and, just like that apple a day, you won't have to say "Eh, what's up Doc?"
Goodness knows how much on staff time and consultants and the like on program administration and measuring of your butt kicking wellness program.
BUT does it every worry you that the $.75 peps (yes, that's per employee per soda) that you spend on providing free pop that is corroding the value of what you have been spending on prevention?
Does a sugar by any other name taste as sweet?
Most of us forgot the difference between glucose, fructose and sucrose long ago while starring wistfully at our high school heartthrob during chemistry. It wasn't something we needed to know and, I mean come on, who can tell the difference right? All of them taste sugary.
They were also less sensitive to insulin, showed elevated blood levels of lipids, increased fat production in the liver, and elevated LDL (so-called 'bad' cholesterol) and larger increases in blood triglycerides. Yikes!
According to the study, those drinking glucose-sweetened beverages showed none of these changes. Unfortunately for us, most of the sugars that are readily available in the store come in the form of high fructose corn syrup or sucrose (table sugar).
So, uh, skip the soda and maybe provide a fruit bowl instead?
Do you feel grody about breaking into a sweat? Always have a change of clothes and a stick of antiperspirant handy in case a brief lunch outing leads to unsightly sweat rings during a meeting? As much as you might feel awkward raising a sweaty arm mid-meeting, Recess wants to give you three good reasons to embrace your sweat this summer!
Reason # 1. Sweat Keeps You Alive. It’s a hot day and you’re sitting on your porch drinking ice tea. You feel something wet on your brow, forming there into a bead, then rolling down your face. Your immediate reaction might be, “Eew,” but it’s actually your body’s way of keeping you the right temperature. Without it we’d die. Learn to love your sweat because it keeps you happier than you’ll ever know, and-because the average person sweats up to 8000 milliliters on hot a day-you’ll have to get used to it.
Sweating is controlled from a center in the hypothalamus, a part of your brain that, among other things, regulates body temperature. The hypothalamus is connected to temperature receptors in your skin and in your core, so when the skin gets hot it sends a message to your brain asking it to cool you off. However a rise in core heat causes more sweating than a rise in skin heat. Most people think sweating simply cools off the skin, and it does, but the actual process of sweating also regulates core temperature while the evaporation of sweat cools the skin.
There’s been lots of controversy about whether or not sweat releases toxins in the body, but there isn’t enough scientific evidence to prove this one way or the other. One thing is for certain: sweat does not, itself, contain toxins housed in the body. However, the act of exercising, and ergo sweating, can burn fat, which often stores up toxins that like to bind themselves to lipids. So don’t become a sauna rat just yet.
Reason # 2. The ladies love it! Sweat is not pure water, which is why, in addition to the presence of underarm bacteria, it smells. It contains trace amounts of salt and urea, the same chemical found in urine. But did you know that it also contains a chemical called androstadienone, a strange substance has been shown to change the mood and physiological arousal in women. Ooh lala!
"Many people argue that human pheromones don't exist, because humans don't exhibit stereotyped behavior,” said Claire Wyart, a post-doctoral fellow at UC Berkeley who lead a study on the smelly substance. “Nonetheless, this male chemical signal, androstadienone, does cause hormonal as well as physiological and psychological changes in women.”
Durring Wyart’s study the research team had women sniff samples of androstadienone, which smells vaguely musky, and then immediately had their blood tested for concentration of cortisol, a hormone commonly associated with alertness or stress. Upon getting a whiff of this chemical the level of cortisol rose in heterosexual women. Though Wyart’s findings don’t necessarily suggest the presence of pheromones in the human anatomy, "This is the first time anyone has demonstrated that a change in women's hormonal levels is induced by sniffing an identified compound of male sweat,” she said.
So this chemical might not attract a partner as readily as one might have hoped (Pepé le Pew comes to mind) but these results might provide scientists with a safer, more natural way of fighting diseases characterized by low cortisol, like Addison’s disease. Instead of giving the hormone in pill form, which has side effects such as ulcers and weight gain, doctors might be able to synthesize a therapeutic musk. Perhaps they’ll call it Eau d’Armpit.
Reason # 3. Letting it alone can help you fight cancer. Even though those notorious underarm circles may make you feel self-conscious, antiperspirants can have negative long term effects on your health. Some research has linked aluminum-based compounds, the active ingredient in most antiperspirants, to the onset of breast cancer. When you apply these compounds to your underarm (which happens to be only stones throw from your breast) the aluminum forms a kind of cork in the sweat duct. The cork stops the flow of sweat to the skin's surface and you kiss your pit stains goodbye. However, when applied frequently and left on the skin the aluminum can be absorbed and cause hormonal effects similar to those brought on by an excess of estrogen. And too much estrogen, as it were, promotes the growth of breast cancer cells.
Others believe that the chemical in question is paraben, another active ingredient in some antiperspirants. Parabens, unlike aluminums, directly mimic the effects of estrogen. Eek! Luckily, with ingredient names like methylparaben and propylparaben it’s pretty sinchy to tell whether or not an antiperspirant contains this dangerous substance. Just in case, the National Library of Medicine’s Household Products Database has provided information about the ingredients used in most major brands of deodorants and antiperspirants. That database is available here.
Try using alcohol or baking soda instead of antiperspirants. Alcohol kills the bacteria that causes odor to occur, allowing your sweat glands to live in peace without the mucky side effects. Baking soda, on the other hand, simply absorbs the odor because of its highly porous surface. Remember when mom used to put baking soda in the freezer to take out the smell of your uncle’s fish catch? It’s essentially the same mechanism. Just under your arms!
And if that's a little too free-love and sweat embracing for your tastes then try experimenting with the growing number of paraben free underarm tonics in your local mercantile.
Far be it from me to want to turn away work that could put food on the table for my staff, but as wellness consultants we are often asked by clients to address issues stemming from workplace stress. Probably no one is surprised to hear that many Americans find work stressful:
An NIOSH report from the early 1990s cites the following:
40% of workers reported their job was very or extremely stressful;
25% view their jobs as the number one stressor in their lives;
75% of employees believe that workers have more on-the-job stress than a generation ago;
29% of workers felt quite a bit or extremely stressed at work;
26% of workers said they were "often or very often burned out or stressed by their work."
The report goes on to quote an insurance company study that concluded "Problems at work are more strongly associated with health complaints than are any other life stressor-more so than even financial problems or family problems." Yikes.
Here's the freaky part, though. It gets worse. According to the American Institute of Stress an average of 20 workers are murdered each week in the U. S. making homicide the second highest cause of workplace deaths and the leading one for females. Many employees cite their or their co-workers increased job stress and lack of ability to cope with such stress with an increase in physical or verbal hostility in the workplace. 2 reports in 2000 compiled by Gallup and Integra revealed that:
14% of respondents had felt like striking a coworker in the past year, but didn't;
25%have felt like screaming or shouting because of job stress;
29%had yelled at co-workers because of workplace stress;
14% said they work where machinery or equipment has been damaged because of workplace rage
19% or almost one in five respondents had quit a previous position because of job stress and nearly one in four have been driven to tears because of workplace stress;
62% routinely find that they end the day with work-related neck pain;
34% reported difficulty in sleeping because they were too stressed-out;
12% had called in sick because of job stress;
Over half said they often spend 12-hour days on work related duties and an equal number frequently skip lunch because of the stress of job demands.
If you can pick even three of these items and you feel they adequately describe your working environment, there is no amount of on-site yoga or wellness campaigns that can help. Your problem is systemic. That is not to say that yoga or corporate wellness can't help those employees who participate better cope with a stressful situation, but if you look around and see the signs of deteriorating health and humanity in your workplace chances are good you have bigger issues to address.
Where is this all coming from? I reached out to professionals on facebook, Twitter, LinkedIN and the blogosphere to ask what they saw as the biggest sources of workplace stress. Their answers seemed to echo two main themes:
Lack of clarity and discipline in work processes.
Typified by responses like this: "This is related to employees who refuse to answer or even acknowledge emails. And, as a project manager, I'm held responsible for not having an answer. That's stressful for me."
"Process. Inefficient coordination that wastes time kills spirit. "
This includes: passive, unfocused or unclear communication or hierarchy among team members, lack of consensus or goals, poor accountability to project deadlines or deliverables, leading people to feel as though they were constantly firefighting rather than working effectively and productively.
- or -
Lack of empathy and understanding.
Typified by responses like this:
"Unreasonable expectations. Often of the, "I want an answer today!" type, when the standard timeline is several days."
"When everyone needs everything RIGHT NOW. Clients don't care that you have other projects or other clients."
"Treating everything as an emergency, as a top priority, while less urgent items are ignored to become tomorrows' emergencies. "
When coworkers or clients not taking time to define their own goals and understand project and time constraints, the ensuing lack of clarity in communication seems to drive people nuts. We can probably all recall a project fraught with: interrupting, introduction of scope creep, lack of respect for other organizational priorities, dropped balls which result in blaming and deviceiveness among team members, leading to micromanagement and disrespect for co-workers' expertise.
How do we stop this train wreck from happening? So here is the interesting part for me. Nope, wellness alone won't fix the underlying problems. This is something that even we have to grapple with as a wellness company. Perhaps the best advice we've had to offer in this arena is our own example. There is a quote by Thich Nhat Hanh that is displayed prominently in our office and included in every employee orientation at Recess.
"Our own life has to be our message."
Easier said than done. Especially if everyone at your company is communicating a different message. Getting everyone on the same page, unifying around a vision, mission, set of values and ways of doing business is hard work. It means that at every level of the organization people need to be given time to work on the business as well as in the business and that all new hires, client acquisitions and business decisions must be constantly evaluated through this lens.
Cameron Herold was COO at 1-800-GOT-JUNK? His leadership helped build a presence in 46 states, 9 provinces, and 4 countries while being ranked the “2nd Best Company to Work for in Canada” by Canadian Business Magazine and “the #1 Company in BC to Work for” twice by BC Business Magazine. During his tenure the company was studied by numerous MBA programs including Queen’s University in Canada & Harvard. Here's Cameron (please note, no subtitles provided for his Canadian accent):
He articulates in his talks the need for a broad and all encompassing vision that is then executed through a series of well orchestrated and disciplined internal processes and plans. Take a look at how that vision trickles down on a daily basis:
Even before starting Recess, I worked as a management consultant. When I showed up on client site I'd see everyone running around frantically, firing off emails after email, powering through lunch, working long days on projects that still never seemed to be done "right" or on time. The company that I worked for advocated a long painful process whereby clients aligned their work habits with long range planning and resource allocation and right sized their organizations rather than simply grabbing anyone breathing (only to leave a firing bloodbath once sales dried up).
I saw over and over that trying to implement suggestions like Cameron's can be difficult once organizational problems are endemic; however, doing so is probably the best way for an organization to achieve rapid business growth without churning and burning the exceptional employees and clients it worked so hard to find. If you really want to eliminate workplace stress then:
Define long term, mid term and short term goals based on vision.
Create systems that balance the skills, talents and availability of your workforce with a realistic plan for achieving your goals. This provides a basis for communicating your vision in a meaningful way to every person in your organization.
Manage the process. Track. Measure. Create structured and regular opportunities for employees to report on milestones, then get out of their way.
Of course the last bullet requires that you hire capable people who value your mission. Weed out employees, managers and clients who don't get it. Bad apples are like entropy inducing kryptonite for even the best run companies.
So while I don't want to discount the benefit that yoga and good health have on well being (after all I would be out of a job if that were the case), companies that wish to lessen the impact of stress should start by doing the difficult systemic work necessary to create a humane work culture. Culture isn't something you can get through a workplace personalysis or a ropes course. Best management practices improve your company's bottom line and make work a more predictable, reliable and sane place for the people that keep your organization afloat.
Are you updating your facebook status via Twitter from your iPhone as you apply your make-up or eat your burger on the drive to your next open enrollment meeting? Many Americans feel as though they are good at multitasking and engaging in multiple activities simultaneously leads them to believe they are accomplishing more.
In her book, Distracted: The Erosion of Attention And The Coming Dark Age, author Maggie Jackson points to a growing body of research studies that seem to suggest the opposite. A flood of stimulation, interruption and fleeting human contact have created a culture of "diffusion, fragmentation."
She points out the consequences of what most of us consider par for the course in our lives and working environments:
Interruption and the knowledge worker:
Knowledge workers switch tasks every three minutes. And once interrupted, a worker takes an average 25 minutes to return to their original task, according to informatics scientist Gloria Mark.
How often are we interrupted? The average worker gets 156 emails a day, according to the Radicati research group. And that's just the beginning; instant-messages, phone calls, faxes and snail mail add to the influx.
Making a national habit of multitasking:
Sixty-five percent of people eat while they drive.
Sixty percent of kids age eight to 18 multitask some or most of the time they're doing homework.
Twenty-five percent of restaurant meals are ordered from the car, up from 15 percent from 1988.
American kids are exposed on average to nearly six hours a day of non-print media.
Two-thirds of children under six live in homes that keep the tv on half or more of the time, an environment linked to attention-deficiencies.
Time and time again in the world of wellness we see this habitual tendency toward mindless overcommitment, interruption, and multitasking lead to programs that are too diffuse to do much good if the desired outcome is a healthier workforce and reduced health care costs. Why wellness fragmentation does not equal results
How does ROI for wellness work? It is more of a cost avoidance than an actual savings in most cases. Here is a simple (and maybe a little too simplistic) example to help walk you through the "savings."
Half of your workforce participates in a risk based population health strategy (wellness program) and the other half does not.
For the participating half of the population, whose risk is known, you are able to offer outbound (active) and passive programs that directly impact and address the risks you've identified as prevalent to this group.
Let's say the programs you've implemented are effective, engagement in them is high, and you retain these employees. Over a series of years you should see something happen that is counter to what will have happened with no intervention.
That is to say, this group will not get sick as often as non-participants because your interventions were effective and employees stuck around long enough for you to see results.
The non-participants at your company, as an aggregate, are an unknown entity to you. You have very little data on their risks and, as a group, they will most likely continue to use health care at the same rate as before.
Yet, if your company-wide wellness communications are effective and appealing, your participant group is vocal and influential, and your non-participants stay at your company without developing any major illness then some studies indicate that your wellness program might actually have a halo effect.
That is to say, even non-participants will learn a little more about self care whether they participate or not. Sure, that could slow the rate of health care cost growth in that group, though probably not by a lot.
Both groups' cost trends together is your overall trend. Both may continue to rise, but your participant group's trend over several years will rise more slowly - making your overall costs appear to grow more slowly.
UNLESS. Yes, there is an unless. Unless, your participant group is so small and the growth in the cost of health care is so large that your non-participants' health care usage effectively nullifies any impact you had on participants.
Wellness is not Wii Fit. You need to focus.
As much as we know that on an individual level good health is as simple as: sleep well, eat right, and move more, achieving a successful organizational wellness strategy is as much an art as it is a science. It takes focus, discipline and rigorous measurement to impact behavior, motivate and sustain participation, and to quantify results.
If your program is to be successful then you will need to engage a large chunk of your workforce, stratify their risks, and follow a disciplined series of steps over several years in order to see return on investment. Oh, and do all of this while simultaneously carrying out the core work of your company.
Fight the urge to multi-task
While multi-tasking may be transitioning out of vogue when it comes to work effectiveness, its cousin - work sequencing - can help break large and complex tasks into more manageable pieces.
Plan to succeed by drafting a multi-year strategy with a realistic timeline. Schedule monthly (core team), quarterly (key shareholders and decision makers) and annual reviews (company wide) of a the wellness program before you even begin work. This will hold you accountable for reporting progress toward implementing your strategy and plan.
Build up to maximum efficiency by starting with only a few key program components that will get you the most bang for your buck. Gradually add complexity as your initial program begins to show results.
More often than not, companies initially underestimate how much time it takes to implement a strategic wellness program. They allocate too few resources and take on too many program components to ever really get much traction. As a result, their programs suffer from poor participation due to fragmented management and the overall program shows high attrition. Plan intelligently and sidestep this common trap.
Will restricting HSAs and FSAs and tax credits help cut health costs?
So what do you think?
Workforce.com reported today that:
"The Senate Finance Committee will discuss controversial options that include curbing the tax-favored status of employer-provided health care coverage, wiping out health care flexible spending accounts and placing new restrictions on health spending accounts when it meets Wednesday, May 20."
How will this effect your company and its employees?
Will this change the kind of benefits you currently offer?
How will this impact your company's willingness to offer wellness and health benefits to your covered employees and dependents?
The Bun In The Oven & The State of Preventative Health
Here are some snippets from an email I received from the US Department of Health and Human Services today:
"We know that the health care crisis impacts every American, but our mothers, daughters and sisters are paying a particularly heavy price. Today, 21 million women and girls are uninsured. Women who try to purchase insurance find that the private market is often stacked against them. Premiums in the private market for young women are often higher than they are for men. In some states, insurance companies can legally discriminate against women, and leave them with higher health care bills or inadequate coverage.
We know America's women can't afford to wait for comprehensive health reform. Roadblocks to Health Care reports:
In the individual insurance market, women are often charged higher premiums than men during their reproductive years. Holding other factors constant, a 22 year old woman can be charged one and a half times the premium of a 22 year old man.
In a recent national survey, more than half of women (52%) reported delaying or avoiding needed care because of cost, compared with 39% of men. "
Why are women charged more? Among other things, because we can get pregnant and pregnancy in the US is very expensive. We therefore use more health care and are charged more or denied insurance coverage. But here is the crazy part, folks: women cannot self-impregnate!
Not long ago, I received a very personal lesson on the wacky state of preventative health care for maternity. As an otherwise extremely healthy person with a good track record for taking care of myself and little in the way of worrisome health risks, I'd gone the way of financial prudence. I purchased a health plan with a high deductible, but with inexpensive co-pays on doctor's visits and alternative medicine as well as discounts on pharmaceuticals should I need them.
This was all working out very well. I continued to do my part for the team by taking good care of myself, paying my insurance company dutifully and not using any medical care! I was mentally prepared should a catastrophe befall me. I figured, should that happen, my piddly $5k deductible would seem like chump change in comparison to what I would otherwise have had to spend out of pocket for catastrophic care. All those years of paying unused premiums to my carrier would have been put to good use!
Then, about 6 months ago I developed a small "medical" problem. That's right. I got pregnant. Ok so this is no catastrophic illness or disease condition, right? I mean, there are more than 6 billion people on earth and unless I am mistaken pregnancy is the way we all got here. As a scientist I will grudgingly agree that pregnancy looks suspiciously like a highly evolved parasitic infection. Yet, unlike malaria - for instance - my health plan wasn't ponying up any cash for pregnancy vaccines or other preventative measures against this "disease."
So it was one $20 co pay with my primary care doc, the cost of a pregnancy confirmation test and then I was on my own. At that point my options were to start clocking maternity care against my catastrophic deductible. After meeting that limit I'd pay 30-70%. After doing the math I realized that if I ended up in a hospital for a routine, healthy birth with no serious complications that I would most likely end up paying $7,500+ out of pocket for my "disease." Compare this to a $2000-2500 bill if I pay cash for a home birth with a certified nurse midwife including all prenatal scans and labs and two months of well baby care and it left me scratching my head. Now if there were complications (need for surgery, premature birth, gestational diabetes, preclampsia, etc.) that led to a need for emergency medical intervention then, as I said, there is not much room to gripe over the deductible when so many dollars and someone's life is on the line. Yet when all signs in my case (and in the case of nearly 75% of pregnancies that come full term) point to a completely normal, healthy pregnancy and birth I am perplexed about how this situation serves any sort of greater good.
In my case I simply opted to pay the midwife out of pocket and should an emergency arise, well, it's an emergency - deductible be damned. Yet I think about all of the women whose partners may have left them; women whose partners lost their jobs; women who have lost their own job and are not sure how to afford COBRA, but would be denied individual coverage due to their "pre-existing condition"; women who are short on the cash to be able to afford the relatively less expensive but still cost prohibitive bill for good prenatal care and who end up with very costly bills later on down the line due to having delayed or avoided care.
And these mothers who were impregnated by partners who - in most cases - will not be denied coverage or see rate increases due to their partners' "disease," are left unable to pay and to pass on the costs to the remaining payers in the current insurance system - thus becoming contributors to the astronomical rise is insurance rates. These are not some handful of bad people "out there." If you are reading this blog, breathing and have a pulse right now then you have a pregnant woman to thank.
People are not going to stop making more people, people. It just isn't going to happen. So what are our options when it comes to taking pregnant women off of the bad apple list with regards to health care costs?
Provide safe, effective and affordable contraception and family planning services to women of reproductive age (yes, this means after menarche) .
Ensure that health plans rapidly identify and direct high risk pregnancies to maternity care and coaching programs that help manage behavioral risk factors and more closely monitor pregnancy through birth.
If you are en employer providing maternity benefits and health insurance for your employees and spouses, make sure you emphasize prental care and maternity benefits offered by your health plan. Consider setting aside lactation rooms to encourage breastfeeding mothers to pump so that they can continue to feed their babies breastmilk (which has health benefits for the mother and child).
Support legislation that accomplishes all of the above and funds community health education centers that provide outreach, education and services to uninsured populations - eliminating a cost barrier which might keep pregnant women from seeking care until it is too late.
If altruism isn't your bag, then consider that early prenatal care helps all payers in the health insurance game by lowering costs shared by the pool. And if you are still feeling the glow from that gift that had your mom in tears last weekend, then - hey - do it for the lady who loved you enough to endure nausea, swollen feet, ill-fitting clothes and a whole lot more to bring you into this world.
I was recently listening to an episode of This American Life titled, "Ruining It For The Rest of Us" where they featured stories about how easily one person's behavior can have a contaminating effect on others. One particularly haunting story covered the research of Will Felps, a professor at Rotterdam School of Management in the Netherlands, who placed a confederate in a group and observed the impact that this "bad apple" had on the rest of the group. In nearly every case the influence of even one spoiler tarnished the productivity and the morale of the group. One thing that the researchers in Phelp's study didn't look at, however, is that poor health can impact mood. Could an apple a day and a brief jaunt outdoors help the bad apple get his mood back on track? Or could workplace health and wellness be a protective means of coping for those who might otherwise be affected by a bad apple?
How do health and mood interact in your workplace? Have you seen an instance where a bad apple lowered the productivity of a work group and subsequently led to more sick days or a reluctance of team members to show up for work?
Every kid can probably remember a schoolmate who was sent away to fat camp and forced to endure not only the mockery of fellow children, but also bland, paltry portions of undressed salad and other "diet" foods. Losing weight was never cool, but with the mercurial rise of reality shows, even fat camp has been buffed to a high gloss. Shows like The Biggest Loser and other reality diet shows feature die hard trainers who effectively supplant the participants' "lack of will" with their own shrill and uberfit war cries. They harass participants through bootcamp-like workouts (4-6 hours worth at a pop) and analyze their every bite. The results are - well - dramatic enough to capture the attention of a rapt television audience.
Corporate wellness programs seem to be picking up on the trend. Home grown Biggest Loser competitions are popping up all over in America's offices. Sure, this approach can work. Particularly when on someone else's dime and exercising 4-6 hours a day, but for the average working Joe or Josephine, dramatic weight loss can be a setup for disappointment.
And for the ambitious wellness program director? For starters your program might not actually be reaching the least healthy among your workers. A skinny pack a day smoker who does not exercise (unless you count lifting beer to mouth) and has a family history of illness may not have a lot to lose when it comes to shedding pounds.
While it may be tempting to assume that we can look at someone who is obese or overweight and judge their level of health, studies show that a moderately active obese or overweight worker is at less risk of disease than a thin co-worker with high stress, sedentary lifestyle, poor sleep habits, and a lousy diet. Some of the more serious risk factors for cardiac conditions and stroke (think cholesterol and high blood pressure) are not necessarily something you can determine by looking at a scale.
On top of that, if there are big prizes on the line there are actually plenty of unhealthy ways to show dramatic weight loss (think: dehydration, binging, diuretics, stimulants). About 65% of the human body is made of water. Do the math on that. Ask any amateur wrestler (you know the guys who basically wear garbage bags as they run around the block prior to being weighed in) and they can give you a few easy hints for ways to manipulate scale weight. Such tactics can dramatically alter scale weight; however, they put unnecessary stress on the body (dehydration and muscle loss) and the results are typically temporary at best.
Additionally, men have an advantage in the weight loss game. Men's hormonal makeup allows their bodies to rev up the fat burning engines. Women, and particularly those undergoing hormonal changes such as menopause, can still see tremendous benefits from exercise, but thanks to their hormones and body composition will see more gradual weight loss than most men.
So to recap:
'Skinny smokers' have little incentive to get healthy - there's not much to lose and have you ever tried running a mile after a cig? It's not fun.
Weight Loss competitions unnecessarily shame larger people. Health and its relationship to weight is complex. You could be singling out otherwise healthy people based mainly on their appearance, which is not exactly a textbook team building approach.
The fix is in. Offering prizes can emphasize unhealthy weight loss methods and put men at an advantage over women.
The graph below shows average excess medical cost per employee of various health risks. Do you think the Biggest Loser is going to do much to reduce the first two?
If your wellness goal is to improve the health of your workforce, emphasize friendly competition and team spirit, and improve productivity then is fat camp really for you?
Tanya Barham spoke at IHRSA this year and took a moment to ask legislators to consider how better health for Americans could go a long way toward improving our economy.
Research shows pain relievers make matters worse Do you suffer from chronic headaches? Research indicates that as many as 50 percent chronic migraines sufferers and 25 percent of all headaches, are actually triggered by the overuse of common both prescription and over-the-counter drugs used to treat them.
So when your head is pounding is there anything you can do to stop the pain?
90% of headaches are primary headaches (i.e. not caused by another medical condition) and can be attributed to tension (tight muscles and spasms of the neck and back), vascular (migraine), and cluster (non medical causes such as stress).
Sitting for long periods without stretching or moving, jaw clenching, and the kind of physical habits we adopt at work can contribute to muscular tension. Short bouts of stretching (20 seconds of stretching every twenty minutes) and exercise (a 5 minute walk around the block) can ease muscular tension, will produce hormones that counter stress and help you relax. While you may not see immediate results, continued adherence to a self-care routine will lead to more overall relaxation and fewer headaches.
In tough economic times, many companies are forced to go through rounds of layoffs. No employer enjoys layoffs and it's not a parade for employees, either. An AARP report shows that the economic downturn is affecting people's health. In some cases those employees remaining are left fearing for their jobs and doing more work for the same amount of pay leading to burnout, dips in productivity, and poorer work quality.
On the client and community side, even private employers seem to be under more and more scrutiny by their constituents. Poor business ethics, lousy customer service and other "slips" are broadcast at lightning speed through modern social media. Yet, with fewer people doing more of the work such oversights seem inevitable.
How do you balance cost effectiveness with employee appreciation, good corporate citizenship and quality work product?
Measuring is important, but sometimes it is not easy. That's why good managers know judgment is important too. How are the effects of layoffs or other "soft" or non-quantifiable issues affecting you or your company?
If you were a client how important would you say quality customer service is in your choice of vendor?
As an employer would you say stress negatively impacts your bottom line?
As a manager, how important do you feel good morale is to work quality? Does it matter if you are in a service based versus a manufacturing environment?
How are you coping with these problems in ways that are cost effective?
It's the little things - Part 2: When you don't measure, you fail.
A lot of people think that being healthy is all about the stressful hour at the gym and an ascetic lifestyle/diet rivaling that of a cloistered monk (and not in one of those monasteries that brews yummy beer). The truth is actually a lot less likely to make it the stuff of a good television mini-series.
Small, intelligently thought out changes made consistently over long periods of time are much more likely to produce sustainable results than are heroic efforts that can only be sustained for a couple of months at a time. In wellness, it seems, pacing is key. This is true for both the individual wellness program and the corporate wellness program.
True story. I talk to a lot of people about corporate wellness. Many people tell me they have a corporate wellness program in place. When I ask what program they have in place they typically rattle off one or all of the following answers: a wellness fair, an online portal offered for free or low cost by their health plan or Employee Assistance Program, a yoga class, on-site massage, a corporate gym membership.
My next question? "What is participation like in your {fill in random program here} program?"
The answer is normally a variation of one of the following two responses:
The truth:
"I don't know," or, "It is pretty lousy - just a handful of people."
The euphemistic version of the truth cooked up to make the respondent feel better about spending money on this program:
Respondent: Well there are a couple of people here who seem to really like the program and {more totally anecdotal blah blah blah} there's been quite a positive response. Me: So have you participated? Respondent: ...... Me: So about how many people, would you say, have given you this positive feedback? Respondent: A lot Me: 5? 10? Respondent: Well the Director's assistant... Me: 2? 20? Respondent: Maybe 3 Me: Out of how many employees? Respondent: 2,000 Ok so the rosey assessment of their wellness offering is based on a sample size of less than 1% of their employee population??!?!?! I'm sorry, but in this economy please hope that I never am your manager. Because if I find out that you are justifying an expenditure with anecdotal feedback and a quantitative evaluation with a sample size of 0.0015% I will fire you.
Measurement helps you manage programs so that you get more for each $
When companies, consumers, the government, banks, and - hey - just about anyone who turns on the radio or TV these days is blowing a freaking gasket about the economy you need to be able to show that you are making effective use of your company's money.
Even if your company's cash position is solid, perception is reality and investors, managers and employers are taking this very grave moment in history as an opportunity for a little financial introspection. When the top brass turns its eye on your pet programs, you'd better show that they have value and that you are creatively exploring ways to get more for your money.
Today I will let sleeping dogs lie and side step the issue of how effective any of the specific programs mentioned above are likely to be outside the confines of a strategic, planned, well-measured and effective wellness program design. Let's just assume all of the programs are fantastic and each is amazingly effective at transforming the health of its participants {cough}.
But I do have to complain about the very minimum employers could do to ensure the effectiveness of wellness programs but often don't do: measure them. Data is one of those little things - those small, pesky continuous things that is not fun to collect, clean or analyze for most of us.
On the flip side, those who have meticulously gathered data around wellness have shown that well-rounded, multi-year, multicomponent wellness programs produce significant, positive return on investment (ROI). This is especially vital to businesses who shoulder the health care costs of employees - a cost that now makes up the lion's share of employer sponsored benefits.
The catch?
The average study length of effective, multi-component wellness programs is 3.6 years.
The average participation in effective, multi-component wellness programs must be more than 40% in order to make a dent in health care costs.
If you are going to be allowed to manage a program that is responsible for that much in spending, for those many years, and touches half or more of your workforce, do you think anecdotal evidence is going to help this program survive the revolving door of HR Directors, C-Suite execs or directors at your company?
Take a minute to answer that.
No?
Oh really.
Measure measure measure.
Look at the data in excruciating detail. Get deep into it. Ask questions. Are you not a numbers person? Find someone who is. Hire someone who is. Make excel your Valentine. Ask all the questions that the CFO and shareholders will be asking you. Dissect the data 20 different ways until you feel satisfied that you understand.
At a freaking minimum - measure program cost and participation and ask how and whether you can get more people to particpate for the same or less money. When someone asks you how many people use your program and how much it costs per person, produce a cogent answer. If the number looks unimpressive present a convincing plan on how you will improve matters.
The easiest way to ensure you do this is to pick 6 key things to measure early on in your program. Define what you are measuring, how that measure relates to some of your company's strategic goals, where the data comes from and how often it needs to be collected, and some of the considerations and assumptions you are making when analyzing the data. Once you've pulled that together in a one page overview, simply filling in new data points should not be too difficult.
It's the little things - Part 1: You are what you eat
A lot of people think that being healthy is all about the stressful hour at the gym and an ascetic lifestyle/diet rivaling that of a cloistered monk (and not in one of those monasteries that brews yummy beer). The truth is actually a lot less likely to make it the stuff of a good television mini-series.
Small, intelligently thought out changes made consistently over long periods of time are much more likely to produce sustainable results than are heroic efforts that can only be sustained for a couple of months at a time. In wellness, it seems, pacing is key. This is true for both the individual wellness program and the corporate wellness program.
You might have trouble reading this but the table on the left shows a client's food log. Nothing too crazy on there...this person never felt as though she was binging or eating excessively. In general she averaged about 3000 calories a day, which given her unique body composition and level of physical activity was just right to maintain her post baby weight. Trouble is, she wanted to be pre baby weight - a mere 10 pounds lighter. Losing any more weight was not necessary or healthy.
The stuff highlighted on the left shows things she worked with a consultant to substitute or go without. Little things: cheese - OR - BBQ sauce on her burger, but not both. A bagel with low fat cream cheese instead of a soft pretzel. Little things. But the little substitutions added up. The table on the right - with the substitutions amounts to only about 2,300 calories per day. Big difference, huh?
Is cutting out more better?
While it might be tempting to think that if she made heroic changes she would lose EVEN more EVEN more quickly, the truth is that few people can sustain, for very long, dramatic shifts in their eating patterns without breaking down to binge or their body down-regulating their metabolism. If the goal is weight loss, then neither of those outcomes is going to help our friend achieve her goal.
After following a consistent, healthy pattern of eating our female friend should expect to lose about .5 pounds per week following about two-six months of consistent and moderate exercise and diet choices. The longer she maintains her consistent and moderate plan the closer she will eek to a weight where he body will happily stay - a healthy weight appropriate for her body type.
Plan well. Be informed. Pace yourself. Slow and steady wins the race.
If you like paying for stuff you don't use - Join a gym!
Ok. Here we go. Picking a fight again.
A 2005 study by two California researchers, titled "Paying Not to Go to the Gym," examined nearly 8,000 gym members' attendance over three years. You might be surprised to learn that 85% of users who bought a monthly contract were spending more money than if they paid on a per-use basis. That's because most members paid more than $70 per month but only visited the gym 4.8 times each month. They paid about $17 for each visit.
How effective were those 4+ visit per month at actually transforming members' health? It's anyone's guess, but chances are a 30 minute workout on the treadmill and a couple of half-hearted bicep curls are hardly enough to make a dent in the number of calories found in daily latte, scone or other weekday indulgence.
Last month we kept it clean, but this month's fight could get ugly:
The 300 Pound Gorilla: Gym Membership
Weighing in at an average of $50-70 per month, this hometown favorite is sure to pummel you with early cancellation fees when you realize that your 4 trips per month just aren't cutting the mustard.
For the same price as a weekday latte and scone the Recess Personal Transformation Package will have you in fighting form. You'll meet more than one time every other week for a year with an expert at your home or office gym. By the time this fight is through you'll have tackled not just strengthening exercise, but also nutrition, cooking, lean body composition and calorie burn.
What is your vote? Would you rather contract foot fungus in a gym locker room or shower in your own bathroom? Weigh in with your answer in the comments below.
So here in the Pacific Northwest we're experiencing some...inclement weather. With snow changing to rain and then back to snow again, you can bet that the thought of skating along the icy streets on foot, bike or by car makes me want to just stay inside. But that also means I have to forgo the usual mediums for physical activity---no gym, no park, no yoga studio. What is this Portlander to do? I've found that the corporate wellness strategies Recess uses to promote balance during a typical work day are applicable to my snow days. Here in my apartment I contend with workplace-like constraints (little space, perhaps short attention span, fewer tools) and I have to get creative.
Stretch. Walk. Hydrate. Repeat.
These types of activities can be packed in a backpack, briefcase, or carry-on, then unpacked and used where ever you may find yourself. I happen to find myself sitting on the floor doing some lower back (blame it on the computer!) strengthening exercises while watching old episodes of Grey's Anatomy....hmm, maybe this weather isn't so bad after all.
Are you ticked that health care seems to be more expensive every year and that it pays for less and less?
Upset that your pregnancy is treated the same as a life threatening illness?
Are you a small business owner who struggles to be able to offer competitive wages and health care for your workers?
Are you a worker who has employer sponsored health care, but still ended up paying huge amounts of money out of pocket when you or a member of your family had an accident?
Many of us can relate to one or all of these stories. Today, Obama appointed Tom Daschle to spearhead the health care reform efforts int he United States. The plan is to get started ASAP. The White House Transition Team is looking for feedback about health care reform from Americans. P Lease remember that democracy is not a spectator sport! Make your voice heard here before Dec. 31, 2008: http://change.gov/page/s/healthcare
If you need a little fodder to get you started feel free to borrow from what I wrote:
The reasons I care about health reform are as personal as the loss of my dear grandmother to preventable disease many years earlier than she needed to go and as global as wondering why a country that spends so much on medicine ranks so low in terms of population health. As a businessperson I also see that in America's current economy and society we've lost touch with food, community, with moving our bodies and this problem is not simply one of sloth, but of a system that on every level rewards the wrong behaviors - behaviors that ultimately don't lead to greater health and prosperity. Particularly I see this burden shouldered by poor people, people of color, small business and their employees - the very people who do the everyday work that has moved this country and economy. I very much appreciate this forum that you have created and hope that all Americans who are affected by this issue will make their voices and ideas heard.
1 - The end to subsidization of insurance companies whose model is patently ridiculous. Current federal programs divert money to health plans that do not manage that money effectively. $50,000 to amputate a foot but not $40 for a nutrition class for a diabetic because the amputation is deemed more "effective"? This is insanity. I literally heard the CEO of a major Oregon health plan tell a room of 250 insurance brokers that "prevention doesn't work." From their business model's perspective this may be true, but from a societal perspective these are reckless words.
Having worked intimately with the behind the scenes claims and health reporting data from various health plans, the inefficiencies are rife. These organizations should be subject to standardized reporting of qualitative and quantitative claims/portfolio data - similar to SEC reports for publicly traded companies, but around various health benchmarks and other efficiency and quality of care metrics. These metrics should be publicly available so that we can truly evaluate the quality of managed care between carrier portfolios. Currently there is no telling which business is better run because the all quantify their metrics differently. It is MADDENING. With as much money and public well-being that is at stake I cannot believe how inefficiently the insurance industry is run, bench marked and evaluated. It's the wild wild west out there.
2 - HIPAA not only is not working the way it was intended, but is is a meaningless drain on health care providers. I say this not as a provider, which I am not, but as a consumer who thinks the mountains of paperwork and red tape are wasteful and environmentally destructive and as a business owner who knows how flimsy those stacks of paper really are in preventing health information from getting into the "wrong hands."
HIPAA is useless, a drain on time and resources that could be better spent on implementing IT and training the health professionals who use it. We also need a system where providers are rewarded for doing the right thing - referring patients to preventative programs and screens, social workers and triage prior to escalating preventable situations past the point of reason. Often, as is referenced above, this unfortunate situation stems from a lack of incentive for the health care provider since insurance companies will pay for costly, surgical treatments but may seldom fund prevention. I think all we need to do is look at the most profitable providers and business segments in health care to see the perversity of misplaced financial incentives on public health.
3 - Employers and private business pay more than a third of the total cost of health care in the United States (and that is only when you don't count one of the biggest employers - the federal government). The cost of health care is a drain on the bottom line - to be sure - but employers are also in part responsible for the problem. Ultimately the CDC says that 75% of health care spending is on chronic, preventable illness. Many of these illnesses could be slowed or prevented through better diet and exercise.
American workers work the longest hours of any industrialized nation. We spend most of our waking hours at work, have little time or energy outside of a long day of work to engage in our personal health. The solutions offered by many employers (normally health fairs, Web portals and other such nonsense offered for free through their health plan) are cheap, unimaginative and ineffective at encouraging better employee health. And these are the employers who are actually trying to make an impact.
Employers need tax incentives for putting in place effective, multi-component health promotion programs that have high levels of employee engagement. High levels of engagement (over 40% eligible) are key, as many programs that I have seen behind the scenes that are offered by employers tend to have low engagement (10% or less) and are usually used most by employees who are already healthy. This is not acceptable. The workplace is a very good place to offer healthy food and exercise alternatives and to encourage such behavior.
Those employers who are brave enough to recognize that this is not just a public service but that it also benefits the bottom line in terms of productivity, employment brand and absenteeism should be given a bit of a financial break in the early years of the program when it is less likely to show economic return. This could come in the form of tax credits or relief from paying into a health care fund (if that is the plan) if they show evidence of mutli-component wellness programs with high engagement.
4 - Ask any American to name 5 whole grains. My guess is you will have a hard time finding many who can. We are completely out of touch with our food system, our bodies and our health as Americans. A study published in the Archives of Internal Medicine showed that if you took all of the Americans who: do not smoke, maintain a healthy weight, consume five or more fruits and vegetables per day, and exercise the surgeon’s general’s recommended 30 minutes 5 days per week, you’d have a whopping 3% of the US population.
We need an inspiring, fun, grassroots movement to work on building systems that connect eaters with local farmers, promoting whole foods, encouraging children to cook. We need a movement and an example from our leaders that helps bring back the American meal - enjoyed over the family table rather than the fast food counter. At the end of the day if we are going to turn this ship then we need people engaged and healthier. We can do a lot to shift costs and make the current broken system more efficient, but we must also shift the bedrock of disincentives to being healthy that we as a culture have in place. Investing a spirit of fun, adventure, service and goodwill into this (instead of the same, tired, sorry guy in a white lab coat approach of past public health messages) will capture the imagination and inspire.
I thank you for creating this forum to discuss a topic that is of central importance in my life and the lives of so many people. I believe that when we as humans are healthy that it improves everything in our lives - our vitality, our engagement in our world and so I am heartened by your efforts and hope I can be one of the many who make them a resounding success.
A fresh, innovative, personalized approach to wellness.
Here, having fun is the key to being healthy. Life's too short for diets, gyms and one-size-fits-all programs. It's time for more exciting and realistic possibilities. It's time for Recess.
ather, for I have cinned.
You always knew 
