Give the Gift of Recess

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.

Doesn't your office deserve a little Recess?

Bringing a weekly or bi-weekly office stretch or yoga class to work is safe, fun, and an extremely cost-effective way to help you and your co-workers stay healthy.

Magical, Multitasking Shoes? We're not buying it.

Real change comes from within.

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.

Better health, gimmick free! >>

Glucose, Fructose, or Sucrose? Whoknose?

What are YOU spending on Wellness?

• $200 per participant in incentives?
• $40-50 per participant for biometrics screenings?
• $6 per participant for a health risk assessment?
• $4-15 pepm for health coaching?
• $2 pepm for incentive management?
• $200 per on site class?
• 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.

So what's the difference? Well, according to a new study published in the Journal of Clinical Investigation, researchers from the University of California, Davis discovered that people consuming fructose-sweetened drinks showed an increase in a particular kind of fat that embeds itself between tissues in organs.

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?

Perspiration Nation

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.

Jack of All Trades & Master of None

Poor focus hampers wellness implementation

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. Have the will but lacking the way? Recess can help. »

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?

1. Provide safe, effective and affordable contraception and family planning services to women of reproductive age (yes, this means after menarche) .
2. Ensure that pre-natal care is covered as preventative care under health plans.
3. Stratify pregnancies by risk and ensure that health plans cover lower cost but safe and effective birth options such as licensed birthing centers and midwife assisted home births for low risk pregnancies.
4. 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.
5. 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).
6. 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.

An Apple A Day or A Bad Apple?

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?

Campaign for a Healthier America

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.

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.

We covered an individual wellness example last time and will cover a corporate wellness example today.

Part 2: When you don't measure, you fail.

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?"

If you actually know then take this poll:
http://polls.linkedin.com/p/24137/smrgy

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?

1. The average study length of effective, multi-component wellness programs is 3.6 years.
2. The average cost of effective, multi-component wellness programs is $150 (or more!) per employee per year.
3. 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.

Snow Daze

Here in the Pacific Northwest people are completely unaccustomed to days of non-stop snowfall. As a result cities are rarely equipped with things like plows. Stores are rarely stocked with things like sleds. Being the resourceful descendants of first nation people and pioneers, the residents of Portland have not allowed a little snow to stop their own personal paths to physical and emotional wellness.

Can't drive due to road closures? No worries. Join the throngs of people who we have been seeing xc-ski past the Recess office all day.

And sledders will NOT be deterred by a shortage of sleddable crafts. Here is a partial list of things I have now witnessed Portlanders using to sled:

• Boogey boards.
• A wok.
• A piece of block styrofoam.
• A metal suitcase.
• A large West Elm package for a bedframe, with plastic duct taped to the bottom.
• The sun visor from a car.
• Garbage can lids.
• A laundry hamper.
• A large plastic sign stolen from a "PODS" container.
• A skateboard with the trucks and wheels removed.

Cabin Fever?

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.

Tell Barack, Joe and Tom what you think.

Hey All:

1. Are you ticked that health care seems to be more expensive every year and that it pays for less and less?
2. Upset that your pregnancy is treated the same as a life threatening illness?
3. Are you a small business owner who struggles to be able to offer competitive wages and health care for your workers?
4. 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.

I work in the field of preventative health but not with the same, tired, boring message that has been flatly ignored for years. Recently I was inspired by this campaign:
http://corporatewellnessprogram.recesswellness.com/2008/11/can-we-make-america-healthiest-nation.html

I think it speaks to what is truly needed:

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.

Sincerely,

Tanya Barham
CEO, Recess
recesswellness.com

Recess vs. The Holiday Party

Photocopies of a tushie or yoga @ work. Who'll win?

In light of the economic downturns, layoffs and overall fiscal belt-tightening in corporate America wouldn't it be a good idea to reconsider the way we spend our "morale" dollars to help the remaining employees weather the economic storm under a wee bit less stress?

While we certainly don't condone violence, this month's newsletter is going to feature a good, clean fight. And we want you to referee!

In the first corner:
The Office Holiday Party

Weighing in at a minimum of $25 per person (that's about 4,000 buckeroos @ a company of 150 people), this hometown favorite is sure to deliver one night of what is sure to be awkward & drunken coversation, inappropriate copies of someone's rear end and a case of serious indigestion - not to mention weight gain.

In the second corner:
Recess Office Yoga, or, No-Sweat Stretch Class

Weighing in at a slight $90 per event (that's nearly a class a week for a year at the same price as The Office Holiday Party), this scrappy challenger pummels the living daylight out of stress, neck and back pain. Quick and nimble he can fit in hallways, board rooms and can do it all without anyone breaking a sweat or having to change clothes. This flexible lad allows you to do all of your booking online (not on the ropes).

What is your vote? Would you rather have 50 yoga, relaxation or stretch classes per year or one holiday party? Weigh in with your answer on our blog and remember that you could win some lucy gear for making your voice heard.

Cast your vote! »

Mysterious?

Hello. It's been a week. Did you miss me? Or were you too busy ruminating to even notice I was gone?

Here's the wiki definition of mental rumination:

Rumination is contemplation or reflection on a particular topic. If very persistent or repetitively focused on problems, it is thought to play a role in the development of clinical depression.

I've even seen journalists and researchers refer to the endless cycle of depressing problem obsessing that young girls do together as co-rumination. I wonder what those same journalists would call an endless cycle of depressing economic and political obsessing? Hmmmm? Maybe 'news'?


Research shows that people who spend a long time mulling over their thoughts may be more predisposed to PTSD than non-ruminators.

Are you a ruminator?

Ruminators share some common characteristics. They often:
• Believe they're gaining insight through it.
• Have a history of trauma.
• Perceive that they face chronic, uncontrollable stressors.
• Exhibit personality characteristics such as perfectionism, neuroticism and excessive relational focus--"a tendency to so overvalue your relationships with others that you will sacrifice yourself to maintain them, no matter what the costs," researcher Nolen-Hoeksema explains.

The thing is, this ruminating is rarely helpful and, unchecked, may actually lead to depression or inaction.

Does work make ruminating worse?

Many people can probably relate to the ruminator's saga on a good day, much less at a time when it seems every radio, TV station and newspaper are running full tilt shock and awe. Work stressors add to the mix as employees, even those with "secure" jobs pick up on the panic and spend time obsessing about the effect that market instability might have on their or their families' welfare.

My typical suggestion in this case would be to interrupt the madness by bringing a little emotionally and physically healthy bonding time into employees' days with on-site yoga. And I am going to extol the benefits of that in just a sec', but I am also going to give you some suggestions for how anyone, anytime, for free can stop rumination in its tracks.

The benefits of bringing a little slice of sanity into the office:

• Yoga at work is safe, convenient and doesn't have to be sweaty.
  
• Our bodies were not actually designed to sit in one position for 8 hours a day. Yoga reduces employees' neck and back pain.
  
• Doing yoga at work often makes people laugh together, unwind a bit and start to see each other as another human beings (rather than snapping impatiently at anonymous co-workers).

The kind of sanity you just can't buy.

Truly, though, remaining calm is a skill that can be practiced and improved just like any skill. Research regarding nueroplasticity shows us that our brains change and adapt. The problem is that most of us have been practicing the wrong habits (rumination, stress, impatience, anger) for a very long time.

Practicing new habits like staying calm during times of turmoil, relaxation, focus and patience mean that like any new skill that we will have to practice it with diligence and in the beginning it might feel pretty flimsy in comparison to things we are better and more skilled at doing (like worrying).

A little exercise that everyone can do is to count your breath. Count to 21 as you breath in and out. As thoughts arise just let them go without berating yourself and go back to the counting. Thoughts will crop up but don't indulge - even if it seems urgently important!!! Beware this trap. You are only counting to 21. Just 21. If the thought is so darned important that you can't make it to the count of 21 then it will be just as important when you are done counting. You won't forget it. I promise.

Try this little exercise when you are feeling annoyed, or when your mind is spinning with worry, or after you check your stock portfolio. Let me know how it works.

If Food Were Health Care

If food prices had risen at the same rates as medical inflation since the 1930’s, we would be paying an astronomical amount for common grocery items:

1 dozen eggs $ 80.20
1 pound apples $ 12.23
1 pound sugar $ 13.70
1 roll toilet tissue $ 24.20
1 dozen oranges $ 107.90
1 pound butter $ 102.07
1 pound bananas $ 16.04
1 pound bacon $ 122.48
1 pound beef shoulder $ 43.57
1 pound of coffee $ 64.17

10 item total $ 586.56

Source: American Institute for Preventive Medicine, 2007

And it's not like we are getting more for our money.

Why aren't we tackling this problem in the forum where Americans spend the majority of their waking hours? If corporate wellness programs help employees and employers then what is the hesitation? When some companies spend hundreds of dollars per employee per year on parties and other goofy events why is it such a stretch to offer programs on a regular basis that help employees reduce stress and live healthier lives?

So what do you feel is keeping your company from offering wellness? And if your company is offering a wellness program what impact, if any, has it had on you during these rough economic times?

Cracking a smile at work

A relatively new concept in the world of mainstream health is one of resilience. It looks a lot like Recess’ 6 steps (or, they look like it?). It's taking small steps to create a lifestyle that helps us through the inevitable peaks and valleys of life without giving up something central - our vitality and well being. Nowhere is the ability to laugh off tension or endure hardship with a sense of humor more important than at work during a freaky economy.

Not taking myself so seriously is something I was never very good at. A while back I took a Nia class with a group of folks going through Recess' Health Immersion Program. It brought up, for me, the importance of letting things go and learning to laugh at myself. I wrote this note to some of the participants in the class:

Being well certainly doesn't mean being happy all of the time. Neither does it mean being Debbie Downer and dead serious or cynical all of the time. Today's Nia class really made me laugh – for a lot of different reasons. In some moments I wondered what might have been going on for some of you. Let me share why.

4 years ago I would not have been caught dead chopping my hands and shouting "HAH!" on the exhale. I've always been kind of a spaz, but stuff like saying "ohm" in yoga, or shouting on an exhale in martial arts just seemed a little too wacky for me. I felt totally silly. Truth be told, though, I also noticed that a lot of my thoughts during the course of a day were spent silently criticizing others in subtle ways for acting against the grain of what I felt was normal, cool, or otherwise acceptable.

I usually never verbalized this stuff and I knew it was silly of me, but the hard part was that when I really started looking in to it I actually spent a lot of time criticizing myself that way, too.

Honestly, it was a pretty exhausting posture to maintain. You’ve probably noticed that I talk a lot. Well, during the course of any given day there were so many opportunities to criticize myself for something stupid I said, an embarrassing gaff I made, a mistake in my work, a goofy face I made during an inappropriate moment in the conversation, a time when I wasn’t keeping up with my friends or colleagues, a time when I was excelling and then I acted like an arrogant jerk. You know this list. It goes on and on and on and on. Even today I still marvel. I mean, seriously, it’s a wonder that I ever got anything done with the amount of effort I spent constantly analyzing my every move post-facto and then berating myself for it!

So then I started a business. That was fun. I mean I’d been someone else’s hotshot for years. Even with my non-stop list of flaws, I still thought I was pretty hot stuff. Now, every day of my life presented me with rather glaring examples of how I was a TOTAL nincompoop. If your ego EVER needs a beat down I suggest you start a business. It’s like the most expensive therapy you will ever buy and with no positive affirmations. The great part, though, was that I didn’t have even a shred of energy or time anymore to devote to that cynical, nasty voice in my head that was always on my case.

Every time it would start in “Oh my god, that was sooooo stupid,” I would just have to shrug my shoulders and say “Oh well. It’s done. I guess I just have to do better next time.” That conversation with myself happened over and over and over and still happens today. Now though, I find that the voice doesn’t try as hard to convince me of all the ways that I don’t measure up because usually I only listen for a second before getting back to the business of whatever is in front of me. Ok, so resilience, and Nia and screaming “hah.”

Look. I will be honest. Groovy dance/exercise stuff can still feel a little silly to me. But now I see it as just another opportunity to practice something that I need to survive in this world – cultivating a sense of humor about myself. Even if I feel completely weird and awkward, just shrugging my shoulders at it and letting it go is such good practice for the times I am really going to need it. You know, like when someone I like rejects me, or when I screw up at work. Instead of making matters worse by beating myself with that moment, spending a lot of time with it, identifying with it, I’m practicing the art of letting it go and moving on.

So I laughed a lot today because I would catch myself going into a mini-tailspin in my head about how I didn't want to do something. It was funny, I mean funny that I was making a commotion over a little arm swinging and shouting? So I would just laugh at myself and keep swinging my arms and shouting, or not, but either way I wasn't going to expend a lot of energy talking to myself about it.

Neurologically speaking, doing something that makes you feel silly in a safe place where people AREN’T judging you and all you have to do is wrestle with your own judgment is a great way to practice the pretty ambiguous, new agey sounding concept of “letting go.” I mean, the stakes are pretty low AND you are getting in good shape! Practicing any skill, means we’ll be better prepared to focus on what needs to get done when the next little (or big) bump in the road inevitably comes. Everything – even a health immersion program – gives us opportunities to practice skills we need to make it in life.

Sometimes our best teachers are the moments that feel a bit awkward. I encourage you to challenge yourself to come and to take home the one thing that can be helpful to you in your life. It might not even be physical, but many of the challenges we face in this modern world are not.

Worker Productivity and "Miracle-Gro" for Your Brain

Dr. John Medina is a developmental molecular biologist and research consultant. He is an affiliate Professor of Bioengineering at the University of Washington School of Medicine. He is also the director of the Brain Center for Applied Learning Research at Seattle Pacific University.

So what does this guy, who knows a lot about brains and not just because his is obviously pretty high powered have to say about how to optimize our brains for work, play and study? Exercise. Yes. Not only does Medina show that exercise is the number one rule for brain health (hint: when our brain was designed regular movement was a fact of life for humans), but he strenuously emphasizes that our modern, sedentary work environment is actually hurting brain performance.

The US's labor landscape continues to undergo dramatic shifts. Manufacturing jobs are fading fast as the rise of the service economy dominates the landscape.

"It's good for us to displace low-wage, manual kinds of labor with higher-skill, higher-tech, higher-education-content labor," says Federal Reserve Bank of St. Louis President William Poole, who compares what's happening with the decline in agricultural employment of the early 20th century.

The problem is we are treating service based workers like factory workers. Workers' brain capacity is - at its core - the very product most service based companies sell; however, the sedentary cube land structured like an automotive assembly line is one of the least conducive set-ups for brain function.

Creative, effective ways to mobilize wellness at work will be central to revolutionizing the effectiveness of the knowledge-based worker. Corporate wellness efforts for such companies cannot simply be seen as a small fluff program for the motivated few who thrill at the thought of spandex leggings, step aerobics in the lunch room, or a gym membership on the company dime.

Wellness, when done right, is a strategic, integrated, and systematic approach for improving employee health, but also key to unleashing the very engine of human creativity - the brain.

Get Well Soon, CEO!

Finding an executive manager is never easy. And once you do find a fearless leader, myriad cultural, economic and - yes - even personal health issues can threaten to throw the whole situation off the rails.

"The impact of replacing senior managers, especially due to sudden health issues, is even more acute than normal turnover. A study by Deloitte shows that 47% of companies cite their biggest people-related challenge as leadership development and succession planning," says Candie Fisher,Director of Client Development for Generator Group, a talent management firm based in Portland, OR

Last year,CFOs at nCipher and Servocell resigned due to ill health. In 2004 McDonald's CEO, Jim Cantalupo died at age 60 of a heart attack. Charles Bell, who replaced Cantalupo, was diagnosed with colorectal cancer only a month after being named chief executive.

Despite their strategic importance to an organization, executive leaders are in many other ways just like everyone else. They have bad hair days (case in point, get a load of Bill Gates and the Microsoft crew in this photo)!


They get sick - often due to preventable causes - just like the rest of us.

Sharon McDowell is an exercise physiologist for the Center for Creative Leadership's Leadership At The Peak Program. The program has looked at the overall health of senior executives and leaders with more than 15 years of management experience, in the top three tiers of the organization, with leadership responsibility for 500 or more people and/or executive staff functions. McDowell says that of the nearly 3,000 program participants screened 58% had high cholesterol; 60% are overweight or obese; and about 50% don't exercise regularly.

Executive managers lead high stress lifestyles and often lack the time for structured exercise. The World Heart Federation and the US Federal Centers for Disease Control say failure to exercise is as bad as smoking a pack of cigarettes every day.

Unexpected leadership transitions are costly, says Fisher, "At the top levels, many companies do not have a strong program in place to fill senior leadership positions from within. As a result, fully-loaded recruiting costs of 1.5 times the annual salary are commonplace."

Fisher recommends companies implement a two-pronged strategy of keeping their senior managers focused on both wellness and succession planning. "Executive level jobs can be stressful, reducing executives health risk through wellness programs can increase leadership productivity thus improving their ability to mentor, groom, and retain high potential talent," she states.

Increasing executives' personal well-being might also improve their effectiveness. McDowell's research has shown that executives that exercise are more likely to be perceived as more energetic and effective than their non-exercising peers in 360 degree management surveys.

If you've never failed, you've never lived.

I'm feeling this today:



I encounter many people in the workforce that dream about becoming more themselves in their work - finding balance and harmony between their personal life and their work life. Many feel too anxious that they won't fit in and continue to lament the disconnect between their personal and professional passions for the sake of keeping a steady job.

The current financial situation leaves a lot of people feeling uncertain, scared and wondering what happens next. It also underlines an important point to always remember - no job and no situation is solid, fixed or certain. Playing it safe might not ultimately save us from job loss or disappointment in life. If life were like horseback riding then what defines us is not that we fall off - since that is nearly inevitable - but whether or not we get back on the horse.

The poet Rilke so eloquently counseled a young man searching to bring his inner and outer world into harmony:

We have no reason to mistrust our world, for it is not against us. Has it terrors, they are our terrors; has it abysses, those abysses belong to us; are dangers at hand, we must try to love them. And if we could only arrange our life according to that principle which counsels us that we must always hold to the difficult, then that which now seems to us the most alien will become what we most trust and find most faithful. How should we be able to forget those ancient myths that are at the beginning of all peoples, the myths about dragons that at the last moment turn into princesses; perhaps all the dragons in our lives are princesses who are only waiting to see us once beautiful and brave. Perhaps everything terrible is in its deepest being something helpless that wants help from us.

This lack of security in the world might be frightening, but it's there. No amount of fantasy or wishful thinking can vanish it. How we embrace that uncertainty is what defines our life. Once you've had a taste of that kind of courage of doing something that feels terrifying, but making it out ok - even if you fail you become pretty brave.

How does this relate to the inner world/work world conundrum? Well wellness at work ultimately starts in the hearts of the people who come to work. Work might not always be a rollicking adventure full of spontaneous self expression, but it need not be a place where you feel completely hidden away. And if you try to bring a more authentic version of yourself to the workplace and it is not exactly met with enthusiasm there are a couple of options:

1. Examine whether what you feel is "authentically" you really serves your life. If you feel that you are authentically a crabby and negative person does holding on an attachment to that part of your personality really get you the kind of results you seek when you picture the life you want? If it's something that you are working with then being frank with people about your crabby disposition without letting it off leash whenever you feel a bit irked might help you find a happy medium.
2. If you feel that you are trying to express a part of yourself that is healthy, part in parcel to helping you achieve a balanced life and to reaching your goals and it is not welcome at work then perhaps it is time to consider if your current situation is a good fit. Keeping in mind that even seemingly solid situations come unglued from time to time, challenging yourself to persue new avenues will ultimately be more rewarding for you and those around you.

And if it fails? There is no need to burn bridges from your past. Exit your situation with a positive, helpful attitude and keep the doors open. You now have more life and work expereince and more perspective should you choose to return.