Redefining Wellness
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In 2005, Dr. David Anderson of Stay Well Health Management presented the Fairview Alive wellness program at a meeting of the Health Enhancement Organization. Fairview Health Services is a community-based not-for-profit health services delivery service in the Minneapolis metropolitan area.
In 2007, an article entitled "Promising Practices in Employer Health and Productivity Management Efforts: Findings from a Benchmarking Study," by Dr. Ron Goetzel, Director, Institute for Health & Productivity Studies, Cornell University, suggested that managing the healthcare continuum issues was a core benchmark practice in successful worksite wellness programs.
The Goetzel article suggested that five health and productivity management integration practices can help better manage the healthcare continuum. At that time, 4 best practices were addressed: individual wellness, environmental, policy, and cultural factors.
Provide fitness center or supplementing fitness center memberships
Provide healthy food offerings in cafeteria and vending machines
Offer employees a variety of different behavior-change program offerings
Target programs along the continuum of care
Offer health risk assessments to designed targeted programs
Use focus groups and employee surveys to address employee needs and interest
Use claims analysis
Look at other data (pharmaceutical, absenteeism, productivity, turnover, etc.)
Use data to ensure well-targeted programming
By 1990, the Wellness Management Model has merged into the Corporate’s Health and Productivity Model
Enhanced Health Care Continuum 1990-2000: Health and Productivity Model
Wellness Management
- ·Knowledge and Skill Training
- ·Motivation and Commitment Building
- ·Preventive Screening
- ·Incentive-Driven
- ·Environmental Supports
Risk Management
- ·Targeted Intervention
- ·Targeted Screening
- ·Strategies to Reduce High-Risk Copay
- ·High-Risk Case Management
- ·Free Tobacco Cessation
Demand Management
- ·Self-Care Culture Initiated
- ·Self-Care Books Provided
- ·Accessibility to Wellness Library
- ·Virtual Wellness Program 24/7
- ·Nurse Advice Line 24/7
Disease Management
- ·Target Classes and Coaching
- ·Compliance to Practices and Medications Tracked
- ·Compliance Rewarded
- ·Risk and Case Management
- ·Web Tools
Disability Management
- ·Risk and Case Management
- ·Specialized Networks
- ·Integrated Return-to-Work Program
- ·Decision Support Provided
- ·Survivorship Support Groups
Wellness History: Reflection of three professional areas growing simultaneously 1980-2010
In 2005, Dr. David Anderson of Stay Well Health Management presented the Fairview Alive wellness program at a meeting of the Health Enhancement Organization. Fairview Health Services is a community-based not-for-profit health services delivery service in the Minneapolis metropolitan area.
In 2007, an article entitled "Promising Practices in Employer Health and Productivity Management Efforts: Findings from a Benchmarking Study," by Dr. Ron Goetzel, Director, Institute for Health & Productivity Studies, Cornell University, suggested that managing the healthcare continuum issues was a core benchmark practice in successful worksite wellness programs.
The Goetzel article suggested that five health and productivity management integration practices can help better manage the healthcare continuum. At that time, 4 best practices were addressed: individual wellness, environmental, policy, and cultural factors.
Provide fitness center or supplementing fitness center memberships
Provide healthy food offerings in cafeteria and vending machines
Offer employees a variety of different behavior-change program offerings
Target programs along the continuum of care
Offer health risk assessments to designed targeted programs
Use focus groups and employee surveys to address employee needs and interest
Use claims analysis
Look at other data (pharmaceutical, absenteeism, productivity, turnover, etc.)
Use data to ensure well-targeted programming
By 1990, the Wellness Management Model has merged into the Corporate’s Health and Productivity Model
Enhanced Health Care Continuum 1990-2000: Health and Productivity Model
Wellness Management
- ·Knowledge and Skill Training
- ·Motivation and Commitment Building
- ·Preventive Screening
- ·Incentive-Driven
- ·Environmental Supports
Risk Management
- ·Targeted Intervention
- ·Targeted Screening
- ·Strategies to Reduce High-Risk Copay
- ·High-Risk Case Management
- ·Free Tobacco Cessation
Demand Management
- ·Self-Care Culture Initiated
- ·Self-Care Books Provided
- ·Accessibility to Wellness Library
- ·Virtual Wellness Program 24/7
- ·Nurse Advice Line 24/7
Disease Management
- ·Target Classes and Coaching
- ·Compliance to Practices and Medications Tracked
- ·Compliance Rewarded
- ·Risk and Case Management
- ·Web Tools
Disability Management
- ·Risk and Case Management
- ·Specialized Networks
- ·Integrated Return-to-Work Program
- ·Decision Support Provided
- ·Survivorship Support Groups
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Health Promotion Defined:
The World Health Organization (WHO) defines health promotion as the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behavior toward a wide range of social and environmental interventions.
“Health Promotion is the art and sciences of helping people discover the synergies between their core passions and optimal health, enhancing their motivation to strive for optimal health, and supporting them in changing their lifestyle to move toward a state of optimal health. Optimal health is a dynamic balance of physical, emotional, social, spiritual, and intellectual health. Lifestyle change can be facilitated through a combination of learning experiences that enhance awareness, increase motivation, and build skills and, most important, through the creation of opportunities that open access to environments that make positive health practices the easiest choice." (See, Michael P. O'Donnell (2009) Definition of health promotion 2.0. American Journal of Health Promotion. September/October 2009, Vol. 24, No. 1, pp. iv-iv)
In providing wellness programming, health promotion defines the basic marketing and promotional aspects of wellness programs. Health promotion is grounded in the disciplines of social marketing, health communication, business marketing and incentives that address consumer health "needs" and customer "wants”. Wellness programming provides the actual employee wellness programs that provide a holistic 7 dimensional approach in changing life-style behaviors, environmental policies and organizational culture. Abbott, 1990.
What Is Workplace Wellness?
Workplace wellness is defined as: “An organized employer-sponsored program that is designed to support employees (and sometimes, their families) as they adopt and sustain behaviors that reduce health risks, improve quality of life, enhance personal effectiveness, and benefit the organization’s bottom line”. (See, Leonard L. Berry, Ann M. Mirabito, and William B. Baum; What’s the hard return on employee wellness programs? Harvard Business Review. Dec. 2010, pp. 1-9).
Where Are We Today?
Health Promotion Defined:
The World Health Organization (WHO) defines health promotion as the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behavior toward a wide range of social and environmental interventions.
“Health Promotion is the art and sciences of helping people discover the synergies between their core passions and optimal health, enhancing their motivation to strive for optimal health, and supporting them in changing their lifestyle to move toward a state of optimal health. Optimal health is a dynamic balance of physical, emotional, social, spiritual, and intellectual health. Lifestyle change can be facilitated through a combination of learning experiences that enhance awareness, increase motivation, and build skills and, most important, through the creation of opportunities that open access to environments that make positive health practices the easiest choice." (See, Michael P. O'Donnell (2009) Definition of health promotion 2.0. American Journal of Health Promotion. September/October 2009, Vol. 24, No. 1, pp. iv-iv)
In providing wellness programming, health promotion defines the basic marketing and promotional aspects of wellness programs. Health promotion is grounded in the disciplines of social marketing, health communication, business marketing and incentives that address consumer health "needs" and customer "wants”. Wellness programming provides the actual employee wellness programs that provide a holistic 7 dimensional approach in changing life-style behaviors, environmental policies and organizational culture. Abbott, 1990.
What Is Workplace Wellness?
Workplace wellness is defined as: “An organized employer-sponsored program that is designed to support employees (and sometimes, their families) as they adopt and sustain behaviors that reduce health risks, improve quality of life, enhance personal effectiveness, and benefit the organization’s bottom line”. (See, Leonard L. Berry, Ann M. Mirabito, and William B. Baum; What’s the hard return on employee wellness programs? Harvard Business Review. Dec. 2010, pp. 1-9).
Employer Wellness
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Workplace Wellness Evolution
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Re-Define Wellness
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It was the late 70’s early 80’s. Many baby-boomers returned to the land and became a seeker. [of self-actualization]. Along the way they found many self-help books that jumped from their shelves to me; Like - Chop Wood Carry Water, Illusions, Travis & Regina Ryan’s Wellness Workbook, and later Travis Wellness Workbook for Professionals [1991].
I met Jack and Elaine at a workshop in Ohio. Elaine Sullivan re-enforced in me that each of us has a story, and it is our story.
It was the late 70’s early 80’s. Many baby-boomers returned to the land and became a seeker. [of self-actualization]. Along the way they found many self-help books that jumped from their shelves to me; Like - Chop Wood Carry Water, Illusions, Travis & Regina Ryan’s Wellness Workbook, and later Travis Wellness Workbook for Professionals [1991].
Personal Wellness
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Power of Perception
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The 7 Dimensional Model of Wellness
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Dependent upon internal motivation vs. external rewards.
Who has more power that self to make change and be well.
Putting the emphasis back on self responsibility is where wellness has always been.
Dependent upon internal motivation vs. external rewards.
Who has more power that self to make change and be well.
Feel free to evaluate yourself and determine where you are in your own wellness
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Wellness is that language, the new green. To bring communities together, there must be a common value or connection.
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Edington’s Summary: “Instead of aiming for a return to the status quo, a focus on positive health would move us beyond the status quo toward outcomes that exceed expectations. While risk reduction and health maintenance are noble, it is time to move the focus and efforts toward positive health potential through improved physical, mental, and social capabilities
Edington: Zero Trends publicity/Rand Report introduced here – What is the problem with this approach? People are do not fit into financial models, i.e. zero trends, behavior economics
Introduction: Current Perspectives
Since the introduction of the Patient Protection and Affordable Care Act (PPACA), there seems to be a “spin” and urgency that goes something like this: Despite the very best efforts of the nation’s most talented worksite wellness practitioners, many health and wellness initiatives have failed to live up to their potential. With redesign of company benefit plan design, remarkable results are finally being achieved. This attitude was not helped with the release of the RAND Report.
After studying and working in the health and wellness side for the last few years, this comment may make one feel less cooperative with management and/or corporate benefit professionals.
A big part of where this “spin” started is with one of the longtime leaders in academic research (University of Michigan Health Management Research Center), Dee Edington, who has appeared in the news as: “Dee Edington is going to irritate a lot of people... Edington had a lot to say about what doesn’t work--interventions focused on behavioral change for one.”
This is not news to those who have been working in the trenches of public health and wellness since the seventies. Public health attributes only 30% of determinants of health to be health behaviors [tobacco use, diet and exercise, alcohol use and sexual activity].
Public Health Contribution to Determinants of Individuals [Health Public Health County Health Rankings Project: http://www.countyhealthrankings.org/roadmaps/what-works-for-health]
Edington’s Summary: “Instead of aiming for a return to the status quo, a focus on positive health would move us beyond the status quo toward outcomes that exceed expectations. While risk reduction and health maintenance are noble, it is time to move the focus and efforts toward positive health potential through improved physical, mental, and social capabilities.”
With the discovery of neuroplasticity we now have the technology and research to support that you can “change the brain” via use of mindfulness and meditation.
I call this welcome to the new Google World - New generation meets new reality of economy/recession: Movie The Interns
Edington’s Summary: “Instead of aiming for a return to the status quo, a focus on positive health would move us beyond the status quo toward outcomes that exceed expectations. While risk reduction and health maintenance are noble, it is time to move the focus and efforts toward positive health potential through improved physical, mental, and social capabilities
Edington: Zero Trends publicity/Rand Report introduced here – What is the problem with this approach? People are do not fit into financial models, i.e. zero trends, behavior economics
Introduction: Current Perspectives
Since the introduction of the Patient Protection and Affordable Care Act (PPACA), there seems to be a “spin” and urgency that goes something like this: Despite the very best efforts of the nation’s most talented worksite wellness practitioners, many health and wellness initiatives have failed to live up to their potential. With redesign of company benefit plan design, remarkable results are finally being achieved. This attitude was not helped with the release of the RAND Report.
After studying and working in the health and wellness side for the last few years, this comment may make one feel less cooperative with management and/or corporate benefit professionals.
A big part of where this “spin” started is with one of the longtime leaders in academic research (University of Michigan Health Management Research Center), Dee Edington, who has appeared in the news as: “Dee Edington is going to irritate a lot of people... Edington had a lot to say about what doesn’t work--interventions focused on behavioral change for one.”
This is not news to those who have been working in the trenches of public health and wellness since the seventies. Public health attributes only 30% of determinants of health to be health behaviors [tobacco use, diet and exercise, alcohol use and sexual activity].
Public Health Contribution to Determinants of Individuals [Health Public Health County Health Rankings Project: http://www.countyhealthrankings.org/roadmaps/what-works-for-health]
Edington’s Summary: “Instead of aiming for a return to the status quo, a focus on positive health would move us beyond the status quo toward outcomes that exceed expectations. While risk reduction and health maintenance are noble, it is time to move the focus and efforts toward positive health potential through improved physical, mental, and social capabilities.”
With the discovery of neuroplasticity we now have the technology and research to support that you can “change the brain” via use of mindfulness and meditation.
How do your kids reflect who you are?
My kids are next
Generation Z
Born: 1995-2012
Coming of Age [20]: 2015
Population: 23 million
When I retired, I saw this generation go through many struggles with who they are , and now When I see my own kids [Gen Z], I wonder where did they get that behavior from? Needless to say I have had to eat “ a’lot of crow!” do you know what that phrase means? – “eat crow” it is not common language anymore!
How do your kids reflect who you are?
My kids are next
Generation Z
Born: 1995-2012
Coming of Age [20]: 2015
Population: 23 million
Generation Y, Echo Boomers or Millenniums Born: 1977-1994
Coming of Age [21]: 1997-2015
Age in 2015: 38 to 21
Population: 71 million
Generation Z Born: 1995-2012
Coming of Age[21]: 2016-2033
Age in 2015 =20
Population: 23 million
What will be the new influence of the New Millennium Generation (Y , Echo-Boomer, Millennials)? They are the largest generation in American history. Born between 1978 and 2000, "WE" are 95 million strong, compared with the 78 million post war and baby boomers
Generation Y, Echo Boomers or Millenniums Born: 1977-1994
Coming of Age [21]: 1997-2015
Age in 2015: 38 to 21
Population: 71 million
Generation Z Born: 1995-2012
Coming of Age[21]: 2016-2033
Age in 2015 =20
Population: 23 million
Generation X
Born: 1966-1976
Coming of Age [21]: 1987-1994
Age in 2015: 61 to 39
Population: 41 million
Boomers I or The Baby Boomers
Born: 1946-1954
Coming of Age [21]: 1967-1975
Age in 2015: 69-61
Current Population: 33 million
Guess what X-Gen your middle age now>>>>>>>>>
Generation X
Born: 1966-1976
Coming of Age [21]: 1987-1994
Age in 2015: 61 to 39
Population: 41 million
Boomers I or The Baby Boomers
Born: 1946-1954
Coming of Age [21]: 1967-1975
Age in 2015: 69-61
Current Population: 33 million
State of American Workplace
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Todays work force is pretty diverse by age
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Engagement is similar in all age groups
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We are creatures of habit.
This is who wellness has served as it developed to meet consumer demands.
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What are basic health promotion and wellness programs: Include wellness programs specifically targeted to the population demographic base and based upon the population health, disease management and risk reduction programs.
They include “comprehensive wellness” strategies including the Public Health Contribution via Determinates of Individual’s health. Indicators that attribute to being healthy include: 30% are attributed to health behaviors; 40% to social and economic factors; 40% to Physical Environments; and 10% attributed to clinical care.
The strongest determines of health are socio-economic and health literacy.
Example of programs include but are not limited to: risk reduction, nutrition and exercise, stress management, health coaching, health promotion, marketing, communications and incentives delivered through focusing on the 7 dimensions of wellness: Spiritual, Physical, Intellectual, Emotional, Career; Environmental, Social.
Individual health and well-being drivers
Financial security and literacy top the list – From PH perspective
These two influence access to and quality of health care and environmental community lived in and personal choice
Well-being is related to an income > $75,000/household Linked article: At What Price Happiness? $75,000
The Five Essential Elements indicates only 7% of the population studied are thriving in all segments: physical, career, social, finance, community wellness. http://www.wbfinder.com/home.aspx Tom Rath and Jim Harter book Well-Being: The Five Essential Elements (2010) Gallup Press, NY, NY. A summary of the well being elements taken from the book are listed below.
Gallup didn’t include religion vs. spiritual
3 “Drivers” (Factors) for
Individual health and well-being:
Socio-economic (40%) Access to health care
Environmental community lived in (10%)
Personal choice – behavior change (30%)-left to our own divisiveness when given too many choices we do nothing- Gallup
Drivers for health are different
What are basic health promotion and wellness programs: Include wellness programs specifically targeted to the population demographic base and based upon the population health, disease management and risk reduction programs.
They include “comprehensive wellness” strategies including the Public Health Contribution via Determinates of Individual’s health. Indicators that attribute to being healthy include: 30% are attributed to health behaviors; 40% to social and economic factors; 40% to Physical Environments; and 10% attributed to clinical care.
The strongest determines of health are socio-economic and health literacy.
Example of programs include but are not limited to: risk reduction, nutrition and exercise, stress management, health coaching, health promotion, marketing, communications and incentives delivered through focusing on the 7 dimensions of wellness: Spiritual, Physical, Intellectual, Emotional, Career; Environmental, Social.
Individual health and well-being drivers
Financial security and literacy top the list – From PH perspective
These two influence access to and quality of health care and environmental community lived in and personal choice
Well-being is related to an income > $75,000/household Linked article: At What Price Happiness? $75,000
The Five Essential Elements indicates only 7% of the population studied are thriving in all segments: physical, career, social, finance, community wellness. http://www.wbfinder.com/home.aspx Tom Rath and Jim Harter book Well-Being: The Five Essential Elements (2010) Gallup Press, NY, NY. A summary of the well being elements taken from the book are listed below.
Gallup didn’t include religion vs. spiritual
3 “Drivers” (Factors) for
Individual health and well-being:
Socio-economic (40%) Access to health care
Environmental community lived in (10%)
Personal choice – behavior change (30%)-left to our own divisiveness when given too many choices we do nothing- Gallup
The core values of an organization are those values we hold which form the foundation on which we perform work and conduct ourselves. We have an entire universe of values, but some of them are so primary, so important to us that throughout the changes in society, government, politics, and technology they are STILL the core values we will abide by. In an ever-changing world, core values are constant. Core values are not descriptions of the work we do or the strategies we employ to accomplish our mission. The values underlie our work, how interact with each other, and which strategies we employ to fulfill our mission. The core values are the basic elements of how we go about our work. They are the practices we use (or should be using) every day in everything we do.
What are core values?
The core values of an organization are those values we hold which form the foundation on which we perform work and conduct ourselves. We have an entire universe of values, but some of them are so primary, so important to us that throughout the changes in society, government, politics, and technology they are STILL the core values we will abide by. In an ever-changing world, core values are constant. Core values are not descriptions of the work we do or the strategies we employ to accomplish our mission. The values underlie our work, how interact with each other, and which strategies we employ to fulfill our mission. The core values are the basic elements of how we go about our work. They are the practices we use (or should be using) every day in everything we do.
Core Values Continued.
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Events like these make us examine our values – what have you learned over the past year?
What are the things you value the most? The basics – worth dying for
Find 3 values you agree on with your partner
(2) Find 2 new partners and find 3 values you agree on
(4) Find 2 more new partners and 3 values you agree on
(8) Find 1 other group and 3 values you agree on
(16) Find 1 other group and 3 values you agree on = common core values for the group posted;
What about outliers? Reason for outliers.
Exercise/ list top 3 values then regression to death-mark them off the list, leaving only one value! What is it?
Is this a common value in your small group?
Over the past year, the war, credit recession, bailout, and a national election have given most of us a “no exit” short of death.
Events like these make us examine our values – what have you learned over the past year?
What are the things you value the most? The basics – worth dying for
Find 3 values you agree on with your partner
(2) Find 2 new partners and find 3 values you agree on
(4) Find 2 more new partners and 3 values you agree on
(8) Find 1 other group and 3 values you agree on
(16) Find 1 other group and 3 values you agree on = common core values for the group posted;
What about outliers? Reason for outliers.
Exercise/ list top 3 values then regression to death-mark them off the list, leaving only one value! What is it?
Is this a common value in your small group?
Authennticity
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The American dream is pretty limited – the connection is bigger than “dream” it has the responsibility to provide vision – connection beyond “1” “self” to connection to all
There is great wisdom in both the “dream” and the “vision”
There are kinds of people, those well connected/not so well connected
The American dream is pretty limited – the connection is bigger than “dream” it has the responsibility to provide vision – connection beyond “1” “self” to connection to all
There is great wisdom in both the “dream” and the “vision”
Compare your values to the most common given in US
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What is your dream?
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This is what drives me..,
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What is the value of having outliers? Keeps group in balance.
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World view spiritual values: consciousness, disciplined practice, compassion, empathy, forgiveness
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Human Values
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