To have any effect on the bottom line, employee health and wellness programs need to be able to improve employee health behaviors. Without improvements in nutrition, physical activity, controlling stress, and other health behaviors, most of the chronic diseases employees experience will not be prevented.
In a way, worksite health programs are really just health interventions designed to help employees and their spouses adopt and maintain healthy behaviors. Most employee health and wellness programs are really good at helping people get started, but after a little while we get distracted or busy or fail to see improvements and we go back to our old ways. For most people new, healthy behaviors don’t persist. A technical term for this is healthy behavior decay.
Maintaining healthy behaviors is really hard to do. Take weight loss, for example. The graph shown here shows what typically happens for most people.
They decide to lose weight and using diet and exercise; just about everybody is successful in the beginning. They have adopted the healthy behaviors that are required to reach a healthy weight. As hard as it is to lose weight, it’s even harder to keep the weight off.
As this graph shows, over time the healthy behaviors that led to the weight loss are discarded and most people gradually go back to their old habits. Not surprisingly the weight comes back.
This is the way it happens with most people. After two years the majority of people are at or above their original weight. The challenge with weight loss and the challenge with all the other healthy lifestyles is to adopt AND maintain healthy behaviors. The same is true of lifestyle changes made in employee health and wellness programs.
Failure to maintain healthy behaviors is common for those who are trying to eat healthy, avoid tobacco use, reduce stress, get regular exercise, or create any new healthy behavior. Humans are creatures of habit. Most people find change to be difficult. This is why it is so hard for some people to maintain healthy behaviors for a long time, and why it is hard for many employee health and wellness programs to succeed.
In addition to our resistant natures, there are many other factors working against employees’ desires to have healthy behaviors. National and international trends show that there are many things working against our desires for good health. Western culture promotes sedentary living, processed foods, and large amounts of food that make it difficult to control our eating.
Today we have more diabetes, obesity, and chronic disease than ever before, despite the efforts of employee health and wellness programs. With so many factors working against us it makes sense to ask people to not get worse. You can almost ask your employees to forget about improving their nutrition and physical activity because they would make some progress if they just stopped getting worse.
Not getting worse could be a worthy goal for any employee health and wellness programs. If we can just get employees to stop gaining weight, we would be making progress.
There is one weakness that almost all employee health and wellness programs have. After 30 years of evaluating dozens and dozens of programs it has become clear that it is difficult to impossible to get large groups of employees to reach and maintain a healthy body weight. The obesity epidemic is caused by a variety of cultural factors and helping employees lose weight has proven to be exceptionally difficult.
While the workplace wellness statistics suggest that helping people improve blood cholesterol, blood pressure, and blood glucose is possible, helping people lose weight and keep the weight off has proven to be hard to do. Then again, no weight loss program is good at doing this. There is some hope. Recently, the RAND report showed some promising results:
If the focus of your employee health and wellness program is to help individuals reach and maintain a healthy body weight you should prepare yourself to be disappointed. The unhealthy culture that surrounds most of us makes it extremely difficult to lose weight, in fact, most people in the United States and in the industrialized world gain weight every year.
I’m often asked: “Dr. Aldana, how long do I have to keep eating a healthy diet and exercising regularly?” I respond with, “That depends on how long you want the benefits of good health. When you stop, the benefits stop. Good health requires health behaviors for the rest of your life.”
What Can Happen After 2 Years of Employee Health and Wellness Programs
In the journal Health Promotion Practice, WellSteps recently published our 8th research study on the impact of our wellness solutions. In this research investigators followed almost 2,000 employee health and wellness program participants for over 2 years.
The purpose of the study was to determine if the employees were able to adopt and maintain healthy behaviors for at least 24 months. This is a tall order given the pressures that we all experience to be unhealthy.
At this worksite, not only did most employees not get worse, but they generally improved health behaviors across the two year implementation period of the employee health and wellness program. The longer they participated the better their health behaviors became. Here are a few of the results:
Since all of these employees participated in healthy eating and exercise challenges as part of the workplace wellness program, is to be expected that there was some impact on their behaviors.
Employees also showed long-term improvements in stress, depression, and life satisfaction. Very few of the employees smoked (just 4%). At baseline there were 77 tobacco users and after two years the number of tobacco users dropped to 66 people. That is a 13% decline in tobacco users.
|Baseline||Year 1||Year 2|
|Health Care Visits||3.10||3.09||3.13|
*Indicates statistically significant changes across time
Among the workplace wellness program participants there was no significant change in self rated health, absenteeism, job performance or satisfaction or the number of healthcare visits per year.
Despite the cultural and social pressures we all have to be unhealthy, these employee health and wellness program participants have been able to adopt and maintain healthy behaviors for at least two years. Other published studies show that the same group was able to reduce their elevated health risks and reduce their health care costs.
If you’ve been able to have a healthy habit for two years, chances are extremely good that you’ll be able to maintain the new behavior for years to come. This is just one more bit of evidence to support all of the reasons why employee health and wellness programs should be a business strategy for every employer.
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