A Buffet of Wellness Programs Brian T Morris

A Buffet of Wellness Programs Brian T Morris, MD, JD, MBA, MPH September 21, 2015

Agenda • Profiles of the average Commercial Motor Vehicle (CMV) driver • Health consequences • Basic wellness programs • Comprehensive wellness program • Questions & answers 2

Profile of the Average CMV Driver • Physical Profile – Gender • Male 92. 6% • Female 7. 4% http: //www. bls. gov/cpsaat 11. pdf http: //www. mmta. com/document_upload/Analysis%20 of%20 Truck%20 Driver%20 Age%20 Demogra phics%20 FINAL%2012%202014. pdf#page=14&zoom=auto, -150, 613 3

Profile of the Average CMV Driver • Physical Profile – More than 40 years of age http: //www. mmta. com/document_upload/Analysis%20 of%20 Truck%20 Driver%20 Age%20 Demogra phics%20 FINAL%2012%202014. pdf#page=14&zoom=auto, -150, 613 4

Profile of the Average CMV Driver • Physical Profile – Weight • 86% Overweight or obese – BMI ≥ 25 – 2007 data • 69% Obese – BMI ≥ 30 – 2010 data – Twice the percent of the U. S. adult working population Ellin, Abby (2011 -11 -21). “A Hard Turn: Better Health on the Highway”. The New York Times. Retrieved 2012 -03 -14. Sieber WK, Robinson CF, Birdsey J, Chen GX, Hitchcock EM, Lincoln JE, Nakata A, Sweeney MH (June 2014). "Obesity and other risk factors: the national survey of U. S. long-haul truck driver health and injury". American Journal of Industrial Medicine 57 (6): 615– 26. 5

PROFILE OF THE AVERAGE CMV DRIVER • Lifestyle Profile – Sedentary • 8% of CMV drivers exercise regularly • 20. 8% of adults 18 years of age and over meet the Physical Activity Guidelines for both aerobic physical and muscle-strengthening activity Levy, Steward. "American Crisis - Health of our Nation's Truck Drivers”. Corporate Wellness Magazine. Retrieved May 16, 2012. http: //www. cdc. gov/nchs/fastats/exercise. htm 6

Profile of the Average CMV Driver • Lifestyle Profile – Smoker • 51% of CMV drivers smoke cigarettes (2010 data) • 17. 8% of Americans smoke cigarettes (2013 CDC data) Sieber WK, Robinson CF, Birdsey J, Chen GX, Hitchcock EM, Lincoln JE, Nakata A, Sweeney MH (June 2014). "Obesity and other risk factors: the national survey of U. S. long-haul truck driver health and injury". American Journal of Industrial Medicine 57 (6): 615– 26. http: //www. cdc. gov/tobacco/data_statistics/fact_sheets/fast_facts/ 7

Profile of the Average CMV Driver • Lifestyle Profile – 80% have poor eating habits • Unhealthy food choices • Lack of healthy choices at truck stops and fast food establishments Jacobson, P. W. ; Prawitz, A. , & Lukaszuk, J. (2007). "Long-Haul Truck Drivers Want Healthful Meal Options at Truck-Stop Restaurants". Journal of American Dietetic Association 107: 2125– 2129. 8

Profile of the Average CMV Driver • Medical Profile – Less healthy than the average person – 61% reported two or more risk factors for cardiovascular disease • • • High blood pressure Obesity Smoking, High cholesterol No physical activity Sleep deprivation Sieber WK, Robinson CF, Birdsey J, Chen GX, Hitchcock EM, Lincoln JE, Nakata A, Sweeney MH (June 2014). "Obesity and other risk factors: the national survey of U. S. long-haul truck driver health and injury". American Journal of Industrial Medicine 57 (6): 615– 26. 9

HEALTH CONSEQUENCES • Increased risk for: – Hypertension – Dyslipidemia – Type 2 diabetes – Coronary heart disease – Stroke – Gallbladder disease – Osteoarthritis – Sleep apnea 10

Health Consequences • Increased risk for: – Some cancers • • • Lung Endometrial Breast Colon Kidney Liver – Mental illness such as clinical depression, anxiety, and other mental disorders – Low quality of life • Body pain • Reduced physical functioning – All-causes of death (mortality) 11

Basic Wellness Programs

Basic Wellness Programs • Tobacco by the numbers – Tobacco still remains the leading cause of preventable death in the U. S. – During 2013 -2014, cigarette smoking was estimated to be responsible for 400, 000 deaths. – The average smoker costs their employer $4, 500 - $6, 000 a year in additional healthcare costs, lost-time, illness and productivity. – An estimated $10. 18 in medical costs, and lost productivity, for every pack of cigarettes sold in the U. S. – According to the CDC, approximately 70% of smokers want to QUIT!

Basic Wellness Programs • Quit Power (Smoking Cessation) – Motivational and educational CD – A Quit Tips handy pocket guide for daily use and encouragement to stop smoking – 8 -week supply of Nicotine Replacement Therapy (NRT) - patch or gum – Health coaching for motivation and private confidential consultation regarding issues and road blocks to quitting – No long meetings or sessions to attend as group

Basic Wellness Programs Quit Power Process Flowchart

Basic Wellness Programs • Quit Power success rate (exceptional results) Data collected between October 2010 and October 2014

Basic Wellness Programs • Quit Power (Smoking Cessation) – One-year quit rate: 45% • HHS statistics – – Quit without help Quit with nicotine replacement therapy (NRT) Quit with counseling and NRT 4 -7% 10. 0% 14. 6% 27. 6% – Unlimited counseling makes the difference. Fiore MC, et al. Clinical Practice Guideline: Treating Tobacco Use and Dependence: 2008 Update. Rockville, MD: US Dept of Health and Human Services, Public Health Service; 2008

Basic Wellness Programs • Quit Power return on investment (ROI)

Basic Wellness Programs • Notable Quit Power Clients • Hundreds of thousands of success stories since 1971.

Basic Wellness Programs • Health Screens – Body Mass Index/body fat analysis – Blood pressure – Finger stick • On-site testing of glucose, total cholesterol, and HDL-cholesterol – Venipuncture • Outside lab runs glucose and full lipid panel

Basic Wellness Programs • Fitness testing – – Weight check with Body Mass Index Assessment of muscle strength and flexibility Bone density testing Chair massage

Basic Wellness Programs • Fitness training – Weight check with Body Mass Index – Assessment of muscle strength and flexibility – Exercises tailored to the individual’s work and lifestyle

Basic Wellness Programs • Educational displays – Smoking cessation

Basic Wellness Programs • Educational displays – Nutrition education with BMI/body fat testing

Basic Wellness Programs • Educational displays – Physical fitness: stretching/exercise demonstration

Basic Wellness Programs • Educational displays – Cancer prevention: skin, breast, prostate, colorectal

Basic Wellness Programs • Educational displays – Stress management education

Basic Wellness Programs • Health and Safety Classes – American Heart Association CPR/AED class

Basic Wellness Programs • Health and Safety Classes – Back care, safe lifting, and ergonomic seminar

Basic Wellness Programs • Flu vaccination clinic

Basic Wellness Programs • EAP Training Catalog of Wellness Courses – Course presented on-site or via webinar – After presentation • Course slides available on-line • Recording of presentation including Q&As available on-line

Basic Wellness Programs • EAP Training Catalog of Wellness Courses

Comprehensive Wellness Program

Comprehensive Wellness Program • Live Wellness Program – Customized to include any and all: • • • Tobacco cessation Blood pressure Preventive screenings Exercise Stress management Weight loss Pregnancy Nutrition Flu vaccination clinic Educational modules C. P. R. training

Comprehensive Wellness Program • Live Wellness Program 2. Engage 1. Predict 3. Employ motivational tools and incentives to encourage participation Identify individuals who would benefit from help and intervention 3. Support 4. Implementation and engagement support plus feedback

Comprehensive Wellness Program • Live Wellness Program – 1. Predict • • Complete on-line Health Risk Assessment Biometric screening (per employer) Complete on-line medical record (optional) Intake call with your wellness coach

Comprehensive Wellness Program • Live Wellness Program – It starts with: • On-line portal • Smart phone app • 800 number

Comprehensive Wellness Program • Live Wellness Program

Comprehensive Wellness Program • Live Wellness Program – 2. Engage • • Health coach designs a customized program to address employee’s needs Mental health issues (e. g. , stress, anxiety, work) are handled in-house Medical issues are referred to Workplace Options (uses Mayo Clinic) Incentives

Comprehensive Wellness Program • Live Wellness Program – 3. Support • • • Unlimited contact with wellness coach Feedback to employee and employer Periodic on-site wellness seminars and clinics Personalized e-newsletters On-line wellness modules – – – – Eat your way to wellness Self-care: remaining resilient The mind-body connection Food, Mood, and behavior Heart attack and stroke prevention Getting fit for fall Fitness and weight loss challenge Staying focused on-the-job

Comprehensive Wellness Program • Live Wellness Program – Sample 2016 Calendar of Events (customized for employer)

Comprehensive Wellness Program • Live Wellness Program – You can’t argue with success!

Wellness Programs • Do wellness programs save money? – Often NO, especially in the short-term – But, how do you put a price on: • • • Feeling of well-being Improved morale Greater productivity Less absenteeism and presenteeism Having fun!

Thank you! QUESTIONS AND ANSWERS 46