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Health Enhancement Research Organization “Creating a Global Culture of Health” Hyatt Regency Chicago O’Hare Airport September 18-19, 2006. Jennifer A. Bruno Worldwide Director Wellness & Health Promotion Johnson & Johnson Deborah Gorhan Project Director - Healthy People

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Health Enhancement Research Organization“Creating a Global Culture of Health”Hyatt Regency Chicago O’Hare AirportSeptember 18-19, 2006

Jennifer A. Bruno

Worldwide Director Wellness & Health Promotion

Johnson & Johnson

Deborah Gorhan

Project Director - Healthy People

Health Fitness Corporation

The World’s most comprehensive and most broadly based Health Care Company
    • 2005 sales of $50.5 billion
      • 230 operating companies in 57 countries selling products throughout the world
    • Three worldwide business segments
      • Consumer
      • Medical Devices/Diagnostics
      • Pharmaceutical
    • Managed by a unique form of decentralized management 116,000 employees worldwide
our credo
Our Credo

The Four Tenets

  • Customers
  • Employees
  • Community
  • Stockholders
healthy people healthy planet healthy business
Healthy People, Healthy Planet, Healthy Business



Healthy Employees

Workplace Safety



Health Care




Reduce Hazardous




Health Risk




Culture of


Medical Case


Talent and


Identification of


Health Risks

Management of


Health Risks

  • LIVE FOR LIFE® Program in 1978 was a partnership of five unique areas:
      • Benefits ─ Medical ─ EAP
      • Safety ─ Wellness
  • James E. Burke, the Johnson & Johnson Chairman and CEO, set two major goals for the LIVE FOR LIFE Program:
    • Encourage J&J employees to become the healthiest in the world through education and easy access to prevention programs
    • Implement on-site programs and services to reduce the cost of health care for the corporation
  • Organized as a shared service for the US in 1995 integrating the functional areas EAP, Occupational Health, Wellness & Fitness, and Disability Management under one umbrella reporting through HR.
  • Today, aligned with the WW EHS organization providing leadership, consultation, guidance and support for the delivery of quality integrated health programs and services worldwide.

Occupational Health

Global Integrated Health









Employee Assistance


Global Integrated Health Objectives

  • Leadership, consultation, guidance and support for the delivery of quality employee health programs and services worldwide:
    • Absence & Disability Management
    • Employee Assistance
    • Wellness & Health Promotion
    • Occupational Health
  • Proactive injury and illness preventive strategies for employees worldwide
  • Delivery of consistent global health services
  • Uniform health standards with local consideration
  • Performance metrics for the global health community
organizational structure commitment
Organizational Structure Commitment

Health & Safety Vision

We are committed to making J&J the world leader in health and safety by achieving healthy lifestyles and injury-free workplaces.

Johnson & Johnson’s organization is structured to support an integrated approach to the design and delivery of Health, Wellness, Safety and Benefit programs

Benefits Vision

Create a healthy, engaged and productive workforce which will support

Johnson & Johnson in becoming the most successful health care company in the world.

J&J Executive Committee

Technical Resources& Compliance

Vice PresidentWorldwide Health & Safety

Worldwide Benefits &Health Resources

Director, US BenefitsPlanning & Operations

Executive DirectorWorldwide Health & SafetyTechnical Services

integrated health services us
Integrated Health Services- US
  • Absence & Disability Management
  • - Management Consultation
  • Medical Case Management
  • Short Term Disability (STD)
  • Disability Appeal Committee
  • Vocational Rehabilitation
  • Return-to-Work Planning
  • Medical Leave Certification
  • Workers’ Comp Case Coordination
  • Injury/Illness Prevention
  • Workplace/Job Accommodation
  • Employee Assistance
  • Management Consultation
  • Critical Incident Debriefing
  • 800 Line Crisis Assistance
  • Short Term Counseling and Referral
  • Supervisor Training
  • Coordination of Field Alcohol/Drug Training
  • Case Management
  • Educational Training
  • Mental Health/Substance Abuse Screening
  • Occupational Health
  • Pre-placement Assessments
  • Medical Surveillance
  • Emergency Treatments
  • Regulatory Compliance
  • Ergonomics Program
  • Preventive Screening
  • Drug Free Workplace
  • Global Health Standards Guidelines & Policy
  • Deployment
  • Workers’ Comp Case Management
  • Return to Work Evaluation
  • Wellness & Health Promotion
  • Healthy People
  • Health Profiles
  • Target Risk Interventions
  • Health Education
  • Environmental/Cultural Support
  • Wellness Center Management
  • Exercise Classes/Personal Training
  • Fitness Assessments
  • Job Conditioning
  • Exercise Reimbursement/Travel Fitness
  • Integration with Benefits & Disease Management
  • Work, Family & Personal Life
  • LifeWorks Consultation Resource & Referral
    • Childcare, Parenting, Adoption
    • Eldercare – Nursing Home Evaluation
    • Legal, Education, Consumerism
  • LifeWorks 800# 24/7
  • Work/Life Seminars
  • Educational Materials
  • LifeWorks Online
  • College Coach

Achieve the Regional Healthy People Goals

Achieve the Health & Safety Goals

Achieve 80% of the Healthy Planet 2010 Goals

Healthiest and Safest Workforce in the Most Environmentally Responsible Corporation in the World

  • Fulfill Credo Responsibility
  • Help Employees Adapt to Rapidly Changing Business Environments
  • Improve Employee Productivity
  • Control Health Care Costs

Healthy Employees Healthy Company

Why Healthiest Workforce?

creating a culture of health
Creating a Culture of Health




Effective Approach

  • Leadership
    • Public advocacy for healthy workplaces
    • Internal management emphasis (talkingthe talk and walking the walk)
  • Healthy Lifestyle Support
    • Health Profile & Lifestyle Counseling
    • Physical fitness—fitness centers, walking trails, pedometer initiative, exercise classes, exercise reimbursement, contests
    • Healthy eating—cafeterias, vending, meeting food
  • Integration of Healthy People 2005 with Benefit Design
  • Global Policies – HIV/AIDS & Tobacco Free Workplaces

Biometrics Wallet Card

Lifestyle Program Promotion

Marketing & Communications—Healthy People Branding

Web Resource Promotion


Personal Profile Reminder

  • J&J’s Better Health – Better Future tag line addressesboth the personal and business motives around health improvement
effective approach

Well/Low Risk

Disease and Injury Risk

Chronic Disease

High Risk/High Cost Claimants*

  • Keep well (mind and body)
  • Keep safe
  • Identify and manage health and injury risks
  • Identify and manage/mitigate disease impact
  • Identify and focus medical and disease management resources
Effective Approach
  • Objectives
    • Address spectrum of needs, and invest in people/programs through strategies that can yield the biggest benefit.
    • Use proven programs/methods
    • Measure outcomes/manage program investments accordingly
effective approach1

J&J Payroll & Eligibility

Financial Management


Vendor Performance & Quality Management



Care Management

Benefit Planning & Design

Health & Wellness

Regulatory Compliance


Worker’s Compensation

Program Evaluation

Dental & Vision

Health & Productivity Management

Financial Accounting

Effective Approach
  • Integrated data drives planning, enables evaluation to achieve total economic value from benefit investments

Inspire & Align



Monitor & Improve

  • Prepared Business Case
  • Identified key executive as Healthy People Champion
  • Created Healthy People Task Force
  • Enrolled Key Business Partners
  • Established Health Indicator Targets
  • Developed Data Collection and Tracking System
  • Launched Communications
  • Standardized Menu of Services
  • Started Deployment
  • Implemented Best Practices Behavioral Interventions
  • Redesigned J&J Health Benefits Plan
  • Integrated HRA and Disease Management Counseling
  • Implementing Programs to Address Inactivity
  • Piloting Healthy Eating Plan
  • Preparing Worldwide Next Generation Goals
  • Incorporating Healthy Culture Measures in Business Processes



Healthy People Strategy

integration of health benefits
Integration of Health & Benefits
  • Improve Employee Overall Health and Well-Being
  • Enhance Employee Productivity
  • Contain Health Care Costs
  • Emphasize Shared Responsibility to Better Manage Health
  • Financial Incentives for Employees Around Participation
  • Continue to Provide CareConnect to Assist Members With Chronic or Complex Conditions
healthy people medical plan
Healthy People Medical Plan
  • Employees receive annual $500 discount on medical plan contributions
  • To maintain the $500 discount, employees must:
    • Complete the Health Profile every two years
    • Participate in Health Profile Counseling, if identified by health risk criteria
    • Participate in disease management program – CareConnect - if identified by chronic or complex condition criteria
  • If employee chooses not to participate in any one of the requirements, they forfeit the annual discount
healthy employees u s
Healthy Employees – U.S.
  • Healthy People Indicators provide US enterprise-wide focus and performance targets
  • Performance meets or exceeds all targets, except physical activity/inactivity

Healthy People U.S.Impact on Health Outcomes & Excess Cost









Data extrapolated to J&J average population of 46,000 and J&J per capital Health Care Costs

health financial outcomes
Health & Financial Outcomes

Impact on Health Risks

For 4500 Employees

identified as High Risk

% Health Risk Change

Modified Risk Factors


Health Risk Reduction Financial Impact: Physical Activity


J&J Inactive Baseline


# Inactive Current




Excess Cost/Inactive Employee

For every 1% improvement in our physical activity risk, the potential cost avoidance is almost $500M.

Potential Cost Avoidance $491,280


Impact on J&J Salaried

Health Care Costs

  • In 2005, J&J’s per capita increase was 6% (National Data 9.5%)
  • Since 1999, J&J’s average trend was at least 1% below the national trend, despite having a significantly richer plan
  • J&J initially attributed its success to their Healthy People programs and initiatives, now being expanded to the Global Employee community
financial health outcomes
Financial & Health Outcomes
  • H&W Redesign Was a Sound Business Investment
  • H&W Saved Money and Generally Improved Employee Health - Above and Beyond an Already Established and Excellent LIVE FOR LIFE Program
  • The High Risk Program Worked Well for the Risk Factors Targeted – and, the Program Saved Money
  • Financial Incentives Work – High Participation Rates (~ 90%) Achieve Impressive Financial Results
  • The Longest Ever Corporate Evaluation Study (9 Years) Provides Scientific Documentation That Integrated Health and Productivity Management Programs Work
population health

Population Health

Addressing Lifestyle, Personal Health Risks and Public Health Risks

physical activity
Physical Activity
  • At least 60% of global population fails to achieve 30 minutes moderate intensity physical activity daily (WHO)
  • Physical Activity Programs
  • Knowledge Building & Behavior Change
    • Pedometers – 30,000 participants globally
    • Million Step Challenge – 10,000 participants
    • Exercise Reimbursement Program – 4,600 participants
    • Online & Nurse Counseling – 5,000 participants
  • Environmental & Cultural Support
    • Fitness Centers/Fitness Rooms
    • Walking Trails
    • Stairwell Campaigns
    • Fitness Center Design & Activity Guidelines

Continue to build momentum toward a global culture that encourages and supports healthy lifestyles.

mental health depression

By year end 2005, 50% of employees & household members worldwide had access to Employee Assistance services. This number will increase to 70% by year end 2006.

Mental Health & Depression

Depression is the leading cause of disability globally, and the 4th leading health burden affecting humanity. (WHO)

Employee Assistance Services (EAP)

  • Worldwide
    • 50% of employees have access to services
    • 6,000 employees have received resilience training
  • Productivity Outcomes Study - U.S.
    • Absence decreased in 96% of EAP clients
    • Mental health status improved in 78% of EAP clients
    • $4,000 savings per EAP user
  • Mental Health Screening
    • Confidential self-assessment to identify individual vulnerability
    • Referral to mental health resource if indicated by screen results
    • Accessed by 13,000 employees
cancer prevention
Cancer Prevention

Single largest preventable cause of disease and premature death in the world

  • Applies to all operating company locations, (property, buildings, leased buildings, company vehicles and company-sponsored meetings)
  • Flexible guideline to comply with local, state, regional laws or collective bargaining agreements
  • Operating companies manage transition to “tobacco-free” by no later than January 2007
  • Partnership with Global Human Resources and Worldwide Benefits & Health
  • Support materials and toolkit from Worldwide Health & Safety

80% of Operating Companies have implementation plans in place; 30% are already “Tobacco Free”


Avian InfluenzaThe world is now closer to another influenza pandemic than at any time since 1968, when the last of the previous centuries three pandemics began. (WHO)

  • Pandemic Preparedness
  • Distributed “Guidance on Preparedness for Human Influenza Pandemic” to management
  • Business Continuity Planning
  • Developed detailed site specific BCP procedure that is pandemic phase dependent
    • Communication Plan
    • Education & Awareness Campaign
    • Human Resource Guidelines
    • BCP – Supply Chain management
  • Assist contacts with access to antiviral prophylaxis and treatment
  • Partnerships and Resources
  • CDC, WHO, Local Health and Government Agencies
  • International SOS, Business Group on Health

Continuing To Evaluate And Anticipate Needs

population health risk factors
Population Health Risk Factors
  • Definition: % of employees meeting the defined Health Risk Threshold levels (based on identified Health Risk Indicators)
  • Formula: % of employees identified by HRA data as being at low health risk
  • Benchmark/Goal:
    • 70% of population will be defined as low risk,
    • 1% annual health risk improvement
  • Data Source:

Health Risk Assessment Indicators:

Obesity–Total Cholesterol- Tobacco Use- Physical Activity- Hypertension- Stress- Alcohol Use – Glucose –Healthy Eating Behavior-Safety Belt Usage (Safety Helmet, where applicable)

  • Update Freq: Annually
  • X-Axis:
  • Y1-Axis:
  • Risk is % of employees in the following defined Low, Med & High threshold levels:

Low 0-2

Med 3-4

High 5 or greater

Visual Example Only

population health risks defined
Population Health Risks Defined
  • Obesity - BMI> 30
  • Total Cholesterol - > 240 mg/dl or > 6.17 mmol/l
  • Glucose - > 126 mg/dl FASTING or > 200 mg/dl non-fasting or > 7.0 mmol/l
  • Hypertension- > 140 systolic and/or > 90 diastolic
  • Tobacco Use- Yes
  • Physical inactivity - <30 minutes and <4 days/week or <most days
  • Stress – Heavily or Actively Stressed
  • Alcohol Use - >14 alcoholic drinks/week
  • Unhealthy eating behavior - <5 total fruits & vegetables/day; and/or daily consumption of high fat foods
  • Safety Belt Usage (Safety Helmet, where applicable) - < Almost always or Always
organizational health

Organizational Health

Addressing Culture & Environment

organizational culture of health
Organizational Culture of Health

Visual Example Only

  • Definition: % of Operating Companies meeting the threshold of Healthy Culture Profile
  • Formula: # of sites/companies will offer & promote minimum of 5 of the 14 global health service offerings for 2007
  • Benchmark/Goal: 93% of WW sites/companies will promote & offer health service opportunities to their employees
  • Data Source: Global On-Line Assessment Tool
  • Update Freq: Quarterly
  • X-Axis:
  • Y1-Axis:
  • Defined as # of sites/companies promoting offering Med & High threshold levels:
  • Meets: 5 or greater
  • Caution: 2-4
  • Needs attention: <2
menu of annual global health service offerings
Menu of Annual Global HealthService Offerings
  • Implementation of WW Tobacco Free Workplace Policy
  • Implementation of Health Risk Assessment
  • Seventy percent (70%) of employee population at low risk (0-2)
  • Employee education & awareness on healthy lifestyle behaviors
  • Access to Employee Assistance Services
  • Resiliency Training program
  • Implementation of WW HIV/AIDS Policy
  • Implementation of a Healthy Eating, Healthy Cafeteria program
  • Cancer Awareness & Prevention Program
  • Physical Activity opportunities (such as: access to fitness centers, exercise rooms, walking trails, etc.)
  • Modified/Alternate or Light Duty Return to Work Program
  • Process for tracking Sickness & Absence
  • Access to Travel Health Resources
  • Medical Surveillance (based on risk) in compliance with all regulatory and J&J requirements
  • Executive Health Program
healthy eating
Healthy Eating

One billion overweight adults – 300 million of them obese

20% or more of all cases of cancer could be prevented with varied amounts of fruits and vegetables.

  • Support employees’ efforts to reduce their risk primarily for hypertension, high cholesterol, cancer and obesity
  • Opportunities for employees to access and enjoy Nutritionally Dense Whole Foods at every cafeteria, food station, vending machine, catered event, and whenever food is served at company functions
  • Piloted at 6 companies in the US
  • Expansion of program by request in 2006

Results = increased sales, decreased subsidy and high customer satisfaction

the process
- The Process
  • Commit
  • Build Relationships
  • Assess & Plan
  • Education & Marketing
  • Implement
  • Evaluate, Adjust, Continuous Improvement
  • Baseline, Final Outcome, Other Related Factors
    • Where you are today
    • Where you want to be
  • Your Intentions, Thoughts, Actions, Effects
    • What do you mean by healthy eating?
    • What will be different?
    • What impact on customer service, profit, etc?
2 build relationships
2. Build Relationships
  • Frame
    • Build the business and employee case
    • Why should they care?
    • Speak to what is important to them (finances, health, public relations, etc.)
  • Advocate
    • What will happen?
  • Illustrate
    • Show what you mean
    • Bring in an influential person
    • Access resources (AICR, NBGH, internal resources)
    • Have someone who has been successful present
  • Inquire
3 assess plan
3. Assess & Plan
  • Visioning, Strategizing, Performing, Assessing
    • How will you know when you are successful?
    • Develop the PLAN
    • What will you measure?
      • Checklists, customer surveys, menus
    • Who is accountable?
      • Policing
      • Sustaining
    • What are the desired outcomes?
4 education awareness marketing
4. Education/Awareness/Marketing
  • Build a communication plan
    • Audience
    • Vehicle
    • Presenter
    • Key Messages
  • Create Marketing/Education Materials
    • Create Communication Materials
    • Create Education Materials & Trainings
      • Food Service Professionals (training)
      • Employee awareness & education
5 implement launch
5. Implement/Launch

However, don\'t let perfectionism become an excuse for never getting started.Marilu Henner

6. Evaluate, Adjust, Continuous Improvement