HealthWorks A National Strategy for Comprehensive Workplace Health Promotion

1. HealthWorksA National Strategy for Comprehensive Workplace Health Promotion Why Wellness: An Integrated Approach to Workplace Health NS Safety Council Conference March 25, 2004 Mary-Lou MacDonald MSc. Director, HealthWorks Heart and Stroke Foundation of NS

2. Objectives • What is “HealthWorks” and why did Health Canada fund this project in Nova Scotia? • What is “wellness” and why is an integrated approach the only successful option? • Why is this initiative important to you?

3. Unique Partnership Major Partners: -Health Canada -Heart and Stroke Foundation of NS -Metropolitan Halifax Chamber of Commerce -Capital District Health Authority Supporting Partners: NSCC, WCB, Office of Health Promotion, AHWI, *National Quality Institute

4. HealthWorks Purpose • Work with business leaders/champions to create local case studies for workplace health (3 pilot businesses selected) • Create a network of public and private organizations committed to sustaining workplace health in Nova Scotia • Develop national support networks for dissemination and sustainability.

5. The Pilot Sites: Small/Medium Size Business • Secunda Marine Services • Rideau Construction • Page and Wood • Developed awareness and commitment • Developed and conducted health and organizational culture assessments • Developed tailored wellness program and interventions • Assisted with the program roll-out and evaluation • Developed business case

6. The Workplace Paradox “The workplace has become an environment that both contributes to employee ill health, while simultaneously offering the most potential for improving overall employee health and well-being”. • Canadian Council on Integrated Health Care 2002

7. Elements of Comprehensive Workplace Wellness Healthy and Safe Workplace Organizational Health Personal Health Environmental Health

8. What is a Healthy Workplace? • Occupational Health and Safety: reducing work related injury, illness and disability by addressing environmental hazards in the workplace, ergonomics and air quality • Leadership: improving job satisfaction and productivity by changing worker attitudes and perceptions, management practices and the way work is organized • Health Promotion: reducing the risk or incidence of worker illness by addressing individuals’ lifestyle behaviors through education, supportive environments and policy

9. Workplace Wellness • Environmental Wellness: ergonomics, noise level, air quality, workplace design, work pace, safe lifting, safety guidelines, physical demands • Organizational Wellness: work-family balance, flextime, morale, training/professional development, recognition, supervisor communication/ feedback, social atmosphere, management style/skills • Personal Wellness: smoking cessation, physical activity, healthy weight, shift work, alcohol/drug use, stress coping

10. The health of workplaces has a determining effect on the health of Nova Scotia and Canada.

11. Cost of Unhealthy WorkplacesIn Nova Scotia/National Comparison • Highest rate of deaths from cancer and breast cancer • Highest rate of death from respiratory disease • Highest rate of hospitalization for chronic illness • Highest percentage of smokers • 80% of NS have one or more of the major risk factors for CVD • 2nd highest spending rate of health $ per capita on institutions

12. Cost of Unhealthy WorkplacesIn Nova Scotia/National Comparison • 2nd highest rate of diabetes • 2nd highest psychiatric hospitalization rate in Canada. • 2nd lowest life expectancy • 3rd highest percentage of heavy drinkers • 3rd highest percentage of overweight adults • Highest reported use of disability days

13. “A strong case can be made that a healthy workforce, a healthy and safe work environment, lead to optimal employee productivity, higher quality of goods and services, and improved corporate performance.” IHPM 2000

14. Productivity cannot be reduced to simple accounting or presence on the job or volume of work output Simple representations of work and production misrepresent the reality of work life A simple dichotomous representation of work such as absent or not, injured or not, or flawed or correct, does not accurately reflect the continuum of performance that extends beyond the absolute boundaries of these incident-based definitions The Human Factor

15. Nova Scotia: Economic Losses Work absences are increasingly due to personal reasons. Canada lost 82.2 million workdays for personal reasons in 2001, up from 65.6, 5 years ago • NS has more sick days than any other province (8.7 days per year) • Ontario has 6 days per year • Canada has 7 days per year • In Nova Scotia more than 400 million a year is lost to the economy due to sickness and disability GPI Atlantic 2003

16. Health and the Workplace “While Canada’s health care system is under intense scrutiny, little attention is being paid to the role of workplace culture on employee health”. Canadian Council on Integrated Health Care 2002

17. Cost of an Unhealthy Workplace Culture • Canada’s workforce is aging. Older workers (55-64) average 2x number of sick days of younger workers. Benefit costs and absenteeism will escalate if older workers don’t improve their health • Workers who have little input into decision-making and how their job is organized were found to be 50% more likely to suffer from heart disease • Mental and nervousconditions have replaced musculoskeletal conditions as the top conditions causing long-term disability. Estimate approx. 30 billion is lost to the Canadian economy annually to mental health and addiction problems.

18. Cost of an Unhealthy Workplace • Canadians are experiencing extreme levels of stress due to work-life conflict. Workers with high work-life conflict registered 13.2 days absence/year vs. 5.9 days in those with low work-life conflict. • Recent study of executives in Canadian public service showed that an individual’s lack of job control increased the likelihood of distress. • High distress in turn was shown to increase the likelihood of experiencing musculoskeletal problems by 90%; cardiovascular problems by 120%; gastrointestinal problems by 210%; coronary heart disease by 350%; and mental health disorders by 1740%.

19. Due Diligence By providing a healthy workplace environment employers protect themselves from liability charges related to exposure to an unidentified work hazard. • Employers may soon face litigation based on lack of due diligence that creates excessive stress for employees. As well, unhealthy employees may threaten the health and safety of others. • As employees become more stressed they become more likely to become involved in workplace accidents and sustain injuries. • Employers are required to protect employees and the public from the unsafe actions of a worker.

20. “All effective interventions aimed at improving the physical work environment probably have some behavioral or social component, and rely on a conducive corporate culture to be effective.” Institute for Heath and Productivity Management 2001

21. More Research Required • Rather than a living representation of mechanical performance, the human also experiences the effects of mental, motivational, emotional and social influences • Because of this strong association of productivity with “softer” factors, researchers and practitioners often have difficulty identifying and describing exactly what it means, let alone what should be done to optimize it.

22. Choose Wisely-But Choose! Employers are now realizing that the astute selection of, and investment in, these programsmay be key in increasing worker performance and corporate productivity-essential factors in business success today IHPM 2001

23. How Long for Return on Investment? • within a few months: • employees engaging in healthy activities during work hours • within 1 year: • your front-line managers see evidence of increased job satisfaction, commitment to work, improved productivity among workers and an increase in customer satisfaction • within 3 years: • Significant quantitative improvements in health related costs • Source: CCIH, 2002

24. Behavior Change Programs • Behavior change programs typically require 3-5 years of intervention programming for cost-benefit to occur • This timeframe puts nutrition, smoking, and exercise programs outside the typical short-term corporate business planning cycle • However, the top four for short term outcomes…

25. Exercise programs for low back pain problems –reduce absenteeism Evidence on exercise and its impact on performance shows short term reductions in absenteeism and reduced turnover etc., etc., etc. etc., etc. • Depression detection and treatment: significant and immediate relevance in work setting. Few health issues take such a broad toll in cost, performance and quality of life. • Smoking cessation to reduce smoke breaks increases productivity: (unscheduled smoke breaks cost NS employers $208 mil/yr; estimate smokers cost employers $2308-$2613 more than nonsmokers) • Vaccinations for influenza reduces both absenteeism and medical cost

26. Pathways to Productivity INTERVENTIONS RESULTS DESIRED OUTCOME Disease Prevention, Health Promotion Reduced Absenteeism Increased Productivity Acute & Chronic Illness Management Improved Performance, Creativity, Motivation Environmental Health & Safety Reduced Accidents, Cost Savings Cost Reduction Healthy Corporate Culture Reduced Health Care Costs IHPM 2001

27. A Healthy Workplace: Why is it Important? • Employee: • Increased job satisfaction, health and productivity, loyalty • Employer: • Positively affects the bottom line of the business • Lower insurance premiums and benefit costs • Better able to attract and retain higher caliber employees • Lower absenteeism rates, disability costs • Community and Government: • Broad social and economic benefits

28. Walk the Talk If people are truly “our most valuable asset” why aren’t more businesses and organizations in Nova Scotia creating work environments that contribute to the health and well being of their workers? • Education • Cost • Support

29. HealthWorks: A National Strategy for Comprehensive Workplace Health Promotion Leverage Incentives Social Marketing Create Awareness Create Sense of Urgency Leadership/ Sustainability Identify Leadership Impact Leadership Training/ Education What, How, Who Infrastructure Tools/ Supports What, Who, How?

30. Leverage Incentives WCB Government Policy Chamber of Commerce Pharma Programs Prevention Health Insurers Legislation Unions Financial Institutions Other

31. Tools and Support • Developed National and Provincial Model for WPHP • Network of Stakeholders • HealthWorks Website • Government of NS: • Workplace Champions Award • Support development of provincial strategy • Corporate strategy • Metropolitan Halifax Chamber of Commerce: • Healthy Business Award • BusinessToolkit (posters, brochures, awareness campaign) • Sponsor National Policy at Canadian Chamber National Meeting • National Quality Institute: Framework for the Development of a Healthy Workplace • Small business assessment tool, recognition and rewards

32. “Nothing is more important to productivity than a healthy, well-motivated workforce… So it is in the economic interest of our business community to take a personal interest in the health and well-being of our employees… We must be much more proactive than in the past.” - Metro Halifax Chamber of Commerce Health Care Task Force, 2001 Metro Halifax Chamber ofCommerce