The BJ’s Wholesale Club study wasn’t the most important employee wellness research published last month. Let’s look at the Workplace Health in America Survey conducted by the Centers for Disease Control and Prevention.
When you put the CDC survey together with BJ’s Wholesale Club research as well as last year’s Illinois University worksite wellness study (both employers found that 12-18 months of wellness programming didn’t reduce healthcare costs or improve productivity) we get a more complete picture of relevance.
The CDC asked about companies’ employee health promotion programs. 2,843 respondents completed surveys — targeting whoever in the company was most knowledgeable about its wellness offerings — from a variety of employers.
Here’s some of what the survey found:
Larger employers can’t quit health risk appraisals…
Not many wellness professionals will publicly admit to using health risk appraisals, but many fessed up on the survey. A quick scan of the raw data reveals that 18% of respondents “don’t know” if their program uses HRAs.
Committee: “A group of the unprepared, appointed by the unwilling, to do the unnecessary.” — Fred Allen
Committees have long been considered a “best practice” in wellness, mostly by employers who haven’t learned about participative processes or who don’t believe in wellness enough to hire professionals to do the work. How’s your company’s sales committee doing? How about its merger and acquisitions committee?
Wellness Budgets: Are we going broke?
More than a third of organizations with wellness programs don’t have a budget. The survey’s raw data reveals that about 6% of all respondents had budgets greater than $100,000, including the 1% that have budgets greater than $500,000.
We “use data” to evaluate programs
Most often cited from the info in this chart (above) will be the finding that only 50% of companies with health promotion programs “use data” to evaluate their program (as opposed to those pesky “non-data” evaluations). In fact, companies don’t evaluate a lot of what they do. How many companies evaluate their performance management strategy? Their compensation strategy? Their EAP?
Of those that “use data” for program evaluation, 73% use healthcare claims costs and 57% measure ROI. More on this, later.
Incentives: The good times roll for vendors selling them
Tying incentives to a health standard (like BMI or blood pressure) is a practice that pushes some programs over the edge from naive to nefarious. But it’s a practice that endures, despite being counter-productive.
“Comprehensive” programs are growing
“Comprehensive” programs, which offer screenings, integration of health promotion, health education, linkages to other resources, and positive environments are on the rise. Don’t like how the CDC defined comprehensive worksite wellness programs in 2010? Get involved with other policy-making decisions that influence the direction of wellness research.
The mistake of obesity management programs
In other slides, the CDC specified “evidence-based” physical activity strategies and “evidence-based” nutrition strategies, but they held back from labeling obesity programs as evidence-based, because they know there aren’t any (with the possible exception of the Diabetes Prevention Program which, ironically, is spearheaded by the CDC). Anyhow, evidence-baseless obesity programs sit high atop the wellness hit parade, with more than two thirds of companies offering them to workers.
In an “Opportunities” section of its summary report, the CDC wrote, “Worksites may want to consider their nutrition and physical activity initiatives when they are planning weight management programs.” Yeah. They may.
Here’s how you know it’s time to fire your wellness manager…
Look, for example, at the cancer screenings in the bar chart (above): 11.3% of employers provide mammography, but only 6.2% include referral to treatment and follow-up education? How do you screen for cancer and not refer people for follow-up?
Total Worker Health
About 1,255 respondents opted-in to answer questions that were deemed less “critical to the survey’s objectives” and relegated to a Supplementary Survey. These asked mostly about Total Worker Health — an evidence-based arm of employee wellbeing. Here are a few of the questions and the percentage of respondents, based on my own calculations, that replied “Yes”:
- 13% provide dedicated quiet space where employees can engage in relaxation activities.
- Only 20% provide training for managers on reducing stress-related issues.
- 23% offer opportunities for employees to participate in organizational decisions that affect job stress.
- 28% provide safe places and/or opportunities that encourage social connectedness.
Read the study results in the American Journal of Health Promotion. Explore the CDC’s summary report on the CDC’s website.
What does it have to do “Wellness Doesn’t Work” studies?
On LinkedIn, wellness leaders have lamented the BJ’s Wholesale Club and University of Illinois studies — which yielded no meaningful improvements in healthcare costs or productivity — and the way the outcomes were sensationalized in the media. “It’s like we’ve always said,” we complain. “Programs focusing on biometrics, obesity, and ROI won’t amount to much, and these programs aren’t comprehensive or typical.”
But the CDC study suggests that in the LinkedOut world, biometrics, health risk assessments, weight loss programs, incentives, and expectations of healthcare cost reduction not only are cornerstones of wellness programs, but these types of programs skyrocketed between 2004 and 2017.
To hear it on LinkedIn — and at our wellness conferences — you’d think that today’s wellness program is all about getting employees to bring their authentic selves to work; discover their why; and arrive at humanized workplaces every day in blissed-out states of mindful gratitude.
The CDC survey doesn’t ask about authentic-self and gratitude programs, so we don’t know how common they actually are, but we know they’re not putting conventional programs out of business. Indeed, many employers with wellness programs continue to promote biometrics, HRAs, weight loss, and/or incentives, and ultimately are motivated by the hope of healthcare cost reduction. (Or they just do wellness for show.) Visit a conference of your local SHRM chapter and ask some HR directors about wellness. Most will pledge their allegiance to using health insurance premium discounts and penalties to promote behavior change. The new CDC study verifies that the types of programs featured in the BJ’s and Illinois studies are alive and well. As such, the studies are relevant to a cross-section of employers.
Call to Action
HR departments’ practices are getting real about the use of analytics, and the wellness industry’s claim that its new objectives are hard to measure will be exposed as a ruse as soon as the next fad comes along. (Remember VOI?) And complaining about fake news won’t get us far, either.
When headlines blare, “wellness doesn’t work,” it’s not enough to say, “Oh yes it does. You’re just doing it wrong.”
Measure it. And show what does work.