Experts: Message of healthy living heard but changing culture takes time
Finding ways to keep Hoosiers healthy means better quality of life for residents and an improved bottom line for businesses.
“Wellness is good business in the long run,” said Marci Crozier, administrative director of health promotions with Franciscan Health.
Crozier said dealing with lifestyle change and wellness initiatives can make a difference but is a commitment that takes time.
“It’s not all or nothing when it comes to health,” she said.
That long-term commitment can produce returns, and she sees corporations buying into wellness for their workforces. But studies reveal there’s much work to do, and there are indications Hoosiers are getting the message.
High rates of smoking, obesity and drug-related deaths in Indiana keep the Hoosier state in the bottom third of the nation in overall health, according to the 2017 America’s Health Rankings report by United Health Foundation.
The poor state of Hoosiers’ health contributes to lower workplace productivity and higher health care costs for businesses and a decreased quality of life for some struggling with health issues.
Indiana ranked 38th worst in the country in overall health, 34th worst in drug-related deaths, 40th worst in obesity and 41st worst in the percentage of smokers, according to the America’s Health Rankings report.
While Indiana lags behind much of the nation in health, the overall ranking is a 1-point improvement over 2016.
Experts say wellness education could help raise the state’s ranking and improve the health of its residents.
Any sign of improvement is good news to Cozier.
“I think corporations are getting it more,” she said.
“Insurance companies are understanding the impact preventative medicine has on our communities and our bottom line.”
Advocating good health
Companies are seeking awareness programming to teach people to make the little changes, such as not eating as much sugar and exercising, but they also are seeking behavioral change programming to help employees live healthier through things like smoking cessation and weight loss.
Mike Telesky, vice president of sales and account management for UnitedHealthcare, said, as an insurer, his company understands the financial sense of making people healthier in general, and the companies it works with are catching on.
“I have seen employers offering up incentive-based wellness programs to support employees’ desires (to get healthier), thus also reducing costs for employees and the company,” Telesky said.
Technology has begun to play a new and important role in managing health care with programs tied to use of programmable fitness managers.
“Wearable fitness trackers are really enhancing wellness,” Telesky said. Trackers provide more accurate information on physical activity, sleep patterns and other health markers enabling individuals to take better care of themselves and allowing insurers like UnitedHealthcare to offer programming that takes advantage of the information provided.
The insurer offers incentive-based programming to use technology to help its customers get healthier and save money.
Participating in HRA (health risk assessment) allows a person to gradually lower their annual deductible by as much as $1,400 based on activity logged in a fitness tracker. Participants can earn up to $3 a day in a health care savings account based on the frequency of activity, intensity and tenacity, he said.
UnitedHealthcare Motion is a wellness program that uses custom-designed wearable devices and enables people to earn more than $1,500 a year in financial incentives. UnitedHealthcare Motion is available to employers of all sizes in more than 40 states, including for companies with self-funded and fully insured plans.
Hundreds of thousands of people across the country have access to wearable devices through wellness programs offered by UnitedHealthcare. Program participants have so far collectively walked more than 180 billion steps, earning almost $30 million in program rewards. Among eligible employees, 66 percent registered their devices, with more than two-thirds of those active with the program.
The program enables employees and covered spouses to earn financial incentives, $4 a day for Healthcare Reimbursement Account plans, and $3 per day for Healthcare Savings
Account plans, based on achieving frequency, intensity and tenacity (FIT) goals. Participants meet the goals by completing 500 steps within seven minutes six times per day, at least an hour apart (frequency); completing 3,000 steps within 30 minutes (intensity); and completing 10,000 total steps each day.
United HealthCare offers a variety of other programming for participants as well, including a 52-week online weight-loss program, gym membership reimbursement and the ability to earn merchant gift cards for meeting health care goals.
Telesky said UHC uses the five Cs when working with employers to develop a plan to help drive engagement and create a successful well-being program. Core to the effectiveness of any program is commitment, communication, culture, cash and contribute.
Executive leadership must make wellness a priority by leading the program and creating a culture of well-being to show commitment. Establishing communication touch points throughout the year help reintroduce employees to the program and remind them the value of participation.
Employees spend more waking hours at work than anywhere else, so it makes sense that creating a healthier environment or culture of wellness at work would help support positive behavior changes, according to the insurer. UHC found research shows that incentives motivate participation, especially financial incentives. It is important to find an incentive that resonates with each workforce.
Employee contribution to the program also is critical. By giving employees an opportunity to share their feedback, they can provide key information to structure a program to meet their needs.
“I think the health of the community obviously impacts all of us,” he said.
Heart health, tobacco awareness, self-esteem, hygiene, dental health and nutrition are some of what Katie Sarver, manager of wellness outreach for La Porte Hospital, described as topics of a robust plan of programming offered by the health system to community members and colleagues.
Adults also benefit from a variety of programming, including a mobile health unit that offers community health fairs with screenings such as glucose, body mass, bone density, colorectal cancer and blood pressure. The clinics also offer an educational component to answer questions such as: Where should I test and how often?
“It is really beneficial to be out in the community, reaching community members,” Sarver said.
Through various partnerships within the community, the system’s clinics reach about 2,500 people annually.
“It’s really awesome to see the community band together to be able to say, ‘we know there’s need for learning about better health and well-being,’” Sarver said. “We start fairly young, to be honest.”
Sarver said programming that targets children as young as fourth grade in the trademarked Lil’ F.I.S.H. Club focuses on teaching youth about staying healthy, and covers topics ranging from exercise and nutrition to bullying.
“We’re starting them younger to work on changing those behaviors that may or may not have already been established,” she said.
Indiana residents’ overall state of health didn’t happen overnight, Sarver said.
“It’s definitely going to take a little longer for us to achieve a better level of health throughout the communities we serve,” she said. “I truly think we are headed in the right direction.”
Education is key
Jill Conner, administrative director of neuroscience and cerebral vascular and structural heart services with Community Hospital in Munster, said education is a key component in improving wellness among Hoosiers. The system has focused on community outreach regarding various programs, including stroke and diabetes awareness and care.
“We’ve really gotten out in the community and have found people are really starved for education,” Conner said.
People want to learn how to eat healthier and do things like manage their blood pressure, she said.
“It’s pretty amazing,” she said. “They want to better themselves.”
Programs teaching people how to eat healthier and manage issues such as blood pressure and diabetes are empowering patients in general, Conner said. Stroke awareness programs help individuals recognize the risk factors and signs of a potential stroke. Better-educated individuals are likely to self-diagnose, which might encourage them to discuss potential issues with their physicians, leading to earlier intervention and better outcomes.
“A lot of patients are self-referrals,” Conner said. “That’s real promising.”
Grant opportunities from the American Heart Association for patient education also has increased access to programming.
“I think it’s an exciting time,” Conner said. “I think that the state has taken a big step toward improving the health care of the citizens in our state.”
Crozier with Franciscan Health said access to programming is helpful, but it comes down to whether people want to change.
“It always boils down to self-responsibility,” Crozier said. “An individual has to take it upon themselves to be healthier.”
She is encouraged by strong participation levels at the three area Franciscan Health Fitness Centers and by the volume of inquiries people are making about wellness intervention to better manage their health.
Crozier is optimistic this indicates a larger trend toward wellness among Hoosiers.
“I do believe people are taking more responsibility,” Crozier said, and that is a good thing for everybody. “Healthier people are happier people.”
Sarver with La Porte Hospital agrees any permanent change comes from individuals wanting to take charge of their health and learning how to live better on a daily basis.
She is confident Hoosiers can raise the collective health of the state as attitudes about health and wellness change. “We will be very successful, but it will definitely take time,” Sarver said. “Basically, we are changing the culture. A culture shift is a hard thing.”