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A CNN story this summer reported that a growing number of airlines, for example, are requiring bigger passengers to pay more to cope with the costly dilemma when obese travelers cannot fit into a single coach seat.1 And an Associated Press story in October reported that ambulances are starting to charge extra for heavy patients, as transporting obese individuals can cost about 2˝ times as much as normal-weight patients due to the time, specialty equipment and extra crew required.2 To curb the impact of obesity from further snowballing, a number of states are adopting some creative strategies—such as a soda tax. Proponents of this tax cite research showing that consuming sugar-sweetened drinks can lead to obesity, diabetes and other ailments. They say the tax can lower consumption, reduce health problems and save medical costs. However, other studies show that while current state taxes of about 3 percent on soft drinks slow consumption, they have only a minor effect on reducing body mass index.3 Meanwhile, some states are set to impose higher health insurance premiums on overweight public employees. North Carolina announced this October that it will start charging higher premiums for overweight insurees, beginning in July 2011. The state of West Virginia is also considering a similar mandate. But will this punitive measure be enough incentive to motivate individuals to shed extra pounds? Only time will tell. In contrast to these tactics, one approach that has already proven effective with engaging people to lose weight and keep it off is workplace health improvement programs. HealthFitness’ Your Weigh…Together, a group weight management program, has helped thousands of employees learn the importance of portion sizes, nutrition and physical activity. To read how this program is driving results for our clients and their employees, click here. Likewise, many of our sites have offered “The Biggest Loser,” a competitive weight loss challenge, and motivated our clients’ employees to collectively drop thousands of pounds. To learn more about the impact this challenge is having at our client sites, read “Client Employees Learn What it Takes to be the Biggest Loser” below. To successfully engage individuals in behavior change, we know at HealthFitness that it takes a solution tailored to the individual and the organization. And we have the results to prove our solutions generate results. In addition to the University of Louisville return on investment (ROI) study we published earlier this year, we are in the process of delivering several new ROI analyses that show our employee health improvement programs generate returns ranging from $2.25 to $3.62 for every $1.00 invested. To find out how HealthFitness can more effectively collaborate with you to affect the health of your employees—including the rate of obesity among your unique population—I encourage you to contact your program manager. Yours in good health,
1 “Airline Policies Juggle Larger Passengers,” CNN.com, June 26, 2009.
http://www.cnn.com/2009/TRAVEL/06/26/obese.passengers.airlines/index.html, accessed Nov. 2, 2009. Inside HealthFitness These regulations affect employer wellness programs that offer health risk assessments (HRA) in connection with a group health plan. HealthFitness has been closely monitoring these regulations as they move through the regulatory process and has recently taken steps to ensure full compliance with the new regulations, which take effect Dec. 7, 2009. Title I of GINA generally prohibits health plans from discriminating against covered individuals based on genetic information. “Genetic information” includes family medical history and information regarding individuals’ and family members’ genetic tests and genetic services. Specifically, Title I of GINA prohibits a health plan from increasing premiums or contributions based on genetic information, and collecting genetic information prior to or in connection with enrollment, or at any time for underwriting purposes. The broad definition of “underwriting purposes” includes things such as changing deductibles or premiums, or providing other rewards under a health plan in exchange for participating in the HRA or wellness program. To be in full compliance with these regulations and minimize legal risks to our clients, HealthFitness is taking two steps, which will be effective by Nov. 21, 2009. First, HealthFitness is removing two HRA questions linked to family medical history. Secondly, HealthFitness is introducing a health risk assessment “Use and Disclosure of Your Information” waiver to be completed prior to the completion of the HRA. This waiver provides another layer of protection for our clients and for HealthFitness against any legal claims. The waiver will appear before completion of the HRA and includes terms instructing participants not to provide any genetic information. If you have questions about GINA and how it affects the HealthFitness health risk assessment offered to your population, please contact your program manager.
Best-in-class Practices and Awards That’s definitely been the case for a technology company client. For two years running, employees of this business have competed for the coveted title of the biggest loser. And in 2009, the client was pleased to learn participants of its on-site “Biggest Loser” program lost more than the year before—in pounds, that is. Based on NBC’s “The Biggest Loser” TV show, HealthFitness associates have taken this theme and developed innovative programming that combines the show’s competitive elements with physical activity, health education and nutrition information to support safe weight loss. At this client site, the Biggest Loser is offered jointly through the company’s on-site fitness center and health management program. In 2009, the program ran 13 weeks and helped 70 people lose 1,007 pounds, with an average weight loss of 15.5 pounds. Through the program, 15 participants reduced their high risk status for obesity and 12 participants reduced their high risk status for hypertension. The annual potential health care cost avoidance associated with these two risk reductions is $43,416. About the program, a participant this year shared: “This was a great competition. My lifestyle was completely changed from overeating and no exercise, to finally learning the proper foods to eat and having a regular exercise routine.” Another participant added: “I learned how to eat healthy and reached a fitness level that I have not seen since high school. Maintaining my loss is a top priority.” In the Biggest Loser, teams of three to six people compete to determine who can lose the greatest percentage of their team’s starting weight. Teams weigh in on the freight scale as one unit each week. With the program at this client site, the winning team collects a cash pot of $10 entry fees paid by each participant. Individuals with the greatest percentage of weight loss also receive gift cards. In 2008, the site offered the Biggest Loser for 10 weeks and had 90 participants complete the program. These participants lost 868 pounds with an average weight loss of 10.3 pounds per person. For 2010, HealthFitness Program Manager Amanda Falcinelli said the site will likely offer the Biggest Loser as a nine-month program to help people sustain lasting change. Interested in learning how to offer a results-driven weight management program at your site? Contact your program manager.
State of Nebraska Employees on the Move Thanks to Strong Engagement, Leadership Participants were challenged to meet or exceed 360,000 steps by March 31, 2010. To date, approximately 40 percent of enrolled employees have met or exceeded their distance goal, including Nebraska Gov. Heineman. More than 200 state employees have reached 1 million steps. “Employees are demonstrating good progress with the wellness program,” said. Gov. Heineman. “Activities such as our walking program help state employees lead more healthy and active lives – something all Nebraskans can strive for. Congratulations are due to those leading by example.” The program began July 6. Currently, participating employees are averaging more than 436,000 steps, with the total of all participant logged steps at approximately 254,000 miles or more than 10 times around world. Walk This Way is designed to help boost employee activity level and enhance overall health by increasing physical activity. Outcomes as a result of program participation include increased physical activity, weight loss, reduced stress, lowered cholesterol, lowered blood pressure, and more energy. A total of 2,709 employees enrolled in Walk This Way. In addition to Walk This Way, the State of Nebraska offers health coaching, which currently has 2,675 employees enrolled. Additionally, the state offers a condition management coaching program, which focuses on seven chronic areas associated with heart and respiratory conditions, depression, diabetes, and back pain, and has 108 employees enrolled.
As for the entire State of Nebraska’s wellness options program, HealthFitness provides health assessments, screenings, health improvement programs, an eHealth portal, EMPOWERED Health Coaching and condition management programs.
Industry Insights As defined by the bill, qualified wellness programs must include three of the following components: health awareness (health education, health screenings); employee engagement (e.g., worksite assessments and program planning); behavioral change (programs that provide technical assistance and problem-solving skills); and a supportive environment (with on-site policies that promote a healthy lifestyle). The bill stipulates that a wellness grant would be awarded to an employer for up to three years and the amount would not exceed $50,000 for the entire period of the grant. A final vote on this bill could occur as early as the end of this week.
Buzz from Recent Research
Researchers randomly assigned 811 overweight adults to one of four diets:
Low fat, average protein, high carbohydrate (20, 15, and 65 percent respectively)
Low fat, high protein, high carbohydrate (20, 25, and 55 percent respectively)
High fat, average protein, average carbohydrate (40, 15, and 45 percent respectively)
High fat, high protein, low carbohydrate (40, 25, and 35 percent respectively)
In addition, the diets consisted of similar foods and met guidelines for cardiovascular health by including 8 percent or less of saturated fat, at least 20 grams of dietary fiber per day, and 150 milligrams or less of cholesterol per 1,000 calories.
The participants were offered group and individual instructional sessions for two years. Participants attended three groups sessions each month in the first six months; then two sessions each month for the remainder of the study. Individual sessions were every eight weeks for the entire study period. Participants were also expected to get 90 minutes of moderate-intensity physical activity each week.
After two years, the study found no significant differences between the four diets in terms of body weight or waist circumference. All diet groups experienced an average weight loss of about 9 pounds.
Attendance of the group and individual sessions was strongly associated with weight loss and it was similar for all groups. In addition, all diets resulted in significant changes with risk factors for cardiovascular disease and diabetes. The low-fat diets and highest carbohydrate diets significantly decreased low-density lipoprotein cholesterol levels. All four diets decreased triglyceride levels and all except the high-carbohydrate diet decreased insulin levels.
Source: Sacks FM, Bray GA, Carey VJ, et al. Comparison of Weight-loss Diets with Different Compositions of Fat, Protein, and Carbohydrates.
New England Journal of Medicine. 2009;360:859–873.
Most Americans Not Meeting Fruit and Vegetable Consumption Recommendations
The Healthy People 2010 objectives aim for at least 75 percent of Americans to eat the recommended two or more daily servings of fruit, and for at least 50 percent of Americans to eat the recommended three or more servings of vegetables daily. To determine the fruit and vegetable consumption of U.S. American adults and high school students, data was collected from the CDC’s health surveillance systems.
The report highlighted the following key findings:
33 percent of adults get the recommended servings of fruit daily and 27 percent meet the recommendation for vegetable consumption.
Among high school students, 32 percent reported eating at least two daily servings of fruit and only 13 percent reported getting at least three servings of vegetables every day.
Only eight states have a policy for healthier food retail improvements. Among other things, this can help increase the availability of healthier foods in small food stores.
Only 21 percent of middle and high schools offer fruits and non-fried vegetables in vending machines, school stores or snack bars.
Source: The Centers for Disease Control and
Prevention. State Indicator Report on Fruits and Vegetable, 2009.
http://www.fruitsandveggiesmatter.gov/indicatorreport/ and
http://www.cdc.gov/media/pressrel/2009/r090929.htm.
Where We’ll Be Next National Business Coalition on Health
International Foundation of Employee Benefit Plans |
