How Exercising at Work Saves Money

Creation of worksite wellness programs is promoted by parts of the Affordable Care Act. If your office doesn't have a gym, it soon might -- out of the company's interest.
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Ever since Karen Straub had her thyroid removed because of cancer in 1999, she has struggled with her weight. She became diabetic and suffered from terrible acid reflux. So when her boss, California State Controller John Chiang, started a worksite wellness program for his staff, Straub decided to give it a try. She joined new Weight Watchers at Work meetings during lunch on Thursdays. She beams activity data from her accelerometer to the Healthrageous website, which allows her to track her activity and interact with her co-workers through a social media platform. She and her colleagues now compete to see who will be the top walker each week. She walks during her work breaks and for 15 minutes at lunch on most days. Since starting the program, Straub has lost 27 pounds. She doesn't have to take pills for her diabetes anymore. Her acid reflux has disappeared.

A common request has been for flexibility around the scheduling and length of lunch and work breaks to allow employees to attend onsite exercises at lunch or simply walk outside.

Chiang's job is to make sure California's tax dollars are well spent -- to root out waste, fraud, and abuse of public funds. Recognizing that the healthcare costs of state employees and retirees were among several threats to the state's fiscal health, Chiang commissioned a study to determine the proportion of costs that were due to modifiable factors such as diet, exercise and smoking. "We all understand that healthcare costs are spiraling out of control," Chiang said.

The California Public Employee's Retirement System health program covers nearly 1.3 million active and retired government employees and their families. Of $1.6 billion spent on healthcare for state employees in 2008, 22 percent was on high blood pressure, heart disease, stroke and kidney disease -- much of which could have been prevented through diet and exercise. The Urban Institute, which conducted the study, estimated that if changes in diet and exercise could reduce the prevalence of these diseases by 5 percent to 15 percent, it would save the state $18 to $54 million per year.

Unlike other worksite wellness programs -- CVS Caremark's, for example, has been lambasted in the media for fining employees $600 if they don't undergo an annual wellness review -- Chiang's program has been very popular among his staff, in part because he seems truly committed to improving their health and morale. Chiang is now working with Service Employees International Union (SEIU) local 1000 -- California's largest state employee union representing 95,000 members -- and others to pilot a worksite wellness program at the California Department of Public Health and the department of Health Care Services.

According to Sarah Zimmerman, deputy chief of staff for SEIU local 1000, "It's not Big Brother because they're designing something that is meaningful to them." The union's involvement has helped identify important obstacles to worksite wellness. A common request has been for flexibility around the scheduling and length of lunch and work breaks to allow employees to attend onsite exercises at lunch or simply walk outside. "A lot of times, managers don't know what is allowed or encouraged," said Zimmerman. "Sometimes it is simply clarifying what the policy is."

Blue Shield of California, which partnered with Chiang in developing the wellness program for his office, has also been experimenting with Wellvolution, a worksite wellness program for its own employees. According to Bryce Williams, Vice President for Wellbeing at Blue Shield CA, "the mantra of going to the gym for 20 to 30 minutes a day, 5 days a week, and changing your diet such that it is low salt and low sugar and low fat and fun free -- that model hasn't worked." His strategy has been to "make the environment such that the healthy choice is an easy choice." Making healthy choices easy choices has included thought to food placement in cafeterias: placing salad bars in the flow of traffic, healthy items at the cash register, soft drinks behind glass at the back, etc. Food is also labeled with Weight Watchers points to help those enrolled in the program.

Now she sleeps well and feels "like a human in the morning."

Lisa Krieger, an employee of Blue Shield of CA, joined Weight Watchers at Work through the Wellvolution program. Krieger, like most working moms, finds it hard to make time for herself. At least at work she can count on breaks and her lunch hour; there are no such breaks at home with the family. After starting Weight Watchers at Work "the weight just started falling off," said Krieger. And once she'd made some inroads through her diet, she had the energy to start exercising. Krieger used to weigh 100 pounds more, the equivalent of strapping three toddlers the size of Krieger's daughter to her frame. She used to get hot and sweaty with the slightest exertion; now she spends her evenings playing with her kids in the backyard. She used to snore and wake up in the middle of the night; now she sleeps well and feels "like a human in the morning."

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Celine Gounder

Celine Gounder, MD, ScM, is an infectious-disease and public-health specialist.

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