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by Donald B. Ardell, Ph. D.
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Wellness in the Headlines
(Don's Report to the World)

Improvising On The Edge Of Catastrophe: Consciously Evolving From Disease Management To REAL Worksite Wellness

Wednesday October 10, 2007

In a recent essay, I promised a follow-up piece about how worksite wellness initiatives could, in time, evolve beyond disease management and related risk assessment programming. Such medically-based activities have characterized "worksite wellness" for the two decades of corporate health promotion. (While it barely needs to be stated, let me take the precaution of noting that such efforts have NOT been about wellness at all -- the fact that the term is often employed as a label for corporate health risk appraisals, medical testing and omnibus lectures about prevention and health education is inappropriate and a bit Orwellian.)

I believe the time has come, given the severity of the crises companies face attendant upon rising medical costs and plummeting employee health, to shift worksite wellness toward genuine wellness, the kind that addresses quality of life beyond medical issues, no matter what terms are used to describe it. What is needed is a progression of programming from disease management to a genuine, REAL worksite wellness agenda. This entails a philosophy or mindset that values, embraces and leads to the daily pursuit of positive satisfactions and physical fitness, for starters. Also, it involves a wide range of practices that enable employees to boost not only their prospects for staying well in the first place but to enjoy the highest quality of life that their genetics, environment, circumstances and fortune will allow. Such an approach is more likely to increase the productivity and quality of service of the work force than the current models, which are clearly too little, too late and focused on the more limited topics. This shift will bring benefits that cannot be realized from standard disease management programming. The benefits of disease management are well established, as was suggested in an earlier essay based upon WELCOA data entitled, The Need For And Returns From Worksite Wellness. The problem is, American companies are running out of Earls. (See the first essay for the story about "Earl.")

The costs of employee health plans only modestly mitigate the dreadful harm done to the profitability of American companies by the burdens of employee health plans (from which, by the way, General Motors just extricated itself). The damage is worsened by the fact that many employees are needlessly unwell. In summary, medical costs are a rising tide of trouble, an overflowing wall of woe pressing against and irrevocably weakening corporate profit dams. Worksite wellness programs that are no more than disease management in nature may return three dollars for every one invested but, however impressive, this is insufficient. That's what current health promotion at the worksite, by any label (worksite wellness, for example) represents: It is a situation that could be characterized as "improvising on the edge of catastrophe." (The phrase was coined by historian Joseph Ellis - in a different context.)

In his new book Super Capitalism: The Transformation of Business, Democracy and Everyday Life, Robert B. Reich, the Secretary of Labor under President Clinton and a professor of public policy at the Goldman School of Public Policy at the University of California, Berkeley, offers this assessment of the crisis facing American companies that, unlike their European, Asian and South American competitors, do not contribute to employee health plans: "Due to intense and increasing global competition, no corporation can any longer indulge in behaviors that don't enhance profitability without risking eventual oblivion."

What follows is not a blueprint for REAL corporate wellness guaranteed to save every organization now providing health insurance from the utter and quite catastrophic economic collapse threatened by unsustainable increases in health plan costs for their medically high-risk employees. In fact, I would not write an essay about such a plan if I had one - it would be worth a fortune.

What follows is a brief outline of REAL worksite wellness elements. I recommend three basic elements of REAL wellness for future worksite wellness. The details within each can and should vary. However, the three, and no doubt other, elements seem vital and thus should be attended in rich detail.

Element one would be to assist all employees to understand and assess the case for icantdoit. This is the reality for most, in my opinion, with respect to living at the top of their game - and achieving and sustaining top fitness levels and a high quality of life. It's unfortunate, it's a reluctant conclusion but it also seems self-evident given the health status of typical Americans - and others, as well. A full understanding of why icantdoit is the common fate has obvious advantages. It improves the chances that employees will take seriously the obstacles and barriers to personal and organizational wellness, for one thing. It also might lead workers to steel themselves for the enormity of the challenges if they plan to seek to overcome icantdoit realities. Finally, it might persuade them to set modest but realistic objectives and goals. To learn more about the nature and power of icantdoit, see the articles on this phenomenon at

Element two would be for companies to organize REAL worksite wellness with the kind of attention you might associate with the Normandy invasion. Don't rush to implementation - and do the disease management things, that is, basic risk assessment and testing, first. Keep the preliminary medical stuff separate from REAL wellness. A checklist modeled after the well known worksite wellness program of Blue Cross Blue Shield of Nebraska involves ten parts:

  1. Understand the baseline data.
  2. Identify the extent of employee interests.
  3. Audit the workplace culture.
  4. Identify the deficiencies and problems.
  5. Customize a comprehensive worksite wellness website for employee education and routine functions (testing, quizzes and the like).
  6. Set up, train and empower teams for wellness.
  7. Establish skilled coaching and mentoring for everyone.
  8. Begin the modular educational sessions (see Element three to follow).
  9. Create incentives for employees to craft personal wellness plans and make advances toward the realization of quality of life goals.
  10. Track consequences with a results orientation.

A typical approach might entail an executive retreat or boot camp for key executives to assess and plan the program, identification of in-house leaders, an employee interest survey, an initial focus on the integrative nature of genuine physical fitness, the creation of a modern wellness library and website, a newsletter, the implementation of supportive policies and culture changes, and gaining support of the area community (and employee families) by hosting fun wellness educational events.

Element three would be to communicate the nature of REAL wellness to all employees including:

The goal is to create the conditions wherein a company wellness mindset supportive of employee initiatives for personal responsibility, applied reason, freedom enhancement and other aspects conducive to a higher quality of life tends to raise the lifestyle IQs of nearly everyone, to the benefit of the organization as well as the employee.

Jerome Rodale, the founder of the magazine Prevention and the Rodale Publishing empire, spent his final moments on earth as a guest on the Dick Cavett Show. According to an account of the episode ("The Day A Guest Died On My Show," St. Petersburg Times, May 13, 2007, p.7.), Rodale had bragged "I'm in such good health (he was 72) that I fell down a long flight of stairs yesterday and I laughed all the way. I've decided to live to be a hundred. I never felt better in my life!" A few minutes later, he slumped over dead while another guest (New York Post columnist Pete Hamill) was being interviewed. The morale, if there is one to be found? I'll go with this: Live every day as fully as you can, and celebrate good health with ample measures of joy and exuberance, in a manner that boosts the chances that you might someday die healthy. Since we all have to die sometime, why not as late in life as you can manage at a moment in time when you have never felt better?

With the advent of REAL worksite wellness, I think more employees, hopefully retired, will manage the feat.

Domain: physical
Subdomain: adaptations and challenges

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