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

Three Trends That Will Influence The Evolution of REAL Wellness

Sunday June 7, 2009

In my most recent essay, I introduced the term "aworksitewellnessism." I invented this word to mean "disbelief in the existence of corporate wellness." Private companies, non-profit organizations and government departments from the federal to the local levels claim to offer worksite wellness. I don't believe it. These claims are based on the common confusion in the public mind. Few realize that steps to prevent illness are not at all the same or even similar to steps to promote well-being. Therein lies the problem.

Programs called worksite wellness are actually medically-based health education efforts. The offerings focus on testing, risk reduction, illness management, basic exercise/nutrition and stress information. All this is good and worthy, but none of it is wellness, at least not REAL wellness. Show me an organization that encourages employees to explore reason, exuberance and liberty. Where are they? Where are the organizations promoting happiness, meaning, ethics or critical thinking? These matters are not part of the ubiquitous, so-called worksite wellness offerings. But, that's how it is now—the essay sketched the other day explained why and how existing programs could be expanded and evolved to include REAL wellness for quality of life enhancement, not just illness avoidance.

Many variables will play a role in a transition to REAL worksite wellness. If the shift occurs and I believe it will, there will be no "aworksitewellnessists" left, not even me. I hope this desired state comes to pass soon enough. I will be happy to end my non-belief in the existence of worksite wellness.

Let's look at just three independent variables that will help shape for better or worse the evolution to genuine or REAL worksite wellness.

The first is how things go with proposed reforms to our overall health system. Some forms of change, such as the creation of a single payer system, will improve the chances for REAL wellness. A decision by the Administration, with consent and support from the Congress, could establish incentives for citizens to act so as to stay well while boosting the quality of their lives. Incentives would provide a foundation level of rewards for simply adopting basic good health habit patterns, so incentives could be tiered. The more you do to enhance your well-being, the better the benefits. Everyone could and should have the basics, but the highest rewards should go to those who do their part. In this fashion, REAL wellness offerings could become a reality. Naturally, corporations and other large employers would no longer bear the health insurance burden. With government providing care funded by general revenues, private health insurance, if it existed at all, would be purchased only by affluent consumers who could afford the marginal added benefits from bypassing the public system.

A second variable would be based on the outcome results of a new system. Could significant improvements in the incidence of morbidity and mortality as a consequence of structural changes (e.g., a national health care model) be demonstrated in a year or two? In all key indicators of health status, America is not number one at present—we are not even a contender. We invest $230 million every hour in treatment-based medical care, but we live shorter lives. Citizens in other developed countries get more return for less investment. We have the second-highest income per capita, but we rank 42nd in life expectancy. According to one recent study (the American Human Development Report), the US is 12th in overall human development rankings. The vast majority of Americans remain overweight and underfit. Will universal care change these numbers anytime soon? It's difficult to predict one way or another, but incentives for some form of wellness should accompany the growing determination to improve health status.

The third variable, mentioned in the previous essay, will be about proper staffing of programs that profess to be about wellness. There must be changes in personnel, at least new additions from outside the health care world. The managers, program directors and staffs of worksite wellness endeavors have been physicians, nurses, exercise physiologists, counselors, health educators and nutrition specialists. According to the Wellness Program Management Adviser (WPMA), a firm that conducts regular worksite surveys, wellness professionals fall into three broad categories: "Wellness screeners, wellness counselors and wellness instructors." The primary training of company wellness staffs has, according to WPMA, been concentrated in such areas as "smoking, stress, exercise and nutrition. They also know how to engage and support people in making and sustaining health improvements and have good people skills." (Source: Worksite Health Programs, WPMA, May 22, 2009.)

No wonder the focus has been medical management. Wellness is different from not engaging in high-risk behaviors, losing weight and giving up bad habits. All these and other risk reduction endeavors are worthy, but do not constitute worksite wellness.

If worksite wellness is divergent from the medical track, changes in personnel are needed. Skill areas associated with REAL wellness must be added. Personnel best suited to promote education in the broad areas of reason, exuberance and liberty have different educational backgrounds and goal orientations from medical managers. To do these things, worksite wellness must be supplemented with a new breed of wellness promoter. The latter might include psychologists, philosophers, astronomers, biologists, ethicists and a range of teachers from the arts and science fields. They must teach reason and science, and make difficult topics like meaning, ethics, global citizenship, critical thinking and the like interesting and compelling.

These are the three variables to watch. In some ways, the medical and prevention approach to worksite wellness has been functional. The worksite movement, after all, required a period of trial and error. The modest investment in corporate and other institutional efforts gave advocates time to win acceptance for the idea that health promotion offered a modest ROI. Much was learned over decades of incremental achievements; the notion of promoting health at the worksite is now well established.

Corporate leaders now have an opportunity to build on past successes in risk reduction and medical management. They can connect the current economic crisis to new directions for advancing worksite wellness to another level. That level is REAL wellness. The time is ripe to systematically evolve the field of worksite wellness. It need not remain a prevention-based endeavor designed to keep things from getting worse and costs from rising higher. Better to embrace REAL wellness to make conditions qualitatively better. Worksite wellness can be a positive initiative that promotes life enrichment and greater life quality. Succeed at this and there will be less dysfunction to worry about preventing.

As noted, these are three key factors that will shape the chances for REAL wellness as an employee option in the near future. There are others, but a focus on these will get the conversation about such matters off in a productive direction.

Be well. Look on the bright side of life.

Domain: purpose
Subdomain: applied wellness

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