Research Team Offers Healthy Take on Workplace Wellness Programs

In a national survey of workplace wellness programs in municipal governments, researchers from The University of Texas at Dallas identified five best practices that reduced health care costs and improved productivity.

“Previous studies simply identified the components of wellness programs in U.S. municipalities,” said Dr. L. Douglas Kiel, co-author of the study and professor of public and nonprofit management in the School of Economic, Political and Policy Sciences. “However, these studies did not attempt to identify the factors that lead to better health outcomes and reduced health care costs. Our study is the first to really examine the performance outcomes of municipal government wellness programs.”

The results of the detailed statistical analysis are described in “Best Practices in Local Government Wellness Programs: The Benefits of Organizational Investment and Performance Monitoring” in the journal Review of Public Personnel Administration.

Over the past 25 years, municipal governments have followed private industry’s lead by implementing workplace wellness programs to combat rising health care costs. To evaluate these measures, the UT Dallas team developed an index to gauge the success of such programs using performance data from a sample of U.S. cities ranging in population from 16,000 to 822,553. A total of 168 out of 482 surveys were completed and returned, resulting in a 34.8% response rate. On average, the cost of a wellness program per employee was $134.25, with a range from $0 to $1,500.

Success or failure of the programs surveyed was measured in changing levels of absenteeism, health insurance claims, hospitalizations and total health care costs.

The UT Dallas team identified five components of successful programs that reduced health care costs and improved productivity:

• Workplace safety education and awareness programs are significant factors. Conscientious employees who understand risk help to prevent injuries and subsequent hospitalizations, Kiel said.
• Chronic-disease and behavior monitoring is another best practice identified by the researchers. The most successful programs tracked height, weight and waist size, and monitored diabetes, cholesterol, hypertension and alcohol use.
• Municipalities that invested in wellness programs also had better outcomes. As expenditures per employee increased, so also did success rates in terms of reduced health care costs and better productivity.
• Local governments that employed a doctor on staff also saw a return on investment and signaled that employee health is important.
• Ongoing evaluation of a wellness program was central to its success.

The analysis found that more than 70% of local governments in the sample offered some form of wellness and fitness activities. But there were several workplace wellness initiatives that did not contribute to measurable improvements. Among these were exercise or fitness financial incentives and weight-loss or stress-reduction programs.

“Basically fitness programs had no significant impact on overall employee health,”  said Dr. Meghna Sabharwal, first author of the study and associate professor and program head of public and nonprofit management. “We’re not suggesting cities stop offering programs of physical activity, but it may mean that people already work out in private gyms and underutilize the program offered by the municipality.”

The second most-common health awareness/educational programs focused on diet, nutrition and stress reduction. Some 60% of cities in the sample promoted awareness on weight loss, tobacco use and sedentary lifestyles primarily via webinars and printed materials.

Health-risk and disease detection — particularly for diabetes, cholesterol and hypertension — was the third most-commonly available program. Most of these initiatives included weight and waist-size monitoring.

The most valuable but least available program offered by local governments included continuous and close monitoring of employees’ health. Sabharwal said this is because monitoring health issues is expensive.

“Statistical analysis revealed that cities that offer disease and behavioral monitoring are likely to produce the most successful wellness programs,” she said. “Targeted investments that include performance monitoring help cost-cutting efforts and improve employee output, because they improved employee health in the long run.”

As health care costs continue to increase, the researchers said identifying best practices that mitigate that trend inevitability are critical for the health of local government itself.

“The major lesson from our study is that wellness programs must be aggressively managed to meet the goals of improved employee health and health care cost reduction,” Kiel said. “Simply implementing a program and assuming the best is inadequate. Employees with chronic diseases should have consistent monitoring of their health status. The wellness program must also be evaluated to provide performance feedback.”

Imane Hijal-Moghrabi PhD’15, assistant professor at The University of Texas Permian Basin, is a co-author of the study, which was funded by a UT Dallas School of Economic, Political and Policy Sciences Advisory Council research grant.