JULY/AUGUST 2011 VOLUME 20 ISSUE 4

ISSN 1060-5517

Practical solutions for health enhancement programming

Workers Suffering, Finds Gallup-Healthways Well-Being Index

John Harris Chief Wellness Ocer and Vice President of Innovation at Healthways

Plus...
Reduce Stressors for Health Promotion Success How to Hire Wellness Employees Without Getting Burned Shared Meals Key to Better Family Nutrition

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Workers Suffering, Finds Gallup-Healthways Well-Being Index

John Harris (Chief Wellness Ocer and Vice President of Innovation at Healthways) used to be frustrated. After 34 years in the wellness field, I watched the stats on unhealthy behaviors just get worse and worse. I felt like the guy who studied cancer for years and finally retired without a cure. Was my career for naught or did I at least advance the thinking that might someday lead to a cure? All that changed in 2007 when Healthways joined the Center for Health Transformation led by former Speaker of the House, Newt Gingrich. Gallup was also among the groups members. John recalls, During our discussions, Healthways and Gallup expressed mutual concerns that health promotion needed to be studied in the wider context of well-being, with a defined method for measuring it. Speaker Gingrich suggested we collaborate to find a solution. Conceptualized from that dialogue, the Gallup-Healthways Well-Being
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Index was launched in 2008, leading to a profound change not only in Johns perception about health and well-being but also the nations. Our primary goal was to create a metric sort of a DowJones Industrial Average of well-being. We knew it could provide great insights on how to change peoples behavior and create better programming to assist in that eort. Using their 70+ years of polling expertise, Gallup assisted Healthways in selecting the best questions. To achieve their daily goal of 1000 representative surveys, Gallup phones approximately 26,000 Americans across the country each day. Last October, the Well-Being Index completed its millionth survey. It asks questions in these domains, with a composite score representing an average of all 6: Life Evaluation Physical Health Emotional Health Healthy Behavior Work Environment Basic Access.

These questions assess the work environment: Do employees feel cared about as an individual? Is their job role a good fit for their strengths? Do they work in a trusting environment? Do they feel their supervisor treats them like a partner rather than a subordinate?

Work Environment Reaches Record Low

In February, the work environment component dropped to its lowest point in the Indexs history and has not substantially improved since. John feels the economy drove much of this decline. The Index only goes back to 2008, but Gallup has information going back decades. Economies have tightened and automation has cost jobs. Theres more strife in the work environment. People feel more stifled and less creative.

However, John doesnt place the blame solely on employers. 50-60 years ago everybody... right down to assembly line workers embodied an entrepreneurial spirit. You dont see that any more. People have increasingly adopted an entitlement mentality. As a result, the creativity that made this country the biggest economic and industrial power on the planet has waned. Both workers and companies need to rediscover those attitudes.

Looking at the Trends

John explains the trends: The score thats dropped the most over time is collaborative supervision. The work environment has gotten more dogeat-dog, unemployment is at record highs, and jobs are less plentiful. Supervisors can get away with being less collaborative and more commandand control-oriented. Since employees need the job, they put up with more restrictive management styles. Employees ability to work to their strengths actually trended up. As the workforce got thinner, businesses tightened their belts. Since there is less oversight people can use their strengths more. Being satisfied with the job dropped slightly, probably due to declines in collaborative management. Yet having a trusting work environment stayed almost exactly level over the 3 years.

John emphasizes that the Well-Being Index extends beyond the work environment, but positive scores in all areas contribute to a healthy workplace. The best work environments make an eort to influence all 6 domains. It starts with changing the culture. Too often we see wellness programs but no supportive policies such as no smoking, a benefit plan design that promotes prevention, or a physical plant that encourages movement. Yet management wonders why people arent making much use of the health promotion program. When it comes to lifestyle, John discovered fascinating correlations among the domains. For instance, weve learned that for every 15 minutes of commute time, employees anger goes up, the amount of stress they experience increases, their rest per day decreases, exercise levels go down, healthy eating goes down, and obesity rates go up. Few organizations have stopped to think what they can do about that and what it would mean to their employees overall well-being. We also know that if people score poorly in the work environment, 31% of them report being angry for most of the previous day. Put into perspective, that level of anger is on par with the 100 poorest counties in the US, as well as the troubled countries of Sierra Leone and Haiti. If employees are already angry when they come to work, whats the likelihood theyll feel the necessary trust to get any benefit from a health promotion program? Wellness managers need to look farther upstream in employees lives to create an environment that fosters healthy change. Use the 6 domains as areas of well-being in your framework. While he doesnt see major dierences in well-being across occupations, John notes that self-employed people consistently score better than anybody else. This is really about control. Even though owning a business is stressful, you wake up every day knowing you

are in control and have the opportunity to chart your own destiny. Theres something liberating about that. A Gallup study performed independently (using GallupHealthways Well-Being Index data) showed a demonstrably lower satisfaction level among union workers compared to nonunion workers. John theorizes, Bargaining units often cultivate more of a contentious them versus us environment. Of course, its also possible that some workplaces werent friendly to workers to begin with and thus needed union representation.

The bottom line is we know that a collaborative environment creates the best possible culture with the highest well-being.
The bottom line is we know that a collaborative environment where management and workers voluntarily partner together, employees feel challenged, and everyone has the resources to get the job done creates the best possible culture with the highest well-being.

John emphasizes that the Well-Being Index extends beyond the work environment, but positive scores in all areas contribute to a healthy workplace.

What the Index Means to Wellness Professionals

John advises wellness professionals to avoid one-size-fits-all workplace wellness programs. Consider demographic age bands when making programming decisions. We looked at 18-29 year-olds and how they perceive their work environment; they routinely rate it as not so good. Theyve recently entered the workforce and realize a
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lifetime of work lies ahead. On the other hand, 30-44 year-olds are pretty neutral. In the 45-64 age group, we begin to see an upswing in acceptance and appreciation of their jobs. Those still working in the 65+ age bracket are o the charts in their excitement about the work environment. Understand that you face an uphill battle with more negative younger workers, while you have opportunities with a more receptive audience of older workers. Develop separate strategies for both. There is a commensurate improvement among older audiences in other areas of the Index, especially in the practices of healthy behaviors and emotional health. They tend to have better overall composite scores, making this demographic more receptive to health and wellness messages. Healthways oers an in-depth workforce well-being analysis for employers. They use the Well-Being Assessment (WBA), a derivative of the Well-Being Index, along with other tools. From a business perspective, John is amazed at how predictive the WBA is for performance of organizations and employees. For example, on average the higher the workers WBA composite score: The lower their annual medical cost The better their performance review The less unscheduled personal time o The more likely theyre engaged on the job The higher their intention to stay at their jobs.

In addition to the impact on individuals, the higher a teams average composite score, the better the team performs. Business units with the highest average aggregate well-being scores are the ones most likely to meet their financial objectives. And conversely, business units with the lowest composite well-being scores miss their financial targets the most.

Avoiding the Comparison Trap of Best Practice

Every time we hear this phrase applied to health promotion, it makes us grin. Invariably, the term is used to suggest that someone has done some research to confirm the ideal approach to produce a desired behavior change. Its often associated with health assessment, high-risk intervention, health coaching methods, incentive models, and other tools in a wellness practitioners bag of tricks. The irony (which produces the grin) is that while some techniques are certainly more successful than others, none that we know will produce unqualified successes across populations over time. In fact, we see a decrease in risk assessments and coaching (while health screenings are on the rise), making the best practice discussion pointless. It shouldnt come as a shock that universally successful approaches to changing health behavior dont exist. A trip to the mall or airport will confirm were not winning the population health war, regardless of the little victories.

Hope for the Future

John concludes, These last 3 years with the Well-Being Index have given me more hope, energy, and excitement about our chances for improving the well-being of Americans than I had in all my previous years combined. Weve collected an incredible amount of data. This information begins to answer questions that have plagued us for decades. This Index is a 25year commitment. I honestly believe the lessons learned, and the actions it allows us to take as a society, will significantly aect the long-term economic viability of America. To access the Gallup-Healthways Well-Being Index in its entirety, go to www.well-beingindex.com. For more information, contact Kelly Motley, Senior Media Relations Partner: Kelly.Motley@healthways.com.

For every 1 point rise in the average WBA composite score, a workers healthcare costs are 1% less.
10 Health Promotion Practitioner

John Harris Chief Wellness Ocer and Vice President of Innovation at Healthways