Employee Wellness… Understanding the Real Cost to Your Organization The Intersect of a Productive...

Employee Wellness… Understanding the Real Cost to

Your Organization

The Intersect of a Productive Worker

Drew Bossen, PT, MBA 2010 Region VII VPPPA Conference

Wednesday, May 26, 2010

“TIMES… THEY ARE

A-CHANGIN”

Part I• The Boomer’s are Coming…

- The Age Shift

- Workforce Implications- Design Consideration

Part II• Size Matters…

Shaping the Future of Ergonomics- Prevalence- Medical Conditions & Associated Costs- Atlas Data- The Future

Agenda…

The Boomer’s are Coming…

What are the implications…

A Generation Defined by…


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• It is the fastest growing population segment. • It is the most affluent consumer group that exists. • It accounts for over 40% of total consumer demand. • It control over 48% of all discretionary purchases in the

U.S.• It owns 62% of all large Wall Street investment accounts.• It dines out 4-5 times per week.

Boomer Factoids…

Source:

Gary Onks – SoldOnSeniors, Inc.

SoldOnSeniors.com

As of today…

Every 7 seconds someone in America turns 50.

Regarding that 50+ age group:

0.4

0.5

0.7

0.9

1.2

1.6

1.9

2.3

2.6

2.9

3.3

3.7

3.8

4.1

4.5

4.6

0.5

0.4

0.6

0.9

1.1

1.4

1.6

2

2.2

2.7

3.2

3.7

3.8

4

4.4

4.5

Population by Age and Sex: 1900

90 years and over

85 to 89 years

80 to 85 years

75 to 79 years

70 to 74 years

65 to 69 years

60 to 64 years

55 to 59 years

50 to 54 years

45 to 49 years

40 to 44 years

35 to 39 years

30 to 34 years

25 to 29 years

20 to 24 years

15 to 19 years

10 to 14 years

5 to 9 years

Under 5 years

Male(millions)

Female(millions)

Source of Life Expectancy:

National Center of Health Statistics, Health, United States, 1990, Hyattsville, MD: Public Health Service, 1991.

Life Expectancy…

0.2

0.6

1.4

2.4

3.4

4.5

4.9

5.0

5.5

6.7

8.7

9.8

10.9

10.7

9.7

9.2

8.7

9.2

9.6

0.8

1.4

2.6

3.7

4.6

5.6

5.7

5.5

5.8

7.0

8.9

10.0

11.0

10.6

9.4

8.7

8.3

8.8

9.2

90 years and over

85 to 89 years

80 to 85 years

75 to 79 years

70 to 74 years

65 to 69 years

60 to 64 years

55 to 59 years

50 to 54 years

45 to 49 years

40 to 44 years

35 to 39 years

30 to 34 years

25 to 29 years

20 to 24 years

15 to 19 years

10 to 14 years

5 to 9 years

Under 5 years

Male(millions)

Female(millions)



National Center of Health Statistics, “Advance Report of Final Mortality Statistics, 1990, “Monthly vital Statistics Report, Vol.41, no. 7, Supplement, Hyattsville, MD: Public Health Service, 1993.

Boomers

Life Expectancy…

0.8

1.2

2.5

4.4

6.6

8.4

10.0

10.4

9.6

9.1

9.4

10.2

10.6

10.8

10.7

10.9

10.8

10.9

11.0

2.2

2.2

3.4

5.2

7.4

9.2

10.7

10.9

10.0

9.5

9.8

10.4

10.8

10.8

10.4

10.3

10.3

10.3

10.4


90 years and over

85 to 89 years

80 to 85 years

75 to 79 years

70 to 74 years

65 to 69 years

60 to 64 years

55 to 59 years

50 to 54 years

45 to 49 years

40 to 44 years

35 to 39 years

30 to 34 years

25 to 29 years

20 to 24 years

15 to 19 years

10 to 14 years

5 to 9 years

Under 5 years

Male(millions)

Female(millions)



Boomers

Life Expectancy…

2.9

3.5

5.4

6.9

7.9

9.2

10.1

10.6

10.5

10.6

11.2

11.7

11.9

11.9

12.3

12.8

12.7

12.5

12.5

6.1

5.1

6.4

7.3

8.3

9.8

10.7

11.3

11.1

11.2

11.7

12.1

12.2

12.0

12.1

12.2

12.1

11.9

11.9

90 years and over

85 to 89 years

80 to 85 years

75 to 79 years

70 to 74 years

65 to 69 years

60 to 64 years

55 to 59 years

50 to 54 years

45 to 49 years

40 to 44 years

35 to 39 years

30 to 34 years

25 to 29 years

20 to 24 years

15 to 19 years

10 to 14 years

5 to 9 years

Under 5 years


Male(millions)

Female(millions)



Boomers

Life Expectancy…

Population 85 Years Old & Over: 1900 to 2050

0.1 0.2 0.2 0.3 0.4 0.6 0.9 1.42.2

3.04.3

5.76.5

8.4

13.2

17.7

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 161900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050

Reported in Millions



Life Expectancy…

In 2000

13% of the workforce was over

the age of 55

Changes in the Workforce…

Source:

Bureau of Labor Statistics, 2003

In 2000


the age of 55

By 2015

20% of the workforcewill be over

the age of 55


Source:


In 2000


the age of 55

By 2015

20% of the workforcewill be over

the age of 55

Source:



28 million

Given that…

What are the implication for the workforce as we approach 2015?


The Implications…

• Visual acuity declines with age≈ 25% by age 60

Vision…


• Visual reaction time doubles

Vision…


• Visual reaction time doubles• The time to react to glare increases 50%

Vision…


• Visual reaction time doubles• The time to react to glare increases 50%• More light is required with aging

– 40-year old requires 2X– 60-year old requires 5-6X

Vision…

• Contrast sensitivity decreases with aging– 40-year old requires 120%– 50-year old requires 160%– 65-year old requires 270%

Vision…


• Field of view, motion perception, and depth perception all decline with age

Vision…

Vision…


• Field of view, motion perception, and depth perception all decline with age

• Color matching declines with age, especially for blue and yellow

Vision…

• Consistent hearing loss with aging – 2-3.5% per year throughout life

• Mid-range hearing loss– By age 50, is 10 dB, – By age 60 it is 25 dB, – By age 70 it is 35 dB

• Elderly adults have a decreased ability to tune out background noise

Hearing…

• Information processing declines with age• Cognitive ability declines with age

– Learn new material or skills– Attend to two or more tasks at once– Long term memory

Cognitive Ability…

Strength…

Strength…

• Strength decreases with age – 5% by age 40– 20% by age 55– 40% by age 75

• Most dramatic after the age 65. – 80% of the loss is due to inactivity however it can be

maintained with training

• Tendon strength decrease with age– Rotator Cuff tears– Achilles Tendon ruptures

Strength…

Metabolic Rate…

Metabolic Rate…

• Basal metabolic rate declines with age

Aerobic Power…

• Maximum Aerobic Power declines with age– At age of 65 it is 70% of what it was at age of 25

Aerobic Power…

Max HR = 220 – age

Aerobic Power…

Max HR = 220 - age = 177

Age vs. Activity…

Changes in our Tissues…

• Aging is associated with changes within skeletal muscle – Decrease force, power, endurance, and – Increase recover time for an injury

• More vulnerable to injury • Reduced capacity to regenerate after tissue

injury due to overexertion

Musculoskeletal Disorders (MSDs)…

• MSDs are the most common cause of disability among workers in their 50’s and 60’s

• 62% of men and women between ages 51 and 61 report one or more MSDs

• Advancing age is associated with more spinal complaints, hand pain, and other upper extremity pain

Slips, Trips and Falls…

• Reaction times slow with aging– 40-year old requires 25% more time – 60-year old requires 150% more time

• Trips are common in older people because of age related changes in gait

• Loss of balance in older people is due to deterioration of muscle feedback mechanisms

• A weaker skeleton intensify the injuries associates with falls in older people

So here they come…

A Boomer’s Perspective…

Who We Are: As 77 million boundless, ageless, timeless baby boomers move into the next stage of their lives, they are redefining quality of life itself and continuing their signature quest for personal and social meaning. Boomers are redesigning mid-life, redefining the empty nest, reinventing retirement and exploring life in new and unexpected ways.

http://www3.sc.maricopa.edu/boomerz/about.htm

A Boomer’s Perspective…

OPTIMISM: ANOTHER WORD FOR DENIAL

A large majority (89 percent) of Boomer respondents are optimistic that they will have a healthy future and nearly all (97 percent) look forward to an active lifestyle in retirement. This optimism is belied, however, by the way many baby boomers actually live -- and choose to ignore potential health problems.

Clyde Yancy, MD

American Heart Association Board Member

Professor of Medicine/Cardiology, Univ. of Texas

Source: American Heart Association, January 2004

Size Does Matter…

Physical Activity…

• Overweight: excess of body weight. – Muscle

– Bone

– Fat

– Body water.

• Obesity: abnormally high proportion of body fat.

• BMI is a reliable indicator of total body fat.– Calculation based on height & weight

– It is not gender specific

– Does not directly measure % of body fat

– Better measure than weight alone

Definitions…

The limits of BMI include:

• It may overestimate body fat in athletes and others who have a muscular build.

• It may underestimate body fat in older persons and others who have lost muscle mass.

• Appropriate weight gain during pregnancy varies and depends upon initial body weight or BMI level.

– Pregnant women should contact a health professional to assure appropriate weight gain during pregnancy.

Limits of BMI…

Calculation of BMI…

BMI = ( Weight in Pounds (Height in inches) x (Height in inches) ) x 703

BMI Tables…

Prevalence of Overweight…

Overweight US Adults (BMI > 25)

71.3M

129.6M

Normal Weight

Overweight

1999-2000 Data

36%



71.3M

129.6M

Normal Weight

Overweight

Overweight US Men

31%

69%

Normal Weight

Overw eight

1999-2000 Data

36%


Overweight US Men

31%

69%

Normal Weight

Overw eight

Overweight US Women

38%

62%

Normal Weight

Overw eight

1999-2000 Data


71.3M

129.6M

Normal Weight

Overweight

36%

Prevalence of Overweight(% of Adults)

35

40

45

50

55

60

65

70

NHES I 1960-1962

NHANES I1971-1974

NHANES II1976-1980

NHANES III1988-1994

NAHNES IV1999-2000

Men

All Adults

Women

Prevalence of overweight among adults. Percentage of adults aged 20-74 who were classified as obese (body mass index ≥25.00 kg/m²) in the National Health Examination Survey 1 (NHES1) and in four National Health and Nutrition Examination Surveys (NHANES)


Prevalence of Obesity(% of Adults)

5

10

15

20

25

30

35

40

NHES I1960-1962

NHANES I1971-1974

NHANES II1976-1980

NHANES III1988-1994

NAHNES IV1999-2000

Men

All Adults

Women

Prevalence of obesity among adults. Percentage of adults aged 20-74 who were classified as obese (body mass index ≥30.00 kg/m²) in the National Health Examination Survey 1 (NHES1) and in four National Health and Nutrition Examination Surveys (NHANES)

Prevalence of Obesity…

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1985

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Source: Behavioral Risk Factor Surveillance System, CDC



No Data <10% 10%–14%


No Data <10% 10%–14% 15%–19%




No Data <10% 10%–14% 15%–19% ≥20




<10% 10%–14% 15%–19% 20%–24% ≥25%




Physical Activity…

Overweight and obesity are known risk factors for:

• Diabetes• Heart Disease• Stroke• Hypertension• Gallbladder Disease• Osteoarthritis (degeneration of cartilage and bone of joints)• Sleep Apnea and other breathing problems• Some forms of cancer (uterine, breast, colorectal, kidney)

Medical Conditions…

The Boomer’s are Coming…

Medical Conditions vs. BMI…

Medical Conditions vs. BMI…

10 kg = 22 lbs

• Energy imbalance • Genetic / metabolic

– Despite obesity having strong genetic determinants, the genetic composition of the population does not change rapidly. Therefore, the large increase in . . . [obesity] must reflect major changes in non-genetic factors.

Center of Disease Control

• Behavioral / environmental • Cultural, and • Socioeconomic status.

Contributing Factors…

Contributing Factors…

Medical Spending…

Medical Spending…

Obese Class I Obese Class II

Atlas DataAtlas Data2003-20042003-2004

913 participants

Six Mid-western Call Centers

BMI Tables…

Atlas Data…

% of Population Experiencing Discomfort

50%

55%

60%

65%

70%

75%

80%

Normal Wt. Over Wt. Obese 1 Obese 2 Obese 3

Atlas Data…

Average Ergonomic Risk

1.9

2

2.1

2.2

2.3

2.4

2.5

2.6

2.7


Atlas Data…

% of Population Experiencing Elbow Discomfort

2%

4%

6%

8%

10%

12%

14%


% of Population Experiencing Elbow Discomfort

Atlas Data…

% of Population Experiencing Hand/Wrist Discomfort

20%

25%

30%

35%

40%

45%

50%

55%

60%


% of Population Experiencing Hand / Wrist Discomfort

Atlas Data…

% of Population Experiencing LBP Discomfort

20%

25%

30%

35%

40%

45%

50%

55%

60%


% of Population Experiencing Low Back Discomfort

Follow-up Data…

Percentage of Population Experiencing Work Related Discomfort

0%

10%

20%

30%

40%

50%

60%

Initial F/U 1 F/U 2 F/U 3 F/U 4 F/U 5

Normal Wt.

Overweight

Obese I

Obese II

Obese III

Archives of Internal Medicine

2007; 167; 766-773

Claim Costs / BMI…

Medical Claims Costs Per BMI

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

<18.5 18.5 - 24.9 25 - 29.9 30 - 34.9 35 - 39.9 > 40

BMI


2007; 167; 766-773

LWD per Claims / BMI…


2007; 167; 766-773

Lost Work Days per Claim

0

2

4

6

8

10

12

<18.5 18.5 - 24.9 25 - 29.9 30 - 34.9 35 - 39.9 > 40

BMI

Da

ys

Short Term Disability…


2007; 167; 766-773

BMI & Short Term Disability Among Employees

1

1.1

1.2

1.3

1.4

1.5

1.6

1.7

1.8

<25 25-30 >30

BMI

Od

ds

Ra

tio

Workplace Injuries…


2007; 167; 766-773

BMI vs. Acute Traumatic Workplace Injury

1

1.1

1.2

1.3

1.4

1.5

1.6

18.5 - 24.9 25 - 29.9 30 - 39.9

BMI

Od

ds

Ra

tio

Risky Behaviors…

Risky Behaviors…

Analysis by Jon Anderson & Stephen Burks; University of Minnesota, Morris.

For background, see the Truckers & Turnover Project web page:http://www.morris.umn.edu/academics/truckingproject/

BMI Grouping Driver Count Risk Ratio Estimate CI

BMI 0 - 25 225 1.00 NA

BMI 25 – 30 187 1.15 (0.92, 1.44)

BMI 30 - 40 165 1.36 (1.08, 1.70)

BMI 40 + 47 1.48 (1.06, 2.06)

Preliminary Estimates from SNI New Hire Panel Study

Why Wellness…

Schneider National, Inc

Wellness Pilot

Why Wellness…

• Obesity is linked to a multitude disease states

• Also linked to a various Work-Comp Metrics

Test & Measures…

Wellness Outcomes…

• Body Mass Index– Range = 25 to 55– Average = 37– Median = 37

• Average Fleet BMI = 31• Normal Weight = 5%• Overweight = 15%• Obese Class I = 25%• Obese Class II = 25%• Obese Class III = 30%

Outcome Data…

Body Mass Index

Underweight < 18.5

Normal Weight 18.5 – 24.9

Overweight 25 – 29.9

Obese Class I 30 – 34.5

Obese Class II 35 – 39.9

Obese Class III > 40

Outcome Data…

• Cholesterol Ratio– Range = 2.9 to 10.8– Average = 5.5– Median = 4.6

• 4 participants were above a 6 indicating MD referral

• 11 participants were in the “at risk” category

Cholesterol RatioNormal < 4

Some Risk 4 - 6

High Risk MD Referral

> 6

Outcome Data…

Outcome Data…

• Fasting Triglycerides – Range = 75 to 586– Average = 211 – Median = 161

• 6 participants were over 200 indicating MD referral

Fasting Triglycerides

Normal < 180 mg/dL

Referral to MD > 200 mg/dL

Outcome Data…

Outcome Data…

• Fasting Glucose – Range = 93 to 206– Average = 120– Median = 111

• 5 participants > 120 mg/dL• 2 diagnosed with diabetes

for the first time

Fasting Glucose

Normal < 100 mg/dL

Impaired 100 - 120 mg/dL

Referral to MD > 120 mg/dL

Outcome Data…

Outcome Data…

• Age – Range = 38 to 61– Average = 47 – Median = 45

Outcome Data…

• VO2 Max – Range = 3.9 to 45.7– Average = 19 – Median = 21.5

• For a perspective… the average score of our recruits would be classified in the “Low Classification” if you were 60 years old.

Outcome Data…

Outcome Data…

The Future…

Prevalence of obesity among children and adolescents. Percentage of children aged 2-5, 6-11, and adolescents 12-19, who were classified as overweight (95th percentile of body mass index for age according to the 2000 Center for Disease Control growth charts) in the National Health Examination Survey 1 (NHES1) and in four National Health and Nutrition Examination Surveys (NHANES)

Prevalence of Overweight - Children…

Funding vs. Disease Prevalence…

NIH Appropriations & Obesity…

Life Expectancy…

• Obesity could shorten the average lifespan of an entire generation.– 2-5 year reduction in the lifespan of a child born

todayNew England Journal of Medicine

March 2005

Life Expectancy…

• “Childhood obesity is like a massive tsunami headed toward the United States.”

David Ludwig, MD

Pediatric Endocrinologist

Boston’s Children’s Hospital

Conclusions…

• As worker become older and heavier– Risk of injury, illness and disability increase– Some impact on injuries but greater impact on

chronic disease– Impact of weight is greater than age for work related

injuries– Heavier, older workers with chronic problems may

have performance problems at work (but not well studied); certainly will have more problems with physical tasks

• Obesity is preventable while aging is not• Despite all… we can improve the workability of

aging workers

Finally…

We must take care of our kids…

Drew Bossen, PT, MBA

4191 Westcott Drive NE

Iowa City, IA 52240

Phone: 616-844-6322 Ext. 3202

Cell: 319-430-3382

Fax: 616-328-6768

Email: [email protected]

Questions…

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