A healthy workplace.

A general manager of a large electronics firm participated in a corporate health screening program offered by his company. He found that his cholesterol level was high (280), he was overweight by 20 to 25 pounds, and was under heavy stress. In addition, he did not exercise regularly. He realized these risk factors made him a prime candidate for a heart attack and committed himself to improving his lifestyle. He wrote out these goals: exercise 30 to 60 minutes every other day, lower cholesterol to less than 200, and lose 20 pounds. He quit eating red meat, used only nonfat dairy products, cut out most sources of fat, and ate more fresh fruits, whole-grains, vegetables, and legumes.

Within six months he lowered his cholesterol to 183, lost 21 pounds, and was walk/jogging 12 to 15 miles per week. He said, "I'm like a new man. I look better, feel better, and work better." He then challenged all his top managers to join him in a personal wellness program.

While some companies are cutting benefits in response to today's escalating health-care costs, others are taking a more creative approach by starting programs such as the one at the electronics firm.

Corporate wellness programs are increasing in popularity because of their focus on the real problem of rising health-care costs-unhealthy lifestyles.

According to the Report of the U.S. Preventive Services Task Force, "improved control of behavioral risk factors, such as use of tobacco, alcohol, and other drugs, lack of exercise, and poor nutrition, could prevent half of premature deaths, one third of all cases of acute disability, and half of all cases of chronic disability. Corporations can reduce their health-care costs in the long term by creating a corporate culture that rewards healthy living, motivates employees to improve their health, and provides the education and intervention programs to make it possible."

Many companies have realized extraordinary benefits from well-designed programs, while others have simply wasted money on poorly designed ones. Vanderbilt University's Health Plus program is one that works, according to participants:

"Possibly the best idea and benefit Vandy ever gave the employees. It has meant dropping almost 30 pounds, bringing my blood pressure and stress levels down, meeting people and relearning life. Thanks, guys!"

"Health Plus has been an outlet to me; it gives me time to unwind from the stress of my job before going home to my family. Working out has given me more energy. I feel more positive about myself."

"Since Health Plus opened, I have increased my workouts from three to five times a week. My energy level has increased, and I haven't felt this good for the past 30 years."

What makes this program and others like it work so well? Any corporate wellness program that demonstrates health status improvements and cost effectiveness includes some basic elements. if you're an employer or employee interested in starting such a program, consider these guidelines.

Planning. Establish a wellness committee and a wellness coordinator. This group can include interested employees, health professionals, health educators, exercise specialists, etc. If needed, invite a local health professional to join the committee to provide direction and input. This group should set some general long-term goals for the program such as:

* Improve health status

* Reduce health-care costs

* Attract healthier, more productive employees

* Prevent the loss of any key personnel

Situation analysis. After you establish a committee and set some general goals, the next step is an employee health needs and interests assessment. You must determine employee risk factors in order to plan intervention and follow-ups.

Equally important is determining the health interests of the employees. This gives you an idea of what types of programs will generate the most participation. Without participation a wellness program has no chance of success.

A thorough assessment should include the following:

Fitness. include strength, endurance, flexibility, cardiovascular fitness, and body composition.

Nutrition. Evaluate intake of fat, cholesterol, fiber, complex carbohydrates, salt, and sugar.

Safety. Assess driving safety, seat belt use, smoke alarms, and risk of back injury. Stress. Look at stress warning signals, coping status, energy levels, sleep, and social support systems.

Cancer. Include smoking, diet, cancer warning signs, and other risk indicators.

Coronary risk. Evaluate cholesterol (LDL and HDL), triglycerides, glucose, blood pressure, activity level, and health history.

Medical care. include health history, sick days/year, doctor visits, and hospital days.

Lung function. This is especially important for smokers and those working in smoky/dusty environments.

Health age. Assess longevity based on health practices.

A computerized health risk assessment (HRA) is the most efficient method of assessing needs and interests. A variety of HRAs are available and vary widely in their coverage of health factors and educational impact. Companies should find an HRA that fits their needs and goals best.

Corporate objectives. Once the health status of the company has been assessed, the results should be analyzed to pinpoint problem areas, identify high-risk individuals, and set specific program objectives, such as the following listed in the Healthy People 2000 report. Your company may be able to set even higher goals.

* Reduce work-related injuries to no more than 6 per 100 workers.

* Reduce cigarette smoking to no more than 15 percent of adults.

* Reduce overweight to a prevalence of no more than 20 percent of people.

* Reduce dietary fat intake to an average of 30 percent of calories.

* Increase moderate daily physical activity to at least 30 percent of people.

* Reduce sedentary lifestyles to no more than 15 percent of people.

Personal objectives. The most important factor in the success of any corporate wellness program is the personal commitment of each participant. Changing one's lifestyle requires a great deal of effort. The wellness program should provide a structure and climate that encourages people to achieve their personal goals and maintain their commitment throughout the year.

The participant should set specific, attainable goals, develop a plan of action to achieve those goals, and put them in the form of a personal contract. Then he or she should actually sign the contract as a symbol of personal commitment. Some examples of personal goals include:

* Reduce cholesterol level to less than 200.

* Lower blood pressure level by 10 points.

* Quit smoking.

* Get at least 30 minutes of exercise three or more days per week.

* Eat fewer high-fat foods.

Educational programs and interventions. The success of the wellness program depends on its ability to change lifestyles. This is not the easiest thing to do. Therefore, the more significant the corporate commitment to the program, the more likely it will produce health status improvements that will impact the bottom line.

Offering several types of intervention can help increase participation by letting people select the program with which they are most comfortable. Some examples include:

* One-to-one guided self-help

* Mini-group interventions (two to seven participants)

* One-to-one formal consultation

* Full-group classes

Counseling and education programs should address the following areas:

Blood pressure education. Persons in the high-risk category are 68 percent more likely to have annual claims more than $5,000 and have 25 percent more hospital days than those in the low-risk category.

Cholesterol reduction. Losing excess weight and maintaining ideal weight reduces risk of heart disease, cancer, hypertension, diabetes, and other serious health problems.

Nutritional counseling. Good nutrition habits raise energy levels, improve resistance to disease, and help prevent heart disease, cancer, obesity, and osteoporosis.

Physical fitness. Regular exercise helps prevent many serious health problems, including heart disease, stroke, diabetes, obesity, hypertension, cancer, and osteoporosis.

Smoking cessation. Smoking employees miss 3.5 more days of work per year than nonsmokers, have 50 percent higher illness rates, and typically cost their employers $400 more per year.

Stress management. Stress contributes to a number of physical and mental ailments, including ulcers, tension headaches, back problems, depressions, and decreased job satisfaction and productivity.

Community resource. Companies that don't have the resources to hire wellness counselors can still have an effective wellness program. Many resources exist in the community that provide health counseling and education services to employees. Contact your local hospital health promotion department, YMCA, American Lung Association, American Heart Association, or American Cancer Society for information about programs in your area.

Self-help resources. Health books, wellness newsletters, video tapes, and self-help learning guides are good resources to make available to employees through mailings, paycheck stuffers, or a wellness library. These can also be used in a class or support group setting.

Program evaluation. Another important element in the design of any successful wellness program is periodical evaluation.

Wellness programs are a new concept for most companies. Therefore, the program must be able to justify its existence. The objectives established in the beginning of the program should be monitored so that adjustments can be made to improve the program and ensure its continued effectiveness.

Benefits. The manager of a bakery division of a large grocery store chain initiated a safety and fitness promotion program in the plant in an attempt to contain rising worker's compensation costs. He started by contacting a local hospital that offered fitness assessments and personal health counseling. Fitness assessments were done on a quarterly basis.

As fitness scores improved, worker's comp claims began to drop. After several years of this ongoing program, he realized savings of $400,000 per year in decreased medical claims and reduced workdays lost because of illness or injury by 92 percent. With these savings he built a fitness center in the warehouse that includes exercise equipment for back strengthening and muscle conditioning, basketball and volleyball courts, and aerobic dance classes. Now the majority of his workers rank in the good to excellent fitness category.

Employers are beginning to recognize the limitations of the cost containment strategies of the eighties and are turning to corporate wellness programs as the most promising solution.

If your company doesn't have a formal wellness program, become involved in starting one. But don't wait for a corporate wellness program to start living healthier. You will feel better, have more energy, and be more productive.

Don Hall is founder and president of Well-source, Inc., a provider of health risk assessment software, training, and consulting services and other resources for corporate wellness programs. If you would like more information about personal or corporate wellness programs, contact Wellsource, Inc., at 1-800-533-9355.