Health in the Workplace Transforming Healthcare Delivery Advancing

Health in the Workplace Transforming Healthcare Delivery: Advancing Multidisciplinary Research at Purdue University Healthy Lifestyles and Healthy Workplaces James D. Mc. Glothlin, M. P. H. , Ph. D. , C. P. E Balmatee Bidassie, MS, MA Irene Mena, MS School of Health Science, Purdue University 550 Stadium Mall Drive, West Lafayette, IN 47906 Julie Huetteman Ph. D Work. Life Programs Purdue West 1402 West State Street, West Lafayette, IN 47907

Outline for Presentation n n n Motivation for Study of Relationship between Healthy Workplaces and Healthy Lifestyles at Purdue University Healthy Workplaces: Background Statistics Musculoskeletal Injuries and Worker’s Compensation at Purdue Healthy Lifestyles: Description of Purdue Wellness Program and Incentives to Participants Study Approach/Methods Results/Discussion On-going and Future Research James D. Mc. Glothlin - School of Health Science 2

Synergies between Healthy Workplaces and Healthy Lifestyles Ergonomics Program for Intervention and Control of Musculoskeletal Disorders among Employees Datasets: • OSHA 300 • Worker’s Compensation Variables: • Injury count and injury rate • Severity rate • Cost per injury Goal: To implement ergonomic measures in workplaces and quantify injury and economic outcomes from these measures. Healthy Lifestyles and Healthy Workplaces Datasets: • Aggregate data from Vendor • OSHA 300 Variables: • Lifestyle risk factors and risk scores • Number of reported back injuries Goal: To determine if selected lifestyle risk factors affect the risk of work-related back injuries. Integrated Outcomes: v Best work and lifestyle practices. v Reduced injury and severity rates (on and off the job). v Improved quality of work and family life. v Reduced cost to the university, and to individual supplemental health plans. v Increased worker’s satisfaction, morale, less turn over, and absenteeism. v Develop best strategies for exercise, fitness, and well being. 4 James D. Mc. Glothlin - School of Health Science

HEALTHY WORKPLACES THROUGH IMPLEMENTATION OF ERGONOMICS CONTROL PROGRAMS James D. Mc. Glothlin - School of Health Science 5

Back Injuries n Nearly 80% of the U. S. population has suffered or will suffer from back injuries. James D. Mc. Glothlin - School of Health Science 6

Back Injuries at Purdue n At Purdue University, back injuries have been in the top 5 medical conditions throughout the years. 2005 James D. Mc. Glothlin - School of Health Science 7

Motivation n n Back injuries and their causes have been studied by many researchers over time. Besides the much-studied occupational causes, there are non-occupational causes as well. Purdue pays approximately $100 Million annually on Medical Cost. Purdue recognizes there may be a relationship between occupational and non-occupational risk factor and back injuries Because of this Purdue is offering incentives to reduce workplace risk factors and improve healthy lifestyles James D. Mc. Glothlin - School of Health Science 8

Some Occupational Causes of Back Pain n n Heavy manual work Exposure to vibration Trunk rotation Lifting James D. Mc. Glothlin - School of Health Science 9

Some Non-Occupational Causes of Back Pain n n Tobacco use Weight Alcohol use Exercise and physical activity *BOTH occupational and non-occupational factors should be considered. James D. Mc. Glothlin - School of Health Science 10

Background Statistics for Medical Cost among Purdue University Employees (Based on 2004 Data) 1. Medical Cost 2. Workers’ Compensation 3. OSHA 300 Logs James D. Mc. Glothlin - School of Health Science 11

1. MEDICAL COSTS Table 1: Total and Person Expense of Low Back Injuries: Gender and Employee Groups Table 2: Total and Person Units of Low Back Injuries: Gender and Employee Groups James D. Mc. Glothlin - School of Health Science 12

2. WORKERS’ COMPENSATION n Data is analyzed for clearly evident musculoskeletal diseases only. n Part of body (excluding head): n n n n Neck Upper extremities (i. e. shoulders, arms, hands, wrist, fingers) Trunk, except back (i. e. chest, ribs, abdomen, pelvic) Back Lower extremities (i. e. legs, ankles, feet, toes) Others (i. e. multiple body parts) Nature of injury, for example: n n n Carpal tunnel syndrome Strains/sprains Numbness/tingling James D. Mc. Glothlin - School of Health Science 13

2. WORKERS’ COMPENSATION (Musculoskeletal Disease in Different Parts of the Body) % Musculoskeletal Disease Count* % Musculoskeletal Disease Cost Incurred* *Percentage is take out of total count of musculoskeletal diseases only. James D. Mc. Glothlin - School of Health Science *Percentage is take out of total count of musculoskeletal diseases only. 14

2. WORKERS’ COMPENSATION Top Locations for Worker’s Compensation Claims (by % Total Cost Incurred) James D. Mc. Glothlin - School of Health Science 15

3. OSHA 300 LOGS n 239 cases related to musculoskeletal diseases, of which 175 are recordable cases. James D. Mc. Glothlin - School of Health Science 16

COMPARISON OF MEDICAL COST, WORKERS’ COMPENSATION, & OSHA 300 LOGS, AS IT RELATES TO MUSCULOSKELETAL INJURIES AND ILLINESSES, GENERALLY TEND TO AGREE WITH EACH OTHER. James D. Mc. Glothlin - School of Health Science 17

n The Healthy Purdue initiative was designed to support the partnership between Purdue University and its benefit-eligible faculty, staff, long term disability participants, and their spouses or same-sex domestic partners, working together to promote health and contain health care costs. Official Purdue retirees and their spouses or same-sex domestic partners may take part, but will not receive financial incentives. Participation is voluntary. http: //www. purdue. edu/hr/Work. Life/healthy. Synopsis. htm James D. Mc. Glothlin - School of Health Science 18

Study Approach n Preliminary Study: Foundation for Study n n n Use aggregate data to determine lifestyle risk factors associated with back injuries Data Source: 2000 – 2005 OSHA logs and Workers’ Compensation claims Core Study: Phases 1 -3: Achieve more detailed and accurate results (Based on Preliminary Study) James D. Mc. Glothlin - School of Health Science 19

Core Study: Phase 1 Participants (All 4 Campuses) n 8, 991 people participated in Healthy Purdue. n n 6, 451 were employees, 2, 438 spouses and domestic partners, and 102 Purdue retirees and spouses. 93% filled out their health risk assessment online – only 7% filled out the paper version. James D. Mc. Glothlin - School of Health Science 20

Core Study: Phase 1 Participants (All 4 Campuses) n Average =46. 5 n n 56% were female 44% were male. James D. Mc. Glothlin - School of Health Science 21

HEALTHY PURDUE WELLNESS PARTICIPANTS INCENTIVE PROGRAM n Wellness screening n n HRA Questionnaire (Health Risk Assessment). n n n Participants qualify for health coaching based on HRA www. purdue. edu/healthypurdue. Wellness criteria. n n Participant’s values are needed from their wellness screening to complete the questionnaire. Coaching and resources. n n Height, weight, blood pressure, total cholesterol, HDL, and glucose (blood sugar). Additional opportunity to promote health (i. e. , losing weight, smoking cessation, etc) Incentive strategy n Financial incentive for screenings, questionnaire and wellness criteria. James D. Mc. Glothlin - School of Health Science 22

Core Study Data Sets n Use risk factors and biometric data from the Health Risk Assessment performed by Purdue’s Work. Life Programs. n n Dataset included information on nearly 9, 000 participants. Data was Filtered (6, 052 Purdue University’s West Lafayette employees*) n n n Remove participants with missing information, Remove those who were not employees at the West Lafayette campus. OSHA 300 logs and Workers’ Compensation claims for the year 2006. *Purdue University (West Lafayette) Faculty and staff pop = 10, 751 James D. Mc. Glothlin - School of Health Science 23

Scoring Lifestyle Risk Factors Questions n n n Private healthcare contractor, used the HRA data to calculate health risk scores, which were calculated based on a combination of factors. Risk categories were obtained in order to see how participants were distributed. Scores: low (1), moderate (2), or high (3) James D. Mc. Glothlin - School of Health Science 24

Risk Factors n n n Alcohol Back Exercise Smoking Stress n n n Body Mass Index Well-being Self-Care* Cholesterol Blood Pressure * Likelihood to visit a health professional (Ability to decide when to call or visit a health professional) James D. Mc. Glothlin - School of Health Science 25

Hypotheses n n n Selected lifestyle risk factors, job status and corresponding occupational risk factors are associated with higher reporting of back injuries among employees at Purdue University. James D. Mc. Glothlin - School of Health Science 26

Demographic & Biometrics Data n n n n Gender Age Campus Job status Weight Body mass index Cholesterol Systolic and diastolic blood pressure James D. Mc. Glothlin - School of Health Science 27

Method n Perform analyses on lifestyle aggregate data to determine how the different aspects of lifestyle influence the risk of developing back injuries and to determine the most important lifestyle risk factors for each job status. James D. Mc. Glothlin - School of Health Science 28

Method n Incidence and severity rates of back injuries will be determined from OSHA 300 logs and Workers’ Compensation, as well as the proportion of back injuries for each job status. James D. Mc. Glothlin - School of Health Science 29

High Risk Scores for Each of the Risk Factors James D. Mc. Glothlin - School of Health Science 30

Personal Risk Factors for Back Pain n Obesity n Exercise and physical activity n n Can help prevent and treat back pain Fatigue, depression, difficulties in sleeping James D. Mc. Glothlin - School of Health Science 31

Multiple Regression Step Variable Entered Number Vars In Partial RSquare Model R-Square Pr > F 1 Exercise Risk 1 0. 2898 <0. 0001 2 Job Status = Clerical/Service Staff 2 0. 0534 0. 3433 <0. 0001 3 Weight Risk 3 0. 0217 0. 365 <0. 0001 4 Smoking Risk 4 0. 0198 0. 3848 <0. 0001 5 Well-Being Risk 5 0. 0173 0. 4021 <0. 0001 6 Gender 6 0. 016 0. 418 <0. 0001 7 Stress Risk 7 0. 0062 0. 4243 <0. 0001 8 Job Status= Admin/Prof Staff 8 0. 0011 0. 4254 0. 0006 9 Age 9 0. 0007 0. 4261 0. 0061 10 Cholesterol 10 0. 0008 0. 4269 0. 0032 11 Alcohol Risk 11 0. 0006 0. 4275 0. 0113 James D. Mc. Glothlin - School of Health Science 32

Preliminary Results – Regression Tree Exercise < 2. 5 Job Status < 2. 5 Weight < 1. 5 Gender >= 1. 5 Stress < 2. 5 1. 22 1. 59 1. 58 2. 42 2. 35 A description of the regression 33 results is on the next slide James D. Mc. Glothlin - School of Health Science 2. 88

Low Back Risk Score Moderate Back Risk Score High Back Risk Score A person who exercises, is faculty or administrative/ professional staff, and has low or moderate stress levels A person who exercises, is faculty or administrative/ professional staff, and has high stress levels A person who exercises, is service or clerical staff, and is a male A person who exercises, is service or clerical staff, and is a female A person who does not exercise, and is not overweight A person who does not exercise, and is overweight James D. Mc. Glothlin - School of Health Science 34

On-going and Future Research James D. Mc. Glothlin - School of Health Science 35

Stress Risk More than 60% have moderate or high stress risk n 36. 7% Low Risk (n=2221) n n 46. 8% Moderate Risk (n=2830) n n n perceive life not very stressful, and handle stress effectively perceive life not very stressful, and not handle stress effectively perceive life very stressful, and handle stress effectively 16. 6% High Risk (n=1002) n perceive life as very stressful, and not handle stress effectively James D. Mc. Glothlin - School of Health Science 36

Effect of Social Support on Risk Factors James D. Mc. Glothlin - School of Health Science 37

Conclusion n n Results provide a glimpse of how closely related workplace and lifestyle activities are in the development of musculoskeletal injuries. Top 3 contributors to risk of back injuries come from both the occupational and non-occupational aspects of a person’s life: exercise, type of job and body mass index n These findings need to be considered when developing strategies for reducing and preventing back injuries at work, at home, and at play. n Future research is being conducted on relationship between stress and social support network and the prevention of back injuries. James D. Mc. Glothlin - School of Health Science 38