Integrated Health & Safety Management: Integrating Health Protection and Health Promotion for Individual and Organizational Wellbeing E. Andrew Kapp, PhD, CSP, CHMM Research Manager, Workplace Health and Safety Underwriters Laboratories Inc.
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Definition of Integrated Health and Safety Integrated Health and Safety (IHS) is the strategic and systematic integration of distinct health and safety programs and policies into a continuum of organizational, personal, occupational, community and environmental activities that are replicable, measurable, and integrated across institutional silos, enhancing the overall health and well-being of workers and their families and preventing work-related injuries and illnesses
Why integrate?
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$685,000,000
Claim Costs Frequency Claims Frequency and Severity WC Frequency and Severity Trends $20,000 8,000 $18,000 $16,000 $14,000 $12,000 7,000 6,000 5,000 $10,000 $8,000 $6,000 $4,000 $2,000 4,000 3,000 2,000 1,000 Indemnity Severity Medical Severity Frequency per 100K Workers $0 0 1997 1998 1999 2000 2001 2002 2003 2004 Policy Year Medical severity rose more than twice as fast as the medical CPI from 1995 through 2007 (8.3% vs. 4%) 1 Recent Indemnity severity trends exceed wage inflation Medical claim costs have increased 9+% since 2002 2 1 Workplace Safety Index, Winter 2008, Liberty Mutual Research Institute for Safety 2 NCCI Holdings, Inc. Annual Issues Symposium 2008, State of the Line
U.S. Workforce is Aging
Median Days Away From Work Due to Injury, by Age Group
Healthcare Costs: Effects of Age Annual Medical Costs $11,909 $11,965 $10,785 $7,991 $12,000 $9,000 $5,114 $5,710 $6,625 $7,989 $8,927 $6,000 $3,000 $0 $4,620 $2,565 $3,353 $4,613 $3,734 $2,193 $2,740 $1,776 $5,756 19-34 35-44 45-54 55-64 65-74 75+ Age Range High Med Risk Low Edington DW. Zero Trends: Health As a Serious Economic Strategy. Health Management Research Center, University of Michigan. 2009. Edington, American Journal of Health Promotion. 15(5):341-349, 2001
But retirement will take care of the aging workforce problem, right?
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Healthcare Costs: Effects of Age and Health Risk Annual Medical Costs $11,909 $11,965 $10,785 $7,991 $12,000 $9,000 $5,114 $5,710 $6,625 $7,989 $8,927 $6,000 $3,000 $0 $4,620 $2,565 $3,353 $4,613 $3,734 $2,193 $2,740 $1,776 $5,756 19-34 35-44 45-54 55-64 65-74 75+ Age Range High Med Risk Low Edington DW. Zero Trends: Health As a Serious Economic Strategy. Health Management Research Center, University of Michigan. 2009. Edington, American Journal of Health Promotion. 15(5):341-349, 2001
Estimated Health Risks of Working Population Body Weight Stress Safety Belt Usage Physical Activity Blood Pressure Life Satisfaction Smoking Perception of Health Illness Days Existing Medical Problem Cholesterol Alcohol Zero Risk 41.8% 31.8% 28.6% 23.3% 22.8% 22.4% 14.4% 13.7% 10.9% 9.2% 8.3% 2.9% 14.0% Overall Risk Levels Low Risk 55.3% Medium Risk 27.7% High Risk 17.0% 22
$90,000
Healthcare Costs $1.00 Productivity Loss $2.30
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Non-Fatal Occupational Injury and Illness Rates per 100 FTE 26
Fatal Work Injuries per 100,00 FTE 27
Increases in Frequency and Severity of Injuries Associated with Poor Baseline Health Numerous studies have shown an increased likelihood of workplace injuries and illnesses for those with poor baseline health Not just strain/sprains and WRMSD Even greater research on increased severity (i.e., increased duration of recovery, increased cost/healthcare utilization, decreased likelihood of full recovery, increased risk of complications) 28
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Opportunities
70 % of illness is lifestyle related and thus may be preventable Mayo Clinic (2003), Direct and Indirect Benefits of Health Promotion Programs
Integrating Health and Safety
Focus today is how to best integrate health and safety programs to achieve optimal benefits Health Safety
3 Logics of Integration 1. Avoid Gaps 2. Avoid Duplication of Efforts 3. Avoid Sub- Optimization/Risk Shifting 35
Dollars Study Linking Worker Health with the Market Performance Publicly Traded CHAA Employers vs. S&P 500 20000 18000 16000 14000 12000 10000 8000 6000 4000 2000 0 $17,569.21 $9,923.14 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Portfolio Worth (6/30) S&P 500 Fabius R, et al. The link between workforce health and safety and the health of the bottom line: Tracking market performance of companies that nurture a culture of health. J Occup Environ Med. 2013;55(9):993-1000.
VOI Study Linking Worker Health with the Market Performance
Taking Integration to the Next Level: The Integrated Health & Safety Summit Gaining traction among thought leaders
Journal for Occupational and Environmental Medicine
The Process Plan Rationale & Motivation Review & Adjust Plan Integrating Health & Safety for Operational Excellence Assess & Evaluate Current Standings Monitor & Evaluate Plan Implement Plan
A New Integrated Health & Safety Index aligned with the Dow Jones Sustainability Index Economic Leadership & Management Healthcare Cost, Absence & Disability Management Integrated Health & Productivity Dow Jones Sustainability Indices Integrated Health & Safety Index Environmental Culture of Health & Safety Healthy & Safe Environment Healthy & Safe Workers Social Prevention & Wellness Value Based Benefits Management Corporate Social Responsibility impacting Community Health Loeppke, R; Hohn, T; et.al. Integrating Health and Safety in the Workplace: How Closely Aligning Health and Safety Strategies can Yield Measureable Benefits. Journal of Occupational & Environmental Medicine 2015: 57 (5): 585-597. May, 2015.
Integrated Health & Safety
Roundtable Outcomes The Non Negotiable 1. Create an overarching management structure 2. Use a holistic approach 3. Make a commitment 4. Present the business case 5. Prepare for new education for business professionals 6. Get everyone involved 7. Nurture a culture of health & safety
Standard UL904Z: Integrated Health and Safety in the Workplace http://www.comm-2000.com/
UL-ASSE Integrated Health and Safety Program Survey 37% 2% 7% 26 23% 12% 19% Company Size 69 49 45 Manufacturing Oil & Gas Services Public Sector Other Not Specified 283 472 ASSE members surveyed Regression analysis Investigating the influence of organizational structure, leadership and communications On the perception of degree of integration of health and safety < 50 50-249 250-499 500-999 1,000+
10 Factors Supporting Integrated Health and Safety Management 1. Written policy 2. Incorporation into larger business plans 3. A discrete budget 4. Multiple ways of communicating 5. Frequent communications 6. All stakeholders coordinated in the implementation 7. At least one person with responsibility 8. Senior management is commitment 9. Mid-level managers and supervisors are committed 10. Mid-level managers and supervisors accept their responsibilities
Organizational Structures: Policy & Budget Policy Budget ß =.63, R 2 =.39 p <.001 ß =.58, R 2 =.30 p <.001
Organizational Structures: Champion in Place & Part of Larger Business Plan Champion Part of Larger Plan ß =.48, R 2 =.22 p <.001 ß =.67, R 2 =.41 p <.001
Leadership: Senior Management Commitment Senior Management Commitment ß =.65, R 2 =.37 p <.001
Communications: Methods & Frequency Multiple Means of Communication Frequent Communications ß =.70, R 2 =.39 p <.001 ß =.68, R 2 =.42 p <.001
Stakeholder Engagement Stakeholder Engagement ß =.60, R 2 =.33 p <.001
UL-ASSE Integrated Health and Safety Program Survey - Key Takeaways Begins with senior management commitment A well written policy IHS is incorporated into larger business plans Frequent and diverse communications with stakeholders throughout design and implementation
Success Stories
Dow Chemical Priorities: For Integrating Health and Safety Health as a Business Performance Driver and Manage Costs Safety Reliability Human Capital Priorities Engagement Talent: Attract and Retain Human Performance Sustainability Corporate Social Responsibility Corporate Reputation Source: Dr. Cathy Baase Corporate Medical Director, Dow Chemical 58
Target Behaviors and Risks that Impact Health, Safety and Performance 8 risks and behaviors 1. Diabetes 2. Coronary artery disease 3. Hypertension 4. Back pain 5. Obesity 6. Cancer 7. Asthma drive 15 chronic conditions 8. Arthritis 9. Allergies 10. Sinusitis 11. Depression 12. Heart failure 13. Pulmonary disease 14. Kidney disease 15. High cholesterol Accounting for 80% of total costs for all chronic illnesses worldwide Companies that target 3 major modifiable risk factors can save an average of $700/employee/year in health care costs and productivity improvements. Source: 2010 World Economic Forum Source: Dr. Cathy Baase Corporate Medical Director, Dow Chemical 59
Dow Outcomes from Integrated Health & Safety Strategies Health 9% better health risk profile 17% less chronic health conditions 17% less spend on chronic health conditions Safety Dow workers are 20 times less likely to experience injury and illness when compared to overall U.S. manufacturing injury and illness rate. In 2011, the Dow Injury and Illness rate was 0.28 per 200,000 hours of work. The 2015 Goal of 0.12 per 200,000 hours (75% improvement from 2005 rate). Economic 5 + year healthcare cost trend is < 2% Cumulative savings since 2004 is > $150MM Source: Dr. Cathy Baase Corporate Medical Director, Dow Chemical
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