September 2007 | Back to Table of Contents

Pulse

The Healthy Workplace

Employers are finding that an investment in wellness can curb health care costs and improve productivity.

Julia Halberg, M.D., walks briskly through the skyways of General Mills’ headquarters in Golden Valley, pointing out the fact that the path we are on is part of a quarter-mile circuit designed to encourage employees to take breaks and even hold meetings on foot, that the park-like lawns are often the site of lunchtime activities such as dodgeball games, and that a dozen employees are working out in the corporate fitness center at 2:45 p.m. “Health is a priority for both our products and our people,” she explains.

The tall, slender Halberg directs health services for General Mills, which has been hailed a national champion in employee wellness. Among its titles: a 2007 gold award from the National Business Group on Health for promoting a healthy lifestyle among employees and for serving as a model for other businesses that want to improve the health of their workforce.

Halberg is one of two physicians who run the company’s onsite medical clinic. In this role, she not only helps create and implement fitness and wellness programs, she also advocates for employees who have questions and concerns about their health. “We can be a bridge for them into the health system,” she says.

General Mills has had a medical clinic for more than 30 years. With a focus on prevention and cultivating a healthier lifestyle for its employees, it’s one way the company strives to address the escalating costs of health care. In addition to the physicians, the company employs two physician assistants, four nurses, a lab technician, and other staff at its three Twin Cities’ offices. At the company headquarters’ Total Health Clinic, consultants specializing in preventive cardiology, dermatology, men’s and women’s health, counseling, dentistry, and optometry provide care to employees. General Mills also offers Weight Watchers meetings and healthy cooking classes, smoking-cessation assistance, and health risk assessments and coaching, in addition to physical therapy and fitness activities. Most services are free to employees. “If you do what’s best for the individual employee, you do what’s best for the company,” Halberg says quoting Jim Craig, M.D., who founded the clinic. Although General Mills may be somewhat unique in having a full clinic in house (see “The Doctor is In—the Office”), Halberg, who has been with the company for six years and who in 2006 was an invited panel member for the Centers for Disease Control and Prevention’s discussion on obesity prevention in the workplace, has noticed companies of all sizes promoting health among their employees. University of Minnesota researchers writing in an article published in the June 2006 issue of the Journal of Occupational and Environmental Medicine confirm her observation, noting that 95 percent of companies with more than 50 employees offered some type of activities to promote health and prevent disease. “There’s definitely a trend toward doing more,” Halberg says.

Fighting Fat
When asked about the biggest health concerns for the 5,500 employees of General Mills in the Twin Cities, Halberg names three: cardiovascular issues, diabetes, and weight management. Increased weight is the most costly health risk related to workers’ lifestyle, according to a study of nearly 36,000 auto workers and their spouses by University of Michigan researchers. The findings, which were published in the July 2006 Journal of Occupational and Environmental Medicine showed that for every one-point increase in body mass over 25 (the threshold for being overweight), annual medical costs increased by $120 and drug costs by $83.

Halberg says General Mills is trying to address health concerns in a number of ways. In 2004, the company started Health Number, a program in which employees answer questions about their seat belt use, alcohol and tobacco use, physical activity, and eating habits, and go through blood pressure, blood sugar, cholesterol, and BMI screenings. They receive an immediate assessment of their health status and hints on how they could improve it, and have the opportunity to meet with a nurse or health coach.

The Doctor is In—the Office Company medical clinics are making a comeback after falling victim to budget crunches in the 1980s and ’90s. Pepsi Bottling Group, Toyota, Sprint Nextel, Florida Power and Light, and Credit Suisse, for example, have added or expanded onsite clinics during the last two years, according to a January 14, 2007, New York Times article. A study by benefits consultancy Watson Wyatt found more than 250 of the largest 1,000 companies in the United States are expected to offer some form of primary or preventive health care on their premises by the end of the year. General Mills, which has operated a clinic at its Golden Valley headquarters for more than 30 years, focuses on preventive care. The clinic serves about 5,500 employees in the Twin Cities area, offering a variety of free services. “It helps our employees and thus the company if health issues can be addressed early and efficiently, without them having to leave the worksite,” says Julia Halberg, M.D., director of health services and one of the physicians who sees patients at the clinic. Carlson, which operates a number of travel and hospitality businesses, has housed a MinuteClinic at its Minnetonka headquarters since 2004. Employees can receive care from an advanced practice nurse for some 20 common conditions for a co-payment of $5. “They save money, the organization saves money, and they get better faster,” says Charles Montreuil, vice president of corporate human resources.—K.K.

Last year, the company screened 3,850 employees at its headquarters, sales offices, and 14 of its manufacturing plants. Halberg says they haven’t formally measured outcomes, “but we’ve had a number of success stories where our employees uncovered high blood pressure or diabetes.”

In January 2005, General Mills rolled out a weight-management initiative at its headquarters that encouraged employees to lose 10 pounds in 10 weeks. Participants who had a body mass index over 25 and were deemed ready to participate after an evaluation by a nurse and physician worked with a nutritionist to learn about food choices, a physical therapist to become more active, and a behaviorist to avoid the emotional pitfalls that go along with trying to lose weight. They also took part in weekly support meetings. “The idea was to use a combination of approaches so that they could succeed,” Halberg says. The 529 employees who enrolled that first year have lost nearly 3,000 pounds, and their average BMI dropped from 27.9 to 27. Halberg says participants continue to meet to help each other sustain their weight loss, and the company has extended the program to other General Mills facilities.

Carlson in Minneapolis, which is the parent organization for a number of travel and hospitality businesses, will begin a drive to improve the health of some 500 employees with type 2 diabetes later this month. Those employees will receive a report card that evaluates whether they have refrained from smoking, maintained blood pressure lower than 130/80, kept their LDL cholesterol below 100, take a daily aspirin if they’re older than 40, and keep their A1c level below 7. Their progress will be measured every six months.

The company is hoping the initiative will lead to reduced costs associated with caring for diabetic employees. “On average, the type 2 diabetic at Carlson costs around $10,000 a year in medical costs. If we get them to achieve optimal outcomes, which may take a year or two, we can reduce that cost to about $6,000 a year,” says Charles Montreuil, vice president of corporate human resources.

Getting Employees to Move
But do such efforts pay off? According to researchers from the Centers for Disease Control and Prevention, the answer is yes. In a study published in the December 2005 issue of the American Journal of Preventive Medicine, researchers reported that employers who invested in worksite health promotion activities such as offering screenings and lifestyle counseling could realize a return of $3 to $6 for every dollar invested over two to five years.

Halberg says that although General Mills doesn’t have return-on-investment figures, the company’s health care costs have remained flat in recent years and insurance premium increases were below the national average. And Montreuil says healthier employees use fewer sick days and need less time off for doctor appointments, the cost of which can add another 25 percent to 30 percent to their medical costs.

But even when employers offer onsite fitness centers, smoking-cessation programs, options for healthful eating, and free health screenings, getting employees to take advantage of them is another story. “You’re not going to make a whole culture change among 300 people just because the owner is excited about health,” says Doug Huseby, founder of Becker Furniture World, which has about 300 employees in Becker, Minnesota. Huseby has overseen a number of initiatives to prevent illness and promote health. For one, the company installed air purification systems to cut down on exposure to chemicals in fabrics and paddings. It has also encouraged employees to eat better by giving away healthful foods. Before adding a restaurant at the retail complex in the early 1990s, Huseby set up a kitchen and hired a cook to prepare fresh fruit and vegetable drinks. “If you tell employees you’re going to charge $5 for a cup of carrot juice, they’re probably not going to take it. But if you give it to them instead of pop and pay for it, they’ll try it,” he says. Huseby adds that they still give away nutritious drinks to employees on weekends and that the company’s restaurant has eliminated transfats in cooking.

Montreuil says Carlson employees will earn “gold points” for participating in the diabetes program and for making progress on three out of five measures of success. Participants will be able to redeem those points for gift certificates, airline tickets, electronics, and other merchandise. General Mills found incentives worked well, too. Participants in the weight loss program, for example, were entered in a drawing for a week’s stay at an Arizona spa.

Halberg says General Mills is very open to sharing what they’ve learned with others. “It’s doing the right thing,” she says, adding that she recently got an e-mail from someone at another Fortune 500 company who wanted to learn more about General Mills’ program. “Our employees’ family members may be working for those companies. We hope they do the right thing for their employees as we try to do for ours.”—Kim Kiser