Efforts in Massachusetts for Healthier Communities

By Kathy Yi, Healthy Communities Partnership Associate

A comprehensive alliance of public health advocates in Massachusetts launched a new campaign called “The Act FRESH Campaign” on February 7^th to promote healthier neighborhoods and schools. This three-year policy change initiative aims to make local healthy food more available and affordable, to increase public space for physical activity, and to reduce obesity and chronic disease. Some strategies this campaign hopes to get approved include

· Enforcement of zoning that promotes walking and bicycle riding,

· Promotion of groceries with abundant supplies of fruits and vegetables in every neighborhood, and

· Schools with robust physical education classes and cafeterias serving nutritious meals.

While the state of Massachusetts considers extensive zoning reform, public health specialists will for the first time have a seat at the table to be a part of the decision making process. In addition, the campaign will be supported by Dr. Judy Ann Bigby, the top health official in Governor Deval Patrick's administration, as well as Dr. Howard Koh, a former Massachusetts public health commissioner who now serves as Assistant Secretary for Health in the Obama administration. With its strong foundation of support for change, the campaign brings hope in the prospect of healthier communities. We will be watching to see the success of this campaign, and for lessons it may have for our own state’s Healthy Communities Partnership.

To learn more about this project, click here.

Wal-Mart, Setting an Example

By Kathy Yi, Healthy Communities Partnership Associate

With its storied history as a “problem employer”, Wal-Mart seems an unlikely model for healthy employer practices. But that may be just what the retail giant is aiming to become.

What changes has Wal-Mart made after experiencing two aggressive anti-Wal-Mart campaigns and a drop in stock of 27 percent from the year 2000 and to late 2005?

First, as other firms are scaling back or eliminating employee benefits like health coverage, Wal-Mart has been expanding it. It has also put into practice many innovations that promise higher quality and more efficient care such as digital records, partnerships with prestigious organizations such as the Mayo Clinic, and specific projects that target costly health problems such as obesity and premature births. The wait to enroll in its employee health plan was reduced from two years to one year for part-time employees and to six months for full-time employees. Wal-Mart also conducted comprehensive research on its own personnel, finding their needs for more choice and especially for low-cost emergency coverage options. Wal-Mart responded with a menu of deductibles, co-payments, and maximum out-of-pocket costs. Wal-Mart also focused on specific initiatives such as “Life with Baby,” a project aimed at reducing premature births. Wal-Mart’s efforts and accomplishment of a health care plan with a shorter waiting period before a new employee is eligible and lower premiums have been impressive. Although it still falls short of the comprehensive care that President Obama says he wants for Americans, one of the world’s largest retailers has overcome enormous challenges to become a health policy success story.

Wal-Mart has been expanding its health image beyond employee benefits, pioneering the $4 generic prescription drug just a few years ago, during the height of the national debate about that benefit in Medicare.

But most notable among Wal-Mart’s health awakenings may be its recent campaign to offer more healthful foods and its push that its suppliers do the same. First Lady Michelle Obama recently commended the low-priced retail giant for its efforts, calling it “a huge victory for folks all across this country” and said it has the “potential to transform the marketplace.” Wal-Mart’s plan is to make thousands of its packaged food items more healthful and affordable by 2015; build more stores in underserved areas and increase its charitable donations to nutrition programs. The plan also includes reducing sodium and sugar in some foods, lowering prices on produce and product labeling to enable customers more easily to identify healthful items. Despite early skepticism, some labor groups have adopted a more open view toward Wal-Mart’s new efforts.

Several smaller food companies have made similar efforts for more healthful food products. But as the world's largest retailer, Wal-Mart stands in a unique position to influence the practices of its more than 60,000 suppliers. So these moves could be a tipping point in the battle for healthier communities.

For more information about Wal-Mart’s new plan for healthier foods, click here.

For more information about Wal-Mart and their employee health-care, click here.

Workplace Wellness, Part II

By Greg Cook, HCP Associate

Most employers realize healthy employees are better for the bottom line. The question then becomes how to achieve a healthy workforce without bankrupting the company. Another question is how to make the effort attractive to workers. And a third question is what laws exist—or might exist—to help companies implement these changes to complement other areas of public health policy.

One preliminary task is settling on definitions. At least four different terms are used for this area of wellness: workplace, worksite, workforce, and employee. The first two emphasize the place where people work, while the second two terms refer to the people at the place. The two different emphases should be seen as complementary, not opposed. Workplace and worksite mean that many of these services are delivered on-site (and can be associated with occupational safety considerations in some cases); workforce and employee refer to the human component of a business instead of the infrastructure. But what does a wellness plan entail? The American Heart Association has a succinct sketch of basic components: “a comprehensive program should encompass tobacco cessation and prevention, physical activity, stress management/reduction, early detection/screening, nutrition education, weight management, and cardiovascular disease prevention.” Other aspects that might be included are “back pain prevention and management, adult vaccination, alcohol and substance abuse assessment, maternal and infant health education and guidance regarding effective use of the health care system.” The ongoing sluggishness in the private sector and budget shortfalls in the public sector mean funds for workplace wellness can be hard to come by. The federal health care law includes provisions such as tax incentives to help businesses implement wellness programs. Here in Washington, some further policy options might include: providing state B & O tax credits for smaller employers offering workplace wellness activities; developing a workplace wellness materials (language) translation center; and, urging WA’s congressional delegation to push for faster implementation of federal health reform provisions that support workplace wellness programs.

Some beneficial changes could happen at the internal level. One simple change involves re-considering food and beverages served at meetings. The CDC has these suggestions for offering healthier foods. Another element to consider is shifting how food is presented in cafeterias. The New York Times recently had an interesting interactive graphic of how this could work. (The example is for a school lunch line but could be adapted.) Grocers and other retailers have long known that shelf location is an important element in marketing and consumer choice. Advocates of this approach call for a level playing field for healthy foods.

The Healthiest Communities Partnership (HCP) is a state-wide private-public effort to identify and promote public policies in workplace wellness and other areas. HCP hopes to make healthy choices the easy choices. For more information on HCP, click here.

Workplace Wellness 101

By Greg Cook, HCP Associate

Do workplace wellness programs work? Are they worth the investment by employers? Do employees make full use of them? And what are the goals of workplace wellness? These are the questions U.S. employers, unions, policy makers and public health researchers are asking. Thankfully, there are answers based on solid evidence and rigorous study.

A benchmark for this field is the Health Affairs study published in January of this year. (For a link to an abstract of that article click here.) The authors surveyed published studies in the field and came to this conclusion: “medical costs fall by about $3.27 for every dollar spent on wellness programs and that absenteeism costs fall by about $2.73 for every dollar spent.” They do caution that “[a]lthough further exploration of the mechanisms at work and broader applicability of the findings is needed, this return on investment suggests that the wider adoption of such programs could prove beneficial for budgets and productivity as well as health outcomes.” This is the kind of bottom-line proof hard-pressed employers need in order to make decisions that will not hurt their finances and benefit their greatest resource—their employees. Workplace wellness programs are also good news for the field of public health. Researchers in Washington state have laid out the case for such programs as beneficial to both employer and employee and an important part of overall public health strategy.

However, evidence also provides another truth about workplace wellness programs: They need to be targeted and they need to be implemented with thought and attention to the needs of the employer, workplace, and workforce. A study sponsored by the non-profit National Institute for Health Care Reform (NIHCR) shows that there are better and worse examples of implementing these programs. (NIHCR is a joint effort of auto-makers and unions; to see the study click here.)

The broader business community has already done work in this area. For instance, the U.S. Workplace Wellness Alliance—co-chaired by the U.S. Chamber of Commerce and the Partnership for Prevention—has formulated proposed policies based on scientific research and the needs of businesses. (For a link to USWWA’s website click here.) The Healthiest Community Partnership (HCP) is beginning this work in Washington. HCP is a public-private partnership committed to policies to roll back chronic disease often connected to smoking, nutrition, and lack of healthy physical activity. For more information on HCP, its members, and its goals, click here.

References:

Baicker, Katherine, Cutler, David, & Song, Zirui. (2010, Jan. 14). Workplace wellness programs can generate savings. Health Affairs. Accessed on 11/15/2010 at http://content.healthaffairs.org/cgi/content/abstract/hlthaff.2009.0626v1.

Harris JR, Lichiello PA, Hannon PA. Workplace health promotion in Washington State. Prev Chronic Dis2009;6(1). http://www.cdc.gov/pcd/issues/2009/jan/07_0276.htm. Accessed 11/15/2010.

Tu, Ha T., & Mayrell, Ralph C. (2010). Employer wellness initiatives grow, but effectivenessvaries widely. Accessed at http://www.nihcr.org/Employer-Wellness-Initiatives.html on 11/15/2010.

U.S. Workplace Wellness Alliance. The business case for investing in worksite health promotion. Accessed at http://www.uswwa.org/portal/uswwa/case/default on 11/15/2010.

Private, Public Agree on Benefits of More Fresh, Local Food

By Greg Cook, WHF Associate

This October grocery giant Wal-Mart Stores announced a comprehensive plan to bring more locally-produced foods into is supply chain and on its shelves. Wal-Mart’s position is that this move will help food producers around the world and offer fresh foods to more people. As part of the move, Wal-Mart will provide a “sustainability index” for consumers to use to help make choices between similar products. This plan is one more endorsement of thinking about health, nutrition, and local food producers, with the added feature of “scaleability,” meaning that, due to Wal-mart’s ability to manage its procurement and supply on a vast scale, locally-gown foods may become available to a wider population. Critics of the growing local food movement have pointed to distribution and marketing difficulties, but Wal-Mart’s new emphasis in this area could be a game-changer. As “the world’s largest grocer” (according to The New York Times), Wal-Mart’s commitment to buying and selling locally-grown food and investing in growers sends an unmistakable signal to others in the grocery sector.

Wal-Mart’s new focus could bolster efforts in Washington to promote agriculture across the state and offer healthier choices to our state’s residents. This state is fortunate to have The Access to Healthy Food Coalition, a group of private and public partners looking at how food gets to people and how that process can be improved, as well as improving the quality of food while also supporting Washington farmers. Earlier this year, the coalition issued a report on the subject: Opportunities for Increasing Access to Healthy Foods in Washington (click here for a link to that report). This report attempts to show many of the ways healthy food makes its way onto the plates of Washingtonians.

When private and public forces connect to overcome barriers and increase the supply of healthy local foods, families, businesses, and institutions can then work on ways to make healthy choices (such as selecting nutritious foods) the easy choices. That is a cornerstone of the Healthiest Communities Partnership’s (HCP) approach. HCP is a private-public partnership bringing together businesses, philanthropies, non-profits, community groups, and government to craft policies fighting back against chronic diseases and making Washington a healthier state. For more information on HCP, click here.

Community Members Volunteer to Get Kids Excited About Fitness

By Greg Cook, WHF Associate

For children, the journey to fitness begins at home but continues at school. And for some Seattle kids, that means walking to and from school. Kids in the Phinney Ridge area have been joining together since 2005 to make the trip to school as part of a “walking school bus.” This effort relies on parent volunteers to ensure everything runs smoothly. Participants say they enjoy the exercise and interacting with others as well as getting exercise. The lack of exercise and corresponding decline in the health of many school-age children has worried observers in the health care sector, business, and even the military. According to The New York Times, a panel of retired military officers reports that an alarmingly high number of armed forces recruits fail basic physical fitness tests.

Thankfully, the message that our children need better exercise and nutrition habits is being heard across Washington state. In Pierce County’s Edgewood, for instance, students at one school participate in a voluntary fitness program with lessons about good nutrition. Program founder Ladd Wolfe says that he sees many of the participating children go on to keep up their healthy habits. The U.S. Department of Health and Human Services (HHS) has published a guide entitled “Promoting Physical Activity and Healthy Nutrition in Afterschool Settings” with strategies and suggestions “to reverse childhood obesity trends by promoting healthy lifestyles for children and youth.”

The Washington Health Foundation’s Healthiest Communities Partnership (HCP) applauds these efforts as a solid first step to roll back the spread of chronic diseases in our state’s communities. HCP is a public-private partnership seeking to promote policies that will contribute to making our state the healthiest state in the nation. Policy advocates from business, health care, philanthropies, and non-profits, together with the Washington State Department of Health, will be convening to shape an action agenda to help our children, our workforce, and our families and communities in the fight against chronic diseases. For more information on HCP and this effort, click here.

Public Procurement of Food and Healthy Communities

By Greg Cook

Public purchasing by institutions such as schools and hospitals is big business. It is also a crucial part of strategies to roll back increasing levels of chronic diseases.

Leaders from both the public and private sectors have begun to consider the role public procurement of food plays in nutritional health among populations of students and others fed through publicly-funded means. The Kaiser Permanente Institute for Health Policy (IHP) puts it this way: “The food system is a key pathway to individual, public and global health—above and beyond basic nutrition.” Re-assessing the procurement process can have many benefits, including improved nutrition for consumers, reduction of public health scares involving pathogens such as salmonella, decreased pollution, and a decrease in health inequalities for at-risk populations and minorities.

Companies in the private sector are showing some ways in which procurement can be re-thought. Walmart has been making efforts to purchase more locally-sourced and organic foods. Chipotle Mexican Grill is guided by its corporate philosophy of “food with integrity” in reaching outside the existing supply chain to buy humanely-raised and drug-free meats.

There is also movement in the public sector. Washington State has instituted a farm-to-school food program that encourages schools to purchase food from nearby producers. Another aspect of this program is a set of pilot projects at state prisons to serve food grown by inmates.

Current issues of procurement arise, ironically, from past success in standardizing and efficiency. The massive scale of much procurement has led to small and/or local suppliers being shut out of the process. The growth of huge supply chains has also interacted with fluctuating transportation costs.

The Healthiest State Campaign and the Washington State Department of Health are working to bring together concerned private and public advocates from business, philanthropies, non-profits, and government to talk about ways to improve the public procurement process and work on other issues. This Healthiest Communities Partnership seeks to enlist interested partners from throughout the state to make our state a healthier state and our communities healthier places to live, raise families, and do business.

For more information on the Healthiest Communities Partnership click here.