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An underlying premise of the Affordable Care Act provisions that encourage employers to adopt health promotion programs is an association between workers' modifiable health risks and increased health care costs. Employers, consultants, and vendors have cited risk-cost estimates developed in the 1990s and wondered whether they still hold true. Examining ten of these common health risk factors in a working population, we found that similar relationships between such risks and total medical costs documented in a widely cited study published in 1998 still hold. Based on our sample of 92,486 employees at seven organizations over an average of three years, $82,072,456, or 22.4 percent, of the $366,373,301 spent annually by the seven employers and their employees in the study was attributed to the ten risk factors studied. This amount was similar to almost a quarter of spending linked to risk factors (24.9 percent) in the 1998 study. High risk for depression remained most strongly associated with increased per capita annual medical spending (48 percent, or $2,184, higher). High blood glucose, high blood pressure, and obesity were strongly related to increased health care costs (31.8 percent, 31.6 percent, and 27.4 percent higher, respectively), as were tobacco use, physical inactivity, and high stress. These findings indicate ongoing opportunities for well-designed and properly targeted employer-sponsored health promotion programs to produce substantial savings. [PUBLICATION ABSTRACT]

OBJECTIVE:To assess the evidence regarding the economic impact of worker health promotion programs. OBJECTIVE:Peer-reviewed research articles were identified from a database search. Included articles were published between January 2000 and May 2010, described a study conducted in the United States that used an experimental or quasi-experimental study design and analyzed medical, pharmacy (direct), and/or work productivity (indirect) costs. A multidisciplinary review team, following specific criteria, assessed research quality. RESULTS:Of 2030 retrieved articles, 44 met study inclusion criteria. Of these, 10 were of sufficient quality to be considered evidentiary. Only three analyzed direct and indirect costs. CONCLUSIONS:Evidence regarding economic impact is limited and inconsistent. Higher-quality research is needed to demonstrate the value of specific programs.

When the OSH Act of 1970 was passed, Congress created the Occupational Safety and Health Administration (OSHA) to ensure safe and healthful working conditions for employees. OSHA did so by setting and enforcing standards and by providing training, outreach, and education.Early standard setting was aggressive and ambitious, with the incorporation of industry consensus standards and the promulgation of new standards. OSHA's standard setting and enforcement sparked increased membership in safety and health professional organizations, which in turn led to strong demand for obtaining safety or health certification. Additionally, this growth drove the development of a wide variety of safety and health products, in effect creating a new market. Vendors used OSHA standards and enforcement to motivate sales.

OBJECTIVE:To determine the ability of the Health Enhancement Research Organization (HERO) Scorecard to predict changes in health care expenditures. METHODS:Individual employee health care insurance claims data for 33 organizations completing the HERO Scorecard from 2009 to 2011 were linked to employer responses to the Scorecard. Organizations were dichotomized into “high” versus “low” scoring groups and health care cost trends were compared. A secondary analysis examined the toolʼs ability to predict health risk trends. RESULTS:“High” scorers experienced significant reductions in inflation-adjusted health care costs (averaging an annual trend of −1.6% over 3 years) compared with “low” scorers whose cost trend remained stable. The risk analysis was inconclusive because of the small number of employers scoring “low.” CONCLUSIONS:The HERO Scorecard predicts health care cost trends among employers. More research is needed to determine how well it predicts health risk trends for employees.

OBJECTIVE:The research objective was to test the hypothesis that corporate health and wellness contributed positively to South African companies’ financial results. METHODS:The past share market performance of eligible healthy companies, based on Discoveryʼs Healthy Company Index, was tracked under three investment scenarios and compared with the market performance on the basis of the JSE FTSE All Share Index. RESULTS:The evidence supports the hypothesis that a culture of health and wellness provides a financial advantage, in so far as the portfolio of healthy companies consistently outperformed the market over the selected simulations. CONCLUSIONS:Given the limitations of the investigation, namely small sample size, the brevity of the period of investigation, and the reliance on accessibility sampling, the research provides the first and preliminary evidence supportive of the direct financial benefits of companies’ wellness programs.

Background: Occupational safety and health issues are closely associated with the wellbeing and survival of every worker and family, as well as of society as a whole. It is a type of typical public issue and requires cooperative governance among different governing subjects. Methods: According to the questionnaire investigation on 2179 subjects with different identities, the research explored the willingness to pay (WTP) for occupational safety and health and the degree of attention, with different identities, through the difference analysis and descriptive statistical analysis. The research studied the relationship between public attention and WTP through the methods of cross-analysis, correlation analysis, and regression analysis. Results: (1) The public show a disregard attitude to occupational safety and health. (2) The public expect the government to fund and solve occupational safety and health problems rather than for themselves to pay directly. (3) Over 50% of questionnaire respondents defined occupational safety and health problems as being classified into two categories, namely, “no attention—government payment” or “no attention—refusal of individual payment”, according to the analysis. (4) The level of attention paid to occupational safety and health can significantly predict the individual income WTP, item WTP, subject WTP, and event WTP. Conclusions: This research aimed to outline the implications for the governance of occupational safety and health.

OBJECTIVE:The objective of this study is to evaluate effectiveness of a firmʼs 5-year strategy toward improving well-being while lowering health care costs amidst adoption of a Consumer-Driven Health Plan. METHODS:Repeated measures statistical models were employed to test and quantify association between key demographic factors, employment type, year, individual well-being, and outcomes of health care costs, obesity, smoking, absence, and performance. RESULTS:Average individual well-being trended upward by 13.5% over 5 years, monthly allowed amount health care costs declined 5.2% on average per person per year, and obesity and smoking rates declined by 4.8 and 9.7%, respectively, on average each year. The results show that individual well-being was significantly associated with each outcome and in the expected direction. CONCLUSIONS:The firmʼs strategy was successful in driving statistically significant, longitudinal well-being, biometric and productivity improvements, and health care cost reduction.

OBJECTIVE:The aim of this study was to determine the impact of a targeted, personalized wellness program on reducing employees’ future risk of metabolic syndrome. METHODS:Aetna piloted a year-long program that included a limited genetic profile, a traditional psychosocial assessment, and high-intensity coaching in a randomized controlled study of Aetna employees with an increased risk for metabolic syndrome. RESULTS:Sustained employee engagement of 50% over the course of 1 year; 76% of participating employees lost an average of 10 pounds (4.5 kg) (P < 0.001 vs baseline weight), and there were trends in improved clinical outcomes relative to three of five metabolic factors. Average health care costs were reduced by $122 per participant per month, resulting in a positive return on investment in the programʼs first year. CONCLUSIONS:At scale, such programs would be expected to lead to significant downstream reduction in major clinical events and costs.

The review aimed to synthesise recent evidence on health service use and health outcomes among international migrant workers, compared with non-migrant workers. A search was carried out in MEDLINE, PubMed, Embase, and CINAHL for studies published between Jan 1, 2010, and Feb 29, 2020. Included outcomes were: occupational health service use, fatal occupational injury, HIV, and depression. Two authors independently screened records, extracted data, assessed risk of bias and judged quality of evidence. We meta-analysed estimates and conducted subgroup analyses by sex, geographical origin, geographical destination, and regularity of migration. Twenty-one studies were included comprising >17 million participants in 16 countries. Most studies investigated regular migrant workers in high-income destination countries. Compared with non-migrant workers, migrant workers were less likely to use health services (relative risk 0·55, 95% confidence interval 0·41 to 0·73, 4 studies, 3,804,131 participants, I2 100%, low quality of evidence). They more commonly had occupational injuries (1·27, 95% confidence interval 1·11 to 1·45, 7 studies, 17,100,626 participants, I2 96%, low quality of evidence). Relative risks differed by geographical origin and/or destination. There is uncertainty (very low quality of evidence) about occupational health service use (0 studies), fatal occupational injuries (5 studies, N = 14,210,820), HIV (3 studies, N = 13,775), and depression (2 studies, N = 7,512). Migrant workers may be less likely than non-migrant workers to use health services and more likely to have occupational injuries. More research is required on migrant workers from and in low- and middle-income countries, across migration stages, migrating irregularly, and in the informal economy.

In order to study the relationship between China's safety production indicators and economic and social indicators, the development trend of indicator data in the past 20 years was statistically analyzed, and qualitative and quantitative research was conducted using grey relational analysis and multiple linear regression analysis methods. In the past two decades, there has been a significant improvement in the number of deaths, work-related injuries, and occupational patients in China's safety production, and the country's three categories of 14 economic and social indicators have achieved rapid development. Using the grey relation analysis method, the grey correlation degree between the number of deaths, work-related injuries, and occupational patients in China over the past twenty years and 14 economic and social indicators was obtained. The ranking of economic and social indicators that affect the number of deaths, work-related injuries, and occupational patients varies greatly. A multiple linear regression model was established for the number of deaths, work-related injuries, occupational diseases, and 14 economic and social indicators. The rationality of the model was verified from four aspects: R 2 , F-value, P-value, and deviation between actual and fitted values. Provide guidance for the development of safety production indicators and economic and social indicators in China through research.