Early in my career, I had gotten a job that I was really excited about. It was a gap in my career that I wanted to fill and I had filled it in with a reputable company that was going to be able— I thought— to give me the experience that I was looking for. Right away they sent me off to training at their corporate office in Chicago. It was the first time I had gone to Chicago and I was excited to be there, and I was going to be there for a whole week! This entry event was open to all the new employees who had been hired for particular positions over the last quarter. There were about 50 of us. Although I was only in Chicago for a week, I remember one thing particular about this event and it happened one afternoon.
After an all-day session at the corporate office, all of us were walking back to our hotel— all 50 of us— let’s make it clear that I was the only black person out of all 50! Everyone was excited to get to know each other and we started talking. The primary part of the conversation was about the TV show “Friends.” The people in the group went on and on about what happened in the last few episodes and what their favorite episode was, and what they thought was going to happen going forward. Even to this day I only know a handful of black people that have ever watched “Friends.” I was one of those black people who didn’t watch “Friends.” I had nothing to say. I tried early on in the conversation by asking if anybody had ever seen “Martin.” No one had; but they knew it was a black show, I guess. No one seemed to care to ask me any questions about it. So, I sat through the conversations about “Friends” waiting for an opportunity to find a topic that we could all connect on. We talked about the schools we had gone to, what we have majored in, and where we lived. Basically, just making conversation.
The next part of the conversation, as we were getting closer to the hotel, was about where and what we were going to do that evening. What bar and club were we going to go to that night? I didn’t know a lot about Chicago. But I did know something about the bars in the clubs that were in our area. The ones that were mentioned were the ones that were generally predominantly white. No one asked me if I had any suggestions. No one asked me if I would go. And that’s what I remember about that trip.
You might say that that’s just one incident. Yet, that experience repeated itself similarly dozens of times throughout my career. The loneliness of being “the only” sometimes just gets really difficult. But like I said, I’ve experienced it a number of times at trainings and conferences where people don’t really know each other, and within workplaces. Conversations about “common” high school experiences and songs and bands, and more sinister issues, such as when Trayvon Martin was killed —these were all equal opportunities to feel lonely.
About 6 weeks ago, many, many years after Chicago, I sat in on a Zoom call with 50 professional black women. All of them feeling some level of loneliness. Managers who didn’t know what to say to them would rather ask about how their dog was doing than to ask about them. Coworkers who just overlooked that any of this was really going on, just wanted to stick to the work script. Or the best one was the one black employee who had produced and led a TV show on diversity who then turned out to be the only person who had to work on the company’s newest holiday, Juneteenth. It was the only way that she was going to be able to get her show produced on diversity. Loneliness.
Lack of inclusion. This is one way that racism shows itself in our workplaces, isolating others and ourselves because of awkwardness, fear, etc. Lack of inclusion often shows itself as loneliness which we know is associated with a higher risk for depression, anxiety, and suicide. I invite organizational leadership to explore creating healthier workplaces.
Employee health may start with the benefits or wellbeing program. I believe it ends with us creating comfortable, inclusive, and productive workplaces that support employees and that will lead to better facilitating the company’s mission and outcomes.
Among many other activities, January is a time to review your company’s health and wellbeing strategy for the upcoming year. It’s the time I work alongside my clients to discover gaps to fix quickly and other gaps that take more in-depth planning and execution. Most often the gaps are moderate; except this year, 2021, is different. We can all agree that whatever employee health initiatives were in place in January 2020 can now use some amount of revision. I’ve seen within several organizations, that there have been significant changes to the work policies and the workforce that have a long-term impact.
This January may be a time to wrap your arms around what the heck happened and what needs to happen. Over the past several months, I’ve found three common trends that are important to note. These are health areas that have significantly impacted and have likely shown up in most of your workplaces.
Number 1: Mental Health Access
It seems like an obvious issue given all the reports that we’ve heard about lack of mental health and the emergence of a mental health crisis. In September 2020, the rate of moderate to severe anxiety peaked, with over 8 in 10 people scoring moderate to severe anxiety. So what’s stopping them from seeking care? Reasons include cost, stigma, and getting started. But let’s not overlook access.
This past year, another prevalent barrier leads to delays and loss of access—non-diverse networks. Fewer therapists who look like us have similar lifestyles or similar experiences.
This is a HUGE challenge for Black, LatinX, and LGBT people. And don’t forget about the intersections, for example, finding a therapist who is LatinX and LGBT.
Short & Long Term Solutions: Find ways to diversify your mental health offerings. It’s not the most straightforward task as many mental health providers don’t have or provide the information needed to ensure your therapist network’s diversity. You’ll need to approach this issue from different angles. These options include:
- Work with your mental health provider to contract with diverse therapists and therapy groups. It’s much easier for your health plan to contact provider groups and fulfill a contract so that there is a more diverse group of therapists available for your employees.
- Enhance your non-network benefit reimbursement so that employees and their families can more easily access a therapist that fits their needs.
- Explore adding therapy options grounded in a telehealth model that provides broader access than networks built on brick and mortar geography.
Number 2: Decreases in Early Detection
Chronic disease causes 7 out of 10 deaths. This statistic particularly applies to your employees in the 30 to 49 year age bracket and their families. What we know is that since March 2020, access to preventive care services has decreased. Some of the findings that stand out in the most recent report from the Health Care Cost Institute indicates that since the pandemic, through September 2020:
Mammograms were approximately 10 percent lower than in 2019.
Colonoscopies were down about 10-15% compared to last year.
Childhood immunizations had declined by about 23% compared to 2019.
Keep in mind that preventive care keeps minor health issues from becoming major problems. Before they spread, screenings find tumors, identifies depression before it gets out of control, and prevents hypertension from turning into a stroke.
What employer’s can do….
- Encourage employees to get their preventive health visits. Even incentivize them if you have a wellbeing incentive strategy.
- Remind employees there is no cost to them for preventive care.
- Suggest telehealth visits and/or contacting their physician to understand the procedures for in-person visits. I’ve found that doctors and dentists have very safe practices in place.
Keeping employees healthy has a benefit to both employees and employers (medical, disability, and leaves).
Number 3: More Vacation?
“All I keep hearing from employees is that they want more vacation. We’re not able to provide any more days to employees.”
I hear this comment a lot. What employees are saying is that they need to find a way to reduce their stress. Employers can help in reducing the stress and bring some ease into the workday.
Options I’ve seen work…
- Zoom-free is acceptable – Allowing employees to feel comfortable to be off-video sometimes can add some ease to their day. I like being able to see others in a video call; however, if I’m on video calls all day, every day, it can be tiring. Studies indicate that over 38% of video users experience “Zoom fatigue.” Stanford University’s Virtual Human Interaction Lab has found that “Zoom smothers you with cues, and they aren’t synchronous. It takes a physiological toll.”
- Moving meetings – turn off the camera, and everyone agrees to stand or take a walk while attending the call.
- Add an extra break and make it stress-free – This is mainly helpful for those who must be physically at the workplace. Adding another work break into the day to engage in a stress-relieving activity helps with relieving tension. It builds support for each other, particularly if you find a way to share practical exercises—two things we all need.
Please share other ways that you’ve been able to implement improvements in these areas. We’d all like to hear them. If you have any questions or would like any support in implementing new strategies in our recently evolved work world, please feel free to reach out to me, Sylvia@OpenCircles.net
What comes to your mind when you hear the term “employee health and wellness?” For me and many employers that I speak with, this term brings to mind the long history of engaging with health and wellness partners who have promised to deliver improved health to an employee population.
I can recall the large number of health and wellness solutions that were founded on good, solid health principles that, in theory, should have achieved measurable results of lower claim costs, more productive employees, and human resources looking like a star for implementing the program. Unfortunately many of us have lived through the excitement of engaging with a new vendor solution just to find that lack of engagement and poor results are what laid at the end of the rainbow.
But does it have to be that way?
I’m a believer in wellness, the healthy employee, and solid health principles. I’m also a believer in data and tracking the right things.
In some cases it may be difficult or even nearly impossible to demonstrate short-term results that would be better derived through longer term cohort analysis, statistical overviews, and years of evaluation. To that point, there is a way. They are called “Guideposts.” Guideposts are the indicators that shine within the data and can tell us whether or not we are on the right path. They are critical and particularly valuable when we’re trying to measure the health of a population.
First the Framework
First things first (as my grandmother used to tell me). We need to have a method to get at that data easily and quickly and define clear profiles of our employees.
1. Dynamic Data Dashboards are Imperative
What are your data sources for employee data? Do they include employee information and health data? I find that some organizations have access to their employee data and use it, others have access and don’t use it, and then there are many who simply do not have great access.
The only way to “get into” your employee data is to have a system that is current, easy to manipulate and accessible.
I’ve found that organizations approach this in one of two ways:
- Have dedicated talent who can incorporate the data using business intelligence software such as Tableau, or
- Engage with one of the data analytic tool vendors that will provide you with de-identified data and supportive dashboards.
Either way, we need to be able to create a system of ease and access.
2. Sub-Profiles of your Employee Populations (plural) is Key
Nearly all organizations have different groups of employees or sub-profiles. These sub-profiles can be described by age group, type of work, geographic location, medical plan enrollment, top diagnoses, etc. Understanding the different types of employee groups or sub-profiles that we have within our populations, provides an overview of “who’s here.” This is found to be a more strategic approach than simply fitting all of our employees into one big bucket instead of recognizing that each sub-profile needs a little something different.
Clear Sight in Execution
The junction of having accessible employee data and detailed sub-profiles on the employee population, makes it tremendously easy to employ a health and wellness strategy and engage the best vendors to support that strategy. In my opinion, it is the cornerstone to a successful health and wellness strategy. We can more accurately determine the problems we wish to tackle and predict the immediate and long-term results that we expect to see. Now on to the guideposts…
Guidepost #1 – Expected Health Data
This reminds me of our dynamic phone maps that tell us we should expect to see a gas station, store or favorite coffee spot, as we travel to our destination. Expected health data is very similar. We can often expect to see certain movement with specific health or employee data elements as we move forward with a new health / wellness vendor solution. What is it that we expect to change in that sub-profile once they engage with this new solution?
An example I’ve seen is a company pay for bariatric surgery to those who have both an obesity and type 2 diabetes diagnosis. The employer may not be able to track an employee’s weight loss however there is the ability to track reductions in diabetic supplies and drugs. The diabetic supplies and drugs are the guideposts. In this instance, you can see that an impact is being made and even begin to quantify that impact in your annual budgeting.
Guidepost #2 – Engagement Upticks
One of the most difficult tasks as an employer is to get employees interested and excited about a new health / wellness solution. We may have a proven communication strategy that we use or perhaps we get lucky because the moon and the stars aligned that day. At any rate, tracking upticks and attempting to define their existence is a good use of our time. I would expect that this data is tracked regularly and especially after planned communication is distributed.
I talked to an employer who had primarily been using email for communication. They switched to their internal Slack channel and engagement in their wellness program increased. Funny thing is that initially they did not even notice that was happening. Regularly reviewing this data keeps us from missing those surprises and allows us to capitalize quickly.
Guidepost #3 – Unexpected Results
Unexpected results may be the most important guidepost. What I find most fun and interesting about the unexpected results that will emerge is that they tell us 3 things:
- They tell us something about the type of employee who is really connecting with the program. Perhaps it’s a different sub-profile than we expected or it’s more sub-profiles than expected.
- They tell us that our solution produced a broader impact than expected. Those who have bariatric surgery not only reduce their usage of diabetes medication. They also reduce their usage of hypertension and hyperlipidemia medications and have fewer sick days.
- They tell us when we’re off track. Perhaps we’re looking at the wrong indicators. Or perhaps we have the wrong vendor solution or process in place. Both concerns are worth thought and discussion.
What gets measured gets improved
Data, Data, Data
An effective program requires that we look towards our guideposts while adjusting and adapting throughout the year. Data is a significant tool that helps us do that. Data gives us the info to disrupt our status quo of anemic strategies and programs and move towards real disruption leading to positive results for our employees and our organizations.
Sylvia is a strategic advisor to emerging health and wellness companies with innovative solutions for employers and their employees. With over 15 years of an unusual array of experience including working in the employer, consulting, and health plan environments, she brings a targeted approach to new solutions achieving remarkable results in the employer ecosystem.
A couple months ago I attended Disability Allyship: Advocation for Abilities, an event sponsored by Breaking.Glass. This one-day conference was focused on disabilities in the workplace and employees with disabilities. Some employees come to the workplace with a disability, others may develop a disability while working. Some have a disability that we can see, others may have a hidden disabilities.
Being a person who studies health care and its cost, I’ve paid particular attention to the cost of disability. I think sometimes we expect these costs to show up as a worker’s compensation or disability claim. Of course it does, but what about the disability that we just haven’t seen yet. The type that develops from too much sitting, too much typing, and too much stress. Essentially all the challenges that are often put upon our employees everyday.
Years ago, early in my work career, I began to develop pain in my left elbow. The pain was related to all the typing and computer work that I was doing. My elbow would be sore and swollen and I would keep working. I sought the help of doctors who suggested surgery (which I was not interested in pursuing) or simply reducing the amount of work I did (again I wasn’t interested), or begin to lean on alternative support such as voice dictation. The way I chose to NOT help myself at work was by NOT raising my hand to ask for an accommodation such as voice dictation software or a more comfortable desk set-up. I chose instead, to avoid any hint that I may be on the brink of filing a worker’s compensation claim or too weak to do my job. I’d spend my spare time roaming around the office looking for more comfortable chairs that weren’t being used or making a makeshift sit / stand desk out of books and boxes.
Lucky for me after years of just dealing with this pain I connected with a chiropractor and acupuncturist that fixed my elbow within a relatively short period of time. I was lucky.
Recently I met Michelle who was not quite as lucky. Michelle worked for years and spent many hours on the computer. She was a “go-getter” and loved the work that she was doing. As a result, she worked despite the pain in her arms, wrists, and neck until finally, one day, her arms and fingers completely froze up and she was unable to type another letter! This sent Michelle on a long journey of worker’s compensation, surgeries, disability, and depression.
She eventually was able to work again, with accommodations, which then sent her on a new journey of learning to engage with potential employers when you have a hidden disability. All of this being complicated by her own and other’s opinions and insecurities related to hiring people with disabilities.
So where do the hidden disabilities reside in our populations? Are we seeing them in our healthcare data? Are we noticing them before they become disabilities? What about depression, anxiety, back issues, wrists problems? Do we have policies and the culture in place to make it easy for our employees to ask for help?
- 10% of Americans have a medical condition which could be considered a hidden disability.
- 96% of people with chronic medical conditions live with a condition that is hidden.
- 25% of them have some type of activity limitation, ranging from mild to severe.
The cost to an employer for a disability accommodation averages $500. The cost of a disability is much more!
If you’re looking to build a more supportive organization and more well-rounded health approach, here is list of some wonderful resources on disabilities in the workplace. Please also share your own.