Workplace programs, policies and environmental supports to prevent cardiovascular disease
Ninety-nine percent of the U.S. population has at least one of seven cardiovascular health risks: high blood pressure, high total cholesterol, high blood glucose, unhealthy body mass index (BMI), tobacco use, physical inactivity, or poor diet. The combined contribution of these risk factors increases employer medical spending by 213 percent per person per year.
“Organizations need to assess their heart health programs, policies and environmental supports to reduce health risk factors for cardiovascular disease, lower the prevalence of the illness, and reduce medical expenditures,” said Ron Z. Goetzel, Ph.D., vice president of consulting and applied research at Truven Health Analytics, an IBM Company.
The American Heart Association (AHA) offers the Workplace Health Achievement Index (WHAI) to help organizations perform these assessments. Last year we connected organizational WHAI measures to individual employee medical, drug and health risk data housed in the Truven Health MarketScan® multi-employer database, and together we analyzed the data.
Results from the study
Twenty large employers participated in this study to assess the association between organizational health and measures of cardiovascular health risks, disease prevalence and medical costs. Some results of the study included:
- One fifth of employees have cardiovascular disease, with an average per member per year spending of 9 for the disease
- The most common health risk for these workers was unhealthy weight (72% prevalence), followed by poor diet (71%) and high blood pressure (66%)
- The least common health risk was tobacco use (5.5%), which was substantially lower than that for the U.S. adult population (16.8%)
- A higher WHAI score was associated with lower prevalence of four modifiable health risk factors: high blood pressure, high cholesterol, tobacco use, and physical inactivity
- WHAI scores were not correlated with high blood glucose and unhealthy weight, but were positively correlated with poor diet
- A higher WHAI score was associated with lower cardiovascular disease prevalence but higher cardiovascular disease spending, a result meriting further study
Though there is no clear pattern as to which organizational health factors are associated with better outcomes, we encourage employers to participate in the next wave of multi-employer studies that aims to look at trends in organizational programs, policies and environment, and how these support a healthy lifestyle among workers[SE1] [GRZ2] .
What can employers do with these results?
- Employers can act now! There is no need to wait for more research before implementing evidence-based health promotion programs proven to positively influence employee health and well-being.
- When implementing a program, remember to always measure and evaluate. This can be done by designing “dashboards” that track key program structure, process and outcome measures for the organization.
- Finally, employers can experiment with different health promotion strategies at different business units/locations and track the effectiveness of alternative models.
Dr. Goetzel presented the study findings at a briefing event sponsored by Health Affairs on Tuesday, February 7, 2017 at the National Press Club in Washington, DC. For more information, click
 Ford ES, Greenlund KJ, Hong Y. Ideal cardiovascular health and mortality from all causes and diseases of the circulatory system among adults in the United States. Circulation. 2012;125:987-995.
 Goetzel RZ, Pei X, Tabrizi MJ, Henke RM, Kowlessar N, Nelson CF, et al. Ten modifiable health risk factors are linked to more than one-fifth of employer-employee health care spending. Health Aff (Millwood). 2012;31(11):2474-84