Category Archives: Workforce issues
The Bipartisan Policy Center (BPC) in Washington, D.C., and nine CEOs from leading U.S. companies issued a report yesterday that lays out their ideas for improving individual and community health while reducing health care costs. The report, Building Better Health: Innovative Strategies from America's Business Leaders, shares strategies from all the companies and makes several recommendations:
- Implement and track the outcomes of corporate health and wellness programs
- Collaborate on the implementation of community-based programs
- Improve the health care system by supporting the movement toward transparency and payment and delivery models that are based on outcomes rather than on volume
The CEOs are members of the BPC’s CEO Council and collectively employ more than one million people and provide coverage for over 150 million people. Council participants include McKinsey & Company, Aetna, Johnson & Johnson, The Coca-Cola Company, Verizon Communications, Bank of America, Blue Cross Blue Shield Association and Walgreens Co.
In addition to the report, the council released an interactive website with examples of initiatives the companies have taken to improve individual and community health. Some examples also improve the corporations’ bottom lines, such as Verizon’s partnerships with university research centers to test wireless health monitors that individuals or companies can download and buy through the technology company. However, David Erickson, director of the Center for Community Development Investments at the Federal Reserve Bank of San Francisco, points out that no for-profit company can afford the investments required for improving public health without also being able to see an impact on their own bottom line. Examples include increased sales and greater efficiencies in delivering health care.
For example, Walgreens has increased its share of flu shots given from fewer than one million in 2009 to more than seven million in 2013. While that represents improved income for the company, Walgreens—which has stores within three miles of 63 percent of Americans, 75 percent of African-Americans and 78 percent of Latinos—has also worked with state and federal health officials to publicize and increase immunization initiatives. It has also worked with many third-party payers so that patients are often fully or largely covered for the vaccines, with little or no copayment required. Retail clinics such as those at many Walgreen stores also often improve on current health care delivery, such as being open 365 days a year, unlike most doctors’ offices.
The first federal minimum wage was set in 1938 by the U.S. Fair Labor Standards Act. It was 25 cents per hour. Twenty-two subsequent increases now put the wage at $7.25—that equates to about $15,000 per year for a person who works a standard 40-hour workweek.
A new interactive dataset from Public Health Law Research (PHLR) enables researchers, policymakers, media and others to track these and other changes in both the federal and state minimum wages. PHLR is a national program of the Robert Wood Johnson Foundation and Temple University dedicated to building the evidence base for laws that improve public health
“By tracking the changes to the rates and the law’s characteristics over time, we have laid the ground work for researchers and others to study the effects of minimum wage laws on many factors, such as housing, education, and health and well-being,” said Sarah Happy, JD, the PHLR program’s Director of Policy Surveillance, in a release.
Why does income impact health? A good paying job makes it easier for workers to live in healthier neighborhoods, provide quality education for their children, secure child care services and buy more nutritious food—all of which affect health.
Among the facts and trends revealed by the interactive dataset:
- Forty-five states and Washington, D.C., have minimum wage laws. The only states that do not are Alabama, Louisiana, Mississippi, South Carolina and Tennessee.
- In many states, the recent trend has been to increase the minimum wage above the federal rate and adjust it yearly for inflation. Currently, Washington, D.C., has the highest state minimum wage rate at $9.50 an hour.
- Arkansas, Georgia, Minnesota and Wyoming all have lower minimum wages than the federal wage, meaning their residents would receive the federal minimum, in most cases.
- Alaska and Connecticut are the only two states that have had a minimum wage consistently higher than the federal minimum wage rate since 1980.
PHLR’s “Minimum Wage Laws Map joins more than 25 other maps on the PHLR LawAtlas.org website tracking laws across states and over time in more than ten public health issue areas, including chronic disease; injury and violence prevention; and environmental health.
>>Read more on the impact of income and jobs on health.
Beginning later next year, more than a million workers in New York City will have a brand new, health-promoting benefit: paid sick leave days that guarantee wages on a set number of days when they or a family member they care for is ill.
The new law, passed last June by the New York City Council and overriding an earlier veto by the mayor, begins to go into effect in April 2014. New York now joins San Francisco, Calif., Washington, D.C., Seattle, Wash., Portland, Ore., and the state of Connecticut in adopting at least some sick leave provisions.
Not every employee in New York City will get paid sick leave under the new law. The bill that passed the City Council initially applies only to businesses with 20 or more employees, who will be required to provide five paid sick days a year; that extends to companies with 15 or more employees beginning October 1, 2015. Smaller businesses and manufacturing firms are exempt from the paid leave provisions for now, though these workers will gain five days of unpaid sick leave, so they can take time off without fear of losing their jobs. Advocates hope to extend paid leave to cover those workers before long.
Advocates say paid sick leave is critical for smaller businesses, and especially for low wage earners. A survey by the Community Service Society (CSS) of New York found that half of low-income respondents said they have less than $500 to fall back on in case of an emergency, and according to CSS, without compensation for sick days, people are often forced to choose between caring for themselves or a loved one and heading to work.
A 2012 study in the American Journal of Public Health shows why the measure that is critical to individuals and families is equally crucial to society as a whole. The study found that lack of certain workplace policies, including paid sick leave, led to an additional 5 million cases of adult H1N1 (swine flu) during the 2009 outbreak.
Funding for much of CSS’s advocacy came through a County Health Rankings & Roadmaps grant to focus on four areas in two New York City boroughs, the Bronx and Brooklyn, that have very poor health rankings. The goal was to build support among small businesses, faith-based organizations and low-wage workers for passage of the ordinance through grassroots events, town halls, story collection and media coverage, as well as by encouraging partners and allies to include this policy as part of their policy agendas. The grant runs through November 2014 and CSS will be focusing its efforts, now that legislation has passed, on creating awareness and implementation of the new law.
NewPublicHealth recently spoke with Nancy Rankin, vice president for policy, research and advocacy at CSS about the new law and its impact.
NewPublicHealth: Key components of the legislation you advocated for passed. What’s next in your efforts on paid sick leave?
Nancy Rankin: We are continuing to work on this issue because we recognize that having a law pass is not the end of the story. We now need to do outreach to inform workers about their new rights and employers about their new requirements, because a new law requires compliance and it requires people to be aware of its provisions.
Economic constraints cause many Latinos to settle in low-income neighborhoods that have limited access to affordable healthy food options, playgrounds and parks, and pedestrian and bike-friendly streets. Instead, these neighborhoods have fast food restaurants that offer primarily nutrient poor food and, limited resources for recreation which limit physical activity options.
“Latinos will tell you it’s too hard to get fruits and vegetables,” Said Dr. George R. Flores, MD, MPH, Board of Directors, Latino Coalition for a Healthy California at APHA 2012. “Inequality in the social and physical environments in Latino communities contributes to the obesity epidemic by failing to provide opportunities for healthy eating and physical activity.”
Latino populations on average have some of the highest rates of obesity, which can have the severe consequence of type 2 diabetes. The diets of Latino children are higher in fat and lower in fruits and vegetables.
Late last year, NewPublicHealth spoke with Marc Freedman, MBA, CEO and Founder of Civic Ventures, about the “encore career movement”—a new stage of life and work that combines necessary continued income with new meaning and a chance to create social change. “One of the real challenges from people moving into this period is how you get from what’s last to what’s next. A lot of people are being discouraged, especially in this economy, when they are spending time and money to find themselves in these do-it-yourself ventures,” said Freedman. “We’re interested in trying to create better pathways for people in something that’s really distinct from retirement and the stage of work.”
To that end, Civic Ventures partnered with Intel to pilot the Encore Fellowship program, which provides paid, part-time, yearlong assignments working at local nonprofits, and is open to all Intel employees who are eligible for retirement. NewPublicHealth recently spoke with Amber Wiseley, U.S. Retirement Benefits Program Manager, and Julee Weller, U.S. Health Benefits Program Manager, both at Intel, to find out more about the Encore program, as well as the company’s broader approach to employee health and wellness.
NewPublicHealth: What is Intel’s overall approach to health and wellness for employees?
Julee Weller: Intel is strongly committed to developing a culture where employees and their families are healthy, productive, and engaged in living wellness-oriented lifestyles every day.
Intel has developed a portfolio of health benefit plans and wellness programs designed to encourage employees to evaluate, improve, and maintain their health and the health of their families. Intel’s award-winning wellness program, Health for Life, is designed to inspire and motivate employees to take action toward achieving their best possible health and quality of life. The program includes onsite primary care (providing employees convenient access to quality care at low cost), onsite biometrics, annual health assessments, fitness programs, wellness seminars, flu prevention, and personalized wellness coaching.
NPH: Have you seen increased productivity or other business or economic benefits from your wellness efforts?
David Michaels, PhD, MPH, Assistant Secretary of Labor for the Occupational Safety and Health Administration (OSHA), and a former Robert Wood Johnson Foundation health policy fellow, addressed the APHA annual meeting at the closing session today, focusing on workplace injuries and making workplaces safer and healthier. NewPublicHealth caught up with Dr. Michaels to talk about workplace safety successes and a look idea to what's on tap for the agency.
NewPublicHealth: What’s the critical issue for OSHA?
Dr. Michaels: Workplace injury rates have fallen but they’re still far too high. We’re down to twelve deaths a day but still twelve deaths are too many. And so, we are focusing our activities in ways to have a very broad impact and to reduce injuries, illnesses and fatalities across the board, and the way to do that is to encourage employers to develop injury and illness prevention programs, to assess the hazards in the workplace and fix them. In other words, we’re saying employers should really go past simply compliance with OSHA standards to taking a more systemic view of their workplace. We know that that’s successful. There are thousands of companies around the country that are doing this now as part of OSHA voluntary program and they will tell you that these programs not only reduce injuries but they save money.
NPH: Do you have any successes you can point to already?
A recent article in the journal PLoS One noted a rare downside to gainful employment—jobs requiring moderate physical activity accounted for 50 percent of the labor market in 1960, but have fallen since then to just 20 percent of the total. The article’s authors say the remaining 80 percent of jobs are either sedentary ones or only require light physical activity, and that the reduced activity is a factor in the rise in obesity in the U.S. in the last five decades.
NewPublicHealth spoke with Andrew Webber, president and C.E.O. of the National Business Coalition on Health, about the study findings and opportunities to increase physical activity, and other healthy behaviors, among U.S. workers and the general population. NBCH is a national membership organization of purchaser-led health care coalitions.
NewPublicHealth: Recent research about the link between a decline in jobs requiring physical activity and weight gain in the U.S. in the last five decades seems quite dramatic. What should businesses be doing to help reverse the trend?
Andrew Webber: First of all, we’re in the middle of an obesity epidemic in this country and it’s not just the working population. We’re increasing in weight gain everywhere across the board. And there are a lot of reasons for that increase. A great deal of research has indicated that the conditions, both at the workplace and in the community, are not conducive to people losing weight--from lack of physical activity opportunities to individual behaviors to challenges in purchasing healthy food in many communities. There are a lot of reasons why we have this obesity epidemic and of course it is a precursor for the tsunami of chronic conditions in this country.
From an employer perspective, we have a huge interest--a business imperative--to be investing in the health and productivity of our workforce. And not just because we have a moral or social responsibility, but because the health and productivity of our workforce is a competitive asset. It’s the key to our bottom line. We need healthy, productive workers who can do their work. A responsibility--a business imperative for the business community--is investing in their human capital and improving the health and productivity of their workforce as a bottom line issue.
NPH: Do you think that businesses have a social responsibility to go beyond their employees and to help make communities healthier?
Andrew Webber: The answer is yes. I think employers have a responsibility to think about the influence of community dynamics on influencing the health and productivity of their workforce. The simple fact is an employer can do a wonderful job within the four corners of their work site in terms of building a culture of health. But then often individual employees walk, after their eight hours of work, into very unhealthy communities with no safe streets, with fast food restaurants on every corner, with no investments in local parks and recreation and sidewalks. Employers need to understand that the community influence can compromise their investments in workforce health. I think the employer community needs to be thinking about their contribution to improving population health at a community level as well.