Assessment of Feasibility of Workplace Health Promotion

Measurement, Health Promotion

Partenen, T. Preventive Medicine, 2002, Vol. 35, ppg. 232-240

False

A simple empirically based method for assessment of the feasibility of workplace health promotion programs is described, focusing on cancer hazards (lifestyles, workplace hazards, deficient early detection). The basic components of feasibility are addressed: extent of hazards; needs of employees for hazard reduction and acceptability of WHP; and social context. The procedure consists of six modules: guidelines on feasibility assessment; employee questionnaire; interview checklists for probing attitudes of management and partners (social context); data form; debriefing; and assessment of feasibility. Pretesting was completed in 16 workplace communities representing industry, construction, transport, telecommunications, health care, lodging and catering, teaching, and municipality jobs in five countries; a total of 1,085 subjects completed the employee questionnaire on health hazards, needs, and acceptability. The method demonstrated its utility in obtaining and summarizing the necessary data. Feasibility was assessed for the 16 test communities. The procedure can be customized; it has a high degree of face validity or understandability, and it is applicable in a wide variety of settings.

Association between the Decline in Workers' Compensation Claims and Workforce Composition and Job Characteristics in Ontario, Canada

Regression analysis, Economic models, Production methods, Safety management, Compensation claims

Breslin, F.C. et al. (2007). Association between the Decline in Workers' Compensation Claims and Workforce Composition and Job Characteristics in Ontario, Canada. American Journal of Public Health. Vol.97, Iss. 3; 453.

False

We examined associations between workforce demographics and job characteristics, grouped by industrial sector, and declines in workers' compensation claim rates in Ontario, Canada, between 1990 and 2003. Gender, age, occupation, and job tenure were predictors for claim rates in 12 industrial sectors. The decline in claims was significantly associated with a decline in the proportion of employment in occupations with high physical demands. These findings should generate interest in economic incentives and regulatory policies designed to encourage investment in safer production processes.

Association Between Wellness Score from a Health Risk Appraisal and Prospective Medical Claims Costs

Health Risk Factors, Health Care Costs

Journal of Occupational and Environmental Medicine: Volume 45(10) October 2003 pp 1049-1057 Yen, Louis PhD; McDonald, Timothy MHSA; Hirschland, David MBA; Edington, Dee W PhD

False

This study examines how wellness scores generated from the Health Risk Appraisal are associated with prospective medical claims costs, controlling for age, gender, and disease status. The study was conducted among 19,861 active employees who participated in the Health Risk Appraisal and selected indemnity or PPO medical plans from 1996 to 1998. A multiple regression model based on group averages of age, gender, disease status, and wellness score levels was developed among a randomly selected screening subsample (n = 10,172) from the study sample. Total medical claim costs of -$56, $88, and $3574 were estimated for one additional point on the wellness score, 1 year of additional age, and an existing major disease, respectively. No significant differences were found between the model predicted and actual medical claims costs for the individuals in both screening and calibration (n = 9689) subsamples.

Association of Additional Health Risks on Medical Charges and Prevalence of Diabetes within Body Mass Index Categories

Diabetes, Disease Management, Obesity, Health Risk Factors, Health Care Costs

Musich, S. et al.: American Journal of Health Promotion: January/February 2004, Vol. 18, No. 3.

False

The prevalence of obesity and diabetes continues to increase among employee populations. Although medical costs and the prevalence of diabetes have been studied across increasing body mass index (BMI) categories, little attention has been given to the association of additional health risks within those categories. The purpose of this study was to examine the association of health risk levels on medical charges and prevalence of diabetes across BMI categories within an employee population. A cross-sectional study design utilized health risk appraisal data (30% response rate) to measure BMI levels, self-reported diabetes status, and selected additional health risks amoung 38,841 active employees under age 65 of the General Motors Corporation. Associated average annual medical charges from 1996 to 2000 were calcualated for defined health risk levels across five BMI categories (<18.5; 18.5-24.9, 25-29.9, 30-34.9, and >34.9). Results showed significantly higher medical charges associated with additional health risks (zero risks to four or more risks) across each of the BMI categories: $2689 to $7576 (<18.5; $2655 to $6555 (18.5-24.9); $3239 to $7118 (25-29.9; $3579 to $7758 (30-34.9); and $4151 to $8075 (>34.9). Medical costs and the prevalence of diabetes were lower when the numbers of additional health risks were lower, regardless of the BMI category. Program to promote weight management have largely been unsuccessful in maintaining long-term weight control. The current results suggest that a strategy focused on reducing health rishs within any weight category could provide an alternative strategy to achieve medical cost savings and a lower prevalence of diabetes. The implied benefits of risk reduction within BMI categories would need to be confirmed with a longitudinal study.

Association of Asthma Control with Health Care Utilization: A Prospective Evaluation

Asthma, Program Evaluation, Disease Management

Vollmer, W.M., et. Al.: Am. J. Respir. Crit. Care Med., Volume 165, Number 2, January 2002, 195-199

False

Population-based disease management should be enhanced by good risk assessment models and instruments. We prospectively evaluated the ability of a simple measure of short-term asthma control (scored 0 to 4) to predict asthma 12-mo health care utilization (HCU). A total of 5,172 adult asthma patients completed a brief questionnaire in fall 1997 to assess current level of asthma control. We then evaluated HCU for calendar year 1998. Ninety-three percent had health plan eligibility in 1998 and were included in this analysis. Both acute and routine asthma utilization increased with increasing numbers of asthma control problems. Rates of acute care episodes were 3.5 (95% confidence interval [CI] = 2.9, 4.3) times more likely for those with 3 to 4 control problems versus those with no control problems. Lesser, but statistically significant, increases were seen for those with two (relative risk [RR] = 1.7, 95% CI = 1.4, 2.2) or one (RR = 1.4, 95% CI = 1.1, 1.8) control problems. These patterns were similar for men and women, and diminished with increasing age. The asthma control index contributed significantly to prospective prediction models even after adjusting for administrative data such as medication use and prior HCU. These data reinforce the usefulness of measures of short-term asthma control both for the individual clinician and for those interested in population-based asthma management.

Association of Health Risks With the Cost of Time Away from Work

Absenteeism

Wright DW, Beard MJ, and Edington DW. Journal of Occupational and Environmental Medicine, December 2002; 44(12): 112-1134.

False

The purpose of this study was to combine absences, short-term disability, and workers' compensation into a sum of the cost of time away from work (TAW) and compare it with health risk status and individual health risks of 6220 hourly workers at Steelcase Inc. The study used 3 years (1998 to 2000) of TAW and health risk appraisal data. Higher TAW costs were associated with illness days, drug/medication use, the individual's lower perception of physical health, job dissatisfaction, high stress, life dissatisfaction, and physical inactivity. More high-risk individuals (80.6%) had a TAW occurrence than medium- (72.8%) and low-risk (61.1%) individuals. High-risk individuals had higher TAW costs than medium- and low-risk individuals. Of the total TAW costs, 36.2 was attributed to the excess risks of the medium- and high-risk individuals or nonparticipants compared with low-risk participants. If TAW costs follow risk reduction, a potential annual savings of $1.7 million could be achieved.

Association of Healthcare Costs With Per Unit Body Mass Index Increase

Health Care Costs, Body Mass Index, Diabetes, Heart Disease

Wang, F., McDonald, T., Bender, J., Reffitt, B., Miller, A., Edington, D. Journal of Occupational and Environmental Medicine. 2006; Vol. 48: ppg. 668–674.

False

The objective of this study was to quantify the healthcare costs per unit increase in body mass index (BMI). This cross-sectional study included 35,932 employees and spouses in a manufacturing company who participated in an indemnity/PPO plan and one health risk appraisal during 2001 and 2002. Within the BMI range of 25 to 45 kg/m2, medical costs and pharmaceutical costs increased $119.7 (4%) and $82.6 (7%) per BMI unit, respectively, adjusted for age and gender. The adjusted medical costs related to diabetes and heart disease increased by $6.2 and $20.3 per BMI unit. The likelihood of having any medical claim increased 11.6% per BMI unit for diabetes and 5.2% for heart disease. Each unit increase in BMI is associated with higher healthcare costs and increased likelihood of having claims for most major diagnostic codes and for diabetes and heart diseases.

Asthma Disease Management Program

program evaluation, research design

Burton WN. Connerty CM. Schultz AB. Chen C. Edington DW. Journal of Occupation and Environmental Medicine, February 2001; 43 (2); 75-82

False

Non-occupational asthma is a common disease affecting approximately 6% of the US population. Asthma accounts for an estimated 3 million workdays lost each year in the United States and for reduced employee job productivity. Although asthma disease management programs are relatively common in managed care organizations, they generally have not been offered at the workplace. A total of 168 employees with asthma were identified, and 76 participated in a worksite asthma disease management program. Of them, 41 (53.9%) completed an Asthma Therapy Assessment Questionnaire (ATAQ) at baseline, post-program (2 months), 4 months, and 12 months. The total ATAQ Index declined from 3.59 at baseline to 2.76 at 12 months (p , 0.01). After the program, significantly more employees reported using controller medications (the desired behavior) rather than reliever medications. A worksite-based disease management program for asthma should reduce medical care costs and absenteeism and improve worker productivity. (J Occup Environ Med. 2001;43:75-82)

Asthma Disease Management: A Worksite-Based Asthma Education Program

Asthma, Disease Management, Health Care Costs, Absenteeism, Productivity

Wayne N. Burton MD ; Alyssa B. Schultz MS ; Catherine M. Connerty RN ; Chin-Yu Chen PhD ; Dee W. Edington PhD: Disease Management Volume: 4 Number: 1 Page: 3 -- 13

False

Asthma accounts for an estimated 3 million workdays lost each year in the United States in addition to reduced worker productivity. Although asthma disease management programs are relatively common in managed care organizations, they have generally not been offered at the workplace. Seventy-six employees participated in a five-session worksite-based asthma education program. A total of 47 of 76 (61.8%) employees completed baseline and 12-month follow-up Asthma Therapy Assessment Questionnaires (ATAQ). The ATAQ includes measurement of poor asthma control, behavior/attitude barriers, knowledge barriers, patient/provider communication barriers, and efficiency. Significant improvement was noted in measures of asthma control (p < 0.05), communication (p < 0.005), knowledge (p < 0.001), and the total ATAQ Index declined from 5.53 to 4.04 (p < 0.001). Employee satisfaction results for the program were exceptionally high. A worksite-based asthma education program should reduce medical care costs, worker absenteeism, and improve worker productivity. The worksite can be a very effective location for disease education programs.

Back Pain And The Integrated Health And Disability Program

Disability, Back Pain

Whitehouse, R. National Underwriter. Life & Health. Aug 7, 2006: Vol. 110; ppg. 20-21

False

The concept of integrating health and disability benefits is not new, but many employers just now are beginning to implement joint programs to reduce costs, improve health outcomes and increase worker productivity. In fact, according to a 2005 National Business Group on Health/Watson Wyatt survey, 21% of employers have merged these benefits, a 400% increase from the previous year. Back pain is a serious health concern that is taking a heavy toll on both employers and workers. When employers integrate health and disability, employees with back disorders can be referred into these programs by their case manager when they file a disability claim. How quickly an employee returns to work is a meaningful metric for evaluating the success of an integrated benefits program.

Behavioral Health Benefits: Key to a Healthy Workforce

Disease Management, Mental Wellness

McClanathan, A. Employee Benefits Journal, March 2004, Vol. 29, ppg. 11-16.

False

Mental disorders exact a heavier toll on workplace productivity than do physical illnesses, but a complete behavioral health program is often looked upon as just one more driver of rate increases. Properly understood, promoted and utilized, however, behavioral health benefits can contribute to decreased absenteeism and increased productivity, and even help offset the treatment costs of medical disorders.

Benefits at 3 yrs of an asthma education programme coupled with regular reinforcement

Asthma, Program Evaluation, Disease Management

Ignacio-García J-M.[1][2]; Pinto-Tenorio M.[1]; Chocrón-Giraldez M.J.[1]; Cabello-Rueda F.[1]; López-Cozar Gil A.I.[1]; De Ramón-Garrido E.[3]: European Respiratory Journal: 1 November 2002, vol. 20, no. 5, pp. 1095-1101(7)

False

The benefits at 3 yrs of an asthma self-management education programme coupled with educational reinforcement were assessed at follow-up visits in 63 adults with chronic asthma. Changes in asthma-related morbidity parameters, lung function and use of different classes of drugs before intervention and after 1, 2 and 3 yrs of the asthma education programme were compared using Friedman one-way analysis of variance. Improvements in the number of days off work or school, general practitioner consultations, admissions to emergency services, hospital admissions and nocturnal awakenings, as well as increases in forced expiratory volume in one second (FEV1), were significant. Comparison of data obtained at 1 yr and 2-3 yrs showed significant differences in the number of asthma-associated sleep disruptions, days off work or school and unscheduled visits to the general practitioner, as well as FEV1, but significant differences between the data obtained at 2 and 3 yrs were not observed. The percentage of patients using oral steroids had decreased significantly at 3 yrs. In adults with chronic asthma, an asthma self-management education programme coupled with educational reinforcement was effective at decreasing asthma morbidity, improving lung function and decreasing consumption of oral steroids.

Best Practices For Creating An Effective Return To-To-Work Program

Absenteeism, Disability

Mitchell, K. Compensation and Benefits Management, Summer 2002; 18(3): 34-37.

False

The financial and productivity effects of unscheduled employee absences, although seldom quantified by an individual organization, hit hard at a company's bottom line. Companies with effective absence management andreturn-to-work (RTW) programs minimize this disruption of productivity and profitability. Today's absence management programs provide employers with tools designed to strategically address return-to-work issues. One such program, at bank holding company Comerica, is examined with the broader framework of best practices in implementing an absence management program.

Better, faster, lower cost: Online benefits enrollment

Health Care Costs

Michael Prince. Business Insurance. Chicago: Jun 5, 2000. Vol. 34, Iss. 23; pg. 27, 1 pgs

False

Soon, using paper forms to enroll employees into health plans may seem as quaint as driving to work in a horse and buggy. The Internet can make the delivery of benefits "better, faster and cheaper," said Jim McAloon, a consultant with Hewitt Associates, at a conference on the Internet and health care that was sponsored by the New York Business Group on Health. By creating links to health-information Web sites, employers will enable employees to make better-informed health plan decisions.

Body Mass Index and Future Healthcare Costs:

Body Mass Index, Healthcare Costs

Thompson, D., Brown, J., Nichols, G., Elmer, P., Oster, G. Obesity Research. 2001; Vol. 9. ppg. 210–218.

False

To assess the relationship between body mass index (BMI) and future healthcare costs. We undertook a retrospective cohort study of the relationship between obesity and future healthcare costs at Kaiser Permanente Northwest Division, a large health maintenance organization in Portland, Oregon. Study subjects (n = 1286) consisted of persons who responded to a 1990 health survey that was mailed to a random sample of adult Kaiser Permanente Northwest Division members who were 35 to 64 years of age; had a BMI $ 20 kg/m2 (based on self-reported height and weight); did not smoke cigarettes; and did not have a history of coronary heart disease, stroke, human immunodeficiency virus, or cancer. Subjects were stratified according to their BMI in 1990 (20 to 24.9, 25 to 29.9, and $30 kg/m2; n = 545, 474, and 367, respectively). We then tallied their costs (in 1998 US dollars) for all inpatient care, outpatient services, and prescription drugs over a 9-year period (1990 through 1998). For persons with BMIs of 20 to 24.9 kg/m2, mean (6SE) annual costs of prescription drugs, outpatient services, inpatient care, and all medical care averaged $261 (618), $848 (659), $532 (685), and $1631 (6120), respectively, over the study period. Cost ratios (95% confidence intervals) for persons with BMIs of 25 to 29.9 kg/m2 and $30 kg/m2, respectively, were 1.37 (1.12 to 1.66) and 2.05 (1.62 to 2.55) for prescription drugs, 0.96 (0.83 to 1.13) and 1.14 (0.97 to 1.37) for outpatient services, 1.20 (0.81 to 1.86) and 1.38 (0.91 to 2.14) for inpatient care, and 1.10 (0.91 to 1.35) and 1.36 (1.11 to 1.68) for all medical care. Future healthcare costs are higher for persons who are overweight, especially those with BMIs $ 30 kg/m2.

Brokers Can Help Clients Tackle 'Presenteeism'

Presenteeism, Employee Assistance Programs

Margoshes, B. National Underwriter. Life & Health; Aug 1, 2005; Vol. 109, ppg. 16, 24

False

Presenteeism is not a new problem for employers and appears to be getting worse according to a 2004 study by the Cornell University Institute for Health and Productivity and the health information company Medstat. Presenteeism is often the result of an illness, such as migraine headaches, asthma, allergies or back pain, or can be caused by side effects, such as drowsiness, nausea or dizziness, from medications used to treat those conditions. Brokers whose customers are looking for ways to increase productivity and reduce overall health and lost time costs should advise their clients to consider the effects of presenteeism as part of an overall health and productivity program. Among the options available to help minimize the impact of presenteeism are Employee Assistance Programs. Brokers can play a key role in that effort by acknowledging the significant impact that presenteeism has on employers and their workplace and by recommending programs that focus on wellness, education and workplace accommodations.

Can Disease Management Reduce Health Care Costs By Improving Quality?

Disease Management, Health Care Costs

Fireman, B., Bartlett, J., Selby, J. Health Affairs. Nov/Dec 2004. Vol.23, Iss. 6, pg. 63, 12 pgs.

False

Disease management (DM) promises to achieve cost savings by improving the quality of care for chronic diseases. During the past decade the Permanente Medical Group in Northern California has implemented extensive DM programs. Examining quality indicators, utilization, and costs for 1996-2002 for adults with four conditions, we find evidence of substantial quality improvement but not cost savings. The causal pathway - from improved care to reduced morbidity to cost savings - has not produced sufficient savings to offset the rising costs of improved care. We conclude that the rationale for DM programs, like the rationale for any medical treatments, should rest on their effectiveness and value.

Cardiovascular disease health burden, treatment benefits and challenges: the need for partnerships

Hypertension, morbidity, mortality, costs

Mitra Boolell, MD, John Glasspool; Health & Productivity Management, Vol. 5, No. 4; December, 2006.

False

The global incidence of hypertension among adults is approximately 26% (~1 billion people). Hypertension is often called a ‘silent killer’, as it usually has no obvious symptoms and can remain undetected until complications occur. The morbidity and mortality associated with hypertension impose a substantial medical and economic burden on society and hypertension is poorly managed as many patients are either undiagnosed and/or untreated. Furthermore, of those receiving treatment, less than half achieve adequate blood pressure (BP) control. One of the main reasons for inadequate blood pressure control is poor compliance with medication, often as a result of increased pill burden. Compliance can be improved by developing fixed-dose combination (FDC) products to reduce the complexity of treatment. Novartis is committed to developing new antihypertensive therapies, including FDCs, and the initiation of innovative patient support programs, aimed at educating employers and employees about the importance of achieving BP goals in order to reduce the burden of cardiovascular disease.

Cardiovascular Risk Factor Clusters and Employment in the United States

Cardiovascular Disease, Risk Factors, Productivity

Sullivan, P., Ghushchyan, V. Value in Health. 2007: Vol. 10 (1); ppg. S52-S58.

False

The prevalence of cardiovascular disease is increasing dramatically partially because of the alarming rise in overweight/obesity, diabetes, and related cardiovascular risk factors such as hypertension and hyperlipidemia. These risk factors are often preventable and usually cluster together. The purpose of this study was to examine and quantify the impact of cardiovascular risk factor clusters (CVRFC) on employment in the United States. Using the nationally representative Medical Expenditure Panel Survey, the current research estimated the likelihood of employment and the impact on annual wages using a recursive bivariate probit model and a Heckman selection model, controlling for sociodemographic characteristics, smoking status, marital status, and geographic region. CVRFC included body mass index (BMI) ≥ 25 or BMI ≥ 30 with two of the following three: diabetes, hyperlipidemia and/or hypertension. All estimates were expressed in 2005 US dollars. Unadjusted analyses suggest that less than half of individuals with CVRFC were employed compared with 74% on average in the United States. Results of the bivariate probit analysis suggested that individuals with CVRFC were 40% (using BMI ≥ 25) and 45% (BMI ≥ 30) less likely to be employed than those without. Common CVRFC have a significant deleterious impact on employment in the United States. Employers, medical professionals, and public health programs need to address this problem and institute treatment strategies and prevention efforts to mitigate the deleterious impact on societal productivity in the United States.

Caregiving for Ill Dependents and Its Association with Employee Health Risks and Productivity

Health Risks, Productivity, Absenteeism

Burton, W. MD, Chen, C. PhD, Conti, D. PhD, Pransky, G. MD, MOccH, Edington, D. PhD, Journal of Occupational and Environmental Medicine. 2004;46:1048–1056.

False

This study examined the loss of productivity and health risk status associated with employees who provide care for an ill dependent. A total of 16,651 employees (23% response rate) of a major financial services company completed a confidential Health Risk Appraisal (HRA) that included an eight-item version of the Work Limitations Questionnaire and a self-report of time missed from work during the previous 2 weeks to care for an ill dependent. A total of 10.6% of the respondents reported an average of 7.7 hours absent from work during the previous 2-week period to provide care for an ill dependent. Caregiving also was associated with a significant increase in the number of health risks for the employee. As the demand for caregiving time increased, caregivers reported a significant increase in work limitations. Caregiving for an ill dependent is associated with increased absenteeism and significant work limitations while on the job. Programs and work organization that helps employees balance their caregiving responsibilities for ill dependents may have a positive effect on health and productivity.

Case management interviews and the return to work of disabled employees

Return to Work, Long term disability

Høgelund, J., Holmb, A. Journal of Health Economics. 2006: Vol. 25; ppg. 500–519.

False

This study measures the effect of case management interview (CMI) on 1,000 long-term sick-listed employees’ probability of returning to work. In contrast to previous studies, we use instrumental variables to correct for selection effects in CMI. Using a competing hazard rate model, we find that CMI increases the probability of returning to work for the pre-sick leave employer, but has no effect on the probability of resuming work for a new employer. We argue that CMI either motivates the sick-listed employees to resume work or adjusts for asymmetric information between the employee and the pre-sick leave employer. Høgelund, J., Holmb, A. Journal of Health Economics. 2006: Vol. 25; ppg. 500–519.

CCH Unscheduled Absence Survey 2002

Absence, stress, trends

http://www.cch.com/absenteeism/Default.htm

False

According to the latest CCH survey, conducted by Harris Interactive®, the average per-employee cost of absenteeism climbed to an all-time high of $789 per year in 2002, up from $755 in 2001, while the absenteeism rate declined slightly to 2.1 percent from 2.2 percent in 2001. The trend of most employees calling in "sick" for reasons other than physical illness continues. The survey found that while Personal Illness was the single most common reason for last-minute no-shows (33 percent), reasons other than illness account for two-thirds (67 percent) of unscheduled absences, with nearly twice as many employees taking time off for Personal Needs (21 percent) in 2002 than last year. Of significant concern to employers is how to address the non-health-related reasons that can keep workers off the job and cost large companies millions of dollars each year.

CCH Unscheduled Absence Survey 2002 - Interventions

Absence, trends, work-life, absence management

http://www.cch.com/absenteeism/Default.htm

False

Pressed for profits and heightened employee productivity, organizations are engaged in a tug of war for their employees’ time. According to the findings of the 2002 CCH Unscheduled Absence Survey, however, employers have been unable to address the persistent problem of unscheduled absenteeism. But it’s not all bad news: Through the implementation of effective policies and practices, companies can help employees balance the demands of their work and personal lives. These work-life programs can create a more flexible workplace and provide employees with resources to gain more control over their time. Best of all, work-life programs can help employees increase their individual contribution to overall business goals.

Centers for Disease control and prevention: Managing diabetes on the job

Diabetes, Disease Management

Anonymous: Business & Health: November, 2000.

False

Diabetes is becoming a larger and larger problem. Many people with diabetes face devastating consequences such as losing limbs and blindness. The article shows four ways that employers can help those with diabetes to avoid the more debilitating effects of the disease. The number one goal is to maintain regular blood sugar. Successful diabetes management programs at large companies are discussed.

Change in Health Risks and Work Productivity Over Time

Productivity, Risk Factors, Absenteeism

Pelletier, B. MS, Boles, M. PhD, and Lynch, W. PhD: Journal of Occupational and Environmental Medicine. Volume 46, No. 7, July, 2004, ppg. 746-754.

False

We sought to examine the relationship between changes in health risks and changes in work productivity. Pre- and post-analysis was conducted on 500 subjects who participated in a wellness program at a large national employer. Change in health risks was analyzed using McNemar chi-square tests, and change in mean productivity was analyzed using paired t tests. A repeated measures regression model examined whether a change in productivity was associated with a change in health risks, controlling for age and gender. Individuals who reduced one health risk improved their presenteeism by 9% and reduced absenteeism by 2%, controlling for baseline risk level, age, gender, and interaction of baseline risk and risk change. In conclusion, reductions in health risks are associated with positive changes in work productivity. Self reported work productivity may have utility in the evaluation of health promotion programs.