Optimizing Health Assessments and Five Benefits for Employers and Employees
“Many individual success stories of employees learning of a health risk for the first time, taking control, and improving their health.”
Above was one of the success stories shared in a Buck Consultant report in response to the question below:
What are the greatest successes you've achieved with your health promotion and wellness programmes?
‘’More staff were unaware of their individual health risks and the health risks were higher among senior staff and management members’’ part of the conclusion of the health risk assessment research in a corporate organisation in Ghana. Self-reported hypertension was 32% vs measured BP indicating 60% hypertension incidence among the employees! (Aido et al 2015).
Among firms offering health benefits in US, 42% of small firms and 60% of large firms provide employees the opportunity to complete a health risk assessment. Biometric screenings offered by 33% of small firms and50% of large firms among the same group. (2020 KFF Employer Health Benefits). Among large firms,38% offered biometric screening to employees in 2021 due to COVID-19 related challenges. Some large firms expanded the number of providers and some permitting screening on digital platforms (Health Benefits in 2021: Employer programs evolving in response to COVID-19 Pandemic).
What does it mean to complete a Health Assessment (HA)?
A health risk assessment includes questions about your demographics, medical history, health status and lifestyle.
Employee health promotion programmes usually request participants to complete a brief questionnaire that summarises key health information, which can then generate a statistical estimate of employee’s overall health status at that time. These assessments (or surveys) are often called “health assessments”. Health assessments(HA), also known as Health Risk Assessments or Health Risk Appraisals (HRAs))help identify health issues and should provide a feedback mechanism or follow-up plan to help employees to understand the results and what they should do with the information.
Biometric Screenings, such as such as body mass index (BMI), blood pressure, cholesterol, and glucose levels, may be part of a health assessment or may be done separately. In either case, like HAs, there should be a follow-up plan to make good use of the results.
Just as seeing a doctor without receiving counselling or recommendation on corrective steps offers limited benefits. In the same way, completion of a HA alone will not result in a significant change in one’s overall health profile. Best practice is that all HAs should be followed by specific counselling and opportunities to participate in health promotion strategies (like nutrition counselling or organised physical activity) relevant to the significant modifiable health behaviours identified through the completion of an HA.
It is critical to employee participation, as well as legal compliance, that the privacy of individual employees is protected. Outsourcing to third parties is common with no disclosure agreements in place for individuals.
HA results, when aggregated in a confidential manner across multiple members of employee population, and where HA results are periodically available from the same respondents, can provide useful and powerful means of tracking the impact of employee health promotion and wellness programmes over time. For this reason, best practice is for HAs to be the fundamental starting point in any employee health promotion effort and that these measures serve as the primary measuring gauge of programme impact and effectiveness.
Key Considerations for Health Assessment selection
1. Appropriate to the culture and language of the location
2. Customisable and adaptable to your situations and adding questions as required
3. Meaningful and actionable aggregate reports with intervention opportunities
4. Identifies and explains modifiable risk factors for individuals
5. Cost effectiveness
6. Confidentiality and data security and protection
7. Different modes of administration suitable for your employee population.
Benefits of Health Assessments
Benefits to the employer:
1. Helping the employer build a culture of health.
2. Establishing a gateway to targeted prevention and intervention programmes that engage employees in health education and self-care.
3. Encouraging employees to obtain age-appropriate, evidence-based health screenings.
4. Serving as the core of a systematic approach to organizing preventive health information.
5. Providing the ability to aggregate data by organizational division and risk prevalence to inform wellness program planning, benefits design, monitoring of trends and evaluation.
Benefits to participants:
1. Serving as a relatively non-threatening, anonymous entry point to health and lifestyle services they might need.
2. Creating or reinforcing awareness of personal risk factors for chronic disease and injury, a necessary first step to lowering risks.
3. Empowering the individual with information and setting goals about “do-able” actions he or she can take to impact current and future quality of life.
4. Monitoring progress toward health-related goal accomplishments (if HRA is offered periodically).
5. Linking participants with other health-related services sponsored by the employer, such as disease management or employee assistance programmes (EAP).
What are the different types of Health Assessments?
1. Self-reported - individual focused. Only self-reported lifestyle information is collected. Reliability is limited.
2. Self-reported and medical data – Individual and aggregate focused. This “comprehensive” HA outputs individual health scores ,aggregate data for employers, and educational support materials. It allows individuals to see the cumulative effects of certain lifestyle risk factors.
How does a Health Assessment(HA) work?
HAs calculate the probability that a person with certain health behaviours will acquire various chronic diseases or die in a given time period. This probability calculation compares your lifestyle information, medical data, and health and family history to people with similar demographics. As an organization, you can decide what factors you want to assess and how often you want to do assessments. Your ultimate goal is to reduce individual risk factors and the number of employees that have multiple risk factors, since “high risk” employees will generally result in higher healthcare costs.
General Practitioner (GP) Visit vs. Health Assessment (or both)
Online assessments and biometric screenings are the usual practice in health assessment. Another option is for employees to schedule anannual medical check with their General Practitioner (GP). Both have theirlimitations and some alternate between the two options, with a GP visit oneyear and a health assessment and biometric screening the next year. Preventive visits can be a great option asthey are usually covered under your health plan and they allow your members toestablish a relationship with their GP and become a better health care consumer.
1. Working Well A global survey of healthpromotion, workplace wellness and productivity strategies Buck Consultants 2014
2. 2020 KFF Employer Health Benefits
3. Health Benefits in 2021 : Employer programsevolving in response to COVID-19 Pandemic. Health Affairs 40, 12, 2021:1961-1971
4. Working Well: A global survey of workforcewellbeing strategies 8th ed Dec 2018
5. Department of Health Services, Division ofPublic Health, Chronic Disease Prevention Programme, Wisconsin Partnership forActivity and Nutrition. Wisconsin Worksite Resource Kit to Prevent Obesity andRelated Chronic Diseases. March 2018
6. Aidoo et al. Journal of Occupational Medicineand Toxicology (2015) 10:30 - Health of the corporate worker: health riskassessment among staff of a corporate organization in Ghana.
7. Health Risks Appraisal at the worksite: Basicsfor HRA decision making National Business Coalition on Health 2008