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Chronic Disease

Working Toward a Healthy Culture

Most people spend 40 hours or more each week at their jobs, so the workplace is a natural place for people to get healthier.

By Rose Hoban

At the Campbell Soup factory in Robeson County, company officials had a problem: Their health care costs were higher than at any other Campbell’s factory in the U.S. Although the costs for other aspects of doing business in southeastern North Carolina were lower than in many other locations, the cost of health care came to a nickel per can.

“Their goal was to get those costs down,” said Ken Lewis, head of FirstCarolinaCare Insurance, based in Moore County. As an insurer, Lewis worked with the company to lower health care costs for the more than 850 employees at their plant. Their strategy was to implement an employee-wellness plan.

Over time, it worked, and costs came down. Now Campbell is expanding in the area.

Commerce Secretary Sharon Decker laid out her priorities for improving North Carolina's business climate. Top of her list was having a healthy workforce.

Commerce Sec. Sharon Decker laid out her priorities for improving North Carolina’s business climate. At the top of her list was having a healthy workforce. Photo: Rose Hoban

Lewis told that anecdote last week to a roomful of about 100 business leaders from around the state as part of a gathering convened by North Carolina Prevention Partners, an organization that’s helped schools and hospitals in North Carolina create healthier workplaces.

“We have to create a culture of wellness. Prevention Partners started with hospitals. That’s expanding to other parts of the counties those hospitals are in,” Lewis told the group, convened at the Cary headquarters of the North Carolina Hospital Association. “It’s only with that kind of change that we can achieve critical mass.”

It was a message echoed by Commerce Sec. Sharon Decker, who spoke to the group. She put having a healthy workforce at the top of her five-point list for increasing North Carolina’s business competitiveness.

“It’s one of the top-three increasing costs in business: the cost of providing health care,” Decker told the group. “So if we can say to [businesses] that when you come to North Carolina, you have the opportunity to operate at less cost in this area because we have a healthy population, we’ve done something very valuable for business owners across the spectrum.”

Hospitals, then schools, now other businesses

Prevention Partners, based in Chapel Hill, has been around for only 15 years, but in a short time has managed to accomplish a lot.

In 2003, the organization created a voluntary initiative to get hospitals to go tobacco-free. In the first year, only two hospitals had signed up. But by mid-2010, all of the state’s hospitals, including the psychiatric hospitals and the Veterans Affairs facilities, were tobacco-free on their campuses.

Click here to see an animated timeline of tobacco-free hospitals in North Carolina.

Click here to see animation.

Click here to see animation.

The organization has also helped school districts create and implement tobacco-free schools in all of the state’s districts. The organization has now turned to other aspects of healthy living, such as physical activity and nutrition.

“There’s an interest in doing the right thing, but people don’t know how to do it, how to start. And if they do, they don’t do the things that the science says works best,” said Meg Molloy, president of Prevention Partners. “We’ve taken all the science and made it simple for people to see the other pieces, to help people focus on what works.”


One company that’s worked with Prevention Partners to get employees healthier is the accounting firm Johnson, Price and Sprinkle, based in Asheville with offices in Boone and Marion.

CEO Ben Hamrick described how his organization started about six years ago by getting employees into the local YMCA. They created office tournaments of wallyball, a fast-paced hybrid form of volleyball that’s played on a racquetball court.

Johnson, Price & Sprinkle CEO Ben Hamrick.

Johnson, Price & Sprinkle CEO Ben Hamrick. Photo courtesy JPS

“We started to see what we’re doing was good. It was fun and having an impact on our employees and our firm,” said Hamrick, who described employees coming to him to say they’d been taken off of medication or lost weight as a result of the new activity.

But Hamrick also wanted to make the changes stick, so he partnered with Prevention Partners to come up with techniques to help further his company’s efforts. That resulted in a nutrition program to help employees eat better at work.

“During that first quarter of the year, we had a lot of meals catered into our offices. We’ve developed guidelines and policies for caterers to always provide healthy options,” Hamrick said.

“We still had dangerous goodies there too,” he said. “But what we started trying to do is let the healthy options take more space.”

Now, he said, instead of bringing in cakes and cookies, many of his 55 employees bring in produce from their gardens to share.

“And if people see we don’t have a salad, they ask,” he said.

Hamrick said leadership and modeling by management was critical to their success, something echoed by Doug Stein, who works in human resources at LORD Corporation, based in Cary. The company manufactures specialty products and chemicals for the aeronautics and automotive industries.

“We’re trying to build a culture of wellness,” Stein said. His company started requiring employees to have a health assessment, get to know their numbers for cholesterol and get educated about healthier living. And it started cutting the costs of insurance premiums of people who didn’t use tobacco. That last initiative got a lot of push back at first.

“But I think our employees are beginning to believe in this culture,” Stein said.

Some researchers have critiqued workplace-wellness strategies, saying they don’t save a significant amount of money. Stein said that was true, to a point, but that his company was now seeing health care costs rise at a slower rate, and to flatten out for some employees.

“Ultimately, I don’t know if you can work to that magical world where everybody is healthy and no one gets sick, but the preventive costs are lower than the reactionary costs,” he said.

Culture change

“Many companies may be doing neat things to encourage their employees to be healthier,” Molloy said. “Some of these people, they’re maybe not even doing a lot yet, but they heard about what others are doing and they started talking to each other, which is really what we wanted to do here.”

An employee from Prevention Partners lead meeting participants in an exercise break.

An employee from Prevention Partners leads meeting participants in an exercise break. Photo credit: Rose Hoban

But she and others noted that getting people to change their habits is a slow process. Cathy Thomas from the Division of Public Health said the Maintain, Don’t Gain program offered online through the Department of Health and Human Services every year during the holidays can prime people for success.

“If you get a person to a place of readiness, then other resources can open doors. So if they can experience some bit of change during Maintain, Don’t Gain, we can get them to another place,” Thomas said.

Her co-worker Thad Brown said that as they travel the state, they’re hearing from more community leaders that wellness is becoming a priority.

“We were in a county in the eastern part of the state, and county officials there said [they were] the third-worst county for these diseases, and that’s become their focus,” Brown said. “They may want to make changes from the top down and the bottom up.”

Molloy pointed to a program within the Department of Transportation that educates workers who spend most of their days on the road about healthier choices at fast-food restaurants.

“Changing culture is hard, and changing habits is hard, and changing organizational behavior is just as hard as individual behavior, so we’re focusing on organizations,” she said.

“We want to make sure it’s not just, ‘We’re sending you to cholesterol screening because we’re going to charge you more if you have high cholesterol,’ and then give you a sausage biscuit,” Molloy said. “We have a lot of misaligned incentives.”

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