Study: Employees don't know their cholesterol levels

Even free screenings may not get employees to act

One in six Americans, which is almost 36 million people, have never had their cholesterol checked, according to new statistics from the Agency for Healthcare Research and Quality (AHRQ).1 According to the report, based on 2005 data from the Agency's Medical Expenditure Panel Survey, the following have never had their blood cholesterol checked:

  • more than one-third of uninsured people aged 20 to 65, 22% of people who have public insurance, and 16% of people with private health insurance;
  • one-fourth of Hispanic adults, 16% each of black and Asian adults, and 15% of white adults;
  • 20% of males, and 14% of females;
  • about 21% of people who did not graduate from high school;
  • nearly 40% of people ages 20 to 34, 17% between 35 and 44, 6% between 45 and 64, and 2% of people 65 and older.

"I do not find these results surprising," says Judy Pirnie Smith, health & productivity manager at Atlanta-based UPS. "Health literacy is a problem of long duration."

Various UPS locations offer free screenings to raise awareness of employees about their health risks, but this screening alone doesn't guarantee employees will take action, says Pirnie Smith. "It takes a sustained effort, with individualized approaches, to achieve behavioral change," she says.

Sandi Alexander Tuttle, manager of Rochester, NY-based Xerox's Recreation Association, also says that the results come as no surprise. Offering free or low cost cholesterol screenings is one tool to help employees become aware of their cholesterol level, and offering those on-site makes it convenient for employees to participate, says Tuttle. "But in and of itself, a screening won't motivate people to make lifestyle changes," she says. "As a result of a screening, someone may find out that they have a cholesterol problem. But unfortunately, even the awareness of the problem is often not enough to get a person to take action."

Most of Xerox's larger employee sites offer a free on-site screening at least once per year, and employees with borderline or high numbers are referred to their own primary care physician for follow-up, says Tuttle.

Preventative services such as cholesterol screenings often are underutilized by employees, says Ann Kuhnen, MD, MPH, vice president of employee health management at Glaxo SmithKline. "This is a problem because preventive measures such as screenings, exercise, and proper nutrition can help prevent costlier chronic illnesses and complications," Kuhnen says. "We are always looking for new ways to encourage our employees to take advantage of preventive services and make it easy to take that first step."

Some employees are aware of the benefits of prevention and have the best intentions, but they struggle to make the time for regular screenings, says Kuhnen. For this reason, onsite health fairs are offered frequently at Glaxo SmithKline, including cholesterol checks, with employees alerted about the screenings via video monitors, web site posts, postcards, visual displays, and through personal contact. "Through these communications, we link the importance of one's health with a larger purpose: having more energy to be more productive, being able to enjoy leisure activities, and living longer," says Kuhnen.

Use data to support programs

Share the ARHQ study's findings with senior management to support a business case for change, and justify interventions including worksite screenings, recommends Michele Becker, vice president with the health and benefits practice for Chicago-based Aon Consulting.

Worksite screenings demonstrate a commitment to employee health and well-being, says Becker. "Biometric testing, while somewhat costly, is often used by occupational health professionals and benefit managers as an integral component of their wellness strategy," she says. "Most employees like to know their numbers. And with proper communication, employees can be reassured that testing is voluntary and results will be kept confidential."

However, good intentions often fall short, because screening results are not fed directly to health risk assessments and the employer's data warehouse, or shared with primary care physicians and care managers, says Becker.

To track risk reduction, return on investment (ROI), and health and productivity linkages, you must use data effectively from every available source, says Becker. She recommends the following:

  • Discuss reporting capabilities before signing a contract with your screening vendor.
    You'll need aggregate reports so you can manage risk and ROI, as well as individual participant data feeds to care managers, health risk assessments, and data warehouses, says Becker.
    Individual data feeds enhance the risk identification and intervention process, improve the accuracy of health risk assessment stratification, and facilitate linkages among health care, disability, absence, and worker's compensation costs, says Becker.
  • Provide two copies of test results, which makes it easy for employees to share results with their primary care physician.
  • Conduct focus groups or surveys to understand why some employees chose not to participate.
    "The solution may be as simple as communicating differently with certain groups," says Becker.
  • Benchmark changes in health risk over time.
    Answer these questions: How well are programs working? Are employees getting healthier? Is cholesterol really an issue for our employees? If it is, what should we do about it?
  • Have health educators onsite at screenings, to provide individual coaching for employees at risk.
    "Take advantage of teachable moments," says Becker.

Reference

1. Soni A. Cholesterol screening among the U.S. noninstitutionalized adult population age 20 and older, 2005. Statistical Brief No. 187. October 2007. Agency for Healthcare Research and Quality, Rockville, MD.

SOURCES

For more information on cholesterol screenings for employees, contact:

  • Michele Becker, Vice President, Health & Benefits practice, Aon Consulting, Somerset, NJ. Phone: (732) 271-2678. Fax: (732) 356-1983. E-mail: michele_ becker@aon.com.
  • Ann Kuhnen, MD, MPH, Vice President, Employee Health Management, GlaxoSmithKline, Philadelphia, PA. Phone: (215) 751-3916. E-mail: ann.e.kuhnen@gsk.com.
  • Judy Pirnie Smith, RN, Health and Productivity Manager, UPS, Atlanta. Phone: (404) 828-6677. E-mail: Jpsmith@ups.com.
  • Sandi Alexander Tuttle, Manager, Xerox Recreation Association, Rochester, NY. Phone: (585) 423-2623. Fax: (585) 423-4272. E-mail: sandi.alexander.tuttle@xerox.com.