The Value of Health

Cathryn E. Gunther, Associate Vice President, Global Population Health, Merck & Co.

What ONE value would you share with a child as the basis for a good life?

My choice would be health. And by ‘health,’ I mean health as it’s defined by the World Health Organization (WHO) in 1948 as “a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.”

And why health as opposed to ethics, love, compassion, or hard work? One reason I would choose health is that it is tough to achieve in today’s society. Our day-to-day environment is stacked against health, with prolonged periods of inactivity, poor nutrition, workplace stress, financial concerns, and social isolation. In this article, I propose that the workplace can actually be a means to create health by establishing a culture of health and wellbeing. Why it’s important, how to build it, and the potential Business Benefits are described. In fact, an argument can be made that it can be one of the most powerful business strategies for companies large and small.

WHY: Over 159 million workers in the U.S. alone spend at least 1/3 of their days and five days each week in a workplace environment that has the capacity to promote health, prevention, and safety. The private sector has an unparalleled opportunity to stem the tide of unhealthy lifestyles and chronic conditions that cripple our societies. The current focus on high-cost co-morbidities which commandeers 80% of all health care spending in the U.S. is important, yet insufficient. The majority of these conditions are preventable, yet we lack appropriate investments upstream. We can and must leverage employers to promote health, prevention, and safety among their workers. The evidence is compelling. Many companies – even in the health care sector – have not genuinely committed to creating a culture of health and wellbeing within their workforce. If employers would all commit to this effort, whole communities could become healthier and more prosperous.

HOW: At Merck, our mission is to save and improve lives. As part of this mission, we are committed to supporting the health and wellbeing of our employees. Described here is a selection of steps from our ‘Culture of Health’ roadmap and some lessons learned.

• Start with data: In 2016, a small team analyzed multiple data sets to evaluate the current health status of our workforce in the U.S. and around the world. This analysis informed two goals: 1) address targeted areas of health that represent ‘low-hanging fruit’ and 2) advance our culture of health across the enterprise through the implementation of an evidence-based approach. We reviewed benchmark companies and established aspirational goals for moving the needle on metrics that lead to better health. We developed a business case for investing in employee health and presented evidence from the literature, a hypothesis, and anticipated benefits to each member of the C-suite.

Lesson learned: Data informs the foundation of your strategy. Benchmarking creates realistic metrics and goals.

• Bust silos: We established a cross-functional team comprised of members from Human Resources, Global Population Health, Occupational Health Services, and Environmental Health and Safety. We invited colleagues from procurement, Diversity, and Inclusion, EBRGs (Employee Business Resource Groups), Legal, Learning and Development, and others to contribute their perspectives. We engaged our external vendors supplying health coaching, mental health support, food services, and fitness centers. Colleagues from each of these areas participated in the discussions, plans, programs, and policies designed to promote health and enhance the company’s culture of wellbeing. We were consistently pleased with the level of collaboration and trust that emerged based on the common pursuit to promote health.

Lesson learned: The more people engaged in the movement, the faster and further you will go, but it requires deliberate integration and careful orchestration.

• Pursue quick wins: As a company that researches and manufactures vaccines, we recognized the opportunity to boost our own employee vaccination coverage with a deliberate plan to make immunizations more convenient to all of our employees, including field-based staff. In 4 months, we increased our adult vaccination rates by 20% by bringing vaccination capabilities to annual meetings. After identifying worksites with a higher prevalence of diabetes risk factors, we initiated a campaign for healthier eating, more movement, health promotion, and deployed health coaches. In 2 years, we lowered the rate of weight gain and reduced the number of risk factors in that employee population.

Lesson learned: Leveraging large workforce meeting locations and hot-spotting health improvement opportunities can produce quick results. Early wins build confidence in the strategy and nourish the longer-term cultural shift.

• Tap into champions: Champions for wellness are embedded in organizations. But unless you give them a platform and empower their voice, these impassioned colleagues remain untapped. By building a champions network, you can unleash the power of people to extend the messaging, support grassroots efforts, scale the campaign, and act as role models for change. We have over 250 Wellbeing Champions currently at Merck, and we deliberately nurture their sustained engagement. People in the network come from many functions and roles and provide heartfelt stories and boundless enthusiasm in support of workplace wellbeing.

Lesson learned: Executive support is critical, but the workforce is your customer. Identify and engage champions to drive the movement.

Business Benefits: There is mounting evidence in the literature that organizations that support a culture of wellbeing through integrated policies, programs, and environmental cues reap the benefits of reduced health care spending, better employee engagement, higher productivity, fewer injuries, and improved overall corporate performance. In fact, recent published, peer-reviewed articles by Dr.Fabius et al. in the Journal of Occupational and Environmental Medicine demonstrate a strong correlation between the pursuit of a benchmark culture of health and reductions in medical cost trend as well as the fact that awarding-winning culture of health and safety companies outperform in the stock market.

"Our focus must extend beyond health care and pharmacy costs to deliver programs and policies upstream that prevent the need for health services and medications."

A best practice is to design a corporate cockpit, or dashboard, to track and monitor progress against specific goals in order to calculate the return from investing in wellbeing. At Merck, we have seen reductions in our health care cost curve, enhanced employee engagement, and improvement in health metrics that serve as early indicators of wellbeing. And we have earned top awards for workplace wellness from the National Business Group on Health, the American Health Association, and the CEO Roundtable on Cancer. This external recognition places the company in a favorable position for recruiting and retaining talent as an “employer of choice.” Focused opportunity areas for 2020 and beyond to enhance employee population health include, mental health, and cancer. To learn more, see ‘Building a Culture of Health and Well-being at Merck’ The workplace offers abundant opportunities for health promotion, health protection, and safety for the near 160 million workers in the U.S. Not only is it a good thing to do, but it creates competitive business advantages and addresses the fundamental social determinants of health for the good of society. Our focus must now extend beyond health benefits to make the healthy option the easy one. Our focus must extend beyond health care and pharmacy costs to deliver programs and policies upstream that prevent the need for health services and medications. The WHO tells us that 40% of cancers and 80% of both heart disease and diabetes are preventable. We can make this a reality, one employer at a time.

Back to the question of what ONE value would you share with a child as the basis for a good life? I hope health rises toward the top of your list. I urge you to become a champion for health at home, at work, and at play for your sake and the sake of the next generation.

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