Dow Chemical Company (1994)

Narrative Description of Program

Goals: Goals are consistent with excellence in the provision of three defined "deliverables" to the business. These are:

• Health status improvement for Dow families
• Positive net value for the company (cost/benefit and cost effectiveness)
• High perceived value by Dow families (recruiting/retention, morale, Human Resource issues)

Parallel goals of alignment with the business are set in support of the program vision -"Dow Businesses have a Competitive Advantage through Health."

Nature of Intervention

Health issues as directed by a thorough needs assessment are addressed through a comprehensive, menu-based approach using proven methods where available. Options include fitness centers, health libraries, screenings, HRAs, individual counseling, classes, multi-session workshops, and self-directed programs. In addition, specific referral mechanisms are set up from internal health professionals, our EAP program, and community physicians.

Target Population

Primary, secondary and tertiary prevention programs are targeted to all Dow employees, retirees, and their families.

Staffing

A central resource staff series the entire network of Dow sites. Local Dow and contracted staffing serve individual sites. Their numbers vary by need and population. A representative management team exists to drive common system development, create core guidelines, advocate at the division level, perform strategic planning, identify success measures, and assess themselves and the function of health promotion.

Funding source

The central resource group is funded through a corporate budget. Site budgets vary from $25-$150 per employee per year depending on the program maturity, staffing, facilities, and the economic climate at the site. Additional revenues are acquired via fees assessed to registrants of programs and services.

Narrative Description of Evaluation Results

Evaluation in the Dow Health Promotion program is part of a complete process of measurement based program management (see diagram). The approach to evaluation includes staff education, protocol development and most importantly the maintenance of an accurate, well-designed, easily queried common data system which is used to record every interaction where a participant can be identified.

Evaluation efforts appropriately balance the need for outcome data with the cost and staff time to accomplish them and minimize intrusive burden on participants. In this regard, Dow has chosen to collect minimal new information directly in the health promotion effort and to access/merge with existing data sets to obtain necessary information for studies. Recently, multiple existing data bases were merged to allow a large scale, low cost, six year longitudinal cohort study designed to characterize participants in Dow sponsored health promotion programs and determine associations between participation and health status changes as well as health care claims costs. This study of 11,496 employees substantiated that preventive health initiatives are producing statistically significant health improvements and are highly valued by the employees. An association between participation and lower health care claims was also identified. Other internal studies included describe examples of health issues studied over the last few years.

• Dow Chemical Company - Dow Health Promotion

The following assessment of program strengths and weaknesses has been abstracted from reviews by the Task Force on Program Selection of The Health Project. Where weaknesses are postulated, it must be taken into account that the review Task Force is very critical, that no programs are perfect, that the Award Winning programs have been selected from over 300 candidate programs and represent the very best, that the materials reviewed may have been incomplete, that suggested deficiencies may have resulted from incomplete understanding of the program by the reviewers or that any problems may have been corrected since the time of review.

Evaluation

Dow Chemical's nine year old "Up With Life" program on smoking, alcohol use, cholesterol, hypertension, mental health, AIDS awareness, overweight, lactation support, mammography screening and back safety, includes locations in Europe, South America and pacific rim countries. With program cost ranging from $25 to $150 per employee per year, participant costs have been lower by 15 percent to 21 percent at three locations for a net savings after all expenses of $3 million a year.

The program is comprehensive, well-managed, and is being applied in multiple sites. The smoking program has had a long-term effect. The lactation program deserves high praise and was very successful. There are high participation rates. Programs are comprehensive and include mental health. There is a good program planning process of five steps with fine corporate goals and strategies. There is development of a centralized data base and use of multiple existing data bases such as personal claims and medical data for evaluation purposes. Data on health care cost reduction and relation to smoking habits is powerful. Program budget is generous. Evaluation plan is a model for the industry. Rigorous research efforts are impressive. A good overall program to be emulated. Excellent longitudinal data base.

Although cost data was analyzed and savings potential was indicated, this was not fully documented across all programs. There is some concern about the conclusions from the claims analyses, in particular how they controlled for self-selection bias. Medical self-care and its potential impact on demand reduction was felt to be missing. Whether the program was responsible for decline in injury rates was not completely documented.