How do we create real, sustainable

health improvement for all

Minnesotans?Understanding Policy, Systems

and Environmental Change strategies

The goal of Workplace Wellness:To create a culture of wellness that supports healthy behaviors that are sustainable over time

BENEFITS OF CREATING A CULTURE OF HEALTH

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Individual / Employee

Where one works

Where one lives

Traditional focus

Culture of health: Focus to achieve sustainability and long-term results

A culture of health increases organization’s visibility as an advocate of health • makes healthy choices

easier • reaches ALL employees

What determines health?Are we solely a product of our own, personal choices?

A person’s health is a product of several factors• Genes and biology• Personal choice (health

behaviors)• Social determinants of health

– Social environment or social characteristics– Physical environment or total ecology– Health services or medical care

Which of these are most important?

What Influences our health

• Socio-Ecological Model: – Individual: knowledge, attitudes,

beliefs– Interpersonal: family, peers, social

networks– Organizational: employers, schools,

etc.– Community: social norms and

standards– Policy: a law, rule at an employer,

college, or multi-unit housing

What Influences our health

• Socio-Ecological Model: – Individual: knowledge,

attitudes, beliefs– Interpersonal: family, peers, social

networks– Organizational: employers, schools,

etc.– Community: social norms and

standards– Policy: a law, rule at an employer,

college, or multi-unit housing

What Influences our health

• Socio-Ecological Model: – Individual: knowledge, attitudes,

beliefs– Interpersonal: family, peers, social

networks– Organizational: employers,

schools, etc.– Community: social norms and

standards– Policy: a law, rule at an

employer, college, or multi-unit housing

What Influences our health

• Socio-Ecological Model: – Individual: knowledge, attitudes,

beliefs– Interpersonal: family, peers, social

networks– Organizational: employers, schools,

etc.– Community: social norms and

standards– Policy: a law, rule at an employer,

college, or multi-unit housingWhe

re w

e’ve

trad

ition

ally

spe

nt o

ur e

fforts

What Influences our health

• Socio-Ecological Model: – Individual: knowledge, attitudes,

beliefs– Interpersonal: family, peers, social

networks– Organizational: employers, schools,

etc.– Community: social norms and

standards– Policy: a law, rule at an employer,

college, or multi-unit housingWhe

re w

e’ve

trad

ition

ally

spe

nt o

ur e

fforts

What is m

ost effective

Individual change efforts:• Result in temporary behavior

change• Are usually unevenly applied to a

few people• Often involve marketing

campaigns which are expensive• Are usually time-limited

Policy, systems and environmental approaches: • Support social norm changes

• Support individual behavior change

• Are widespread• Have long-term impact

What is policy change?• Policy strategies may be a

law, ordinance, resolution, mandate, regulation, or rule (both formal and informal).– Example: Organizational policies

that provide time off during work hours for physical activity.

What is systems change?• Systems strategies are

changes that impact all elements of an organization, institution, or system. – Types of systems include: school,

transportation, parks and recreation, etc.

What is environmental change?

• Environmental strategies involve physical or material changes to the economic, social, or physical environment.– Example: Incorporating sidewalks,

paths, and recreation areas into community design.

Why?“It is unreasonable to expect that

people will change their behavior easily when so many forces in the social, cultural, and physical environment conspire against such change.”---Institute of Medicine, Smedly and Syme (2000)

ExampleWhat allows this man and his

children to get physical activity?

Credit: Bike Walk Ambassador Program and Dudley Edmondson

Sidewalks

Boulevard strip adds to feeling of safety

Street lights

Trees

Ensuring properties

are maintained

adds to safetySchool

may have a safe routes

program

ExampleWhat would allow these people to

eat more fruits and vegetables?

Capital Farmers Market

Organization manages and promotes it

Accessible location

for farmers

Location provided

Food inspection for safety

Accepts EBT

Zoning allows for

it

Healthy food available

because of the farmers

market

Good health at work through workplace wellness programs

Tobacco Free• Policy approach• Rather than just telling people to

quit tobacco offer:– Tobacco free campus that includes e-cigarettes– Access to cessation support through Quitlines– Access to cessation medication

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LAKES COUNTRY SERVICE COOPERATIVEREDUCING/ELIMINATING TOBACCO USE

As of July 1, 2014 LCSC is a tobacco-free campus. The LCSC Board adopted a Tobacco-Free Worksite Policy. The policy includes all tobacco products and e-cigarettes.

Public announcement made before each event held in their facility that highlights: TF policy,lactation room, healthy food options.

Healthy Eating• Policy approach• Rather than just telling people to

eat healthier, offer: Healthy snack stations (in some cases financially supported by the

organization) Healthy catering guide Food labeling system for vending machines and cafeteria Healthy vending options Community Supportive Agriculture (CSA) on site Healthy food options during meetings where food is offered On-site Farmers Market, community garden and orchards

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Clay County Give one take oneACCESS TO HEALTHY FOODSFruit & Vegetable Vending• Ongoing program, slightly subsidized by Wellness budget

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ACCESS TO HEALTHY FOODS

• Essentia Health St. Mary’s participated in a CSA with Feather Pond Farms• Vending Machines carry health snacks and are labeled as a “fit pick” • EHSM hosts a Farmers Market on Tuesday

in the parking lot• Cafeteria has a color code system for food served to help

employees make good choices• Red = bad choice• Yellow = Mediocre choice• Green = Good choice

- based on fat content and carbohydrates

Access to Healthy Foods

• EHSM Hosts the Farmers Market on Tuesdays in the parking lot

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Breastfeeding• Policy approach• Offer:

– Designated space that is available for employees and if possible the public

– A plan around supporting mom’s who may need portable kits and locks

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Ecumen- Detroit LakesSUPPORT FOR NURSING MOMS

Ecumen created a dedicated mother’s room withlocking door,electricity, a refrigerator and comfortable chair.

Found this to be key to employee satisfaction and retention.

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Clay CountySUPPORT FOR NURSING MOMS

Lactation roomsOne permanently available in Family Service Center

Portable Lactation kits • Portable fridge• Lock for door• CD player• Relaxing music CD’s• Information for new mothersLactation policy

Physical Activity• Policy approach• Rather than just telling people to

get more physical activity, offer:– More bike paths, sidewalks, and safe

crosswalks – Flexible work hours– Short physical activity breaks during meetings– Walking meetings– Onsite fitness center– Bike share opportunities

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LAKES COUNTRY SERVICE COOPERATIVEPHYSICAL ACTIVITY OPPORTUNITIES

• Multiple length walking route maps posted • Daily walking group – 15 min walk at 10 AM &

2 PM• Adj. Standing Workstations• Participation in annual Corporate Cup and other challenges

UNITED COMMUNITY BANKPHYSICAL ACTIVITY OPPORTUNITIES

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Fitness area in the basement of the main branch

Ringdahl EMS- Fergus Falls, MNBike Friendly Business