The magazine of the UW School of Public Health

Workplace Wellness

The Tacoma-Pierce County Health Department uses a workplace wellness program to improve employee health.

By Rebecca L. Levine

The Affordable Care Act’s (ACA) Prevention and Public Health Fund has provided new opportunities for workplace wellness programs. By identifying workplace wellness programs as a national priority, the ACA promotes a cultural shift towards recognizing how social and structural interventions influence public health.

The Tacoma-Pierce County Health Department has some tough challenges. Pierce County is the second-most populous in Washington State, but ranks an alarming 26th out of 39 counties in county health rankings. The county’s rate of tobacco use and percentage of individuals classified as obese are higher than state and national averages.

Workplace wellness programs could be an important part of the solution, and in March 2014 the health department launched a new program for the health and well-being of its approximately 270 employees. Kirsten Frandsen, a project manager at the department, explains, “Prioritizing funding for internal uses is hard when we are losing services in the community, but worksite wellness, implemented correctly, saves costs in the long run.”

Worksite wellness programs are designed to help employees reduce or prevent chronic disease. In the United States, full-time workers with chronic health conditions miss about 450 million more days of work each year than healthy workers, resulting in an estimated $153 billion in lost productivity annually. Many companies, including Seattle-based Starbucks, have turned to workplace wellness programs. The coffee giant established its Thrive Wellness program in 2004, which includes weight loss and smoking cessation resources for its employees.

The Tacoma-Pierce County Health Department had its own wellness program in 2005, but it ended in 2008 due to a lack of funding. Linda Graves, a health promotion coordinator, remembers that when this program was active, participating employees enjoyed a strong sense of camaraderie that motivated their ongoing engagement. So when the health department was able to begin a new wellness program in 2014, staff welcomed it.

The program’s reincarnation was made possible by ACA funding allocated to the Centers for Disease Control and Prevention (CDC). In 2011, the CDC received $9 million from the Prevention and Public Health Fund to create the National Healthy Worksite Program (NHWP). NHWP has three goals: (1) reduce chronic disease risk among employees and their families through science- and practice-based workplace prevention and wellness strategies; (2) promote sustainable and replicable workplace health activities such as developing a worksite health committee, senior leadership support, and community partnerships and health coalitions; and (3) promote peer-to-peer business mentoring.

The Tacoma-Pierce County Health Department is part of a select group that is participating in NHWP. Only 104 employers in eight counties across the country are part of this program, which targets organizations with 1,000 or fewer full-time employees that offer health insurance but lack a comprehensive wellness program. Counties selected for the program have high rates of chronic diseases and health risk behaviors. At the same time, all participating counties must have resources to support sustainable wellness programs. Fifteen Pierce County employers with a combined total of 1,386 employees are participating in NHWP.

Budgetary concerns limit the program’s scope at Tacoma-Pierce County Health Department, but the program saves two percent in health insurance costs because it incorporates wellness program criteria from the department’s insurer. The program also includes valuable “no cost” elements, such as promoting walking meetings, flexible hours to encourage participation in exercise programs, and use of an onsite fitness room. Additional services are available through the department’s health insurer, such as nutrition counseling, biometric assessments, and behavioral health classes. “We welcome the chance to promote employee wellness within our organization and model healthy behaviors to the community,” said Anthony L-T Chen, MD, MPH, Director of Health at Tacoma-Pierce County Health Department. “Over time, we have taken steps to implement a healthy food policy, an exercise room, and a tobacco-free policy; this worksite wellness grant is helping us to re-energize, reassess, and refocus our efforts,” he said.

Over a period of 24 months, the department will work with a government contractor (Viridian Health Management) to develop a set of interventions that help employees reduce their risk of chronic disease. These interventions will include supports such as fitness classes, chronic disease self-management tools, or wellness newsletters. Leadership at the department will receive training, technical assistance, and mentoring so that it can effectively administer the program.

Evaluation is an important part of NHWP. For ten months after the two-year program ends, an employee survey will assess changes in knowledge, behavior, and health status. The survey will also ask about changes in productivity through decreased absenteeism. The CDC intends to share information gathered through NHWP with participants and also with other employers and organizations across the country seeking to develop wellness programs.

Although continuing or expanding NHWP depends upon additional funding, positive results could encourage employers nationwide to develop interventions based upon emerging data. Partnerships formed through NHWP could create a nationwide network that supports employee health programs.

Though effective worksite wellness programs require investment up front, decreases in lost work days, workers’ compensation premiums, and employee attrition may achieve net cost savings. Companies such as Johnson & Johnson, Citibank, Chevron, and Proctor & Gamble have reported positive returns on investment from workplace wellness programs.

Can a medium-size organization like Tacoma Pierce County Health Department realize similar benefits?

Graves is enthusiastic about the opportunities, stating, “Creating a culture of health is a win-win situation:
employees are more satisfied when they have opportunities to be healthy, and employers gain a healthier workforce.”

For additional information, go to and search “ACA workplace wellness.”


Rebecca Levine is a Judicial Clerk at the Washington State Court of Appeals.