Initiatives Results Elements of Success

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Working to Create a Culture of Health at

• Initiatives ? Results ? Elements of Success

Susan Tierman, MD NA Medical Director, Global
Health Services
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• The Worlds most comprehensive and most broadly
  based Health Care Company
• 2006 sales of 53.3 billion
• More than 200 operating companies selling
  products throughout the world
• Three worldwide business segments
• Consumer
• Medical Devices/Diagnostics
• Pharmaceutical
• Managed by a unique form of decentralized
  management 122,000 employees worldwide
• Investment in research and development were 6.3
  billion in 2005

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Strategic Principles

• Broadly Based in Human Health Care
• Manage for the Long Term
• Decentralized Management
• Ethical Principles-Our Credo 
• The Four Tenets
• Customers
• Employees
• Community
• Stockholders

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Business Value
An important part of our Credo responsibility to
our employees is providing them with resources to
lead healthier lives. Good health is important
to all of us. Good health is also good
business. William C. Weldon CEO Johnson
Johnson

• We believe that a healthy employee is a more
  productive employee and that good health is good
  business. We will support Operating Company
  growth and create competitive advantage by
  creating and sustaining a culture of health for
  our employees and their families.

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Business Case to Support Global Health

• We believe that a healthy employee is a more
  productive employee and that good health is good
  business. We will support Operating Company
  growth and create competitive advantage by
  creating and sustaining a culture of health for
  our employees and their families.

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History of Employee Health Management

• LIVE FOR LIFE Program in 1978 was a partnership
  of five unique areas
• Benefits - Medical - EAP
• Safety - Wellness
• James E. Burke, the Johnson Johnson Chairman
  and CEO, set two major goals for the LIVE FOR
  LIFE Program
• Encourage JJ employees to become the healthiest
  in the world through education and easy access to
  prevention programs
• Implement on-site programs and services to reduce
  the cost of health care for the corporation
• Organized as a shared service for the US in 1995
  integrating the functional areas EAP,
  Occupational Health, Wellness Fitness, and
  Disability Management under one umbrella
  reporting through HR.
• Today, continued reporting through HR with
  alignment to WW Environment, Health and Safety
  organization providing leadership, consultation,
  guidance and support for the delivery of quality
  integrated health programs and services
  worldwide.

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Workforce Challenges

• Speed of change
• Job demands/technology
• Work/family balance
• Globalization 24/7 world
• Complex social, economic, political
  environments
• Mental Health/Stress-Related Disorders Two of
  the leading causes of illness, disability,
  impaired productivity

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Johnson Johnson Global Presence

• Europe, Middle East Africa
• 43,000 Employees
• 43 Manufacturing Facilities
• 120 Admin/Sales/Distribution
• 30 Languages

• North America
• 55,000 Employees
• 118 Manufacturing Facilities
• 91 Admin/Sales/Distribution
• 3 Languages

• Asia Pacific
• 16,000 Employees
• 15 Manufacturing Facilities
• 60 Admin/Sales/Distribution
• 12 Languages

• Latin America
• 8,200 Employees
• 8 Manufacturing Facilities
• 36 Admin/Sales/Distribution
• 3 Languages

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Why Global Health?

• WHO Global Health Concerns
• Mental Health and Depression
• 450 Million people currently suffer from these
  conditions, placing mental health disorders among
  the leading causes of ill-health and disabilities
• Overweight and Obesity
• One billion overweight adults 300 million of
  them obese
• Physical Activity
• Physical Inactivity causes 2 million deaths per
  year
• Tobacco Use and Cancer
• Single largest preventable cause of disease and
  premature death in the world
• Emerging Infectious Disease
• Recent experience with highly pathogenic H5N1
  avian influenza have given the world its first
  advance warning that another influenza pandemic
  may be imminent
• HIV/AIDS
• Forty million plus people living with HIV and
  AIDS at end of 2005

Global Health Programs seek to proactively
address these issues in the JJ Community
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Global Health Actively Addressing Health
Issues That Affect Our Employees Worldwide
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Success of Global Health

• Traditional Company Thinking
• Concentrated on keeping health care costs down
• By defining health as an expense
• A line item to keep low by managing benefits
  packages
• A New View Health Productivity Management
  (HPM)
• Emphasis on doing more to keep employees healthy
• Companies adopting HPM find that healthy workers
  cost a company less and boost productivity

Requires major shift of thinking from health
being a cost to health being an investment
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Culture of Health
The health of our employees and their families is
inseparable from the health of the Corporation.
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Healthy People Addressed at every level
Total Health An integrated approach to the
design and delivery of health, wellness and
benefit programs and services to JJ employees
JJ employee
Global Health Organization dedicated to
creating, promoting and sustaining a Culture of
Health worldwide via programs services
JJ Global Community
EHS Organization dedicated to providing world
class healthy and safe working conditions
JJ Working Environment
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Global Health Mission

• Optimize medical services, and the health and
  productivity of Johnson Johnson employees
  worldwide.
• This is accomplished by providing
• Optimal, sustainable, and effective services to
  achieve human potential
• Successful management of health risks
• Product stewardship
• Health protection and health promotion strategies
  that are efficient and cost effective

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Health Promotion Program Elements

• Assessment of employee health needs (Health
  Profile)
• Targeted health promotion plan (based on
  identified health risks)
• Healthy Eating
• Promoting Activity
• Tobacco Cessation
• HIV/AIDS awareness
• Employee education/intervention (culturally
  appropriate)
• Supportive environment
• Outcomes Measurement

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Health Profile Process
Receive Invitation
Collect Biometrics
Access Web site
Complete Questionnaire
Review Report
Enter User Name and Password
Maintain Medical Contribution Discount
Password process dependent on prior
registration and access to JJ e-mail. To
maintain the MCD, Choices eligible employees must
also participate in Health Profile counseling
and/or CareConnect if invited.
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Medical Contribution Discount

• An annual 500 discount to an employees medical
  benefits contribution (19.23/pay period).
  (Choices eligible employees only)
• New hires receive the discount automatically upon
  hire.
• Three requirements to maintain the discount
• Complete the Health Profile within 90 days of
  invitation date (Discount is actually lost at 120
  days after 30-day grace period)
• Participate in Health Profile Counseling with
  SHPS, if invited.
• Participate in CareConnect Disease Management
  Program administered by SHPS, if invited.
• Choices eligible full-time employees who waive
  medical coverage must take the Health Profile and
  Health Profile counseling in order to receive
  Additional Dollars.
• Employees who are not receiving discount can
  participate any time to regain their discount (or
  Additional Dollars) on a prorated basis.
• Employees can check the Your Benefits Resources
  Web site (YBR) to determine whether they are
  receiving the discount.

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Health Profile Interventions

• Counseling
• Telephonic sessions tailored to the needs of the
  individual in areas that align to JJs Healthy
  People focus
• Smoking
• High Cholesterol
• High Blood Pressure
• Physical Inactivity

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Health Profile Interventions

• Online Tailored Health Interventions

A personalized and effective Smoking Cessation
plan
A personalized Nutrition plan made simple
A personalized comprehensive Weight Management
program
A personalized Stress Management plan
All results based on JJ Data 30 Day post
program
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Healthy Eating
One billion overweight adults 300 million of
them obese 20 or more of all cases of cancer
could be prevented with varied amounts of fruits
and vegetables.

• Eat Complete
• Support employees efforts to reduce their risk
  for hypertension, high cholesterol, cancer and
  obesity
• Opportunities for employees to access and enjoy
  Nutritionally Dense Whole Foods at every
  cafeteria, food station, vending machine, catered
  event, and whenever food is served at company
  functions
• Partnership with Food Service vendor, Global
  Health Services and Facilities/HR
• Implementation underway in the US
• Healthy Eating
• Guidelines for healthy global application are
  available

Results to date high customer satisfaction with
healthy choices
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Tobacco Free Workplace Policy - January 1st 2007

• Policy Elements
• No tobacco use at all Operating Company locations
  (property, buildings, leased buildings, company
  vehicles and company-sponsored meetings)
• Flexible guideline to comply with local, state,
  regional laws or collective bargaining agreements
• Education and Support materials/toolkit
• Planned education program
• Cessation support
• Progress
• 98 of Companies are Tobacco Free
• Several partial exemptions based on
• local laws (requiring an outside smoking area)
• safety and security issues
• CEO Cancer Gold Standard accredited - US

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HIV/AIDS Policy

• Statistics
• 42 million adults world wide HIV
• 14,000 new cases daily
• Policy Elements
• Non discrimination
• Confidential, voluntary counselling and testing
• Care, support and treatment
• Prevention, education and awareness
• Progress
• India 100 medical reimbursement for HIV/AIDS
• China included training of employees family
  members
• Malaysia Fun run to promote HIV/AIDS Awareness

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Our TotalHealth program has added significant
value to our employees and the bottom line

• The HealthyPeople program has successfully
  improved the health of US-based
  employees
• Johnson Johnsons overall medical cost
  experience has historically been below per capita
  and trend benchmarks
• Past 10 years consistently 1-2 below
  benchmarks
• Johnson Johnsons Health Wellness programs
  reduce health care costs by 400/ employee /year
• 10 year cumulative savings of 250 million

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Health Profile InterventionsOutcomes

• Impact on Health Risks

For 4500 Employees identified as High Risk
Health Risk Change
Modified Risk Factors
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Health Profile InterventionsOutcomes

• Financial Impact (per employee per year)

Utilization Type
Healthcare Expenditures in Dollars
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CareConnect

• Telephonic counseling program designed for
  individuals with complex or chronic medical
  conditions
• Individuals are matched to SHPS registered nurses
  with specific expertise in their condition

Complex Medical Conditions
Chronic Medical Conditions

• Cancer
• High-Risk Pregnancies
• Spinal Injuries
• Organ Transplants

• Diabetes
• Asthma
• Heart Disease
• Hypertension

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Cancer Prevention
Smoking is the single largest preventable cause
of disease and premature death in the world

• Bill Weldon Chairman of CEO Roundtable on Cancer
  Prevention
• Tobacco Free Policy applies to all Operating
  Company locations (property, buildings, leased
  buildings, company vehicles and company-sponsored
  meetings)
• Flexible guideline to comply with local, state,
  regional laws or collective bargaining agreements
• Operating Companies manage transition to
  tobacco-free by January 2007
• Partnership with Global Human Resources
• Support materials and toolkit from Global Health
  Services

100 of Operating Companies have implementation
plans in place 98 are already Tobacco Free
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• Employee Mental Health and Well-Being

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Employee Stress Mental Well-Being

• 450 million people suffering from mental health
  disorders at any given time
• By 2020, it is estimated that depression will be
  highest cause of disease in the developed world
• 200 billion annual cost to industry - WHO
• 60 80 of workplace accidents are stress
  related (ILO)
• 40 of workers report job is very or
  extremely stressful (NIOSH)
• At any give time, 8 of workforce is suffering
  from psychosocial health concerns (WHO)
• UK Japan Require that programs are in place
  to address workplace stress

 

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Employee Assistance

• Delivery Options
• Face-to-face consultations (on-site or community
  based)
• Telephonic consultations
• Web-based support
• Hybrid (mixture)
• Program Components
• Critical incident intervention
• Management consultation
• Assessment, counseling referral (if required)
• Education awareness
• Preventive screening
• Trend analysis

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Best Practices

• Inclusion of ROI questions before and after a
  case
• Marketing initiatives
• Brochures, posters, leaflets
• Workshops, seminars on site
• On-site counseling in India
• Newsletters and Web sites
• Orientation briefings and management referral
  trainings
• Attendance of EAP counselors at sales meetings
  and health fairs
• Close collaboration with Corporate Security and
  HR
• Customer satisfaction evaluation forms
• China design of an online screening tool to
  increase mental health prevention efforts

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Employee Assistance - Success Story

• Global Status
• 2004 30 coverage
• 2007 80 coverage
• U.S. Outcomes Study
• Return on Investment - 12MM in 2006
• Absence decreased in 90 of EAP users
• Productivity increased in 92 of EAP users
• Mental health status improved in 81 of EAP
  users

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Key Elements of Success

• Build the most appropriate business case
• What are the drivers?
• Speak the language and align with the business
• Global standards with local solutions
• Communication and recognition of cultural
  diversity
• Regulatory environment (laws, health systems,
  policies,etc.)
• Leverage global, national and regional health
  trends and initiatives
• Qualified resources health professionals
• Flexibility, patience and commitment

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Thank You !
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Creating a Successful Wellness ProgramAdopted
from Health Quest Wellness Toolkit
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Step 1 Senior Management Support1.
Organization short and long term strategic
priorities?2. What benefit can you expect from
wellness initiative and potential value?3. What
are the decision makers leadership style?
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Step 2Create a Cohesive Wellness Team1.
Develops and oversee
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Step 3Collect Data to Drive Health Efforts1.
What does the business need for health
promotion?2. What do employees want?
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Step 4Craft an Operations Plan1. Research on
biggest health risks in your companies2. Check
out HERO studies on money savings with health
promotion. www.the-hero.org3. Leverage your
teams talents.4. Be realistic when set your
goals.
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Step 5Choose appropriate interventions1.
What risk factors are prevalent in your
company?2. What does senior management want to
achieve?3. What do your employees want?4. How
much time and money do you have?5. What does
the research say?
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Step 6Create a Supportive Environment1. Not a
business fad2. Make sure that managers walk the
talk.3. Involve employees in programs4.
Spotlight employees
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Step 7Evaluate Outcomes1. Is the intervention
working?2. Is there a cost benefit?3. Provide
information and feedback
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No money-what can I do?American Heart
AssociationNational Cancer SocietyNational
Diabetes AssociationAll have free wellness
toolkits and can help you develop a program for
free with newsletters, diets, exercise programs,
etc.
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BACK UP
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Health Profile InterventionsOutcomes

• Background Two separate but related evaluation
  studies were initiated June 2002
• An evaluation of health risk changes over time
  and the impact of the high-risk intervention
  program
• A financial impact analysis of the entire Health
  Wellness Program

Studies published in the Journal of Occupational
and Environmental Medicine
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Workforce Challenges

• Mental Health/Stress-Related Disorders Two of
  the leading causes of illness, disability,
  impaired productivity
• Speed of change
• Job demands/technology
• Work/family balance
• Globalization 24/7 world
• Complex social, economic, political environments

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2007 Key Strategic Objectives

• Create, promote and sustain a Global Culture of
  Health
• Develop and support worldwide programs and
  services addressing employee well-being and the
  concept of Total Health
• Develop and promote a consistent approach to the
  deployment of occupational health services and
  standards that are in compliance with regulatory
  requirements