[caption id="attachment_44308" align="alignleft" width="105" caption="Scott Setterlund"][/caption]

Scott Setterlund, employer relations specialist for Sutter Health, has been promoting wellness for over 20 years. In his current role, Mr. Setterlund is responsible for incorporating wellness and work site strategies for mid size to large employers,  for all of Sutter's network in San Francisco, Marin and Sonoma counties, a region that includes hospitals as well as the Sutter Pacific Medical Foundation.

Mr. Setterlund will be a panelist at the North Bay Business Journal's Health Care Conference, where he will focus on wellness, particularly from an employer's standpoint looking to curb health care costs. He recently shared some of this thoughts with the Business Journal.

Q. You've been working in wellness for many years now. In what ways have you seen it change?

A. I have seen forward progress in wellness over the years.  Wellness is becoming a major player as a business strategy, partly because owners cannot keep pace with the increase in health insurance.  The language for exact outcomes is still a ways off, but owners are finally understanding the role that poor health has on their bottom-line.  However, many wellness vendors try to address this by selling a culture of health, instead of developing a culture of healthy living.  It’s one of those subtle shifts in thinking, but it speaks volumes on changing behaviors. 

Q. What are some risks of not having a well-thought-out wellness plan?

A. We know that poor health habits are what drives medical utilization, causes injuries, increases unscheduled absences and employee turnover, and correlates to low productivity.  These are line items to a business, yet the dialogue hasn’t caught up with the owners.  I believe a report from the Robert Woods Foundation said that as much as 10 percent  of a business’ annual revenue is lost due to poor health habits. 

 Q. The term wellness on its own can be a bit vague. What challenges do you and businesses face in implementing the best strategy?

A. The challenge is in discovering how “wellness” is defined for each business.  What may work at one company, may have the opposite or no effect at another.  Once a business clearly determines what their wellness goals are, then you see the return on investment.  Most studies report that a basic wellness program will bring about a 3-to-1 return on investment; the more outcome-based, sophisticated wellness programs could result in 12-to-1 return on investment. 

Q. Are there other challenges?

A. In my 20 years of experience in facilitating health promotion, the conclusion I have come to is wellness is everybody's business. We all define wellness differently. There is no reference point for wellness at a business. There's a reference point for the boss, but when you're talking about wellness, we all have different ideas. Therefore, in the business setting, it's hard to have a reference point.

A wellness product can be delivered to two different companies, but what's in those companies -- the characteristics -- becomes part of that culture. So when you talk about wellness, you have to be sensitive to these elements, and that's why it's difficult.

Q. What are some ways to overcome such issues in designing a wellness strategy?

A. What causes wellness to be successful is the buy-in. It's what [employees] do when they're at work. One of the key elements I feel is when you look at the business, it's everyone's business -- especially the c-suit executives. It's like a team. The CEO is in charge. The CEO sets the reference point  for wellness -- actions that relate to performance. A business owner should stand behind a policy such as no smoking. It comes down to business. Does the business want to allow people to to be accountable? How many customers are they losing because of someone's poor behavior.

Q. How does an employer get employees to buy-in?

A. I know a lot of employees don't know what's it's like to exercise seven days a week, but there is a minimum amount of activity we need to do to sustain our health. Most people, there only activity is going to work. About 5 percent of the population is getting exercise, about 20 percent do some, and the vast majority don't do any at all. Probably the biggest challenge in effective wellness -- aside from the c-suit buy-in -- is employee engagement and participation. How do you get them to change, to move? How do you change their lifestyles to get healthier? We need something we identify wellness with. It's nothing new, but the difficulty is putting into a dialect that everyone can relate to.