Cost-effectiveness of health risk reduction after lifestyle education in the small workplace

Investigations suggest that worksite health promotions in large companies decrease employer health costs and the risk for chronic disease. However, evidence of the success of such programs in small organizations is lacking. The purpose of this study was to determine whether a worksite health promotion program improves health risk and is cost-effective for a small employer.

Intervention (n = 29) and comparison (n = 31) participants from a 172-employee organization underwent health screening of risk factors for coronary heart disease at baseline (fall 2006) and at 12 months (fall 2007). The intervention group attended lifestyle education videoconferences and reported physical activity. We used the Framingham Risk Score to calculate risk of coronary heart disease. To calculate cost-effectiveness, we used direct employer costs of the program divided by either the relative reduction in low-density lipoprotein cholesterol or the absolute change in coronary heart disease risk.

At 12 months, low-density lipoprotein cholesterol, total cholesterol, and number of metabolic syndrome markers were significantly higher in the comparison group than in the intervention group. Total cholesterol was significantly lower at 12 months than at baseline in the intervention group. Waist circumference and number of metabolic syndrome markers increased significantly from baseline in the comparison group. Cost-effectiveness of the intervention was $10.17 per percentage-point reduction of low-density lipoprotein cholesterol and $454.23 per point reduction in coronary heart disease risk.

This study demonstrated the cost-effectiveness in a small organization of a worksite health promotion that improved low-density lipoproteins and coronary heart disease risk in participating employees.