Julie Currie couldn’t help but laugh when her 4-year-old daughter, Caroline, declined a soda at a friend’s birthday, declaring "sugar is bad for you."
Currie also gets a kick out of the fact that her 2-year-old, Jack, now asks for a piece of fruit for snack time instead of the usual packet of cheese and crackers.
Caroline and Jack’s newfound interest in nutrition is a direct result of a wellness program offered by Currie’s employer, IBM.
This year, the Armonk, New York-based technology company introduced the Children’s Health Rebate, which encourages families to set "healthy living goals" for themselves and keep track of whether they are meeting those targets over a 12-week period. Participants are eligible for a $150 rebate on their health insurance premiums. This year, 22,000 of the 52,000 families in IBM’s health care plan have signed up for the rebate.
With health care costs increasing and childhood diseases, including obesity, becoming more prevalent, an increasing number of employers are including children in their wellness initiatives.
IBM views its Children’s Health Rebate as a natural evolution of its wellness programs, which target employees, says Joyce Young, IBM’s director of wellness. "Some of the behaviors that we try to address through our wellness programs naturally transfer to families," she says.
"Employers that just focus their wellness programs on their employees are missing the boat," says Hewitt Associates principal Tim Stentiford, who refers to plan participants’ dependents as "the forgotten majority."
On average, 20 percent to 25 percent of large employers’ total health care spending is on employees’ children, Hewitt reports. And this number may rise if childhood obesity continues to become more prevalent, experts say.
Childhood obesity rates have nearly tripled among children ages 2 to 5 and almost quadrupled among those 6 to 11, according to the National Academy of Sciences’ Institute of Medicine.
Experts also think that employees may be more likely to act on behalf of the health of their children than they would be to do something on behalf of their own health, Stentiford says.
"If employers are looking to get people’s attention, focusing on children’s health issues is a way of getting people to act," he says.
And by positioning wellness programs as a nice thing for the whole family, employers can take a softer approach than penalizing unhealthy behaviors, he says. It comes off more like they are looking out for their children and loved ones rather than trying to just cut health care costs, Stentiford says.
"If employers approach wellness from a holistic family basis, they have an opportunity to mitigate some of the concerns that employees have about their companies checking up on their health," Stentiford says. "Instead, these programs are viewed as tools that are for the entire family."
All of these factors went into IBM’s decision to offer its Children’s Health Rebate, Young says.
Participating families go online and fill out a form detailing their habits, such as taking an inventory of things like how much time they spend in front of computer and television screens, whether they eat meals together and what kinds of food they eat.
After filling out the online form, the families then set three goals for themselves for the next 12 weeks. Choices of goals include making their own lunches or doing a physical activity together.
Participants have access to a host of online materials on health topics and are sent a pamphlet from Weight Watchers called "Family Power," focusing on healthy living for families.
Each week, families reconvene to fill out a form about whether they met the goals.
"We have heard from parents that often it’s the kids who are doing the tracking," Young says. At the end of the 12-week program, they fill out a final questionnaire and receive the $150 rebate.
Similarly, Texas Instruments allows employees’ children to take its online wellness assessments, but doesn’t offer monetary incentives for them to do so, says Linda Moon, manager of health promotion. Children account for 27 percent of the technology company’s total health care spending.
Employees’ children are also allowed to use the company’s three fitness centers in Dallas, Plano and Sherman, Texas as long as they are supervised. Each of the centers has personal trainers who are available to work with children, Moon says.
Texas Instruments also offers teen and younger children’s camps during school vacations at all three centers. The sessions cost $170 per week and allow children to engage in a number of activities with fitness instructors, such as swimming lessons. A couple of years ago, Texas Instruments added nutrition seminars to the camp sessions.
While the company isn’t capturing any hard data on how the camps might benefit children’s health, Moon says that it seems obvious that they would have a positive effect.
"We think it’s important to target children at a healthy age because we know that many of them will be on our plan until they are 18 years old," she says. By instilling healthy eating habits and exercise in children when they’re young, the company hopes that it can help them prevent health issues such as obesity in their teens.
Minneapolis-based Medtronic has included children in its wellness initiatives for the past 10 years, says Gen Barron, benefits manager and head of the company’s wellness programs.
It makes sense that a medical technology company would make wellness a core part of its culture, Barron says. Many of Medtronic’s employees are parents of young children, so including kids in the company’s wellness programs was an obvious decision, she says.
"If kids are excited about being healthy, they can get their parents excited about being healthy," Barron says. "We feel that it’s important to reach the whole family."
To this end, Medtronic hosts annual Fun Days during the summer, where employees’ children are invited to the company’s headquarters to participate in activities such as bike safety events and yoga classes.
"We often have a nutritionist come in and talk to the kids," Barron says. The company usually gets 50 to 100 children at the event.
Last year, Medtronic went a step further. Since the company is a sponsor of the Medtronic Twin Cities Marathon, it participated in a kids’ marathon program. Through the program, which has been marketed to schools and the local community, Medtronic employees’ children can sign up online and do a virtual marathon over the course of the summer.
While Barron isn’t sure that it’s possible to track the return on investment from its Fun Days, she says that at least the company knows that it’s reaching children through its messages. "Often the question can be raised that you don’t know if your message is getting into the homes. But by bringing the kinds on site, we know that we are reaching them," she says.
Experts believe that the next iteration of wellness programs will include health risk assessments that are customized for children.
"I think we have to begin to include children in some fashion," says Fred Williams, director of health benefits management for Quest Diagnostics. "These are going to be our employees of tomorrow."
While no one interviewed for this article knew of vendors that offer a wellness assessment specifically for children, officials at IBM, Medtronic and Texas Instruments each say they would be interested in such a tool.
The challenge is that companies don’t want to be viewed as encroaching on parents’ domain, says LuAnn Heinen, a vice president at the National Business Group on Health.
"Companies have to be cautious," she says. "They don’t want to offend parents, but they want to include kids."
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