CENTERS FOR DISEASE CONTROL AND PREVENTION
Volume 17 • Number 1 • Fall 2004

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Fieldale Farms
Baldwin, Georgia

Barriers that block access to good health care are a major problem for people new to this country, especially those with difficulty speaking English. In northeast Georgia, a poultry company is helping immigrant employees overcome these barriers and boost their cardiovascular health.

With 3,600 hourly workers and 600 salaried employees, Fieldale Farms is the largest employer in Habersham County, Georgia. About 80% of the employees are Hispanic, and a small number are Vietnamese or Laotian.

Insurance coverage is mandatory for all employees (the company pays half of the costs), and coverage is effective their first day on the job, according to Denise Ivester, the company’s Group Insurance Manager. The insurance plan covers preventive care, with a strong focus on preventing heart disease and stroke.

Cardiovascular health is also a major focus of the wellness program, which Fieldale Farms started 11 years ago. After meeting with the insurance carrier to review past claims, “we learned that cardiovascular disease was the most costly disease in our workforce, even though our workforce is so young, with most employees less than 40 years old,” Ms. Ivester said.

Cardiac Profile Is Comprehensive

The wellness program is offered to all Fieldale Farms employees and spouses who are covered by the com-pany’s health plan; about 60% of employees participate. To limit downtime, the company has on-site mobile units that bring the health screenings directly to employees. The company pays 100% of the cost for a variety of tests, including cancer screenings and a comprehensive cardiac profile.

All employees are eligible to undergo the cardiac profile, which includes tests for total cholesterol, high-density lipoproteins, low-density lipoproteins, triglycerides, and glucose. The wellness coordinator reviews each employee’s laboratory values, risk factors, and other circumstances to determine how great his or her risk is for having a heart attack or stroke. Employees are placed in one of three categories:

• Category I. These employees have normal laboratory values and fewer than three risk factors. They are offered no further wellness benefits.

• Category II. These employees have abnormal laboratory values and fewer than three risk factors or normal laboratory values and three or more risk factors. They are eligible to receive membership at a local fitness center plus nutrition counseling classes by the company’s full-time registered nurse and a dietitian, who work as a team on site visits.

• Category III. These employees are at high risk for having a heart attack or stroke within the next 5 years. They have abnormal laboratory values plus three or more risk factors, are currently experiencing chest pains, or have had a heart attack or stroke in the past. These employees are eligible for a stress test/electrocardiogram, nutrition counseling, and (if the stress test is negative) cardiac rehabilitation.

“We’re not going to add wellness benefits, such as nutritional counseling, fitness memberships, stress tests, or mini-physicals, until their cholesterol levels are at or above 240—these are the people with really severely high cholesterol,” Ms. Ivester explained. “Say an employee is in Category III, and it looks as if he will have a cardiac event in the next 5 years. We’ll send him to a physician for a mini-exam. We’ll get the cardiologist to okay a stress test for that employee. We pay for all of those benefits.”

Looking Beyond the Bottom Line

These wellness interventions have more than paid for themselves, according to Ms. Ivester. “We spend less than $200,000 a year on wellness,” she said, “and wellness makes up about 2¼% of our total health plan costs.” The investment in wellness has helped to reduce the company’s health plan costs over the past decade. The annual cost per active employee has held steady, ranging from $2,462 in 1994 to $2,716 in 2003. In comparison, other employers in the South have seen their health plan costs steadily rise, from about $3,600 in 1994 to $5,281 in 2003.

“The return on investment is very good,” Ms. Ivester said, “and we have less absenteeism. Employee loyalty comes into play because people feel good about coming to work for us.” But the benefits go far beyond the company’s bottom line, she added. “Fieldale Farms is a place where you can come and not speak the language, learn a trade, make very good pay, and get excellent benefits,” noted Ms. Ivester.

“Our employees are out there on that production line working very hard,” Ms. Ivester asserted. “We try to help these folks to stay healthy. And it’s not just the dollar savings. We want to have healthy employees and to make a difference. Our hearts are in it. I have a wonderful team here. It’s not just a job to us. If we have someone here who’s not controlling their blood pressure, it’s a real concern.”

Treating employees with respect and safeguarding their privacy is crucial to a wellness program’s success, she emphasized. And because so many employees at Fieldale Farms do not speak English, overcoming the language barriers was essential. Whether Fieldale Farms is conducting voluntary cholesterol screenings or offering health counseling sessions to employees, “we talk to them in their language,” Ms. Ivester said. “We have translators. We advertise to them in their languages what services are available. And we do nutrition counseling in their languages.”

But other cultural differences, besides language, must be considered. “We’ve even purchased food pyramids and cookbooks that feature American, Asian, and Hispanic foods,” Ms. Ivester noted. “We don’t try to change their way of eating. We’ve found that their chances of being successful are much better if we use the foods they’re accustomed to eating.”

She urges other companies to consider offering wellness benefits to employees. If enough companies were onboard in the nation’s battle against obesity, high cholesterol, high blood pressure, and diabetes, “how different it could be for our children,” she said. The obesity and diabetes epidemics are frightening, she added. “We all have issues we can work on personally, but there’s going to have to be a bigger change. Work site wellness is something that works long term. This is good for the health of individuals and the company, and it’s good for the health of this country. These things are going to make a difference. They could turn the tide for this country.”

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This page last reviewed August 30, 2004

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