When the staff at Easter Seals Iowa gathers for an employee meeting, they’ll now find healthful snacks like fruit or vegetables and bottled water set out rather than high-calorie cookies and muffins.   

It’s a small change, but one of many that together could make a big difference for Easter Seals’ more than 200 workers. In April, the nonprofit became one of the first Central Iowa organizations to be certified as a Blue Zones Worksite. The designation is a part of the Blue Zones Project, a centerpiece program of the Healthiest State Initiative launched in 2011 to make Iowa the healthiest state in the nation by 2016. 

The community well-being improvement initiative is designed to make healthy choices easier through changes in people’s working and living environments. It’s based on nine healthy lifestyle habits shared by the people living in the original Blue Zones areas - pockets of longevity in the world - found by author Dan Buettner.

Easter Seals is among about 200 organizations statewide that have achieved Blue Zones Worksite status so far, said Becky Wampler, business lead for the Blue Zones Project at Wellmark Blue Cross and Blue Shield, which is spearheading the program. Additionally, nearly 1,000 businesses, schools and grocery stores statewide have applied and are in the process of completing Blue Zones certification requirements, she said. 

No silver bullet 

The Blue Zones initiative in Iowa began as a quest by Wellmark several years ago to find effective ways to deal with soaring increases in health care costs.  “(The Wellmark board) gave us the challenge to keep (premium) cost increases no greater than (increases to) the Consumer Price Index,” Wampler said. “That was a pretty significant challenge, because in 2008, the (rate of increase in the) CPI was running around 2 to 3 percent and health care costs were in the upper-single and even double digits. So we looked across the nation and even internationally to say, what is the prevailing knowledge of what works?” 

Realizing the high failure rates of diet and exercise programs, Wellmark officials keyed in on Blue Zones as a way of changing people’s environments to make healthier choices the default option. The potential payoff for employers for the effort is healthier workers who are more engaged and productive. 

“It’s no silver bullet by any stretch of the imagination,” Wampler said. “It’s a lot of little things built into your environment so that you just naturally make healthier choices.” 

As an example, it’s impossible for a Wellmark employee to buy junk food from a vending machine in the company’s Des Moines headquarters, because only healthful items are stocked. 

“It doesn’t mean I can’t have something unhealthy at my desk; I can go over to the QuikTrip and get it,” Wampler said. “But at least I’m moving to do that.”

Little pushback

Sherri Nielsen, CEO of Easter Seals Iowa, first heard about Blue Zones while participating in Leadership Iowa a few years ago. Wellmark Vice President Laura Jackson spoke to the class about “The Blue Zones,” the Buettner book the program is based upon.  “It was fascinating to me because we had been talking about (how to approach workplace wellness) as well, and then I read the book,” Nielsen recalled. “After reading the book, I thought, ‘This isn’t going to require much money to do, and it would be small changes that our staff could model (for our clients).’” 

Using a checklist of suggested changes on the Blue Zones website, Nielsen and her staff chose options that made sense for their worksite and their clients. 

For instance, “one of the things we do is encourage clients to socialize in the community,” she said. “Now we’re suggesting they go out and exercise together rather than going out to eat, so that everyone is getting healthier together.” 

To make it easier for staff members to get in some walking while completing paperwork, Easter Seals installed a standing desk with a treadmill. 

“We were happy to know there were some things we were already doing, like the principle of ‘loved ones first,’ ” she said. “If you have a sick family member, we don’t want you at work.” So far, there has been little pushback by employees. “Everything we’ve done so far, people have said, ‘Yeah, that seems to make sense,’ ” she said. 

There is still much room for improvement, such as moving from a smoke-free environment to one in which none of its team members smoke, Nielsen said. “We aren’t there yet,” she said. “And I would love to see as many non-pop choices as pop in the pop machine.” 

Communitywide impact

The city of Spencer, which in November was named Iowa’s first certified Blue Zones Community, has already achieved significant health improvements through the program. To become certified, at least half of a community’s top 20 employers must become Blue Zones Worksites. Additionally, at least one-quarter of the community’s schools, restaurants and grocery stores must also achieve Blue Zones status, and at least 20 percent of residents must commit to the Blue Zones Project and complete at least one well-being improvement action.  To accommodate a plan to make the community more walkable, the city of Spencer has approved $200,000 in the past two years for new sidewalk construction, leading to about 200 resident applications for new sidewalks. Approximately 250 walking groups have been formed and have logged more than 136,000 walking minutes. The school district also recorded a 10 percent increase in the number of students who walk or bike to school regularly. 

The city has also expanded its community garden plots from one location with seven plots to three locations with 36 plots to enable more residents to grow and have access to fresh vegetables. 

Data from Spencer Hospital, which in August 2012 became Iowa’s first certified Blue Zones Worksite, indicate the community’s efforts appear to be paying off. Health insurance claims paid for hospital visits increased by just 1.4 percent in 2012 compared with 2011, down from an average increase of 15 percent in each of the previous five years. And results from the hospital’s spring 2013 wellness screening revealed that more than half of the residents screened eliminated one or more risk factors for cardiovascular disease and diabetes compared with the previous year, while just 6 percent experienced an increase. 

Employee commitment 

Wampler acknowledged that the majority of the 200 businesses and nonprofit organizations that have achieved Blue Zones Worksite status are concentrated in the Blue Zones demonstration cities. However, the online worksite “tool kit” is available to any organization that wants to use it. The program was also presented in a breakout session earlier this week during the Iowa Association of Business and Industry’s statewide conference in Cedar Rapids. Getting the necessary employee commitment to the program can be one of the biggest challenges for a business getting started in Blue Zones. “If an employer doesn’t have that network or ability to engage employers, it becomes a little harder,” Wampler said. 

To achieve worksite certification, at least 25 percent of a company’s workers must complete the Blue Zones Personal Pledge, which lists steps that individuals can take to improve their health. Participants are asked to select the changes they’d like to make from the list, whether it’s making new friends or finding more meaning in their lives, and commit to making those changes by signing it. 

Probably the biggest step, both for individuals as well as for organizations, is just getting started in some way. 

“There are so many great things here that an employer can do,” Wampler said. “If they at least continue down this path and do some of them, that’s a win.”

Other actions taken by Easter Seals Iowa:

- Formed a wellness committee and all leadership team members participate in the Leading for Well-Being module. 

- Provide free confidential biometric screenings for all team members.  

- Ergonomic assessments were available to all team members to ensure that computer monitors can be used without strain. 
- Clients grow produce in the Easter Seals Garden and sell it at the downtown farmers market. 
- Participation in multiple wellness events, including the Healthiest State Walk and Get Healthy DSM, and hosting a free community health fair.

To become a Blue Zones Community:

50% of the top 20 identified worksites must achieve Blue Zones Worksite designation.

25% of schools must become designated Blue Zones Schools. 

25% of restaurants must become Blue Zones Restaurants.

25% of grocery stores must become Blue Zones Grocery Stores.

20% of residents must commit to the Blue Zones Project and complete at least one well-being improvement action.

The Blue Zones demonstration communities:

Cedar Falls
Cedar Rapids 
Iowa City
Mason City
Sioux City 
Spirit Lake 

Blue Zones Worksite Pieces:

Are the organization’s leaders (at all levels) modeling 
well-being behaviors and influencing an environment that supports the well-being of others? 

Does the organization have a purpose that employees connect with, and does the organization support employees to identify and pursue their own purpose inside the context of their work? 

Habitat/physical environment: Does your worksite promote healthy practices and empower employees to make healthful choices through the physical layout and worksite setting? 

Engagement/creation of social networks
Is there a clearly defined engagement strategy that uses an effective mix of communications, incentives and social events to help promote well-being improvement? 

Policies and benefits
Are your human resources policies and benefits designed to encourage well-being? 

Well-being solutions
Are there engaging solutions to support employee efforts to improve and sustain well-being?