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bone, the exercise intervention affected other factors that are know to be associated with a risk of falling. The women in this study got stronger, increased their muscle mass, improved their balance, and showed an increase in levels of physical activity (8)

Our research has also shown that strength training is safe and effective even in the most frail of seniors in their 10th decade of life. We recruited a group of 100 nursing home residents - many with cognitive disorder and multiple chronic diseases. Ten weeks of strength training tripled their strength, improved their balance, their ability to stand from chair, their ability to walk and climb stairs. This simple intervention increased their activity level and decreased their symptoms of depression. Many told us that they no longer needed to ring for a nurse to use the toilet. Many told use that they could get up and get their meals rather than having it delivered to them.

Strength training is very safe and has a powerful effect in older people. In fact the gains that elderly people make from this exercise are greater than those seen in young men and women. These effects include: improved strength and fitness, increased levels of physical activity, decreased risk of osteoporosis, improved retention of dietary protein (older individuals need more protein than do young people - and this exercise increases the ability of older people to retain protein even on a marginal intake), improved glucose tolerance and decreased risk of type 2 diabetes (and the long-term consequences of this disease), improved balance, and increased Calorie needs (so that the overweight elderly can lose weight safely) (4). Because older people are more frail and have a much higher incidence of chronic disease, there is no single segment of our society that can benefit more from a regularly performed exercise program. Exercise and increased physical activity should be the standard of care for every elderly person (3). The greatest cost savings of good nutrition and exercise will be seen in this population because the effects are seen so quickly.

Finally, it goes without saying that this research could not have been accomplished without support of the Veterans Administration and the National Institutes of Health. These two agencies have been at the forefront of efforts in understanding the physiological and metabolic consequences of aging and how exercise and diet can allow seniors to live and active, productive, vigorous life with dignity.

Although Shakespeare reflected on growing disability with age, he must have also been a specialist in geriatric, because he understood that is was possible to prevent late-life disability through good habits:

Though I look old, yet I am strong and lusty;
For in my youth I never did apply
Hot and rebellious liquors in my

blood

Nor did not with unbashful forehead woo

The means of weakness and debility:
Therefore my age is as a lusty winter,
Frosty, but kindly. Let me go with you;

l'll do the service of a young man

In all your business and necessitites.

As You Like It, Act II, Scene III, lines 46-55.

References:

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2. 3.

4.

5.

6.

Evans, W. Functional and metabolic consequences of sarcopenia. Journal of
Nutrition;127:998S-10035,1997.
Evans, W. What is sarcopenia? J. Gerontol.;50A(special issue):5-8,1995.
Evans, W J. Exercise as the standard of care for elderly people. J Gerontol A
Biol Sci Med Sci;57:M260-1.,2002.
Evans, WJ, I R Rosenber, and J Thompson. Biomarkers: The Ten
Determinants of Aging You Can Control. New York: Simon & Schuster, 1991.
Frontera, WR, CN Meredith, K P O'Reilly, HG Knuttgen, and W J Evans.
Strength conditioning in older men: skeletal muscle hypertrophy and
improved function. J. Appl. Physiol.:64:1038-1044,1988.
Janssen, I, R N Baumgartner, R Ross, I H Rosenberg, and R Roubenoff.
Skeletal muscle cutpoints associated with elevated physical disability risk
in older men and women. Am J Epidemiol;159:413-21.,2004.
Janssen, I, D S Shepard, PT Katzmarzyk, and R Roubenoff. The healthcare
costs of sarcopenia in the United States. J Am Geriatr Soc:52:80-5.,2004.
Nelson, ME,M A Fiatarone, C M Morganti, I Trice, R A Greenberg, and W
| Evans. Effects of high-intensity strength training on multiple risk factors
for osteoporotic fractures. JAMA;272:1909-1914,1994.
Zoico, E, V Di Francesco, J M Guralnik, G Mazzali, A Bortolani, S
Guariento, G Sergi, O Bosello, and M Zamboni. Physical disability and
muscular strength in relation to obesity and different body composition
indexes in a sample of healthy elderly women. Int J Obes Relat Metab
Disord;28:234-41.,2004.

7.

8.

9.

Senator KOHL. Thank you, Mr. Evans. Mr. Herman, tell us about your company.

STATEMENT OF MR. BILL HERMAN, VICE PRESIDENT OF HUMAN RESOURCES, HIGHSMITH, INC., FORT ATKINSON, WI Mr. HERMAN. I am happy to, Senator. Good morning. It is a pleasure to be here.

Like most businesses in our country, Highsmith is a small business. We are a family owned distribution company located in rural Wisconsin, halfway between Milwaukee and Madison.

We have approximately 220 employees. Our customers are libraries and schools.

Over the last 10 years, we have received a remarkable number of awards and a flood of national publicity for our wellness and employee development initiatives. We earned that recognition by managing our health care costs; at the same time, we improved the quality and productivity of our workforce. In fact, those two things are closely linked. But we really set out to accomplish much more.

We set out to ensure the long-term vitality and viability of a growing business.

Our response to the crisis in health care costs and health risk management has always served that goal. In fact, my point today is that wellness and employee development have been successful at Highsmith because we have made them a part of our business plan.

We have learned the value of a well thought out strategic approach to implementing and sustaining health and wellness concepts within our organization, concepts that continue to influence and effect the lives of employees after they retire. Our culture is supportive of health lifestyle choices and encourages good nutrition and lifestyle activity.

At Highsmith, wellness is not viewed as just a program, but rather as a strategic initiative to nurture the human capital necessary to meet corporate goals and objectives.

Over time, we found that traditional definitions of wellness and health promotion often fell short of encouraging personal responsibility for health and wellbeing.

Highsmith undertook a fundamental transformation in our view of wellness. We think the terms wellness and employee development are interchangeable. Engaging employees in their jobs, emphasizing learning and development, providing tools to balance work life responsibilities, along with health and wellness have all been integrated at Highsmith.

This initiative encompasses a carefully managed blend of seven components: job-career development, work life enrichment, personal wellbeing, self-care, physical wellbeing, monetary incentives as applied to health insurance premiums, and a comprehensive array of benefits.

A key piece is the monetary incentives. If an employee and spouse qualify for the incentive, Highsmith pays 75 percent of their single or family health insurance premium. If one doesn't participate, we pay only 60 percent. The voluntary eligibility requirements to qualify for the incentive are enrollment in our health insurance plan, to be a non-user of all tobacco products, participation in our annual health screening, plus age and gender specific physical exams.

Eighty-three percent of our employees on our health plan do participate.

The annual health screening for employees and spouses measures height and weight, blood pressure, a carbon monoxide screen to determine if one smokes, a full blood lipid panel, glucose, and a treadmill fitness test.

Participants also complete a coronary risk profile. The most critical part of the health screening is delivering immediate feedback and helping people understand it.

There are four distinct feedback stations as part of the health screening. One of the stations is a focus on emotional wellbeing. Some of the results that we have been able to measure in the period 2000 through 2004 are we have had a 53 percent decrease in total participants with high-risk cholesterol levels. We have had a 52 percent decrease in total participants with high blood pressure; a 72 percent decrease in total participants whose VO2 submax was high risk-how healthy your heart is. We have normal blood glucose levels in 84 percent of all participants.

We have experienced an average increase in health insurance premiums of only 5.4 percent over the last 4 years. Employee turnover is single digit, and our average tenure is 14 years.

Utilization of our employee assistance program was 22.8 percent for 2004. The national average hovers between 4 and 6 percent.

So in conclusion, I would like to reiterate that wellness and health promotion is not a program at Highsmith. It is not a stand alone. It is really a strategy initiative to have the human capital necessary to meet our corporate goals and objectives. Thank you.

[The prepared statement of Mr. Herman follows:]

Providing libraries and learning with products, services and ideas.

Senate Special Committee on Aging
June 30, 2005 Hearing Test ony

Contact:
Bill Herman
W5527 State Road 106
P.O. Box 800
Fort Atkinson, WI 53538
(920) 563-9571
bherman@highsmith.com

Highsmith Inc. is a distributor of supplies, furniture and equipment to public,
academic and special libraries, as well as schools and school libraries throughout
the U.S. and abroad. Headquartered in Fort Atkinson, WI, Highsmith employs
220 people and markets over 25,000 products through more than a dozen
specialty catalogs and a direct sales force located strategically throughout the
country.
The company has a reputation as an innovator in organization design, employee
development, health risk management & wellness programming. Highsmith
received one of the 2004 Secretary's Innovation in Prevention Awards from the
Department of Health & Human Services and is a two-time recipient of the
Wellness Council of America's Gold Well Workplace Award and the inaugural
recipient of the Platinum Well Workplace Award. In 2003, Highsmith was
recognized by the State of Wisconsin with a Corporate Culture Award for our
focus on employee retention, motivation and our unique learning and
development model. And most recently, we were recognized with the Wisconsin
Psychologically Healthy Workplace Award. Highsmith has also been featured in
The New York Times, Business & Health magazine, MSN.com and on NBC. The
Nightly News with Tom Brokaw.

We have been active in health promotion and wellness initiatives since 1990. At that time, there was very little research that indicated there would be a return on investment for wellness dollar expenditures. We intuitively believed if we promoted healthy lifestyles, we could have an impact on healthcare cost and productivity. We knew this couldn't happen overnight. We needed to slowly raise the awareness of our employees on health, and shift our corporate culture to be more in alignment with supporting healthy lifestyle behaviors. We began to target dollars for services to nudge and encourage employees to make healthy lifestyle decisions.

Fifteen years later, Highsmith's commitment to health and wellness is stronger than ever as evidenced by our successes with employee development, and has allowed us to achieve an average of only a 5.4% increase in our healthcare premiums over the last four years.

We've learned the value of a well thought out strategic approach to implementing and sustaining health and wellness concepts in our organization. Concepts that continue to influence and affect the lives of employees after they retire. Our culture is supportive of healthy lifestyle choices and encourages good nutrition and lifestyle activity. At Highsmith, wellness is not viewed as just a program, but rather as a strategic initiative to nurture the human capital necessary to meet corporate goals and objectives.

Highsmith Inc.
W5527 State Road 106
P.O. Box 800
Fort Atkinson, WI 53538-0800
920 563 9571 TEL
920 563 7395 FAX
www.highsmith.com

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