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	<title>Open Mike &#187; Environment</title>
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		<title>The human factor in so-called &#8220;natural&#8221; disasters</title>
		<link>http://www.mikecritelli.com/2011/09/03/human-factor-socalled-natural-disasters/</link>
		<comments>http://www.mikecritelli.com/2011/09/03/human-factor-socalled-natural-disasters/#comments</comments>
		<pubDate>Sat, 03 Sep 2011 12:01:57 +0000</pubDate>
		<dc:creator>Mike Critelli</dc:creator>
				<category><![CDATA[Business Lessons]]></category>
		<category><![CDATA[Environment]]></category>
		<category><![CDATA[Government]]></category>
		<category><![CDATA[Infrastructure]]></category>
		<category><![CDATA[Politics]]></category>
		<category><![CDATA[Public Policy]]></category>
		<category><![CDATA[Transportation]]></category>
		<category><![CDATA[Transportation Financing]]></category>

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		<description><![CDATA[Our family was fortunate this past weekend in not experiencing any property damage or loss of power from Hurricane Irene.  700,000 other residents of Connecticut were not so lucky.  However, as I have thought about this disaster and others through which I lived during my lifetime, I have increasingly realized that much of the devastation [...]]]></description>
			<content:encoded><![CDATA[<p>Our family was fortunate this past weekend in not experiencing any property damage or loss of power from Hurricane Irene.  700,000 other residents of Connecticut were not so lucky.  However, as I have thought about this disaster and others through which I lived during my lifetime, I have increasingly realized that much of the devastation of natural disasters is not “natural.”</p>
<p>Sometimes, the influence of bad human decision making on the scope of a disaster is obvious: Hurricane Katrina would not have been anything more than just another bad Gulf Coast hurricane, had the levees protecting big portions of New Orleans not failed to protect the city against water damage.  The levees were not built to protect against Category 4 or 5 hurricanes, so a disaster of the type that happened was inevitable and experts were not surprised when it happened.  Experts warned of this kind of problem, but were ignored year after year. Nevertheless, most of the time, we forget the degree to which we can anticipate disasters and minimize their impact.</p>
<p>&nbsp;</p>
<p><span id="more-755"></span></p>
<p>In 1991, after Hurricane Bob, which hit Long Island, the Eastern Connecticut coast, and Cape Cod very hard, the homeowners association of which I was a board member could not initially secure a renewal of our property and casualty insurance policy from any carrier.  National media carried stories about horrific beach erosion in the 4-mile stretch of beach, beginning half a mile west of us.  The beach and the houses on it had been completely washed away by both the hurricane and a nor’easter that followed it a few weeks later.  The media story was that nature was getting more ferocious over time, and people had to stop building homes on the beach.</p>
<p>While it may be good public policy to provide better beach access for all residents of a beachfront community and for visitors, and to reduce the building of private homes on the beach, the story was wrong.  The beach erosion was not a result of nature’s fury, but of a misguided decision by the Suffolk County New York Supervisor some years before to refuse to pay the County’s share of a project to extend protective beach barriers for the last 4 miles of the barrier island.  The 4-mile stretch bore all the force of the ocean tides, instead of having it spread over the entire island.  Ferocious winds and tides destroyed the beach, but it was vulnerable to destruction, because of human error, a decision to leave the beach unprotected.</p>
<p>Similarly, power outages and flooding are usually a result of a number of human decisions.  In many communities, utilities are not permitted by homeowners to trim branches from trees on an appropriate schedule, with the result that those branches break off during storm, hit overhead power lines, and cut the lines.  Street flooding is usually a result of poor drainage from inadequately built or maintained roads.  Basement flooding is often the result of building codes that do not require adequate soil fill under the foundation of a house or other kind of building.  We discovered this when our basement flooded many times in the last decade, because our builder cut corners in having only four inches of soil fill, when best practice indicated that 12 inches of fill was the minimum desirable.  Trees are often uprooted and destroy or damage whatever they fall on because poor soil drainage erodes the soil that holds roots in place.</p>
<p>In the storm’s aftermath, we are seeing the consequences of decades of underinvestment in our commuter rail systems.  The commuter railroads were not  able to resume service as rapidly as the New York subways because they have suffered far more preventable damage.</p>
<p>Wind damage results from structures that are not built to withstand winds above a certain level of intensity, and items inadequately secured to the ground or not stored properly in anticipation of a storm become projectiles that destroy everything in their path. In the spring of 1979, Chicago experienced a freak 70-mile per hour windstorm one afternoon, with the result that a thick wooden restaurant sign hanging by two chains to the restaurant’s patio came loose and killed a pedestrian.</p>
<p>The 1906 San Francisco earthquake caused most of its fatalities because the fire department had not properly secured its water lines, so it was unable to get water out to extinguish some of the fires.  Similarly, communities often fail to think through how they will get rescue vehicles to stranded residents, which created many issues in the Gulf Coast areas after Hurricane Katrina.</p>
<p>We are better at responding to disasters today because of the intense focus on what went wrong with Hurricane Katrina, but the problems with our infrastructure and the underinvestment in rebuilding, maintaining, and renovating roads, bridges, tunnels, and buildings will continue to make the impact of natural disasters far worse than they need to be.</p>
<p>We need better ways to hold elected officials accountable for decisions they make that put us at risk, not immediately, but over time.  Since we do not know when “natural disasters” will hit, it is tempting to defer maintenance, repair, and renovation that will secure our facilities from damage, but insurance companies, bond rating agencies, and watchdogs acting on behalf of voters should do a better job warning us.  As citizens, we need to send strong messages to elected officials that using their office to redistribute wealth and income from taxpaying citizens to favored constituents, instead of using taxes to maintain and strengthen the assets for which they are responsible is wrong.</p>
<p>&nbsp;</p>
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		<title>CHANGING BEHAVIORS</title>
		<link>http://www.mikecritelli.com/2008/10/21/changing-behaviors/</link>
		<comments>http://www.mikecritelli.com/2008/10/21/changing-behaviors/#comments</comments>
		<pubDate>Tue, 21 Oct 2008 19:01:32 +0000</pubDate>
		<dc:creator>Mike Critelli</dc:creator>
				<category><![CDATA[Energy Independence]]></category>
		<category><![CDATA[Environment]]></category>
		<category><![CDATA[Government]]></category>

		<guid isPermaLink="false">http://www.mikecritelli.com/2008/10/21/changing-behaviors/</guid>
		<description><![CDATA[I find a lot of the commentary on what we will have to do to achieve energy independence and to adjust to a time of scarcity to be misguided.  Telling Americans they have to “sacrifice” and “conserve” sounds good, but is not sustainable over the long term. On the contrary, finding ways in which to [...]]]></description>
			<content:encoded><![CDATA[<p>I find a lot of the commentary on what we will have to do to achieve energy independence and to adjust to a time of scarcity to be misguided.  Telling Americans they have to “sacrifice” and “conserve” sounds good, but is not sustainable over the long term.</p>
<p>On the contrary, finding ways in which to conserve energy or reduce spending that actually are perceived as beneficial to individuals is far more likely to succeed and be sustainable.  Why does the “sacrifice” or “conserve” message not work?<span id="more-83"></span></p>
<ul>
<li>Telling anyone to sacrifice will inevitably create the potential for resentment and class warfare, because not everybody will choose to sacrifice equally.  Those struggling to succeed will resent such a message because they believe they are already sacrificing.</li>
<li>I believe that human beings can be in a deprivation mode only during the pendancy of a crisis.  If oil prices decline and if their day-to-day situation gets better, they will stop sacrificing, and we will lose the ability to achieve energy independence.</li>
<li>The wrong kinds of sacrifices will reduce the potential for economic growth and recovery.</li>
</ul>
<p>So what is the alternative way to solve this problem?  With respect to energy conservation, let’s find ways to make less energy usage a positive for Americans.  In my testimony to the Connecticut Transportation Strategy Board, which is posted on my blog at <a target="_blank" href="http://www.mikecritelli.com">www.mikecritelli.com</a>, I make the following suggestions:</p>
<ul>
<li>Give more employees the ability to telecommute all or part of the time.  This saves them significant commuting cost and hassle, and can increase their productivity by enabling them to use effective mobility tools to get their work done at home or at satellite locations.</li>
<li>Make more events or activities at work “business casual” to reduce the cost of wardrobe acquisition and maintenance.  Many workplaces are already five-day “business casual,” and Pitney Bowes made that decision 11 years ago.  However, we can make more events less dressy over time.  This may not help specific segments of the fashion industry in the short term, but they can recover over time by adapting to changed consumer demand.</li>
<li>Shrink the workspaces of employees at work, but provide them with more amenities, such as more conference rooms, more access to light, more environmentally-friendly workspaces, and more common-area amenities, like kitchen areas and fitness spaces.  We did that at our headquarters, reduced costs, and increased our employees’ satisfaction with their work spaces significantly.</li>
<li>Offer services through the mail that individuals today have to access by taking non-work time.  For example, give individuals the ability to vote by mail, to get permits and licenses they need by mail, to get more prescription and over-the-counter drugs by mail, and to get more purchased items delivered to them, rather than having them having to take valuable time looking for them.</li>
<li>At the same time, as we increase delivery options, we should consolidate the number of delivery services that occupy our streets and consume energy and create traffic congestion.  The U.S. Postal Service has recently become the carrier for FedEx, UPS, and DHL for residential deliveries in many geographic areas.  There are many local delivery services that could consolidate their transportation capabilities and have shared services that would reduce their costs, increase convenience for consumers, and improve the environment.</li>
<li>The Internet is a wonderful tool to enable individuals to learn who else is traveling somewhere or who has an item that can be borrowed or purchased at a lower cost in order to save resources and consumption.  For example, I like the idea that <a target="_blank" href="http://www.amazon.com/">Amazon.com </a>is connecting book purchasers with people wanting to sell used books, instead of having a new book printed to satisfy a consumer’s need.</li>
</ul>
<p>None of these ideas require individuals to “sacrifice” or “conserve” anything, but, cumulatively, they can produce significant energy savings, reduced cost, and improved consumer satisfaction.  Government should be convening private sector innovators to employ some of these ideas and should let the private sector do what it can do best to make some of these ideas more widespread.  As an employer, government should also be setting an example in some of these areas.</p>
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		<title>HEALTH RELATED LEGISLATION</title>
		<link>http://www.mikecritelli.com/2008/09/02/health-related-legislation/</link>
		<comments>http://www.mikecritelli.com/2008/09/02/health-related-legislation/#comments</comments>
		<pubDate>Tue, 02 Sep 2008 18:09:12 +0000</pubDate>
		<dc:creator>Mike Critelli</dc:creator>
				<category><![CDATA[Citizen Engagement]]></category>
		<category><![CDATA[Environment]]></category>
		<category><![CDATA[Government]]></category>
		<category><![CDATA[Health]]></category>
		<category><![CDATA[http://www.wsj.com/article/SB121729138312691695.html]]></category>

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		<description><![CDATA[Two news items pertaining to health-related legislation caught my attention this summer.  In the July 22 issue of The Wall Street Journal, in an article entitled “Exiling the Happy Meal,” reporter Sarah McBride discussed proposed legislation in Los Angeles that would ban fast-food restaurants like McDonald’s and KFC from opening in a 32-square-mile section of [...]]]></description>
			<content:encoded><![CDATA[<p>Two news items pertaining to health-related legislation caught my attention this summer.  <a target="_blank" href="http://online.wsj.com/article/SB121668254978871827.html?mod=googlenews_wsj">In the July 22 issue of The Wall Street Journal, in an article entitled “Exiling the Happy Meal,”</a> reporter Sarah McBride discussed proposed legislation in Los Angeles that would ban fast-food restaurants like McDonald’s and KFC from opening in a 32-square-mile section of the city.  Not surprisingly, one critic referred to the proposed legislation as an “example of a nanny state.”  Another critic, the president of the California Restaurant Association, blamed the obesity epidemic on “sedentary lifestyles and lack of nutrition education.”</p>
<p>The article also referred to New York City’s law requiring disclosure of calories on the main menus above the counter, and noted that San Francisco also will implement calories disclosure legislation.</p>
<p>A second article, dated <a target="_blank" href="http://www.wsj.com/article/SB121738143076895605.html?mod=wsjcrmain">July 30, also in The Wall Street Journal, entitled “San Francisco Votes For New Tobacco Rules”</a> reporter Ann Zimmerman describes San Francisco’s proposed law to ban tobacco sales at pharmacies. An article in the <u>Journal</u> the day before, also written by Ann Zimmerman, entitled <a target="_blank" href="http://www.wsj.com/article/SB121729138312691695.html">“Drugstore Tobacco Sales Under Fire”</a>  summarizes arguments from opponents of the legislation that suggest that the legislation will have little impact on smoking rates and will force retailers to deny members of the public something they want.<span id="more-73"></span></p>
<p>The fundamental divide between supporters and opponents of these kinds of legislation is whether changing the environment in which people shop and seek out restaurants will make a significant difference in public behaviors.  <a target="_blank" href="http://www.amazon.com/dp/0300122233/?tag=googhydr-20&amp;hvadid=2315290341&amp;ref=pd_sl_1zeaw9970r_b">A recent book entitled Nudge, co-authored by Professors Cass Sunstein and Richard Thaler,</a> makes a compelling argument that the environmental cues given to people matter greatly.  In their view, the government always is creating a <a target="_blank" href="http://en.wikipedia.org/wiki/Nanny_state">“nanny state”</a> environment.  The only question is whether it is a healthy or unhealthy environment.</p>
<p>While nutrition education certainly makes a difference, as Melinda Beck of The Wall Street Journal in her <a target="_blank" href="http://www.wsj.com/article/SB121728720696791385.html?mod=most_viewed_day">July 29 column entitled “On the Table: the Calories Lurking in Restaurant Food</a>,”<a target="_blank" href="http://www.dr-bob.org/babble/eating/20060628/msgs/694724.html">Dr. Brian Wansink of Cornell University, in his great book Mindless Eating</a>, clearly demonstrates that how much we eat and what we eat are highly influenced by what is available, affordable, accessible, and abundant.</p>
<p>With respect to tobacco products, the easy availability in pharmacies has two behavioral effects: it makes access to tobacco easy, and it sends a symbolic message that tobacco usage is not as risky to health as we know it to be.  Pharmacies have a branding as places to which one goes to buy products that enhance health, not places that destroy health.</p>
<p>I commend Wegman’s, the grocery chain based in Rochester, New York, my hometown when I was growing up, <a target="_blank" href="http://www.pe.com/business/local/stories/PE_Biz_D_smokingbans13.172d121.html">which announced recently that it will stop selling cigarettes in its stores</a>. While some individuals will stop going to Wegman’s because it refuses to sell cigarettes, I would assume that it will gain credibility as a grocery retailer firmly committed to health.</p>
<p>These legislative measures will not solve the problem of unhealthy behaviors, but they certainly are a step in the right direction.</p>
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		<title>SPEECH TO LEADERS-TO-LEADERS CONFERENCE CENTERS FOR DISEASE CONTROL AND PREVENTION WASHINGTON, DC JULY 9, 2008</title>
		<link>http://www.mikecritelli.com/2008/07/14/speech-to-leaders-to-leaders-conference-centers-for-disease-control-and-prevention-washington-dc-july-9-2008/</link>
		<comments>http://www.mikecritelli.com/2008/07/14/speech-to-leaders-to-leaders-conference-centers-for-disease-control-and-prevention-washington-dc-july-9-2008/#comments</comments>
		<pubDate>Mon, 14 Jul 2008 19:59:42 +0000</pubDate>
		<dc:creator>Mike Critelli</dc:creator>
				<category><![CDATA[Education]]></category>
		<category><![CDATA[Environment]]></category>
		<category><![CDATA[Health]]></category>

		<guid isPermaLink="false">http://www.mikecritelli.com/2008/07/14/speech-to-leaders-to-leaders-conference-centers-for-disease-control-and-prevention-washington-dc-july-9-2008/</guid>
		<description><![CDATA[I want to begin by thanking Doctor Gerberding and her team for convening and hosting this extremely important conference. I come to you as a leader of a company, Pitney Bowes that defined employee health and well-being as a core value even before I became CEO in 1996. Our mail stream businesses have always required [...]]]></description>
			<content:encoded><![CDATA[<p>I want to begin by thanking Doctor Gerberding and her team for convening and hosting this extremely important conference.  I come to you as a leader of a company, Pitney Bowes that defined employee health and well-being as a core value even before I became CEO in 1996.</p>
<p>Our mail stream businesses have always required a high degree of subject matter expertise and relationship-building with postal services and customers that take many years to learn and master.  Therefore, for several decades, we had been a generous company in delivering benefits that rewarded and encouraged employee loyalty and commitment.</p>
<p>In 1990, this commitment to employee health and well-being was being challenged by our inability to continue offering health plans that essentially provided medical benefits without meaningful employee contributions in terms of premiums, co-pays and deductibles.  Our costs were increasing at an alarmingly high 14% per year, and we were not delivering a high degree of employee satisfaction.  When I became head of human resources in 1990, I had the unenviable task of committing us to a long-term course of action that required higher employee premiums, co-pays and deductibles, but I also recognized that we had to maintain and/or increase employee satisfaction with our benefit offerings, or we were going to lose one of our key talent retention tools.<span id="more-65"></span></p>
<p>From 1990 on, we changed our philosophy in subtle, but important, ways.  First, we engaged our employees in the dialog.  We gave them the information which helped them understand and embrace the reality that the existing health plan, while it appeared to be highly-beneficial, provided virtually free care, resulting in the siphoning off of money to outside providers, thus reducing reinvestment into our business, shareholder value through dividends, or even yearly compensation increases.  In effect, totally free health care meant massive wealth transfer was taking place from Pitney Bowes shareholders, which includes our employees, to outside health care providers and administrators without obvious benefits or results. Accountability was missing from providers, administrators, employees, and insurance plans.</p>
<p>Second, we helped our employees understand that more care, even if it were free, was not necessarily better care.  Based on data, we demonstrated that there were good, bad, avoidable, and marginal uses of the health care system, and that we would modify our plans to provide our employees with more effective and results based care and to discourage bad, avoidable or marginally-beneficial uses of the health care system.</p>
<p>Resulting from our employee engagement efforts, in 1991, we did increase premiums, co-pays, and deductibles, but we also introduced coverage for many valuable preventive screenings in our self-insured plan, including mammograms, colonoscopies, and blood tests to detect and effectively manage diabetes and cardio-vascular conditions.  We also introduced free coverage for well-baby and well-child care, including immunizations.</p>
<p>In 1992, as planned, we again increased premiums, co-pays and deductibles, but we also opened our first free clinic in our World Headquarters, and we introduced premium incentives for non-smokers and those who regularly used seat belts and safety helmets.</p>
<p>In 1993, we launched our flexible benefits program, which gave employees far more flexibility to use their benefit dollars in ways that mattered to them, but we again increased premiums, deductibles, and co-pays.</p>
<p>We balanced the reality of increasing cost-sharing employee requirements with the provision of ‘value add’ free services, which the employees desired and appreciated.</p>
<p>Later in the 1990’s, based on our earlier challenges, successes and a commitment to trying to reduce the financial impact of burgeoning healthcare costs, we became even more convinced that we needed to develop a strategy which would influence our employees to adopt healthy behaviors.  After much research we implemented a strategy of linking voluntary, healthy behavior adoption to financial incentives.  We built a platform called “Health Care University,” which enabled participants to gain benefit credits for completing a health risk assessment or for participating in various kinds of wellness programs. This initiative exceeded our expectations in terms of employee satisfaction and improved the overall health of our employee base.</p>
<p>Leaping forward into this decade, we have made two further innovations.  First, in our health plan designs, we began to understand that we could predict future costs by looking at population-level data for prior years.  For example, we discovered that if we had employees who had been diagnosed with diabetes, but had not spent any money on maintenance drugs or were not taking them, these participants were highly likely to cause us to spend more than $10,000 in hospitalizations or emergency department care in a current or future year.  The solution was clear. We knew that we needed to modify our plans to reduce the likelihood that this would happen in the future.</p>
<p>In fact, very much like the way Edward Deming and disciplines like Philip Crosby talked about upstream investment in quality that would pay for itself over time, we recognized that upstream investment in engaging plan participants to take maintenance medications would pay off over time in terms of employee health and productivity and improved shareholder investment return.</p>
<p>Thus, rather than increasing the cost of maintenance drugs for chronic illnesses, which was the more common approach across most health plans, we reduced the cost. For chronic disease medications conditions such as asthma, diabetes, cardiovascular disease, and behavior health, we reduced employee co-pays for brand name drugs by between 50% and 85%.  We received a significantly positive payback, which I will share with you in a few moments.</p>
<p>More recently, we became acutely aware of the multiple benefits from creating a positive work environment for our employees.  As we renovated our World Headquarters, we reduced the number of walled offices and shrunk average office sizes.  We also virtually eliminated desktop printers, copiers, and fax machines, and replaced them with core area multi-functional devices.</p>
<p>By doing this, we created more exposure to natural sunlight for everyone; encourage our employees to walk around more during the work day, which was good for their health; and we created more meeting rooms for people to converse with one another, which improved morale and a sense of well-being.</p>
<p>We also significantly altered their experience in our cafeterias.  The healthy food was more plentiful, lower cost and more easily accessible.  The less-healthy food was made more expensive, less plentiful, and less accessible – we increased the distances people had to walk to find it.  We also slowly, reduced portion sizes for all meals to reflect the recommended healthy portions of anything an employee choose to eat.  For those who have chosen to participate fully in our benefit offerings, the wellness results have been tremendous.</p>
<p>Hence, I have come to realize that, while we must continue to emphasize personal responsibility for health among our employees, we, the employers, have an obligation to do what we can to create healthy work environments.  Employees, like anyone else, will respond to the environment in which they find themselves.  We, at Pitney Bowes have made doing the healthy thing an easy course of action to take and maintain.</p>
<p>At the risk of making our Pitney Bowes healthcare story sound easy, like any other large employer, we have challenges.  We particularly are challenged by those employees who work remotely at customer sites in small numbers.  Our Management Services Division has over 600 sites, with an average population of 20 employees per site, which makes that part of our business resemble a collection of small businesses. We also have several thousand sales and customer service professionals for whom their automobile is their workplace, as they travel from call to call during the day. We have come to realize that, for these populations, we need to communicate our health and wellness strategy more regularly at their remote sites and homes, and to engage their spouses or partners for added support.</p>
<p>We also recognized that, for populations in which we experience higher average turnover, like Sales, we needed to emphasize investment in health with shorter paybacks, such as our Flu Fighters program, which we launched in fall 2007.  This program was very successful in getting employees from all over the country to get their seasonal flu shots, which significantly decreased our incidence of both influenza and other upper respiratory ailments last winter.</p>
<p>In spite of the challenging and highly financially competitive business environment in which many of our businesses operate, we have not experienced higher-than-anticipated employee turnover among longer-service employees, or among our executive population.  Our only turnover challenge has been younger and relatively low-tenured professionals, who do not always tend to value health care benefits as highly.</p>
<p>I mention this last population because I believe that the longer-term solution is to educate them that managing their health is as important in their 20’s as they will perceive it to be when they are in their 40’s, 50’s and 60’s.  We know that Type 2 diabetes is hitting our younger people earlier and earlier, and, sadly, the population that seems most resistant to the longer-term declining trend in smoking is younger, single women.  At Pitney Bowes, we have begun an active, but empathetic outreach to these populations to get them more engaged in managing their health, and, although we have experienced some early successes, we are still at the beginning stages of understanding how to be effective in changing health behaviors in young people and how to use our commitment to their health and well-being as a retention tool.</p>
<p>In short, we at Pitney Bowes have achieved a lot, but humbly, there is still a lot of work to do and it is not necessarily easy. It will take creativity and innovation.</p>
<p>One innovation initiative that PB is vested in is the growing arena of tools for self-management of health. We are one of the founders of an initiative called Dossia, a non-profit, third-party organization with members such as Intel, BP, AT&amp;T and Wal-Mart. Dossia’s goal is to fund the development of a web-based framework through which U.S. employees, dependents and retirees, and, eventually, others, can maintain private, personal and portable health records, as a way of empowering individuals to pursue health and to reduce provider medical costs. Dossia’s premise is that we can not overcome the health crisis in this country until most Americans manage their health metrics as closely as they manage their daily and weekly budgets</p>
<p>At Pitney Bowes, we believe that employees should be as conscious of their exact state of health as they are of everything else that matters to them.  Health management is a collaborative opportunity to work with others to share knowledge and to reinforce best practices.  To the degree that we create an environment where people eat healthy foods together, participate in healthy exercise programs together, and support each other in refraining from smoking and excess alcohol consumption, we have created an environment in which they will also team to create shareholder and customer value opportunities. Good health requires vigilance and personal responsibility.</p>
<p>What are the tangible results of Pitney Bowes decades of efforts?</p>
<p>For many years during this decade and before, we were able to keep per-employee health care costs for employees at our sites growing at low single-digit rates.  For our total population, which included the half of our population which worked at our remote customer sites, we have experienced, per employee, consistently increasing cost savings vs. regional benchmarks.<br />
Where by 2007, Pitney Bowes realized an estimated annual total cost offset or avoidance of $39.8 million on a cost base of around $150 million!</p>
<p>It has been hard work, but great reward!</p>
<p>Next, for the specific chronic conditions on which we concentrated this decade’s revised health plan, diabetes, cardio-vascular conditions, behavioral health, and asthma, our rates of increase in cost have been a fraction of those realized by benchmark companies.</p>
<p>We moved medication and services required for these chronic diseases from the more expensive 30-50% coinsurance tier, to the lower or 10% coinsurance tier.</p>
<p>The results were:</p>
<ul>
<li>A 50-80% reduction in employee cost on 30 day supply of medications without utilization of generic asthma controller medications and limited utilization of generic diabetes medications.</li>
<li> Employee copays were kept to less than $20 for diabetes and asthma medications.</li>
<li>Medication adherence increased.</li>
<li>Compliance with disease management programs increased.</li>
</ul>
<p>We were able to reduce the cost of treatment of employees with diabetes by 6% and treatment for asthma by 15%. We reduced annual pharmacy costs associated with diabetes by 7% and for asthma by 19% as well as we were able to keep behavioral health costs essentially flat.  Also, because of our greater focus on adherence to treatment plans, we reduced emergency department use by asthma patients by 30%, hospitalizations by 38% and disability costs by 50%.</p>
<p>In short, we found that our on-site clinics produced a return of $2.30 for every dollar we spent, and those employees in the buildings which housed our clinics and who used clinical services had lower absenteeism, substantially higher adherence to chronic disease treatment plans, and significantly lower incidence of acute conditions.</p>
<p>We proved that the right design and delivery of health care can reduce the rate of increase in health care costs, can improve employee health, can improve workforce productivity, and can be a major factor in improving the quality of life for our employees.</p>
<p>However, our experience is not simply a case study to support the need for the continued involvement of the employer in the delivery of employee health, although it certainly is persuasive in that regard.  It provides a scalable example of how we can tackle the broader issues of health care in our country.  We must:</p>
<ul>
<li>Invest in health first, and lower health care costs will follow.</li>
<li> To invest in health, we must create a healthy environment that supports the consumption of healthy foods, fitness and exercise, and healthy lifestyles.</li>
<li> Deliver high-quality health care at locations and times convenient to the people intended to be served.</li>
<li> Design health plans to drive the right behaviors by both participants and providers, and to discourage the wrong behaviors.</li>
<li> Make health insurance affordable and universal by reducing the overall cost burden of health care.</li>
<li>Enable providers to invest in tools and technologies to improve the quality of health care delivery.</li>
<li>Make sure that providers are both empathetic and competent.</li>
</ul>
<p>These are the fundamentals which drive the Pitney Bowes healthcare story!</p>
<p>Finally, one question which I was also asked by our hosts today to answer was, “How can we can engage corporate leadership in this healthcare dialog?”</p>
<p>The most obvious answer is to highlight the financial results of healthcare optimization and behavior adoption, like those I shared today.  However, the other two leadership engaging aspects are the human factor and leader’s strong desire to want to solve seemingly impossible problems – to be cutting edge.</p>
<p>First, yes, C-suite executives are human.  They understand the basic challenges and concerns about healthcare.  And, like every individual, we experience the positive and less desirable impacts of current healthcare in the United States.  If we want their involvement in this dialog, we have to engage them on a personal level.  At Pitney Bowes, while managing human resources, I was personally able to see first hand the impact of healthcare on all aspects of our employee’s lives.  This is why I personally committed to improving the health of our employees.  And, now as Executive Chairman, I continue this commitment with involvement in initiatives such as Health First Connecticut, a diverse, regional initiative to improve healthcare services for all Connecticut residents.</p>
<p>Second, if we want to engage executives in the healthcare dialogue, we have to capture their passion for mastering new frontiers.  This means highlighting the perspective that healthcare is the next place of innovation, creativity and expansion.  We have to get leaders to see that solving the nation’s health and healthcare crises as equivalent to man’s first trip to the moon.  Organizations such as Partnership for Prevention, of which my panel partner, John Clymer is CEO, provides a forum for this cutting edge and collaborative dialogue.  As a leader, it is one of the critical places I go to keep my own interest engaged, energized and informed about healthcare.  Please consider my comments as an invitation to the conversation.</p>
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		<title>ENVIRONMENTAL IMPACT OF MAIL</title>
		<link>http://www.mikecritelli.com/2008/07/07/environmental-impact-of-mail/</link>
		<comments>http://www.mikecritelli.com/2008/07/07/environmental-impact-of-mail/#comments</comments>
		<pubDate>Mon, 07 Jul 2008 19:38:01 +0000</pubDate>
		<dc:creator>Mike Critelli</dc:creator>
				<category><![CDATA[Direct Mail]]></category>
		<category><![CDATA[Environment]]></category>

		<guid isPermaLink="false">http://www.mikecritelli.com/2008/07/07/environmental-impact-of-mail/</guid>
		<description><![CDATA[Last week, we posted on the Pitney Bowes web site at www.pb.com/mailimpact a white paper detailing preliminary findings on the environmental impact of mail. Several points stand out when we look at the study: Mail is a relatively minor source of carbon footprint compared with common personal and household activities, such as taking a two-minute [...]]]></description>
			<content:encoded><![CDATA[<p>Last week, we posted on the Pitney Bowes web site at <a href="http://www.pb.com/mailimpact" target="_blank">www.pb.com/mailimpact</a> a white paper detailing preliminary findings on the environmental impact of mail.  Several points stand out when we look at the study:</p>
<ul>
<li>Mail is a relatively minor source of carbon footprint compared with common personal and household activities, such as taking a two-minute shower, which has the same carbon footprint as receiving 40 pieces of letter mail.</li>
<li>Electronic communications, on the whole, have a carbon footprint similar to paper-based communications</li>
<li>As noted on pages 21 and 22, the ultimate question is not whether mail or paper-based communications have an environmental impact that could be reduced.  No one questions the need to reduce the carbon footprint of mail or paper-based communications, and the paper talks about sustainability initiatives.<span id="more-63"></span></li>
</ul>
<p>There are two questions:</p>
<ul>
<li>Is what would replace mail better for the environment?  If someone drives a few miles to a retail store, Table 9 shows that the two types of automobiles identified, the medium-sized car and the SUV produce the equivalent carbon footprint of 40 pieces of mail for between 1.8 miles of driving (for the SUV) and 3.3 miles of driving for a medium-sized car.  If ads are placed on TV, we know than an hour of TV watching is equivalent 2.8 pieces of letter mail.  As noted, substituting advertising dollars for a paid search engine on the Internet has its own carbon footprint.</li>
<li>Among all activities, is focusing on unsolicited marketing mail a good use of scarce resources in combating increased CO2 emissions, especially given the negative economic, social, and cultural impact the reduction in mail volumes would cause?  These tables would suggest that we would get far more benefit from focusing on other activities that have less economic, social, and cultural value first.</li>
</ul>
<p>This study is not the final answer on environmental issues, but it is an important step.</p>
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		<title>ENVIRONMENTAL IMPACTS OF POSSIBLE RESPONSES TO ELIMINATING DIRECT MARKETING MAIL</title>
		<link>http://www.mikecritelli.com/2008/06/13/environmental-impacts-of-possible-responses-to-eliminating-direct-marketing-mail/</link>
		<comments>http://www.mikecritelli.com/2008/06/13/environmental-impacts-of-possible-responses-to-eliminating-direct-marketing-mail/#comments</comments>
		<pubDate>Fri, 13 Jun 2008 15:27:45 +0000</pubDate>
		<dc:creator>Mike Critelli</dc:creator>
				<category><![CDATA[Direct Mail]]></category>
		<category><![CDATA[Environment]]></category>

		<guid isPermaLink="false">http://www.mikecritelli.com/2008/06/13/environmental-impacts-of-possible-responses-to-eliminating-direct-marketing-mail/</guid>
		<description><![CDATA[As anyone who has read my past blogs on environmental issues knows, I believe that eliminating unsolicited direct marketing mail may help reduce the “annoyance factor” some mail recipients experience, but there’s no assurance that it will improve the environment.” I have been concerned that if some of those individuals who stop receiving unsolicited mail [...]]]></description>
			<content:encoded><![CDATA[<p>As anyone who has read my past blogs on environmental issues knows, I believe that eliminating unsolicited direct marketing mail may help reduce the “annoyance factor” some mail recipients experience, but there’s <a target="_blank" href="http://www.dmnews.com/DMA-tackles-the-do-not-mail-threat/article/110270/">no assurance </a>that it will improve the environment.”</p>
<p>I have been concerned that if some of those individuals who stop receiving unsolicited mail get into their automobiles and buy an item at a retail store that they would ordered through a direct mail solicitation, the environment is worse off. Until I attended the recent <a target="_blank" href="http://crri.rutgers.edu/">Center for Research on Regulated Industries Conference</a>, I did not have data to support my point. Now I do.<span id="more-61"></span></p>
<p>What I learned is that the <a target="_blank" href="http://timeforchange.org/what-is-a-carbon-footprint-definition">carbon footprint </a>of an automobile using an internal combustion engine in city or suburban driving going to and from a retail store is roughly 450 grams of carbon dioxide for every mile traveled. Preparing, transporting, and delivering a piece of direct marketing mail, including the work of converting trees to paper, results in approximately 70 grams of carbon dioxide. Therefore, if we were to eliminate 100 pieces of unsolicited marketing mail, and assume no substitute form of advertising that would generate carbon dioxide emissions, the result would be the elimination of 7000 grams of carbon dioxide. There is a small amount of carbon dioxide emission from the shipping out of the item by the postal service or a common carrier, but that carbon footprint is relatively small. This data was obtained from an economist who spoke at the conference, Larry Buc, in response to a question I asked.</p>
<p>What would happen to those 100 people not receiving the mail? Some would simply not shop at all for the item for which the direct mail solicitation was sent. Others would learn about it through the alternative form of advertising the marketer selected. Some would seek out a web site to shop for the item, such as a Google search effort, which, by the way, would have a <a target="_blank" href="http://www.economist.com/opinion/displaystory.cfm?story_id=11412495">substantial carbon dioxide emission </a>resulting from the electricity consumed at the data centers containing the web site, at the routers transmitting the web site data to the shopper, and at the shopper’s own computer.</p>
<p>However, some would obtain the item at a retail store. If only one shopper of the 100 did a round trip in an automobile, the carbon dioxide emission would exceed the total for the 100 pieces of mail all by itself if the round trip exceeded 17 miles, i.e. 8.5 miles each way. When you add in the potential carbon footprint from the other potential choices, the only way in which eliminating 100 pieces of mail is a good environmental outcome is to assume that no one drives to a retail store and that most of the individuals do not otherwise attempt to acquire the item that was the subject of the solicitation.</p>
<p>More work has to be done to model out the impacts of eliminating unsolicited direct marketing mail, and, clearly, if someone has no intention of buying the item solicited from any source at any time, it makes sense for many reasons to eliminate sending the letter. Therefore, our goal should be to give mail recipients the ability to describe their choices and preferences in as much detail as possible as often as possible.</p>
<p>That is why the <a target="_blank" href="https://www.dmachoice.org/MPS/proto1.php">Direct Marketing Association Mail Preference Service </a>is the best choice for people. It is the most sophisticated and granular consumer choice system in place, and, unlike the other systems, it recognizes the complexity and confusion that surrounds some consumer choices.</p>
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		<title>FALSE DISTINCTION BETWEEN ATOMS AND BITS</title>
		<link>http://www.mikecritelli.com/2008/05/28/false-distinction-between-atoms-and-bits/</link>
		<comments>http://www.mikecritelli.com/2008/05/28/false-distinction-between-atoms-and-bits/#comments</comments>
		<pubDate>Thu, 29 May 2008 01:10:35 +0000</pubDate>
		<dc:creator>Mike Critelli</dc:creator>
				<category><![CDATA[Direct Mail]]></category>
		<category><![CDATA[Environment]]></category>

		<guid isPermaLink="false">http://www.mikecritelli.com/2008/05/28/false-distinction-between-atoms-and-bits/</guid>
		<description><![CDATA[In many blogs, I have commented on the issue the mailing industry faces with respect to the attacks on unsolicited marketing mail by environmentalists or privacy advocates. In particular, environmentalists argue that it would be better for the environment if everyone communicated electronically, instead of doing so in paper-based communications. I am in the process [...]]]></description>
			<content:encoded><![CDATA[<p>In many blogs, I have commented on the<a target="_blank" href="http://www.dmnews.com/DMA-tackles-the-do-not-mail-threat/article/110270/"> issue the mailing industry faces </a>with respect to the attacks on unsolicited marketing mail by environmentalists or privacy advocates. In particular, environmentalists argue that it would be better for the environment if everyone communicated electronically, instead of doing so in paper-based communications.</p>
<p>I am in the process of reviewing the increasingly robust research which suggests that electronic communication has substantial environmental hazards, in some cases, greater than physical mail-based communications. But the insight I want to share in this blog is that the boundary between physical and electronic communication is not clear, and is getting more muddied as time goes on.<span id="more-59"></span></p>
<p>As a Company which has its oldest products based in the technology for imprinting postage on physical mail envelopes or labels, Pitney Bowes would seem to be in a business dominated by physical mail. However, as we trace the lifecycle of letters, longer documents, and parcels, it is striking how intertwined physical communications are with electronic communication technologies.</p>
<p>Think about a single letter we print and mail. Today, that letter is increasingly likely to be generated on a word processing program on a computer. If we buy a greeting card or personalized stationery and write a handwritten note, the creation of the greeting card or stationery has likely been controlled by software and has been subject to a considerable influence by electronic communications processes.</p>
<p>In production mail communications, such as a billing or statement production run, the original files reside in an electronic system and are converted to printer-ready files by electronically-delivered instructions. They continue to reside in electronic form on the biller or statement originator’s system.</p>
<p>Similarly, when we send a parcel to someone, we are increasingly relying on a web-based interface with the postal service or carrier that we use to get it to the recipient. The time we or others spend on line has a carbon footprint additional to that generated by the movement of the package. In the blog entitled <a target="_blank" href="http://hightechindustry.blogs.xerox.com/2008/04/18/don%e2%80%99t-neglect-document-management-and-output-for-improving-your-organizations-carbon-footprint/">“Don’t Neglect Document Management and Output For Improving Your Organizations Carbon Footprint”, </a>discusses the ways in which companies can begin to improve operations, making them more effective, efficient and environmentally friendly.</p>
<p>With respect to electronic communications, the May 24, 2008, issue of The Economist, in an article entitled<a target="_blank" href="http://www.economist.com/opinion/displaystory.cfm?story_id=11412495"> “Computers and the Environment” and subtitled “Buy our stuff, save the planet”</a> pointed out that the corollary of “cloud computing” is “more and bigger data centers on earth.” An example of this can be seen in usage of a thin client servers, or access points, found in devices such as smart phones, PDA’s, and laptops that enables users to connect to the cloud for resources when they need them. The authors note that globally, data centers account for “more carbon dioxide emissions per year than Argentina or the Netherlands.”</p>
<p>The answer to the environmental challenge is not to eliminate electronic communications, or to phase out paper, but to make every part of the communications activity chain as environmentally friendly as it can be. Many electronic components are hazardous and are not bio-degradable today. We must find newer, less hazardous materials, and make sure that we do not deposit electronic waste in landfills. I was very pleased to see that the U.S. Postal Service has a program for helping consumers and businesses send electronic wastes back to firms that can properly recycle or re-use them. The “Mail Back” Program makes it easier for customers to discard used or obsolete small electronics in an environmentally friendly way. By allowing customers to use free, postage paid envelopes found in 1,500 post offices.</p>
<p>Similarly, while opponents of paper-based communications are wildly off base on the environmental impact of cutting trees (which, in fact, are part of a harvesting process that results in a new tree that takes more carbon from the air than the cut tree) or mail ending up in landfills (less than 1% of total landfill waste), paper manufacturers could improve the environmental friendliness of the pulp and paper mills, which account for more than half of the carbon footprint of the paper lifecycle process.</p>
<p>Paper and electronic communications processes should be joined together in such a way that the total environmental impact is minimized and that, over time, is reduced further. The mailing industry needs to continue its efforts to engage with responsible environmentalists to make this happen.</p>
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		<title>CREATING ENVIRONMENTS CONDUCIVE TO HEALTHY BEHAVIORS</title>
		<link>http://www.mikecritelli.com/2008/05/07/creating-environments-conducive-to-healthy-behaviors/</link>
		<comments>http://www.mikecritelli.com/2008/05/07/creating-environments-conducive-to-healthy-behaviors/#comments</comments>
		<pubDate>Wed, 07 May 2008 14:24:42 +0000</pubDate>
		<dc:creator>Mike Critelli</dc:creator>
				<category><![CDATA[Environment]]></category>
		<category><![CDATA[Health]]></category>

		<guid isPermaLink="false">http://www.mikecritelli.com/2008/05/07/creating-environments-conducive-to-healthy-behaviors/</guid>
		<description><![CDATA[As we move into May, this is junior prom season at high schools, and I have a son who is planning to attend the prom. I remember my junior prom, which took place in May, 1965. It was a wonderful evening with a wonderful date, but what I also remember is that Brother Joseph Clark, [...]]]></description>
			<content:encoded><![CDATA[<p>As we move into May, this is junior prom season at high schools, and I have a son who is planning to attend the prom. I remember my junior prom, which took place in May, 1965. It was a wonderful evening with a wonderful date, but what I also remember is that Brother Joseph Clark, our principal at my high school, Bishop Kearney High School in Rochester, New York, decided that the prom would start at 10 pm and end at 4 am. He said that no one would be allowed to leave the prom before 4 am unless he or she was picked up by parents. His explicit reason for this decision was to keep us in the prom venue until after the bars and nightclubs around town closed.</p>
<p>Today, this same issue has surfaced in a different way. New York City has decided to order all bars closed at 2 am, instead of 4 am. In the Sunday, April 27, New York Post, in the Page 6 Magazine, there were actually two op-ed pieces published on this subject, one opposing the earlier closing hour, and the other favoring it. The proponent, a female freelance writer, made the great comment that nothing much good happened between 2 am and 4 am. In fact, those extra hours probably led to more behaviors that people later regretted, if they could remember them, than during any other 2-hour period during the day.<span id="more-56"></span></p>
<p>However, the opponent of the 2 am closing hour made the argument that the earlier closing would cost jobs and income, particularly for under-employed actors and actresses, and that the bars and nightclubs that stayed open that late were integral to the New York City social scene. He also pointed out that the owners of the <a target="_blank" href="http://www.nypost.com/seven/04182008/news/regionalnews/2_a_m__closing_times_a_sobering_reality_106982.htm">bars and nightclubs would suffer </a>severe financial hardship in an already difficult economy.</p>
<p>My high school principal, Brother Clark, was very wise to make the decision he did because, in those days, unlike what I have seen in our town, most students drove to and from proms, usually with two couples in a car. Today, more students are sharing stretch limos to avoid having to deal with late night driving. It does not stop them from abusing alcohol, but, at least, it avoids the risk of automobile accidents caused by alcohol-impaired teenage drivers. Also, in those days, the liabilities for serving under-age drinkers were not as strong as they are today, so there seemed to be more flagrant and frequent violations of the rules against serving under-age drinkers than there are today.</p>
<p>At the same time, the judgment about the degree to which government should govern adult behaviors is more complex. I personally favor <a target="_blank" href="http://query.nytimes.com/gst/fullpage.html?res=9B0DE0D71F39F933A25751C1A963958260&amp;n=Top/Reference/Times%20Topics/Subjects/R/Roads%20and%20Traffic">New York City’s decision </a>because it is a statement about how much we value the health of citizens. I also believe that it will achieve the purpose intended, which is to reduce alcohol abuse and the consequences that flow from it. However, we have to recognize the economic hardship factor in some way.</p>
<p>We also have to recognize that reforming our health care system, or promoting health through changing diets and focusing more on nutritionally healthy foods will be difficult to achieve all at once because too many people make too much money selling the unhealthy stuff we consume today. Those selling unhealthy food will be in denial that they are hurting other people’s health, but the sooner we acknowledge the real issue, which is how they cope with the economic change a healthier environment brings, the better. By creating a healthy environment that enables individual’s <a href="http://www.gothamgazette.com/article/issueoftheweek/20080301/200/2451">access to healthy foods </a>will encourage people to adopt healthy behaviors.</p>
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		<title>DIRECT MAIL AND THE ENVIRONMENT</title>
		<link>http://www.mikecritelli.com/2008/03/09/direct-mail-and-the-environment/</link>
		<comments>http://www.mikecritelli.com/2008/03/09/direct-mail-and-the-environment/#comments</comments>
		<pubDate>Sun, 09 Mar 2008 16:43:22 +0000</pubDate>
		<dc:creator>Mike Critelli</dc:creator>
				<category><![CDATA[Direct Mail]]></category>
		<category><![CDATA[Environment]]></category>
		<category><![CDATA[Postal Reform]]></category>

		<guid isPermaLink="false">http://www.mikecritelli.com/2008/03/09/direct-mail-and-the-environment/</guid>
		<description><![CDATA[I recently had the opportunity to speak with Eleanor Trickett, the editor in chief of DM News, about the inaugural DM News/Pitney Bowes survey on direct mail and the environment. The survey reveals that consumers greatly overestimate the environmental impact of direct mail. Eleanor and I discussed the implications of this survey and how the [...]]]></description>
			<content:encoded><![CDATA[<p>I recently had the opportunity to speak with Eleanor Trickett, the editor in chief of DM News, about the inaugural DM News/Pitney Bowes <a href="http://www.dmnews.com/DMNews-debuts-first-DMNewsPitney-Bowes-survey/article/99883/">survey</a> on direct mail and the environment.</p>
<p>The survey reveals that consumers greatly overestimate the environmental impact of direct mail. Eleanor and I discussed the implications of this survey and how the industry can implement new technology and other initiatives to reduce the environmental impact of mail. We also discussed how industry leaders can work to improve the public perception of mail, and grow the value of mail as a medium in the long-term.</p>
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		<title>HEALTHY ENVIRONMENT</title>
		<link>http://www.mikecritelli.com/2008/01/28/healthy-environment/</link>
		<comments>http://www.mikecritelli.com/2008/01/28/healthy-environment/#comments</comments>
		<pubDate>Mon, 28 Jan 2008 21:45:21 +0000</pubDate>
		<dc:creator>Mike Critelli</dc:creator>
				<category><![CDATA[Environment]]></category>
		<category><![CDATA[Health]]></category>
		<category><![CDATA[Nutrition]]></category>

		<guid isPermaLink="false">http://www.pb-blogs.com/2008/01/28/healthy-environment/</guid>
		<description><![CDATA[I believe strongly that health is enhanced by healthy behaviors, such as good nutrition, exercise, and healthy lifestyles. To some degree, we can mandate healthy behaviors by law and regulation, or by centralized controls. However, just as I noted in a blog several months ago in which I described some of the findings in the [...]]]></description>
			<content:encoded><![CDATA[<p>I believe strongly that health is enhanced by healthy behaviors, such as good nutrition, exercise, and healthy lifestyles.  To some degree, we can mandate healthy behaviors by law and regulation, or by centralized controls.</p>
<p>However, just as I noted in a blog several months ago in which I described some of the findings in the book <em>Mindless Eating</em>, authored by Brian Wansink, the best behavior change drivers are those of which the individual is not conscious. Steve Victor’s <a href="http://stevevictor.blogcreek.com/blog/_archives/2007/11/29/3382293.html" target="_blank">Fit For Life blog</a> provides a brief summary of the book’s key takeaways.</p>
<p>For example, in our World Headquarters at Pitney Bowes, we have created a healthy environment by the food we serve and the way we price it.  We have an on-site clinic and on-site fitness center, and we have many outreach programs for preventive screenings and immunizations.<span id="more-41"></span></p>
<p>However, supplementing these more formalized approaches are the subtle things we have done to make healthy behaviors more prevalent.  We have built very inviting and conveniently placed stairways as we have renovated the building.  We have created an open office environment in most of the facility, and will renovate the remainder of the building consistent with what we have already done.  We have created a layout that gives every employee in the renovated spaces direct access to natural sunlight.  We have created a brighter color scheme and have used environmentally-friendly building materials and furnishings.  We have also enabled people to get the functionality of a fixed office throughout the building by creating a robust wireless communications system. As pointed out in the <a href="http://employeewellness.blogspot.com/" target="_blank">Employee Wellness Blog</a>, these small enhancements make a big difference, and can be particularly effective when combined with a structured wellness program.</p>
<p>Much of what we have done to encourage employees to walk more, to communicate more with their fellow employees, and to feel better about their surroundings was not obvious in terms of its impact.  We did not mandate that employees increase their walking; the environment made walking more attractive.  We did not mandate more communications and mutually supportive behavior; the environment made socialization a more attractive and natural option.  We did not mandate a brighter outlook; the environment made access to the sun achieve that for us.</p>
<p>Take that principle and apply it outside our four walls.  A lot has been written about how to create an inviting neighborhood environment for walking, exercise, and safety.  William H. Whyte wrote a great book over 20 years ago called <em>City</em>, which consisted of his observations about how New York City residents reacted to different physical layouts.  He found that they walked in certain areas more than others because the environment was more conducive to walking. This <a href="http://thegroundfloor.typepad.com/the_ground_floor/2007/12/the-urban-healt.html" target="_blank">recent post</a> in The Ground Floor blog reviews some intriguing facts for how and why the average life expectancy of New Yorkers has increased due to the walkable environment, among other factors.</p>
<p>Furthermore, Jane Jacobs, in her ground-breaking work <em>The Death and Life of Great American Cities</em>, talked about the benefits of mixed-use zoning, shorter blocks, narrower streets, and easy access to parks and bike paths, all of which were conducive to healthier living.</p>
<p>Similarly, in our headquarters neighborhood in the South End of Stamford, Connecticut, our Neighborhood Revitalization Zone Board, working collaboratively with the City of Stamford, under the brilliant leadership of Mayor Dan Malloy, has eliminated burnt-out automobiles, most of the abandoned, boarded-up housing, and the rubble-strewn parks and yards that make a neighborhood appear menacing and uninviting for walking.  Years ago, I did not feel comfortable walking from our World Headquarters to the Stamford Train Station because I passed dangerous and deserted areas.  Today, it is a relatively inviting walk, and will get better as the Antares Group completes its ambitious plan for mixed-use development.</p>
<p>Ultimately, people respond to both the formal and the implicit cues in their external environment to engage in good or bad behaviors.  We need to create the healthiest possible environment for the right behaviors.  Lower health care costs and a greater sense of well-being are the rewards we reap for those kinds of decisions.</p>
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