Steps Program in Austin

The Steps Program in Austin, a CDC Steps Community, brings together schools, health care providers, work sites, and community leaders to build healthier communities. Over 460,000 residents, nine of the city's 11 Federally Qualified Health Centers, and 117 schools are included in the intervention area. The program's efforts are focused on community members who are most burdened by chronic diseases. Priorities of the program include implementing effective chronic disease prevention activities, making positive health care policy changes for the community, and facilitating knowledge sharing on best practices in the screening, diagnosis, and treatment of patients.

Through a successful partnership between the Steps Program in Austin and the Capital Metropolitan Transportation Authority (CMTA), an employee wellness program was implemented in 2003 with the goal of improving health and reducing absenteeism and health care costs. The collaboration led to the launch of a 24-hour fitness center that provides free assessments and personal training and costs employees only $5 per month. Cash incentives are provided if employees reach certain milestones, such as reducing their blood pressure, cholesterol, and/or body fat to target levels. CMTA also began offering improved access to healthy food, on-site access to weight loss classes, tobacco-cessation services, and a range of community health events.

CDC's Steps Program funds states, cities, and tribal groups to implement community-based chronic disease prevention programs to reduce the burden of obesity, diabetes, and asthma by addressing three related risk factors: physical inactivity, poor nutrition, and tobacco use.

Since 2004, annual increases in Capital Metro's health care costs have slowed substantially. Total costs increased a little less than 10% between 2004 and 2005, compared with an almost 27% increase between 2003 and 2004. Program participants report significant improvements in physical activity, healthy food consumption, weight loss, blood pressure management, stress levels, and overall general health. The purchase of "healthy choice" options in the employee cafeteria increased by 172%. Employee absenteeism rates--an indicator of worker job satisfaction and health--decreased by 44%, from a high of about 12% in March 2004 to slightly less than 7% in June 2006.

A 2009 study of the CMTA worksite wellness program found a return on investment between 2004 and 2007 of 2.43.