INTRODUCTION TO THE “NEW AND IMPROVED” 

CDC WORKSITE HEALTH SCORECARD

NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION 

Division of Population Health
AGENDA • Introduction to the Study Team and Presenters • Benefits of Workplace Health Promotion Programs • Background and History of the CDC ScoreCard • New 2019 CDC ScoreCard (Version 3) • Rationale for Updating the CDC ScoreCard • Update Process • Summary of Key Changes • Where to Find the Updated CDC ScoreCard • Timeline for the Updated CDC ScoreCard Release • Q&A

2
INTRODUCTION TO THE STUDY TEAM AND PRESENTERS

Centers for Disease 

Control and Prevention

• Jason E. Lang MPH, MS

• Dyann M. Matson-Koffman, 

DrPH, MPH, CHES

Johns Hopkins University

• Enid Chung Roemer, PhD –

Co-Principal Investigator 

• Karen Kent, MPH

• Kate McCleary, MS

IBM Watson Health

• Ron Goetzel, PhD – CoPrincipal Investigator

• Amanda Mummert, PhD

• Jacquelyn Palmer, MA

• Kathleen Prince, MPH

• Kathleen Lane

• Jenna Jones, PhD, MPH, PMP

3
PRESENTERS

Jason Lang, MPH, MS

CDC Workplace Health Program

Division of Population Health

4
PRESENTERS

Dyann Matson Koffman, DrPH, MPH, CHES

CDC Office of Science on the Guidelines and 

Recommendations Activity Team 

5
PRESENTERS

Ron Z. Goetzel, PhD 

IBM Watson Health & Institute for Health 

and Productivity Studies, Johns Hopkins 

Bloomberg School of Public Health

6
PRESENTERS

Enid Chung Roemer, PhD 

Institute for Health and Productivity 

Studies, Johns Hopkins Bloomberg School 

of Public Health

7
BENEFITS OF WORKPLACE HEALTH PROGRAMS

8
BENEFITS OF WORKPLACE HEALTH PROMOTION FOR U.S. EMPLOYERS

Chronic and mental health conditions represent about 90% of the nation’s $3.3 trillion annual 

health care expenditures 

Interventions in the workplace can help to mitigate this trend:

• Improve employee health, well-being and safety

• Decrease disability, healthcare utilization and costs

• Reduce absenteeism and presenteeism

• Increase worker productivity, creativity and engagement

• Attract/retain top talent

• Bolster stock market performance

SOURCE: Buttorff C, Ruder T, Bauman M. Multiple Chronic Conditions in the United States. Santa Monica, CA: Rand Corp.; 2017.

Center for Medicare & Medicaid Services. National Health Expenditure Data for 2016—Highlights.

Fabius R, Thayer RD, Konicki DL, et al. The link between workforce health and safety and the health of the bottom line: tracking market performance of

companies that Nurture a ‘culture of health’. J Occup Environ Med. 2013;55:993–1000.

Goetzel RZ, Fabius R, Fabius D, Roemer EC, Thornton N, Kelly RK, Pelletier KR. The Stock Performance of C. Everett Koop Award Winners Compared With the Standard & Poor's 500 Index. J Occup

Environ Med. 2016 Jan;58(1):9-15.

9
10

82% OF EMPLOYERS WITH 200 OR MORE EMPLOYEES OFFER 

ANY WELLNESS PROGRAM

SOURCE: Kaiser Family Foundation and Health Research & Educational Trust, Employer Health Benefits Survey, 2018 10
HOWEVER, ONLY 13% OF EMPLOYERS WITH 200 OR MORE EMPLOYEES 

HAVE COMPREHENSIVE PROGRAMS IN PLACE

Elements Included in WHP Programs (%) as Reported by Employers Who Offer Programs

Adapted from: McCleary K, Goetzel RZ, Roemer EC, et al. Employer and Employee Opinions About Workplace Health Promotion (Wellness) Programs: Results of the 2015 

Harris Poll Nielsen Survey. J Occup Environ Med. 2017 Mar;59(3):256-263. Key elements for effective WHP: Healthy People 2010: With Understanding and Improving Health 

and Objectives for Improving Health. Washington, DC: US Dept of Health and Human Services; 2000. 

11
BACKGROUND AND HISTORY OF THE CDC WORKSITE HEALTH 

SCORECARD 12
BACKGROUND

• The CDC Worksite Health ScoreCard was first released 

in 2012 (Version 1)

• The purpose of the ScoreCard:

• Organizational assessment and planning tool for worksite 

health promotion

• Guidance on key evidence-based strategies to promote a 

healthy workforce

• The CDC updated the ScoreCard in 2014 (Version 2) and 

now in 2019 (Version 3)

13
CDC WORKSITE HEALTH SCORECARD

2014 (VERSION 2) MODULES

125 Yes/No questions assessing health promotion interventions 

(policies, programs, environmental supports) in 16 topic areas

 Organizational supports 

 Tobacco control

 Nutrition

 Physical activity

 Weight management

 Stress management

 Depression

 High blood pressure

 High cholesterol 

 Diabetes 

 Signs and symptoms of heart attack 

and stroke 

 Emergency response to heart 

attack and stroke

 Lactation support

 Occupational health & safety

 Vaccine-preventable diseases

 Community resources 

14
NEW 2019 CDC WORKSITE HEALTH SCORECARD (VERSION 3) 15
RATIONALE FOR THE 2019 UPDATE (VERSION 3)

• To ensure that the CDC ScoreCard:

• Remains current

• Reflects the best available evidence

• Is valid, reliable, and easy-to-use

• Assists employers in: 

• Responding to organizational needs, priorities, and major cost drivers

• Identifying health promotion programming gaps

• Prioritizing and applying high-impact, evidence-based strategies and promising practices 

• Increasing understanding of programs, policies, and practices that work 

• Improving overall employee health and wellbeing

16
THE 2019 UPDATE PROCESS: SURVEY DEVELOPMENT

17
VALIDATION AND RELIABILITY STUDY GOALS

• Validate the pilot survey with a heterogeneous sample of 

employers

• Identify problems in wording and interpretation

• Assess information retrieval, decision making, and response 

processes

18
THE 2019 UPDATE PROCESS: SURVEY TESTING

19
VALIDATION AND RELIABILITY STUDY PARTICIPANTS

20

Characteristic Count Percentage

Worksite Size (n=93)

< 100 employees 22 24%

100-249 employees 15 16%

250-749 employees 19 20%

>= 750 employees 37 40%

Business Type (n=92)

For-profit 26 28%

Non-profit/government 43 47%

Non-profit/other 23 25%

Region (n=93)

Midwest 30 32%

Northeast 10 11%

South 41 44%

West 12 13%
 

 

 

 

 

 

 

 

KEY CHANGES IN THE UPDATED CDC SCORECARD: 

MODULES 

• Addition of 4 new modules 

 Sleep & Fatigue 

 Alcohol & Other Substance Use 

 Musculoskeletal Disorders 

 Cancer 

• Combining of 2 modules into 1 

 Signs and Symptoms of Heart Attack and Stroke + Emergency Response to Heart Attack and Stroke = Heart 

Attack and Stroke 

• Renaming and reorienting 3 modules 

 Tobacco Control renamed to Tobacco Use 

 Diabetes expanded to include prediabetes condition and renamed to Prediabetes and Diabetes 

 Lactation Support expanded to include maternal health and renamed to Maternal Health and Lactation 

Support 

• Placing the “Community Resources” module into the background section 21 
KEY CHANGES IN THE UPDATED CDC SCORECARD: 

QUESTIONS AND POINTS

• Number of questions

• 47 new questions

• 20 in existing modules

• 27 in four new modules

• 13 deleted from existing modules

• Question phrasing and enhanced subtext 

addressed for 100 questions

• Point values adjusted to reflect current 

evidence for 30 questions

2014 (Version 2) 2019 (Version 3)

125 core questions 154 questions 

264 points 294 points

22
 

 

KEY CHANGES IN THE UPDATED CDC SCORECARD: 

MODULE AND QUESTION ORGANIZATION 

• Module order 

• Question order 

• Grouped questions thematically in Organizational Supports: 

• Leadership Commitment and Support 

• Measurement and Evaluation 

• Strategic Communication 

• Participation and Engagement 

• Programs, Policies, and Environmental Supports 

23 
EXAMPLE OF ALIGNING CORE QUESTIONS

2014 Question 2019 Updated Question

Refer tobacco users to a state or other tobacco 

cessation telephone quit line?

Answer “yes” if, for example, your worksite refers 

tobacco users to 1-800-QUIT NOW or smokefree.gov.

Provide educational materials that address tobacco 

cessation?

Answer “yes” if, for example, your worksite offers 

brochures, videos, posters, or newsletters on tobacco 

cessation, including referral to 1-800-QUIT-NOW or 

smokefree.gov, either as a single health topic or 

along with other health topics.

24
EXAMPLE OF RECOGNIZING THE NEED TO PROMOTE

2014 Question 2019 Updated Question

Provide organized individual or group physical activity 

programs for employees (other than the use of an exercise 

facility)?

Answer “yes” if, for example, your worksite provides 

walking or stretching programs, group exercise, or weight 

training.

Provide and promote organized physical activity programs 

for employees (other than the use of an exercise facility)? 

Answer “yes” if, for example, your worksite organizes 

walking groups, stretching programs, group exercise 

classes, recreational leagues, or buddy systems to create 

supportive social networks for physical activity.

Have a written injury and/or illness prevention program?

Answer “yes” if there is a written policy, whether or not it 

is posted.

Have and promote a written policy on injury prevention 

and occupational health and safety? 

This policy could be promoted to employees regularly 

through emails, newsletters, or signage in public places.

25
EXAMPLE OF CLARIFYING A QUESTION

2014 Question 2019 Updated Question

Provide health insurance coverage with no 

or low out-of-pocket costs for influenza (flu) 

vaccination?

Provide health insurance coverage with free 

or subsidized influenza (flu) vaccinations? 

26
EXAMPLES OF NEW QUESTIONS

Module Question Text

Alcohol and Other 

Substance Use

Provide a health plan with insurance benefits that include substance use disorder 

prevention and treatment?

Answer “yes” if, for example, your worksite health plan offers coverage for medicationassisted treatment without prior authorization and lifetime limits, while preventing overuse 

of addictive substances such as use of prescription opioids, use of illicit opioids, and use of 

illicitly-manufactured fentanyl (e.g., reimbursement for non-drug treatments for pain relief 

as a results of an injury such as exercise, physical therapy, and psychological therapies, use 

of drug utilization review, and pharmacy lock-in). 

Physical Activity Promote the use of activity trackers to support physical activity?

Answer “yes” if, for example, your worksite provides or subsidizes the cost of pedometers, 

wearable trackers, online tools, or mobile apps. 27
EXAMPLES OF NEW QUESTIONS

Module Question Text

Physical 

Activity

Encourage active transportation to and from 

work?

Answer “yes” if, for example, your worksite 

subsidizes public transportation; subsidizes a 

bike share program; provides secure bicycle 

storage, lockers and shower facilities for 

employees; allows for a flexible dress code; 

and/or organizes workplace challenges, 

employee recognition programs, or community 

events to increase active transportation.

28
Module

2014 CDC ScoreCard 2019 CDC ScoreCard

# Questions Possible Points # Questions Possible Points

Background/Community Resources (optional) 20 (17+3) 0 22 0

Organizational Supports 18 33 25 44

Occupational Health and Safety 10 22 9 18

Maternal Health and Lactation Support 6 15 7 15

Nutrition 13 21 14 24

Physical Activity 9 24 10 22

Sleep and Fatigue N/A N/A 6 9

Tobacco Use 10 19 8 18

Cancer N/A N/A 8 11

Heart Attack and Stroke 13 21 12 19

High Blood Pressure 7 17 6 16

High Cholesterol 6 15 5 13

Musculoskeletal Disorders N/A N/A 7 9

Prediabetes and Diabetes 6 15 6 15

Vaccine-Preventable Diseases 6 18 7 14

Weight Management 5 12 4 8

Alcohol and Other Substance Use N/A N/A 6 9

Depression 7 18 7 16

Stress Management 6 14 7 14

TOTAL 125

(core)

264 154 

(core)

294 29
SLEEP AND FATIGUE MODULE

30
BENCHMARKING REPORTS – OVERALL SCORES

Figure 1. Average CDC Worksite Health ScoreCard Overall Score for 

Your Worksite and the Study Sample

Figure 2. CDC Worksite Health ScoreCard Percentile Rank for Your Worksite 

Compared to Very Small Worksites and the Overall Study Sample 

31
BENCHMARKING REPORTS – TOPIC SCORES

32
CDC WORKPLACE HEALTH RESOURCE CENTER (WHRC) –

WWW.CDC.GOV/WHRC

500+ resources and growing

Case studies Emerging Issues 

(e.g., Sleep)

Evidence-based 

summaries and issue 

briefs

Library of webinars

and videos

Workplace health 

strategies for small 

business 33
WHERE CAN YOU FIND THE UPDATED SCORECARD?

• The “Manual” [printable (PDF) version] and online version will both be available for download at: 

https://www.cdc.gov/workplacehealthpromotion/initiatives/healthscorecard/index.html. 

• Other materials are available to help you learn more about the CDC ScoreCard

• “Methodology and Citations” (Blue Book) Report 

• Glossary

• Online video tutorials: https://www.cdc.gov/workplacehealthpromotion/initiatives/healthscorecard/usingscorecard.html

34
TIMELINE FOR UPDATED CDC SCORECARD RELEASE

• Target date in January 2019

35
36
THANK YOU

MORE INFORMATION ABOUT THE CDC WORKSITE HEALTH SCORECARD IS 

AVAILABLE ONLINE AT 

HTTPS://WWW.CDC.GOV/WORKPLACEHEALTHPROMOTION/INITIATIVES/HEALTHSCORECARD/INDEX.HTML. 

PLEASE EMAIL WORKPLACEHEALTH@CDC.GOV WITH ANY QUESTIONS

NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION 

Division of Population Health

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

37
Module

2014 CDC ScoreCard 2019 CDC ScoreCard Summary of Changes to Questions

# Questions Possible 

Points # Questions Possible Points

Revised 

Text New Deleted Unchanged

Background/Community 

Resources (optional)

20 (17+3) 0 22 0 4 2 0 16

Organizational Supports 18 33 25 44 18* 5 1 2

Occupational Health and Safety 10 22 9 18 6 3 2 0

Maternal Health and Lactation 

Support

6 15 7 15 6 1 0 0

Nutrition 13 21 14 24 12 1 0 1

Physical Activity 9 24 10 22 7 2 1 1

Sleep and Fatigue N/A N/A 6 9 N/A 6 N/A N/A

Tobacco Use 10 19 8 18 7 1 3 0

Cancer N/A N/A 8 11 N/A 8 N/A N/A

Heart Attack and Stroke 13 21 12 19 8 0 1 4

High Blood Pressure 7 17 6 16 4 0 1 2

High Cholesterol 6 15 5 13 4 0 1 1

Musculoskeletal Disorders N/A N/A 7 9 N/A 7 N/A N/A

Prediabetes and Diabetes 6 15 6 15 6 0 0 0

Vaccine-Preventable Diseases 6 18 7 14 5 2 1 0

Weight Management 5 12 4 8 4 0 1 0

Alcohol and Other Substance Use N/A N/A 6 9 N/A 6 N/A N/A

Depression 7 18 7 16 7 0 0 0

Stress Management 7 14 7 14 2 3 1 2

TOTAL 125

(core)

264 154

(core)

294 100 47 13 29

* This include 3 questions from the 2014 version that were relocated from other modules.

38