July 2011 Corporate Wellness Magazine by Employer healthcare Congress

Volume 9, No 2 | March 2011

CorporateWellnessMagazine.com

July 2011

EDITOR’S LETTER

Rob a Bank for Healthcare - The Only Option in 2011? EDITORIAL STAFF EDITOR Jonathan Edelheit Jon@EmployerHealthcareCongress.com

ASSISTANT EDITOR Sarah Hunt

Jonathan Edelheit Editor-In-Chief

ADVERTISING SALES

jon@employerhealthcarecongress.com

his indeed did seem like the only option for Richard James Verone, a 59-year-old from North Carolina, who robbed a bank on June 9, 2011 claiming this was the only way for him to get coverage; because they have to provide healthcare in prison.

Verone handed a note to the teller claiming he had a gun, and demanded $1 US dollar. After she gave it to him, he sat in the bank’s lobby waiting for the police to arrest him. He asked only for one dollar so that it would be clear his motive was not to rob the bank, but get arrested for medical care. He has no job, two rupture d disks and a growth on his chest. He hoped he would be sent away to prison for three years and that would allow him time to get all the medical care he needed to be healed. Verone told reporters, “If it is called manipulation, then out of necessity because I need medical care, I guess I am manipulating the courts to get medical care.” Unfortunately for Richard, it is estimated he will only get sentenced to 12 months in prison, and may not get all the medical treatment he intended to. I think as individuals, many of us who are involved in the healthcare and health insurance industry forget about the people who don’t have or can’t afford health insurance. We forget to put ourselves in their shoes, to feel their fears, pain and desperation. We are removed by it all, because while it is an emotional topic, we have health coverage, we may not be happy with it, it may be expensive, but we have it. It’s not a healthcare crisis; it’s a healthcare disaster. It’s not getting better, it is only getting worse, and the passage of healthcare reform legislation will just continue to degrade it as costs are increasing. Is this what America has come to? People committing crimes so they can get free medical care from the state while in prison? There are more and more Americans like Richard who don’t have jobs, and in the future small employers may be forced to lay off more employees because of rising healthcare costs. Many small employers are getting renewals on their group health insurance as high as 40%. That’s crazy! What happened to the promises of lower costs under healthcare reform? People are starting to finally realize, that’s all it was, promises, and we need real healthcare reform and soon.

Jonathan Edelheit

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July 2011

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Copyright © 2011Corporate Wellness Magazine. All rights reserved. Corporate Wellness Magazine is published monthly by Global Health Insurance Publications. Material in this publication may not be reproduced in any way without express permission from Corporate Wellness Magazine. Requests for permission may be directed to info@ CorporateWellnessMagazine.com. Corporate Wellness Magazine is in no way responsible for the content of our advertisers or authors.

STRATEGISTS’ REVEAL KEY C-SUITE SECRETS 22 14 ‘PEOPLE TO BEND THE TREND

WORKPLACE STRESS STRAINS ORGANIZATIONS’ BOTTOM LINES

HRAS ~ TIME AND MONEY WELL SPENT

IN WELLNESS COMMUNICATION, CLARITY IS KEY AND LESS IS MORE

DIABETES AND ITS EFFECT ON FUTURE EMPLOYER HEALTH COSTS - GUIDANCE FOR EMPLOYERS

DIABETES MANAGEMENT~ CORPORATE PROGRAMS CAN MAKE A DIFFERENCE

“DRAWN IN 2 WELLNESS” TRAIN YOUR BRAIN TO CREATE LASTING CHANGE

DISEASE PREVENTION THROUGH HEALTHY LIFESTYLE CHOICES ~ FITNESS AND PROPER NUTRITION

IMPLICATIONS FOR HUMAN INTERACTION RELATED TO CRUDE OIL EXPOSURES

A ROADMAP TO CHANGING EATING PATTERNS IN ACCORDANCE WITH DIETARY GUIDELINES

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W O R K S I T E W E L L N E S S

Workplace Stress Strains Organizations’ Bottom Lines

tress is the plague of our nonstop, hyper, 21st Century lifestyle. Ignore the negative consequences at your own peril.

The American Institute of Stress (AIS) definitively reports job-related pressure By Jacquelyn Ferguson is the top source of stress for Americans, skyrocketing in recent decades. Organizations’ bottom lines are eaten away by escalating health insurance and worker compensation costs for many conditions that could be prevented by reducing stress. For example, it’s estimated that: • Occupational pressures are responsible for 30% of workers’ back pain • 80% of workers feel stress on the job • Nearly half say they need help learning how to manage it

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• 42% say their coworkers need such help

The Great Recession Whether organizations supply any, part or all employee health care coverage, they must understand employees feel stretched too thin from the effects of the Great Recession. More than ever, workplaces need to be made less stressful and more appealing to retain valued workers – especially as jobs open up elsewhere.

Rewards of Addressing Worker Well-being Robert Levering’s book, “The 100 Best Companies to Work for in America” found companies that enhance worker well-being have more than twice the earnings per share and more than twice the rate of stock appreciation compared to the average Standard & Poor’s 500 company.

Customer Service Suffers Well-treated customers result in a 5% reduction in customer defection translating into a 30% to 85% increase in corporate profitability. Source: Harvard Business Review study by Reichheld & Sasser. But strained employees don’t treat your customers well enough and cause problems like: • Loss of intellectual capital: Stressedout employees don’t focus on quality and improvement. •“Organization’s ability to make process improvements nearly always stops due to resistance. With overwhelming workloads … and going so fast, (employees) don’t have time to make the process better. It creates a terrible cycle of trying to work harder … because the volume you have to put out is increasing, but you aren’t doing anything to make the process more effective and efficient,” says Jack Quirk of Blue Cross/Blue Shield. •

Work Stress is Expensive AIS Statistics Workplace stress in America is estimated at over $300 billion annually due to: • Accidents • Absenteeism • Employee turnover

Workplace Accidents

• Diminished productivity • Direct medical, legal, and insurance costs • Workers’ compensation awards • The 2000 Integra Survey of employees found: 1. 6 0.2% routinely have work-related neck pain 2. 44% strained eyes 3. 38% hand pain 4. 34% difficulty sleeping

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employees’ thought processes to become more rigid, simplistic and superficial; not conducive to innovation. • The more helpless a person feels, the less likely he is to come up with effective coping responses. Source: Dr. Martin Seligman’s research on “learned helplessness.”

• Job turnover - 40% is due to stress

High-stress jobs with low control cause

July 2011

When over-stressed, your distraction increases and attention narrows, leading to more accidents and injuries: • High stress workers are 30% more likely to have accidents than those with low stress; 60% to 80% of on-the-job accidents are attributed to stress. Source: Jonathan Torres, M.D., of Workmed Occupational Health Services, ME;

• On average, stress-related accident claims are two times more costly than nonstressed related ones. Source: Harvard Business Review; • A study of 3,020 aircraft employees found those who “hardly ever” enjoy their jobs were 2½ times more likely to report back injury. Can you hear your bottom line chipping away?

Factors Causing Employee Stress Working Longer and Harder Until around 1995, Japan had the record of most hours worked compared to the labor force of any other industrial nation. Now America holds this stressful record. According to a 2000 International Labor Organization study, Americans put in the equivalent of an extra 40-hour work week compared to 1990 and work almost a month more than the Japanese and three months more than Germans!

Absenteeism From 1996 to 2000 the number of employees calling in sick due to stress tripled according to a survey of 800,000 workers in over 300 companies with an estimated one million workers absent daily. It’s estimated to cost American companies $602.00 per worker a year. The price tag for large employers could approach $3.5 million annually.

Job Insecurity A 1999 government study found more jobs had been lost in the previous year than any other year in the last half century, and the number of workers fearful of losing their jobs had more than doubled over the past decade. And this was before the dot.com collapse of 2000 – 2001 and the Great Recession! How safe do you think your employees feel today?

Job Demands Versus Control The amount of job stress depends on the extent of

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the demands and the worker’s sense of control or decision-making freedom she has in dealing with them. Multiple scientific studies confirm workers who feel the stress of high demands with little control are at increased risk for cardiovascular disease.

with teams and supervisors.

“Tunnel Vision”

Not all stress is bad. So how can a manager tell when their employees have too much?

Stress creates “tunnel vision,” which causes judgment errors decreasing creativity and the ability to cope with change. When stressed, humans revert to familiar behaviors, making it harder to adapt to never-ending organizational changes.

Workplace Violence Work shouldn’t be a scary place, but it is for many: • On average 20 workers are murdered each week in the U. S. making homicide the second highest cause of workplace deaths and the leading cause for women. • The Bureau of Labor Statistics reports that over two million Americans are affected by workplace violence annually making “desk rage,” “phone rage,” and “going postal” part of our lexicon. • A 2000 Gallup Poll found: 1. 14% of respondents had felt like striking a coworker in the past year, but didn’t 2. 25% have felt like screaming or shouting because of job stress 3. 10% feared a coworker could become violent 4. 9% knew of an assault or violent act in their workplace 5. 18% experienced a threat intimidation in the past year

verbal

Phew! That’s a lot of stress.

But what constitutes too much stress?

An optimal stress level is the amount that makes you feel motivated to tackle the day’s challenges. When you notice employees losing enthusiasm, stress may be the culprit. Too much stress causes everything from physical illness and increased health care costs to resistance to change and high turnover, negatively affecting your bottom line. Too little stress can be just as damaging. Everybody has it, not just the weakest. According to 2006 surveys from ComPsyche and the Anxiety Disorder Association of America (ADAA), employees cite their top work stressors: • • • • • •

Deadlines, 55%; Management, 50%; Workload, 46%; People issues, 28%; Juggling work and personal lives, 20%; Lack of job security, 6%;

The ADAA’s 2006 Stress and Anxiety Disorders Survey found the most common ways employees react to stress: • Caffeine, 31%;

Interpersonal Conflict

• Exercise, 25%;

The St. Paul Insurance report found the main causes of burnout were interpersonal demands from working

• OTC medications, 23%;

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• Alcohol, 20%;

• Smoking, 27%; • Eat (46% of women, 27% of men); • Talk to family or friends (44%, 21%); • Sex (19% for men, 10% for women); • Illegal drugs (12% for men, 2% for women); Fewer than 40% of employees whose stress interferes with their work have spoken to their employers about it mainly because they fear it would be: • Perceived as lack of interest or unwillingness to do something • Labeled “weak” • Detrimental to promotion opportunities • They’d not be taken seriously

Strive For a Healthier Workforce When employees grumble about workplace stress around the water fountain, what do they say? Not knowing can cost you dearly. With an improving economy, retaining employees is increasingly important. How many of your employees will jump ship to get away from their stress? Which ones can you afford to lose? How much does it cost? To understand how much stress costs you, management can begin by answering these questions: • How can you help identify and relieve employees’ main stressors? • How can you give them more control over their day-to-day activities? • How can you help them enjoy their jobs more? Your answers, and more importantly your actions, to reduce their stress will gradually improve your bottom line.

Reduce Turnover Costs Since an estimated 40% of turnover is due to stress, it’s imperative to determine employees’ perceptions of their main stressors before creating a plan.

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Use employee surveys, exit interviews and their statements about what bothers them the most at work. Usually it’s about situations over which they have little control. Once identified, put the requisite amount of energy into preventing and decreasing their stress. Options range from stress reduction classes tilted heavily toward those with “how to” skills, to individualized wellness coaching for those in need. Also, find out what your competitors are doing to help their employees. Some provide concierge services while others pay for on-site yoga classes. A vital step for all employees - over-stressed or not - is to give them increased control over their biggest frustrations. For example, an employee who’s distracted by a coworker talking to himself requested and received the right to work in a different part of the building when necessary. Happy workers are more productive and more likely to stay Experiment with ideas to reduce employee stress and increase their satisfaction. • Train all to do their jobs more efficiently and safely. • Stop supervisory personnel from driving away your

staff by providing them with management training. • Facilitate work and life balance by having teams manage many job functions vs. an individual. If an employee has her child’s soccer game to attend, for example, other team members could cover for her; a wonderful motivator. • Encourage employees to take weekends off and vacations. Price Waterhouse Coopers employees receive a pop-up reminder when sending an e-mail on a weekend: “…it’s important to disconnect and allow others to do the same. Please send your e-mail at the beginning of the workweek.” • Flextime and creative scheduling help employees balance their work and home responsibilities. • Give more personal time. HomeBanc Mortgage Corporation in Atlanta gives employees 24 “being there” hours for times they need a couple hours to take care of personal responsibilities without using vacation time. • Offer regular stress reduction training to all. • Offer individual stress coaching as needed. • Concierge services pamper employees and decrease their errand-running stress. Employees pay for the services, such as dry-cleaning, but not for the concierge service itself. • On-site childcare addresses many parents’ biggest stressor. Offer it year-round, during the summer when school’s out or before and after school hours. • Serenity rooms offer a few minutes of solitude, particularly helpful for those who work in cubicles where there’s no privacy. • Encourage employees to take twenty minutes of work time to meditate daily and watch their errors decrease, energy and wellbeing skyrocket. • HomeBanc sends massage therapists to each office

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monthly for free neck and shoulder massages. ARUP Laboratories subsidizes on-site massage where employees pay $5 for a 15-minute massage. • Provide healthy snacks or meals during particularly stressful times of the year, like during tax season for accounting firms. • Traditional wellness initiatives like subsidized health club membership, nutrition advice, health screenings for cholesterol and blood pressure, financial incentives for quitting smoking, and work time to exercise AND a variety of stress reduction classes such as prioritizing, assertiveness training, etc. • Give everyone, yes everyone, their birthdays off! A cost and benefit analysis can tell you if ideas that seem appropriate for your workers could actually save you money when compared to the high cost of turnover and increased insurance rates. So what are you waiting for? With stress mounting in our frenzied workplace costing you every step of the way, how can you reduce stress in your organization?

Bio Jaquelyn Ferguson is the founder of InterAction Associates, her speaking and coaching firm. For over 25 years Jackie has designed and presented keynotes and workshops on stress management, diversity, workplace harassment, motivation, and communication skills. Jackie is also a Stress & Wellness Coach helping people achieve more success with less stress. Jackie is the author of “Let Your Body Win: Stress Management Plain & Simple” and a weekly column “Stress for Success” in Gannett Newspaper, at www. letyourbodywin.com.

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Join The Corporate Health and Wellness Association www.WellnessAssociation.com

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F E A T U R E

N By Les Meyer

ecessity Prompts Strategic Adaptation

Since maximizing resources for enhancing worker capacity and sustaining a competitive edge is more important than ever before, HR professionals need to become “people strategists” who are capable of aligning the workforce with key business objectives. One critical mission is to tame runaway employee health care costs, but industry practitioners have found that current methods no longer work. The next generation of solutions can be found in the notion of “value realization.” Success depends on insightful decision-making and

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problem solving, as well as an intuitive ability to lead their strategic business unit to create self-sustaining environments and support infrastructure wherein employees and their dependents consciously and subconsciously make healthier lifestyle choices. People strategists have a unique definition of value, which they consider the glue that galvanizes the workforce. In their view, value better aligns the interests of each organization’s leadership with employees to maximize individual peak performance for results that collectively improve a

company’s bottom line. The bleeding edge of this thinking can be found in the C-Suite emergence of “disruptive innovation” (DI), a business term used to describe how a more nimble or entrepreneurial approach to creating value and sustaining a competitive advantage can disrupt certain markets.

brand-equity status and business growth driven by the inextricable link between DI strategies and thriving wellbeing people action plans to sustain a competitive advantage. Strategic Business Process Improvement

DI is the bedrock of strategic business process improvement (SBPI), an effective continuousPeople strategists understand the power innovation approach to align processes with and potential of creative execution and DI, disciplined execution of an organization’s which has a new application regarding how strategic goals to optimize underlying systems organizations can rethink many of the age- and structures to advance focused program old assumptions about the human resources integration convergence to achieve more business model and deepen their investment in efficient results. people through high-value workforce wellbeing initiatives. The DI mindset can be used to create Clayton M. Christiansen, M.D., defines DI “People Innovation Centers” that serve as an in “The Innovators Dilemma: When New information clearinghouse for benchmarking Technologies Cause Great Firms to Fall” as: the business of sustainability. “innovation that transform an existing market or creates a new market through simplicity, People strategists strive to consistently match convenience, accessibility or affordability.” high-value workforce wellbeing designed to step To paraphrase his premise, DI is about profound up employee involvement in adopting healthier change in the C-Suite. It is not just the magnitude lifestyles with what is entrepreneurially and of the advance. If it works to sustain the status culturally feasible in the workplace. They know quo, it is not disruptive. The key is a change it’s not about employee behavior change. It is, in approach to one that better addresses critical in fact, about the wise health behaviors people business issues in the C-Suite and the demands embrace. People strategists are constantly to create and sustain “customer value.” looking for creative business models, real-world impact, farsighted risk taking opportunities and What’s different about DI leadership is that paradigm-busting execution. More importantly, it moves from being an occasional episodic they adeptly convert satisfied customer management by objective shortcoming to a experiences, as well as valuable workforce breakthrough balanced measurement system investments and meaningful achievements, into achievement. It paves the way for the CEO to corporate profits. create C-Suite solidarity and a united culture of innovation and comprehensive health promotion As CEOs continue to reconfigure HR seats achievement in the company. in the C-Suite, they will be more inclined to embrace business-centric people strategists to People strategists judiciously converge on focus on value-realization achievement. Key C-Suite leadership engagement techniques components will include high levels of sales, and incentive alignment SBPI action plans to profits, customer satisfaction, production of precisely execute optimal measurement systems high quality products, improved reputation and designed to determine gaps. This information is

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prioritized for a guided program planning and Profound change will not happen without evaluation strategic roadmap to instate a sense of constructive conflict. “The new value-centric balance and achieve leading-edge best practices. HR professional who has a DI mindset would be an ideal role model and business leader in the A balanced view of the business requires C-Suite to promote the meaningful use of HR continuous predictive data analytics for systematic performance improvement processes insight. Value realization of corporate benefits and best practices,” further states Yeager. administration reporting in the C-Suite has not been meaningful, far-reaching or productive. It is clear that C-Suite distinctive competency Legacy benefits administration reporting is discussions, recommendations and value “aggregated” but not “integrated” and includes realization optimization barriers cannot “data” versus actionable “information.” It also be tackled or resolved if there are no solid is not intelligible, accessible, consistent, precise, metrics to analyze and compare valuable or reliable to the C-Suite. employee engagement investments alongside comprehensive culture-of-health programs that Susan R. Meisinger, former president and CEO emphasize high-value workforce wellbeing of the Society for Human Resource Management under the health promotion umbrella. and a board director for the National Academy of Human Resources, recently wondered: Strategic productive advantage from “Is it possible that we think we’re playing an comprehensive health promotion, high value important role in driving innovation in our workforce wellbeing improvements can be organizations just because of how hard we’re achieved only if understood and embraced at the working and not because we have any data to C-Suite level. To achieve optimal engagement, support that conclusion? Perhaps.” people strategists have created next-generation SBPI C-Suite level benefits administration The time has come for a major paradigm reporting dashboards and scorecards. Value shift that enables pioneering employers to realization materializes when action is taken on simultaneously realize greater employee SBPI measurement insights. trust, talent engagement and customer value realization, as well as prevent spiraling health Cracking the Code care costs and actually bend the trend. Many ideas aimed at improving comprehensive health promotion, high value workforce According to Kathleen Yeager, a senior wellbeing fail to deal with DI and improving the professional human resources (SPHR) specialist business value of health in the C-Suite. People and leading strategist on chief organizational strategists understand and decode the inner effectiveness: “SBPI and DI spotlight creative workings of C-Suite critical thinking behaviors execution and encourage organizations to focus and linkage between employees, customers and on critical talent management [people] challenges profits by isolating perceptions and attitudes of and related ‘customer value realization’ issues health promotion investments and the business and begin to embrace proactive constructive value of workforce wellbeing dividends that change in the HR operating model.” drive strategic SBPI business plans. Value

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realization encompasses several areas and requires relevant on-site, corporate level and company-wide reporting as defined by C-Suite leaders and front-line managers. What gets measured gets improved. The role of the people strategist is to determine what is important for the C-Suite team to measure. The undertaking is intended to rapidly shape and mold the SBPI process created to help pioneering employers answer: 1. How are we doing (versus benchmark employers)?

by the workforce. There is a strong consensus that sustainability related issues are having a significant impact on how people in the C-Suite think and act. Business is driven by value and value creation. No value? Then no sustainability. It’s that simple. But customer value cannot be effectively delivered without people strategists who recognize as their companies grow, they will need a SBPI system to continuously analyze, intertwine and refine their workforce engagement processes and high-value workforce wellbeing best practices.

2. How can we improve (to the point to “bend the trend” on curtailing According to Michael E. Porter, Ph.D., a employee health care costs)? Harvard Business School professor and leading 3. What if authority on competitive strategy: “Value — ( involving simulation capabilities scenarios neither an abstract ideal nor a code for cost for planning and budgeting)? reduction — should define the framework for systematic performance improvement. An evidence-based measurement process Rigorous, disciplined measurement and provides the CEO with objective insight into improvement of value is the best way to drive comprehensive health promotion, high-value system progress. Yet value remains largely workforce wellbeing issues and processes. unmeasured and misunderstood.” People It also gives them the ability to objectively strategists realize that measuring, reporting and identify and help C-Suite leaders manage benchmarking results are the most important their company’s health risks, and provide an steps toward rapidly improving company value early detection mechanism and feedback loop streams to help CEOs make distinct choices resolution option involving identified workforce about improving the bottom line and sustaining well being problems. a competitive edge.

The Sustainability Imperative

Keeping people healthy is a critical business strategy and serious economic imperative. People strategists are adapting in the C-Suite and getting down to business. They bring together thriving wellbeing people, as well as execute strategies and action plans that result in trust, engagement, incentive alignment, use of relevant information and distinct choices

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The Importance of Critical Thinking in the C-Suite

People are the biggest source of a sustainable competitive advantage. And people strategists realize that engaging, deploying and optimizing a fluid company-wide systems improvement initiative entails hard work. More importantly, the final step is to prepare a SBPI business plan that reinforces the company’s focus on DI and

doing whatever is needed to go on delighting its customers. If you look at the most important issues for CEOs, they reveal the need for: 1) evidencebased, high-value workforce wellbeing standards of practice; 2) proven high-touch, employee engagement (health behaviors) return on investments that are integrated with highvalue workforce wellbeing results; 3) keen insights into comprehensive health promotion and neighborhood health assurance business models; 4) know-how to replicate ”experience curve” efficiency gains and bend-the-trend investment output effort; and 5) expertise of informed physician executive leaders as frontline people strategists whose integrated role enables them to be more effective and focused. Critical thinking is not driven by answers but by questions. The driving forces in the people strategists’ critical thinking process are the questions, which can lead to a better understanding of C-Suite leadership behaviors and how to create meaningful connections between employees and customers to achieve high profit margins. What are the secrets people strategists employ to command their CEO’s full attention? The answer can be found in six pointed questions to ask C-Suite executives in order to conform to the CEO’s reality (see Exhibit A).

The CEOs C-Suite SBPI Survey Overview

For more insight about the way to assess C-Suite awareness, knowledge and engagement in a comprehensive workforce wellbeing program, consider the experience of a $15 billion multinational manufacturer with double digit annual health care cost trend growth in self-insured plans. The entire senior

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management team met with HR professionals during an annual leadership conference to focus on business issues to sustain a competitive edge. That effort required gauging the team’s awareness of employee health care issues and the cost of that care. The hope was to elevate these concerns beyond the benefits department and into the C-Suite. Another goal was to provide an objective benchmarking tool to track program progress internally and relative to other employers. The initiative was based on an optional multiple-choice, self-assessment survey of senior manager awareness of the current state and impact of company health care trends. The C-Suite survey tool was designed around commonly known leadership statistics, such as annual budgeted revenue growth.

Nuggets of Perception Reveal C-Suite Realities

This research process is based on a simple premise, which is that an employerâ&#x20AC;&#x2122;s senior management is critical in the development of an effective environment for improving workforce wellbeing corporate cultures of health in the C-Suite. Indeed, too few C-Suite executives are aware that employee health care costs have both a direct and indirect impact on profits or that workplace environment affects workforce health care costs. The message to senior leaders is that they can help reverse the health care cost trend in their organization, but that they also cannot delegate this goal or accountability to others. A small, albeit growing, number of employers are achieving flat or declining health care cost trends â&#x20AC;&#x201D; considerable achievements that not only steer clear of short-sighted, costshifting strategies or benefit reductions, but also by expanding access to care in some cases where such a move is warranted. One

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common denominator among this elite group of organizations is how well their C-Suite scored on tests to gauge their knowledge of this topic.

Key Research Findings

The large manufacturerâ&#x20AC;&#x2122;s findings revealed a steep learning curve among members of the leadership team, who did better at choosing the right answers for traditional business questions than workforce wellbeing. For example, only 38% of the 56 executives and front-line managers who completed the questionnaire answered correctly how much their company spent on health care, with 80% of those who got it wrong underestimating that spending and more than half believing the figure was more than 50% below the actual tab. There were several other indicators showing a serious lack of understanding. Just 34% were able to translate the number of incremental cases of product required to cover expected annual employee health care cost increases and only 20% were able to correctly determine how

many full-time employee positions would have to be eliminated to cover those increases. Of those who incorrectly answered this question, 46% underestimated the number of positions that would be required. With regard to their company’s disability incidence rate, a mere 16% gave a correct answer. Of those who guessed wrong, all of them underestimated the actual rate and 63% picked a rate that was less than half of the correct answer. When asked to describe the kind of health plan coverage their company offers, 40% gave answers that only fit fully insured programs — the implication being that nearly half the senior management team thinks that their health care costs are not direct business expenses.

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Perhaps equally egregious was the C-Suite’s impression that the workforce was significantly healthier than the reality of the company’s situation. Asked to estimate the percentage of covered lives considered to be well, at risk, chronic and catastrophic, 34% of the executives did not even bother to answer this question. And of those who did answer, the average responses were 42% said employees were well when, in fact, only 8% fell into this category. In addition, 32% believed there was more than one risk factor when, in fact, that number was 70%, nearly 18% chose the chronic description, a close estimate to the actual 20% figure, and 6% said there were catastrophic illnesses in the workforce, whose number was 2%.

Conclusion

The DI SBPI decision-making process for strategic adaptation depends on a solid understanding of C-Suite attitudes, beliefs and behavior patterns while improving the linkage between employees, customers and profits. When members of the senior management team in a multinational manufacturer do not know key health care cost statistics for their business or the fact that they’re self-insured, something is seriously amiss in the C-Suite. Without a clear understanding of how to stem rising employee health care costs and what is driving such expenses in any given workforce, employers that remain stuck in neutral on this issue will suffer a competitive disadvantage.

C-Suite critical business issues and financial key performance indicators is profound. Many times the complete lack of understanding [and engagement behaviors] in the C-Suite can be brilliantly transformed into beautiful profits, for the very C-Suite engine that powers the business might just be HR.

People strategists who embrace an HR application of DI along the road to attaining high-value workforce wellbeing will be able to help drive success in the C-Suite and reserve a permanent seat at the corporate leadership table. The secret weapon is a simple leadership survey that HR practitioners can use to highlight this issue in ways that garner much more support from senior leaders to engage in culture of Perhaps equally egregious was the C-Suite’s health solutions the same way they would in impression that the workforce was significantly other resource efficiency programs. healthier than the reality of the company’s situation. Asked to estimate the percentage of covered lives considered to be well, at risk, chronic and catastrophic, 34% of the executives did not even bother to answer this question – suggesting that they did not have a clue. And of those who did answer, the average responses estimated that 42% of the covered lives when, in Les C. Meyer, MBA, is a Dillon, Colo.–based fact, only 8% fell into this category. Collectively health care strategist and vice president of they believed that 32% were at risk with more HealthNEXT, senior fellow, Jefferson School than one risk factor when, in fact, that number of Population Health, Thomas Jefferson was 70%. (They were better able to gauge the University, chairman, Informed Opinion chronically and catastrophically ill cohorts with Leadership Action Group (IOLAG): Employer figures of 18% and 6% while the actual figures Market Sector, board member, Professional were 20% and 2% respectively.) Patient Advocate Institute, and founder Taos

Bio

Beauty is NOT in the eye of the beholder. Teachable moments in the C-Suite may truly predict future bottom line profits. The disconnect revealed in the unique “C-Suite Active Engagement Survey” between awareness and understanding of traditional

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Brain Injury Transitions Institute. He can be reached at 303-916-0017 or Les.Meyer@ HealthNEXT.com.

F E A T U R E HRAs ~ Time and Money Well Spent

By Don Hall In response to Lisa Holland’s April 1, 2011 National Healthcare Reform Magazine article, “Health Risk Assessments: A Waste of Time and Money” (promoting Simplicity Health Plans)

here is usually a grain of truth in most dissenting opinions regarding the proper way to manage an employee wellness program. It is true that we know what most people need to do to improve their health – namely, eat more healthfully, eat less, and exercise more. You don’t need a health risk assessment (HRA) to tell you that. But are HRAs a waste of time and money?

what each individual needs to see the most improvement.

Most people are overweight, but a third of the population is not. Some have high blood pressure, high cholesterol, or high blood sugar, but the majority does not. It’s vital for each person to know what his or her major health risks are and what specifically can be done to minimize the risks and prevent serious health problems in the future. That’s the primary purpose I suppose the same question could be posed of an HRA. about medical care. Since we already know which health problems are the most Here are several excellent and proven common and what most patients need to reasons why you do need a good health do to correct them, why should a doctor assessment at the start of a wellness waste time and money doing physical program. exams and blood tests? The answer to both questions is the same: You have to find out 1. Each individual needs to know what

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his or her major health risks are. Some are obvious, such as smoking and obesity. Others are not. Those include high blood pressure, high cholesterol, specifics about poor eating habits (i.e., low intakes of fiber, fruits, vegetables and whole grains), and symptoms of depression. 2. Each individual needs a Personal Prevention Plan – specific steps on how to lower identified risks and how to specifically improve health. A good HRA provides this information with personalized and specific guidelines for lowering the risk of heart disease, diabetes, cancer, improving eating habits (based on their individual needs), improving their fitness level, etc. 3. HRAs establish benchmarks. When a company starts a wellness program, it is important to have benchmarks – both for individuals (weight, cholesterol levels, activity levels, eating habits, mental health indicators, etc.) and for the organization (number of smokers, number of sedentary individuals, number of employees with signs of depression, etc.) so you can measure change and improvement. Before HRAs became readily available, people ran wellness programs “blind” – without knowing anyone’s health needs, company-wide health needs, or benchmarks. Then when administrators were asked if their wellness programs were successful, no one knew. They had no way to measure improvement. Are there fewer smokers now? Are people eating more healthfully? Are more people exercising now? How can you tell a person that he or she has improved this year (or not improved, as the case might be) unless you can compare current results with earlier benchmarks? Without a good HRA, you wouldn’t have a way to track improvement year by year, which means you couldn’t show if your program is beneficial. Measuring outcomes

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is critical for documenting improvement and benefits from your program. 4. You can identify groups with specific needs for intervention. If you are a wellness coach working with people to improve their health, would you want to work blind – and not know their health needs or practices? Or would you rather have a wealth of information with recommendations at hand so you could talk to people intelligently and specifically about their health? A good HRA lets you query the database to find specific groups that need special attention. This is invaluable for inviting people with specific needs to an intervention. For example, if you have a new intervention on stress management, wouldn’t it be valuable to specifically invite those who have signs of stress?

July 2011

5. Self-reported information IS reliable and is the most common way health information is collected. When an HRA is conducted properly and people are assured that their information will not be seen by management, but used only for their own benefit, the information gathered is quite reliable. Nearly all health studies conducted by the government and research programs are based on self-reported questionnaires. All good HRAs also include collecting biometric data such as height and weight measurements, body composition, blood tests, blood pressure, and fitness tests. These data increase the HRA’s accuracy and objective results. In her article, Lisa does point out the value of collecting biometric data. If you collect this data, you need to record it in a database so you can track any changes, do group statistics, and show individuals their results. A good HRA does all of this automatically. 6. Health insurance claims don’t tell the full picture. For example, if a person is taking a beta blocker, does he or she have high blood pressure, coronary heart disease, or a heart arrhythmia? Do you want to wait until a person is taking diabetes medication to identify who has diabetes, or would you rather have the ability to identify pre-diabetes or those who are at risk of developing diabetes, long before they start taking medication? People with undiagnosed diabetes (a sizeable part of the population) who also have depression or hypertension won’t be found at all just by looking at health claims. But they would be identified with a good HRA and biometric screening. Claims data will give you some information, but it can’t paint a complete picture. It is largely “reactive” – identifying people who already have disease rather than finding those at risk for developing disease. 7. Family history is not as important as personal information. It’s true that government regulations have limited data gathering by disallowing

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family health history and personal genetics questions on HRAs in certain circumstances. But while family history is important, it isn’t critical. In fact, in the esteemed Nurses’ Health Study, women with modifiable risk factors for diabetes had the same risk whether or not they had a family history of diabetes. A good HRA report will point out to individuals if they have a history of early heart disease, diabetes or cancer, they may be at even higher risk. I know that no good doctor would ever treat a patient without gathering a medical history and doing health tests and examinations. Wellness counseling and assessment need to be given the same careful attention and professional treatment to help companies achieve high quality outcomes with their wellness programs. HRAs, which can be done inexpensively and quickly online, provide a rich and beneficial addition to any wellness initiative.

Bio Fitness, nutrition, and health promotion expert – Dr. Don Hall has made good health his life’s work. Don Hall holds a Master in Public Health (MPH) degree in Nutrition and a Doctor of Public Health (DrPH) degree with an emphasis in Preventive Care, both from Loma Linda University. He is also a Certified Health Education Specialist (CHES) and an active member of the American College of Sports Medicine (ACSM). In the early 1970s, Dr. Hall founded Wellsource, Inc. As Chairman, Dr. Hall continues to lead the company into an era when being healthy is not only a good idea – it’s good for all businesses.

F E A T U R E

In Wellness Communication, Clarity is Key and Less Is More

or years, most wellness communication had been riddled with corporate-speak and jargon instead of clear, concise language aimed at busy employees with short attention spans.

employees’ attention in the first place. A good rule of thumb: You can’t educate or motivate unless you captivate.

Savvy organizations accomplish this by creating wellness communication that is conversational and succinct. They deliver By Shawn Connors Before you draft emails, newsletters, posters messages with tones and lengths that fly in and other ways to explain and promote your the face of what other organizations consider wellness program, remind yourself of three to be “proper” and “official.” probable (and unfortunate) realities about your audience and your message: Clarity is Key: If Your Messages • They don’t really want it. • They don’t really have time for it. • They didn’t really ask for it. With that in mind, informing employees about the advantages of participating in your wellness program might be your primary communication goal, but it shouldn’t be your initial one. The original mission is to capture

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Aren’t Obvious, They Can’t Be Understood

Businesses that want to sound “official” usually end up sounding confusing or egotistical. The intent of their messages is lost in the delivery, usually because the messages have more to do with the sender (“This is what we want, and this what we think”) than with the receiver (“Here is what

you asked for, and this is how it applies to you”). Today, there’s a Grand Canyon-sized gap between what companies want to say and how they choose to say it. One problem is most workplace communicators neglect to consider the importance of “voice” — the tone of their communication, as determined by their audience. Another reason is workplace communicators eschew clarity — the main ingredient of effective communication — because, well, they use words like “eschew” instead of “avoid.”

“We can’t keep focusing on our information instead of our readers,” said Audrey Riffenburgh, founder and president of consultancy Plain Language Works, LLC. “Clear communication is about focusing on what your readers need to know and then delivering that by making sure messages are relevant and understandable. Putting that communication in plain language doesn’t mean you’re ‘dumbing down’ messages. It simply means you understand the importance of having employees receive them.”

The growing disconnect between what employers write or say and what employees read or hear has fueled the “plain language” movement in several industries, including health care. The problem in the medical field is understandable: Highly educated doctors often aim to sound highly educated, and their vocabulary — much like the journals and books they read — are technical. A similar issue often affects company CEOs and presidents, who aim to sound business-like.

Need to get clear? Avoid These Common Problems

1. Getting technical and clinical. Some organizations try to show off their intelligence by distributing long articles or emails filled with jargon. Keep your messages simple and understandable.

2. Covering too much. Say it quick, and make it stick. Listen to seasoned radio sources (politicians, book authors, activists, etc.) and But if your wellness messages aren’t obvious, notice how many of them are great at getting they won’t be understood or acted upon. In their points across in “sound bites.” Decide on fact, they might not even be read or heard. This your main concept and focus on getting that is especially true when a topic is viewed by message across. Then stop. Future messages employees as important but intricate (improving should discuss related concepts. overall wellness, learning how to make exercise 3. Failing to highlight important copy. Cut the and healthy eating habitual, etc.). gist of your message down to an “elevator speech” As a workplace communicator, you might have you can describe in a sentence or two. Make those the task of reaching a large variety of workers, words the first ones readers see. Don’t “bury” the including people who struggle to read, and those point. who can read but either don’t take the time or simply tune out health information. It’s an 4. Creating “brick walls” of text. Don’t make important challenge. In fact, the National Patient readers scroll down several screens to read an Safety Foundation says the biggest barriers to email, and don’t pass out an important internal being healthy are not age, income, education brochure that lacks illustrations, charts or tables. level, race or ethnicity. Rather, studies indicate Include subheads, sidebars, pull quotes, boxes that the strongest predictor of a person’s health and the like whenever possible, especially when status is his or her ability to understand and use presenting an idea that can be better understood visuallyon first glance. health information.

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5. Lecturing. Provide take-away value. Sharon Long Baerny, principal of Seattle-based Remember, your audience is going to think, “So communications agency We Know Words. “Whatever you’re communicating, it’s much what?” more important to you than it is to your recipients. To make your messages more effective, you must Less is more: does your wellness communication pass the scan test? begin to think more like them.” The average attention span of Americans today is roughly the time it has taken you to read this The key is brevity. So, think of teasers and sentence. “You only have a minute to gain their billboards. Make your messages easy and attention” is an incorrect maxim. You actually scannable. Cut your articles to a couple hundred words. Get your videos down to one minute, have about 2.7 seconds. max. Stick to the main concept. And then you have to keep their interest so they can act upon your communication? That’s not If you do, your emails, newsletters, and posters easy. You are trying to reach employees at the will come with credibility, not just copy. same time they are updating a file while also Employees might even start looking forward instant messaging with a co-worker while also to receiving it. They’ll realize something you straightening up their desk while also listening to already know: Your organization’s wellness communication is well worth their time. a conference call. How can you get employees to view — let alone Need to get concise? Try These Tips read — your wellness communication? Truth is, people don’t read. They scan. We are a “If a worker views something for a few seconds, populace versed in instant gratification. he or she should be able to describe at least the gist of what you’re saying,” said Alison Davis, Relish the role of making your wellness CEO of employee communications firm Davis communication simple, not just essential. Here & Company, and coauthor of the book Your are four tips: Attention, Please: How to Appeal to Today’s Distracted, Disengaged and Busy Audiences. “If 1. Use short sentences. Keep in mind how you that can’t be done, your communication program would tell people if you were talking to them. Instead of … Joe utilized numerous strategies to is going to suffer a quick death.” achieve his goals of increasing his daily activity Many employees turn a deaf ear to anything and decreasing his consumption of unhealthy involving topics they don’t understand fully. So foods.Try … Joe had two goals: adding activity when they see an email about important changes to his day and eating less junk food. He tackled to the company’s wellness plan, for example, his goals in many ways. their tendency is to delay reading it until they 2. Be positive and inspirational. You want to absolutely must. encourage healthy behavior. Be a cheerleader, “It’s such an unkind reality — yet such a critical not a scolder. Instead of … Smoking is bad for realization — to understand that most employees you. You should give up this unhealthy habit need to be told why they should care,” said before it’s too late! Try … Giving up smoking

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can help you to feel better and live longer. Why • Assuming professional-sounding language not give it a try? Here are some simple ideas that is better than simple “plain speak” in your may work for you. wellness communication 3. Use bulleted lists when including steps or tips. Organizing information into bulleted lists makes it easier to read and process. Instead of … During our next monthly meeting, we will be discussing changes to our program, in addition to new incentives and an update to our points system. Try … During our next monthly meeting, we will be talking about:

• Assuming all employees absorb and retain communication in the same manner and prefer the same medium

• Changes to our program • New incentives • Update to our points system 4. Include actions to take or where to go for more information. Don’t leave readers hanging. If you’re including a story, determine what you want your readers to do with the information. If you want them to sign up for a new weightmanagement program, tell them so and provide them with a link, e-mail, or location of where to sign up. You may also want to include a few steps they could take on their own to get started on managing their weight — a sneak peek of what to expect with the program. 5 Wellness Communication Assumptions to Avoid • Assuming you can get employees to act on your messages without telling them why and without asking them to act • Assuming employees will read, instead of simply scanning, your content • Assuming it’s not worthwhile to encourage employees to make seemingly minor healthcare changes and choices

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Bio Shawn M. Connors is president of Hope Health. He believes behavior change requires a mix of both art and science. He founded the International Health Awareness Center, Inc. (IHAC) in 1981, which focuses on the importance of communication in positively affecting workplace cultures. Recently, he worked with a talented team to develop a workable, realistic health communication system, empowering thousands of workplaces and community-based clients to communicate more effectively with new media. Shawn has earned the respect of marketing professionals and health educators alike. About Hope Health Hope Health, based in Kalamazoo, MI, is an experienced, multimedia content provider offering new perspectives in wellness and benefit communications to workplaces and community organizations. Hope Health’s Website at www.HopeHealth.com includes many free tools, reports and articles you and your Wellness Committee can download and use.

E D I T O R I A L

By Maureen Young

Diabetes Management: Corporate Programs Can Make a Difference

f you don’t have diabetes, you may assume that it’s managing the disease is a simple matter of staying away from sugar, testing your blood sugar and giving yourself an insulin injection. It’s not that easy. Putting aside the fears that many people have regarding needles and the finger pricks required for managing this disease, it is much more complicated thant simple testing, injections and medications. Diabetes is an individual battle that people fight every day. It differs for everyone regarding in terms of what works, what they can eat and which particular outside factors affect them. Corporations can have an impact on their employees’ ability to manage their disease, which will ultimately impact their bottom line.

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The Rising Incidence and Cost of Diabetes

Diabetes continues to be a problem for millions of Americans, and it’s costing us billions of dollars to manage and treat. According to the American Diabetes Association1, over one- third of all Americans will develop type 2 diabetes by the year 2050 unless radical changes are made in our lifestyle and eating habits. Over 57 million people have pre-diabetes or metabolic syndrome with a very high risk of developing diabetes, and over 24 million children and adults already live with type 1 diabetes. The difficulty lies not only in managing your blood sugar to prevent serious, life-threatening side effects, but keeping your health insurance to cover you if any serious

complications arise. If you have diabetes and you aren’t paying attention to your glucose levels every day, you could be setting yourself up for severe problems.

to control. If the pancreas is working just fine, the body handles daily, small changes without any active intervention. Job or personal stress, lack of sleep, skipping a workout, a little too much salt, and obviously, too much sugar can In 2007 the total cost of Diabetes in the United interfere with balanced blood sugar. What if States was $218 billion. Of this number $44 an employee’s job is stressful causing a poor billion goes toward undiagnosed diabetes, pre- night’s sleep, or they catch a cold or the flu? diabetes and gestational diabetes. Diabetes Even minor illnesses can cause glucose levels contributed to 231,404 deaths during 2007, to rise. For diabetics, staying in touch with their and the number continues to grow as more doctor during these times is critical when blood Americans develop type 2 diabetes. sugar levels are difficult to manage. Doctors may recommend additional insulin injections or Of the remaining $174 billion spent on diabetes reduceing the amount if the patient is taking oral each year, $116 billion goes toward excess insulin. medical expenditures attributed to diabetes and $58 billion in reduced national productivity. Diabetes is an underlying cause in many health People with diagnosed diabetes have medical conditions, including heart disease and stroke, expenditures that average 2.3 times higher than blindness, high blood pressure, and kidney the expenditures of those without diabetes. disease. Maintaining a healthy, stable blood Almost $1 in every $10 can be attributed to sugar level over time can reduce the risk of serious diabetes. The indirect costs include absenteeism, complications. Watching for stressful situations, reduced productivity and lost productive which no one can avoid completely, and then capacity due to early mortality2. making changes to account for fluctuations in glucose levels can mean the difference between People with diabetes between the ages of 18-64 saving a person’s sight or limbs and continuing average 8.3 lost work days per year as compared to be a productive employee. to 1.7 days per year for those without diabetes. The medical expenditures are significantly Diabetes is the leading cause of new cases of higher for diabetics at $10,071 per person and blindness among adults ages 20 to -74 and the only $2,669 per person for non-diabetics3. Any leading cause of kidney failure. Forty-four headway that corporations are able to make in percent44% of new cases of kidney failure were guiding people who liveing with diabetes toward attributed to diabetes in 2008. In combination better management of their disease would offer with heart disease and stroke and non-traumatic a considerable cost-savings to the corporation amputations, the downside of ignoring large and to the American public. fluctuations in glucose levels can be disastrous. Every person is different, and this holds true for Diabetes Complications Are those trying to manage diabetes. Something that Serious causes a major glucose shift in one person may There are so many factors that can affect be barely noticeable in another. In addition, glucose levels, and many of them are difficult beyond each person’s individual reactions, over

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time those may shift within an individual that require constant adjustments to what may have been stable diabetes maintenance. Providing guidance and help for diabetics dealing with shifts in glucose levels and new symptoms is critical to a diabetic’s long-term health and productivity.

What can businesses do to help diabetic employees?

worry about privacy and not want others to know that they are diabetic. They may not be ready to accept that they are ill and need to seek treatment. Whatever the cause of employee apathy, there are ways to increase employee awareness and participation in a new diabetes management program. Without employee buy-in, the program will falter and fail wasting dollars that could have been saved when employees control their diabetes well, reduce absenteeism and lost productivity and reduce complications due to diabetes. The website www.diabetesatwork.org provides tool kits and reference materials designed to help employers start a diabetes management program within their organization.

The CDC has partnered with the National Institutes of Health to improve the treatment and outcomes for people with diabetes, to promote early diagnosis, and ultimately, to prevent diabetes. Together these organizations developed the National Diabetes Education Program (NDEP). Their document, Making a Difference: the Business Community Takes on Promote Employee Awareness Diabetes4, offers some guidelines to employers: Employees first need to become aware of the prevalence of diabetes and pre-diabetes in their • Develop a supportive work environment so community and in their workplace. Highlighting that employees with diabetes feel comfortable behaviors that contribute to the development adopting and performing the behaviors that of diabetes type 2 and how avoidance of those behaviors can reduce the chances of developing promote good diabetes control. diabetes can alert employees to how easily their • Provide encouragement and opportunities for own behavior can increase their risks. all employees to adopt healthier lifestyles that Specifically, some steps to increase employee reduce risks for chronic disease. awareness5 include:

• Coordinate all corporate diabetes control • Including the local medical community in efforts within the organization to make them your efforts, so that they see the program as an more efficient as well as accountable. (The aid to compliance and not competition. NDEP publication shows successful examples.) • Work with other businesses in the community who may be interested in sponsoring specific • Demand the highest quality medical care for events or promotions for the program. people who are dealing with diabetes. • Invite an educator specializing in diabetes If corporations decide to embark on a program in for a company hosted brown bag lunch to specifically tailored to diabetes management, discuss warning signs and symptoms of diabetes one of the obstacles they will face is employee type 2 with focus on the importance of balanced resistance for many reasons. Employees may nutrition and exercise.

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• Post NDEP flyers and posters and include the NDEP newsletter in the internal corporate newsletter. •Advertise the program in internal communications such as newsletters and email announcements.

Promote Employee Participation

Once employees are aware of the program, the right employees need to be encouraged to participate in the program5 to really see cost savings from decreases in absenteeism and medical complications that , which will raise health care costs and insurance premiums. Make sure that employees know that you value their privacy and that their information will not be shared with other employees and that it will not increase their health insurance premium. Develop an incentive program for participation in the program. Financial incentives such as bonuses are effective, but other types of financial incentives can be effective as well. Provide financial coverage for testing supplies and in-house testing or health fairs to encourage frequent testing to control glucose levels.

well as high risk, increasing the cost of health insurance or raising the chances of losing it. It will take time to see the financial benefits of a corporate diabetes management program, but with sincere effort and commitment, it can reap large rewards, like those recognized by GM with their LifeSteps Initiative6. GM saw a $2.70 to $1 ROI, the reduction or elimination of 185,000 health risk factors and an increase in low risk participants from 55% to 63.1%. Diabetes is not a disease to be taken lightly. It requires serious attention, EVERY DAY, and can’t be ignored. Help your employees manage their disease better, so that they are in control of their diabetes and keep them happy, healthy and productive!

Use in-house activities such as lectures or brown bag lunches and take advantage of national campaigns such as Diabetes Awareness month. Use targeted mailings sent to prospective participants.

It’s Not a Sprint, It’s a Marathon

Most of us deal with little surprises andor changes every day and just plow ahead. For diabetics the small changes in blood sugar caused by these little “inconveniences” could raise blood sugar consistently, leading to serious long term complications and increased health care costs. Insurance companies see people who do not manage their blood sugar

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Bio Maureen Young is a Consumer Education Advocate for ANY LAB TEST NOW®, a healthcare lab testing facility. She is a writer, health care advocate, and fitness enthusiast driven to explore advances in the health care and medical industries and share her research with the public.

References

1http://www.diabetes.org/diabetes-basics/diabetes-statistics/ 2The Lewin Group, “The Economic Costs of Diabetes in the U.S. in 2007,” Diabetes Care, March 2008, vol, 31 no. 3, 595-615 3American Diabetes Association, Economic consequences of diabetes mellitus in the United States in 1997. Diabetes Care, 1998; 21:296-309. 4Centers for Disease Control and Prevention. Making a Difference: the Business Community Takes on Diabetes. Atlanta, Georgia: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1999. NDEP Pub #33. 5http://www.diabetesatwork.org/NextSteps/AwarenessAndParticipation.cfm 6Tim McDonald, PA, Michigan Department of Community Health, Workplace Wellness Chronicles, August 2005. Online at http://www.michigan.gov/documents/ MDCH-Chronicles-GM-0805_134908_7.pdf.

C O L U M N

Diabetes and Its Effect on Future Employer Health Costs - Guidance for Employers By Jonathan Spero

iabetes is a disease caused by elevated blood sugar with medical complications, which are costly and devastating. According to the Centers for Disease Control and Prevention (CDC), the number of diabetics in the United States has grown to nearly 26 million, a 10 percent increase in the past 2 years. What is more alarming is that, according to the CDC, over 79 million adults in the U.S. are classified as pre-diabetic, a precursor of diabetes. This is a 33 percent increase in the past 2 years. According to the CDC, it is predicted that 25 to 33 percent of the U.S. adult population will have diabetes in 2050. (1,2,3)

related to increased weight and age. With the epidemic of obesity, currently two-thirds of the U.S. population is either overweight or obese. In addition, the average age of the U.S. population is steadily getting higher secondary to people living longer and the baby boom generation now all above the age of 50.

How will this impact employers?

Well, it turns out that the cost of health care for people with diabetes is 230 percent more expensive than for people without diabetes according to the American Diabetes Association.(4) This statistic has been confirmed by a recent report from United Healthcare, which compiled data from 10 million members and found that the average annual health care costs in So why are so many Americans 2009 for a person with known diabetes developing pre-diabetes and were about $11,700 compared with about diabetes? $4,400 for the non-diabetic public â&#x20AC;&#x201C; 260 The prevalence of diabetes is directly percent more expensive. In fact, by the end

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of this decade it is estimated that medical care for pre diabetes and diabetes will account for ten percent of the total healthcare spend in the U.S. Employers will bare a significant portion of this financial burden.

Why is care for diabetes so expensive?

To start, the actual medical care required to treat diabetes is costly. Furthermore, the complications of diabetes are very serious and enormously expensive to treat. These conditions include heart disease, kidney disease, eye disease, nerve disease, and many other conditions.

Therefore, screening for diabetes is critical to diagnose the large population of persons who are undiagnosed. Furthermore, screening also identifies the much larger population of persons with pre-diabetes, a precursor of diabetes. -Employers can screen their entire employee population for diabetes easily and inexpensively with a simple blood finger stick.

Prevention - – Modest weight loss achieved by lifestyle coaching can prevent persons with prediabetes from every developing diabetes. In fact, a large, nationally recognized study published in the prestigious New England Journal of Medicine demonstrated that achieving a modest So what can employers do to 7% weight loss goal resulted in a 58 percent% address this issue? reduction in the incidence of diabetes in a highThe solution for this issue requires a three- risk population that had pre-diabetes.(6) pronged approach – screening, prevention, -Employees with pre-diabetes must be and disease management. The necessary tools encouraged to enroll in diabetes prevention are currently available for employers to tackle program with a focus on proper nutrition and all three. Let’s take a closer look at what these exercise. initiatives are and why all three are necessary. Disease Management - By all measures, diabetes Screening - – Almost 30 percent of persons is sub-optimally managed by physicians in the with diabetes are not aware they have it.(5) United States. Poorly controlled blood sugar and

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lack of routine maintenance care leads to an accelerated risk of complications and increased healthcare costs. Several key diabetes studies have demonstrated that proper disease management intervention not only significantly improves HEDIS scores but also reduces healthcare claims for those patients enrolled in the program. -Employers’ investments in diabetes disease management programs show promise in delivering both short term and long-term health and financial benefits. In summary, diabetes is an epidemic that will significantly impact the cost of healthcare for employers in the near future. There exists well thought out strategies for addressing this issue that demonstrate a clear return on investment.

Bio Jonathan Spero, MD, is CEO of InHouse Physicians and board certified in Internal Medicine. Dr. Spero is an expert in the field of targeted employee wellness programs with measureable ROIs. InHouse Physicians is a global employee health and wellness provider delivering innovative cost containment solutions to corporations around the world. InHouse Physicians high touch employee health services include a wide range of offerings such as cost effective worksite health centers, evidence based “pre- disease” wellness initiatives, health screenings plus analytics, flu vaccinations, and travel medicine.

References 1. Narayan KM, Boyle JP, Geiss LS, Saaddine JB, Thompson TJ: Impact of recent increase in incidence on future diabetes burden U.S., 2005-2050. Diabetes Care 2006, 29(9):2114-2116. 2. Magliano DJ, Shaw JE, Shortreed SM, Nusselder WJ, Liew D, Barr ELM, Zimmet PZ, Peeters A: Lifetime risk and projected population prevalence of diabetes. Diabetologia 2008, 51(12):2179-2186. 3. U.S. Census Bureau. National Population Projections Released 2008 (Based on Census 2000). 4. American Diabetes Association: Economic costs of diabetes in the U.S. in 2007. Diabetes Care 2008, 32:596-615. 5. 2005–2008 National Health and Nutrition Examination Survey. 6. Diabetes Prevention Program Research Group N England Journal of Medicine 2002; 346:393-403 February 7, 2002.

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E D I T O R I A L

By Heather Shreve

“Drawn In 2 Wellness”

Train Your Brain to Create Lasting Change

or most of us, preventing disease, especially cancer, is an important reason to create lasting changes around our health. But, let’s face it, when you are changing your health, you are really changing your life, which is a much bigger topic. Change can be challenging because it requires sustained effort. We all have been there. It isn’t as easy as it looks! To sustain a healthy lifestyle, a deeper traction is required so you can maintain the changes and create a new way of life.

at our value around health and why we even want to be at our best. This is key! Everyone needs a solid motivator to get through the invisible barriers along the way which invite self-sabotage.

The Challenge

You may have heard it takes twentyone days to create a habit, but did you know it takes twenty-one months to create a new lifestyle? Clearly, this is a BIG issue--getting people to change long enough to make it part of their subconscious mind. When that happens, it is known as being ‘an unconscious competent’ or ‘a natural’. The whole process of change requires This is a good thing! A healthy lifestyle an important ingredient in the becomes part of your being, so that you beginning, which is the lynch pin to do not have to think about it anymore. meaningful progress. We need to pause Sort of like driving a car or riding a and THINK. Thinking ensures we look bike.

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The basic challenge is helping people navigate through that critical first twenty-one months. Inevitably, they will run up against invisible barriers (their old patterns, beliefs, and fears) and fall back (hopefully temporarily) into their comfort zones. Oddly enough, humans fear their success, or their ‘light’, more than failure. As a consequence, that last ‘fear’ barrier is a big one. So how do you help your employees make a sustainable shift away from potentially harmful habits into a state of wellness that they can maintain? This is a complex issue, but there are ways to break it down into manageable parts. This is where tapping into our greatest asset through simple symbols and doodles comes into play.

The Concept

How can an image, an icon, a doodle or a picture help us make a shift towards healthy patterns? Well, the idea is simple. We drew before we could speak, so the “art connection” in human learning is very powerful! For us, a symbol

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does replace a thousand words. We all learn better with a visual. This is especially true when it comes to becoming competent at anything, including our lifestyle. Essentially, when we use our imagination and our own doodles, we ‘unlock the box’ on our most important tool in creating lasting change: our subconscious mind. This helps us remember what we want out of life. Keeping your health and wellness goals ‘top of mind’ is the key to getting the results you want. By doodling, not just writing, it becomes more probable that we will make the shift, not ju st possible. Carl Jung, the great psychiatrist, once said “The greatest and most important problems of life are all fundamentally insoluble. They can never be solved, only outgrown.” When it comes to people ‘outgrowing’ their current wellness, doodling yourself back into the wellness picture can be very effective. As you begin to ‘think through your pencil’, your conscious mind and your subconscious mind come together. This is a

July 2011

marriage which truly creates a lasting impression, Everyone has a unique blend of skills and assets and is a great memory tool and can solidify the which brings something special to the table. ideas surrounding our best selves. Maximize all the strengths and gifts that people have, because how they see themselves is actually The Process more important than reality. People with strong Wherever you are (or your company is) in this identities rarely worry about failing—they only process, it is very important to remember that learn, because they know who they are, and they being “hard” on ourselves doesn’t foster growth have built a wall of certainty around themselves. and expansion. Treating ourselves like precious This breeds confidence, and confidence produces objects and focusing on the positive brings out a person who is willing to try. This creates selfresourcefulness. As you reframe change itself, efficacy, and the circle continues. In the end, you and shift the focus onto a compelling wellness invariably have a person with high esteem and a vision for the future, in essence, you create a high level of self-acceptance. Once people know safe haven and fertile ground for you and your who they are, it becomes much easier to decide employees to reveal, rethink and refocus. Let’s what they stand for. From there, it’s even easier look at these three areas (all which can be to think about who they want to become and doodled) and what they mean on the road to what they really want out of life. lasting change. Rethink …your story. Reveal… the real you. Essentially, if people take a good look at their It’s important that people take the time to “story”( their life) they will find patterns, beliefs remember who they are, the gifts and strengths and values that have really served them well. they possess and how this has helped them in life. The trick here is to keep any great patterns and

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July 2011

off. As Albert Einstein once said; “The debt we pay to imagination is incalculable.” Just imagine what it would feel like to have endless energy, a clear mind, and a body that has become an engine against disease and aging! The most important thinking exercise anyone can do around their health and well-being is to create compelling wellness vision. Write it in the present tense, as if it is already here, and put a deadline of three or six months on it. Make it full of detail so that it comes alive in your mind. Where are you? What are wearing? How are you feeling? What are you doing in your life that brings you joy? Think about the most important thing in your life. How does your health overlap it and how does your wellness vision support it? Next, doodle three to five SMART goals (Specific, Measurable, Actionable, Reasonable, Time-lined) that will get you closer to your vision. Draw them as you see them, so they resonate with you and are memorable!

beliefs and ditch any disempowering ones. In every aspect of life, whether perceived as good, bad or neutral, we can find a learning or growth experience. Think of it like ‘wiping the canvas clean’ and starting over with a curious mind to rethink everything. Even the words people use every day may be hanging them up subconsciously. This is really the law of attraction in motion when we choose to doodle a new pattern, a new word or new goal that is Having your employees full of life, disease free healthier. and energized is truly a prize worth pursuing! Since we are all different, exploring a variety of In our fast-paced culture today, it is important to tools will only enhance the work environment look at our world with fresh eyes. It is easy to and encourage designing a positive future filled become trapped in the same old ways. We are with glowing health and vibrant energy. In the unaware that we are not getting our needs met and meantime, give yourself and your employees are unhappy. A lot of the time, we self-sabotage, permission to Dream It, Draw It, See It, Believe because we simply aren’t getting our needs met, It and then BE IT! and food (or another comfort) is an easy answer. This is a delicate topic, but one that deserves attention. Rethinking our basic emotional needs ( Love & Appreciation, Growth and Expansion, Heather P. Shreve is the founder of LIFEguard Comfort & Security, Significance, Freedom, Wellness.com and is wellness coach certified Creativity & Variety) and what may have slipped with the American College of Sports Medicine, away is an important step to discovering what we as well as a certified personal trainer. With her REALLY WANT! triple passion of health, nature and art, Heather has dedicated herself to helping people find selfRefocus …on what you really want! acceptance so that they can design their “best Here is where the concept of harnessing the lives” with strategies to sustain healthy patterns. subconscious mind with doodles really takes

Bio

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July 2011

F E A T U R E

Implications for Human Interaction Related to Crude Oil Exposures Lessons from the Deepwater Horizon Gulf Oil Spill of 2000

By Robert Blackburn

By Clarann Hull

here has been significant Gulf water, coastal areas, marine, interest in following last and terrestrial habitats in the path of year’s Gulf Oil spill related the drift. to human interaction and cleanup for local government workers and volunteers. While there has been very little information related to this subject documented in the federal or state records, we have seen various types of personal injury claims which may be a harbinger of things to come. The first question that we have been asked is “What have been the light crude oil exposures to the environment in the event of this spill?” Crude oil is generally composed of hydrogen and carbon and is usually found underground, but can also be found above ground in oil seeps or tar pits. Our review is related to the underground light crude oil located under the Gulf of Mexico. Light crude contains volatile organic compounds which evaporate, losing up to 10 to 15% of its volume immediately, and up to 25% of its volume within 24 hours. When oil was spilled in the Gulf, it initially spread primarily on the surface of the water. Then it was spread in oil slicks with toxic dispersant materials, which drifted toward the States along the Gulf coastline, primarily Texas and Louisiana. The action of waves, water currents, and wind forced the oil slicks and related toxins to drift over large areas, affecting the open

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Source: http://en.wikipedia.org/wiki/File:BP_Oilspill_ June25.2010.jpg, copyright US Federal Government.

Oil that contains volatile organic compounds partially evaporates, losing 20 to 40 percent of its mass and becoming denser and more viscous. Generally, over time oil waste deteriorates and disintegrates because of exposure to sunlight and biodegradation. The rate of biodegradation depends on the availability of nutrients, oxygen, and microorganisms, as well as temperature. It is too early to determine the exact nature of the oil and related waste, and how it will affect the environment for many years to come. How have these exposures manifested themselves in humans interacting with the cleanup operations? There have been a host of issues related to volunteer cleanup including allergic reactions, development of dermatitis or a skin rash, even from brief contact

with oil. For more prolonged skin contact with the oil, volunteers have experienced skin erythema (reddening), edema (swelling), and burning. In some cases, the skin effects have been worsened by subsequent exposure to sunlight, because trace contaminants in the oil, such as the polycyclic aromatic hydrocarbons (PAHs), are more toxic when exposed to light. The most significant short term issues have involved skin contamination, wound contamination, ocular exposure, ingestion exposure, and inhalation exposure. What preventive measures were taken during the cleanup of the Gulf Oil spill? From our research, very little was done to provide organizational workers and volunteers with the necessary personal protective equipment necessary for their immediate and continuing efforts. According the U.S. Environmental Protection Agency’s Spill Prevention, Control and Countermeasure Plans (SPCC), there is a need to provide training and personal protective equipment to persons involved in cleanup of oil spills, among a host of other measures. Our anecdotal evidence seems to indicate that many local organizations were not prepared to meet the need outlined in the regulations. In some cases, masks, gloves, and boots were provided to first responders. It is unclear after the initial response if there has been any continued

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coordination of the requirements outlined in the Oil Spill Prevention Regulations, US 40 CFR Part 112. For those exposed to oil during the cleanup with no safety measures, what did they experience during that time? Keeping volunteers safe during a catastrophe is difficult. Although workers and those certified to clean oil spills must be well trained (by law OSHA has very clear guidelines). There normally is a small faction of the general public and volunteers who will respond to disasters. Generally, because oil is considered less toxic when it reaches land, volunteers exposed to the nonfloating oil are considered a little “safer” than those exposed to the mousse (or oil mixed with water). Where the Gulf Oil spill is concerned, there were volunteers who ran to the scene long before the experts were available and a proper assessment of the spill had been completed. Doing this placed these individuals in a high risk category for exposure to potential toxins without proper protection. According to a recent article in the New England Journal of Medicine regarding the physical effects of oil spill exposures, volunteers complained of nausea, vomiting, chest pain, dizziness, fast heart beats, skin rashes, scrapes, bites from birds, animals and

July 2011

breathing problems. Another health affect that occurred and took this writer by surprise, were the psychological stresses placed on volunteers. Several of the volunteers experienced depression, exhaustion, sun burns, anxiety, hopelessness, and temperament changes. It’s become imperative that we teach the public about the dangers of exposure to toxins and what people can do to prevent self harm. This way, if they do choose to help, they are aware there is a potential danger and protective gear is necessary prior to “jumping in” if you will. A wonderful thing is that OSHA (Occupational Safety and Health Association) has already provided us with the information on how to guard against potential exposures to toxins. Now, it’s time to teach the public or those that would volunteer so they can protect their children and self while providing a helping hand.

possible at this time. The potential health effects associated with the levels of exposure experienced by cleanup workers are largely unstudied. Heat and stress experienced by these workers may also have adverse longterm health effects. Besides the oil itself, the widespread economic and lifestyle disruption caused by the oil spill may contribute to mental health problems among this population. Stay tuned, since the results of the study will likely provide a roadmap of the long-term human health consequences of this oil spill.

So, what have we learned from this catastrophe? In an Enterprise Risk and Wellness Management program, the corporation (or organization such as a local municipality) must establish an emergency response policy, authorities, responsibilities, and procedures for actions before the event. Ample personal protective equipment is necessary before employing persons to a spill site. Noted below is a simple What are the short and long term toxic checklist for your use in planning your SPCC implications to humans from the exposure and wellness programs. to the cleanup? The National Institute of Environmental Health Sciences (NIEHS) is 1. Responsible Personnel currently undertaking the Gulf Worker Study 2. Spill Reporting (GuLF) which will investigate potential short 3. Project and Site Information and long term health effects associated with 4. Potential Spill Sources the cleanup activities of the oil spill among 5. Pre-Existing Contamination organizational workers and volunteers involved 6. Spill Prevention and Response Training in the Deepwater Horizon disaster. Reportedly, 7. Spill Prevention over 55,000 persons have participated to 8. Spill Response date in cleanup activities related to the spill. 9. Project Site Map Crude oil, burning oil, and the dispersants 10. Spill Report Form(s) used during cleanup efforts contain a range of known and suspected toxins. Exposures Eleven people died during the Gulf oil spill, to persons involved in cleanup range from with many more people continuing to suffer negligible to potentially significant, especially from the exposure to oil and related dispersant for workers involved in tasks associated with material toxins. No one quite anticipated the direct exposure to crude or burning oil, or length of time the leak would continue. Further, to chemical dispersants. However, NIEHS’s no one knew the physical effects the exposure prediction of adverse health effects is not would have over a prolonged time. A ten year

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research study is currently underway to study the short and long term effects.

Training Marine Oil Spill Response Workers Under OSHA’s Hazardous Waste Operations and Emergency Response Standard U.S. In catastrophic events, such as the World Trade Department of Labor Occupational Safety and Center (WTC) where large amounts of people Health Administration OSHA 3172 2001 are exposed to toxins and knowledge of all http://www.oilspillvolunteers.com/docs/OSHA_HAZWOPER_Oil.pdf of the toxins involved is nearly impossible to Education, planning and training alleviate most calculate, it’s paramount that we prepare and risks in life, including accidental oil spills. We share with the public what measures can be hope that organizations will internalize what taken to protect their person such as protective our families have always taught us which is, “an masks, protective gloves, clothes that protect ounce of prevention is worth a pound of cure”. from the sun and toxins and taking time to rest during their volunteer effort. Creating an environment where volunteers can go and discuss the effects of the work they have done may help to decrease the psychological factors Robert J. Blackburn founded Blackburn involved with stress of helping clean the oil Group, Inc. in 1991 as a company spill. So much is dependent on common sense specializing in marketing products and preparation of the volunteer. and services for the risk and insurance

Bio

Education before the event is the most beneficial. Perhaps employers could assist in this area and provide teaching materials on what to do if you should choose to volunteer for any catastrophic event. (Thus preventing an episode like the Deepwater Horizon or WTC where several were exposed or had the potential for exposure) The Gulf area is now laden with health issues due to the spill. Providing educational information through media sources, such as telecommunications, or webmail, even instant messaging and Twitter could become information avenues for teaching, especially the young. Another possible remedy to the problem of exposure and its consequences would be to provide as many people as possible with the guidelines established by OSHA. This link may be of interest and benefit to others:

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management field. At the time of the company’s inception, Mr. Blackburn designed and developed a specialized risk management information system with associated services called RiskPro® to analyze and manage an organization’s operational and human resource risks. Mr. Blackburn may be reached at rblackburn@blackburngroup.com, or at +1 (585) 586-4530.

Clarann Hull is co-author of the book; Ending Hospital Readmissions: A Blueprint for Homecare Providers. She is also owner of Juris Educational Resource Knowledge for Legal Nurse Consultants which is a network of legal nurses who provide both written and verbal expert opinions. Clarann may be reached at rntolaw@nc.rr.com or 919-858-0417 or clara@the_hullgroup.com.

W O R K S I T E

By Deborah MacArthur

Disease Prevention through Healthy Lifestyle Choices ~ Fitness and Proper Nutrition

W E L L N E S S

he mere mention of the words cancer, heart disease and diabetes strikes fear in all of us. These and other disease can affect the young and old, strong and weak, male or female. There are studies, theories, and a multitude of proposed ideas on preventing diseases. New studies show that certain diseases can be prevented through healthier lifestyle choices, including regular exercise and a good nutritious diet. By taking care of the body through proper nutrition and being physically active, it is possible to help ward off mysterious and often fatal diseases.

increased body function, and better sleep and reduced fatigue. Research indicates that exercise can prevent certain diseases and cancers. Here is some food for thought: â&#x20AC;˘ Exercise reduces obesity, which has been noted as major factor in some forms of cancers and other diseases. Generally, people who exercise grow into other good lifestyle habits including eating healthier to stay fit.

â&#x20AC;˘ Exercise speeds up your metabolism, which helps flush out food waste and other harmful substances. These toxins travel at a faster rate through the Regular exercise offers numerous digestive track, which decreases the health benefits, including an improved time that the colon tissue is exposed to sense of well being, increased strength waste and toxin. and flexibility, toned physique,

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July 2011

• Exercise helps to balance hormone levels, which are often linked to certain cancers. The female hormone estrogen seems to play a key role. Exercise lowers blood estrogen, which helps lower the risk of breast cancer. Exercise also reduces other cancer-growth factors such as insulin. • Dr. Inge Haunstrup Clemmensen, of the Danish Cancer Society, has theorized that regular exercise can boost the immune system, and having a strong immune system can stop the growth of cancer cells. Research by the American Cancer Society has indicated that an inactive lifestyle and poor diet are key factors to increased cancer risk, it becomeswhich makes imperative to add exercise into your daily schedule. Below are some suggested activities to engage in that will burn fat and boost metabolism. Keep in mind that the benefits of exercise increase as you increase the intensity: 1. Brisk walking: This can be done indoors on a treadmill, or outdoors around the neighborhood, or on a nature trail. 2. Yoga: A great stress reliever, as well as good physical activity. 3. Dancing: You can put some music on and dance at home in your living room, at a dance studio or at the health club. Zumba and other dance-based aerobic classes are popular offerings. 4. Swimming: Uses all muscles in the body and is a great cardio exercise, which is gentle on the joints. 5. Tai Chi: This form of martial arts promotes good health through controlled breathing and slow moving exercises. 6. Cycling: Whether on a traditional or stationery

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bike, this is a great cardio exercise. 7. Organize a team sport through your workplace: This is a great way to be active, get involved with co-workers and enjoy some healthy competition. These are just a few suggestions, but the message is that everyone needs to be active, get up and move! National activity guidelines suggest at least 30 minutes of exercise most days of the week. There are other small steps you can take to increase your level of activity. When you are at work, walk to your colleague’s office instead of picking up the phone or sending an email. Take a walk after lunch with your co-workers. Don’t take an elevator if you can take the stairs. Each day make a conscious effort to be active and make good choices. The other side of the healthy living coin is proper diet and nutrition. By making good food choices, you can build a strong and healthy body. The American Institute for Cancer Research (AICR), scientists believe a diet based predominately on

July 2011

processed with salt (sodium). 8. Don’t use supplements to protect against cancer. There are a multitude of reasons to fit regular exercise and proper nutrition into your daily schedule. This is an area of your life that you have control over, and making the proper choice may save your life someday. Keep in mind that the plant-based foods may help protect against certain choices you make each day regarding exercise and cancers. This type of diet includes vegetables, nutrition impact your chances of getting cancer. beans, fruit and whole grains. The fiber and water You can begin taking steps today to protect yourself in plant foods gives a feeling of fullness without against cancer, heart disease and other diseases. supplying a lot of calories. AICR recommends that two-thirds of your plate should be filled with Many companies offer corporate wellness programs vegetables, beans, fruit and whole grains, and one- to provide the support and resources to their third or less animal protein. employees to make a healthier lifestyle a reality. If your company doesn’t offer a corporate wellness Below are recommendations regarding healthy program, consider being an ambassador at your lifestyle choices that will help prevent cancer from workplace. You can suggest initiating a wellness the AICR’s Expert report. These coincide with program to your human resources department or the recommendations from the American Cancer company management. Your efforts will not only Society: benefit you, but they might be instrumental to affecting others to make healthier lifestyle choices 1. Be as lean as possible without becoming to prevent obesity, diseases, cancer and maybe underweight. even save someone’s life. 2. Be physically active for at least 30 minutes every day.

Bio

3.Avoid sugary drinks. Limit consumption of energy-dense foods. 4. Eat more of a variety of vegetables, fruits, whole grains and legumes such as beans. 5. Limit consumption of red meats (such as beef, pork and lamb) and avoid processed meats. 6. If consumed at all, limit alcoholic drinks to two for men and one for women a day. 7. Limit consumption of salty foods and foods

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July 2011

Deborah MacArthur is the Director of Marketing and PR for FACTS Fitness, a Commercial and Corporate Fitness Management Company located near Philadelphia, PA. FACTS Fitness is a one stop fitness management company offering corporate wellness and fitness programming, fitness staffing, fitness center design, corporate fitness IT programming, multi-tenant fitness facilities and more. To learn more about FACTS Fitness services including corporate wellness programming, fitness management, fitness center design, etc. please visit www.factsfitness. com, email info@factsfitness.com or call 610-355-3236.

Give your employees something to smile about. They will thank you.

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To learn more about Careington and our discount plans, call (800) 400-8789| or www.careington.com July visit 2011 47 CorporateWellnessMagazine.com

F E A T U R E

By Dr. Rajen Anand

By Dr.Robert Post

A Roadmap to Changing Eating Patterns in Accordance with Dietary Guidelines

oor diet and physical inactivity can lead to many chronic diseases, such as cancer, diabetes, hypertension, osteoporosis, obesity and cardiovascular disease. According to the Centers for Disease Control and Prevention, nearly 1 in 2 adults lives with at least one chronic disease condition and 75 percent of the U.S. healthcare costs are due to chronic conditions. They are widely prevalent in the United States of America and worldwide. In the US, approximately 41 percent of population will be diagnosed with cancer during their life time. Dietary factors are associated with many types of cancer, such as breast, endometrial, colon, kidney, mouth, pharynx, larynx, and esophagus. Nearly 24 million people, ages 20 and above, suffer from diabetes, mostly type 2, which is heavily influenced

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July 2011

by poor diet and physical inactivity. One in three or 74.4 million people have hypertension, which is a major risk factor for heart disease, stroke, congestive heart failure and kidney disease. Many dietary factors contribute to high blood pressure. Half of the women and 25% of men, ages 50 and above, will have an osteoporosisrelated fracture in their lifetime. Sixtyeight percent of American adults are overweight or obese, including 34 % who are obese. Nearly 17% of children are obese in this country. About 37percent of the US population or more than 81 million Americans have cardiovascular disease. Its major risk factors include high level of blood cholesterol and other lipids, type 2 diabetes, hypertension, metabolic syndrome, excess body weight, physical inactivity and smoking. Sixteen percent of Americans have high level

of blood cholesterol. Several dietary factors have been associated with the development of cardiovascular disease and hypertension.

and scientists from the major universities of the nation that are nominated to serve through a public process. This Committee operates externally from Federal purview. For 20 months during 2008 to 2010, the Committee reviewed and analyzed the most current scientific information on diet and health and incorporated it into an evidence-based report after considering testimony of experts and public comments. The Committee was aided by USDAâ&#x20AC;&#x2122;s Nutrition Evidence Library staff, which under the direction of the Committee, performed a thorough systematic review of scientific literature. The Committee weighed and graded the quality of the research literature and the preponderance of evidence on which to base its conclusions to some 135 questions posed by the Committee members. The Advisory Committee submitted a 445-page advisory report to the Secretaries of USDA and HHS in June 2010. The work of the Committee as well as the evidence it reviewed are available at www.dietaryguidelines.gov and www.nutritionevidencelibrary.gov.

Eating a proper diet and performing regular physical activity can help people achieve and maintain a healthy weight, reduce the risk of chronic disease, and promote their overall health. The Federal government regularly issues Based on this report, the USDA led, with HHS guidelines on diet, healthy eating patterns, and assistance, the preparation and issuance of the Federal policy known as the 2010 Dietary physical activity. Guidelines for Americans. This is a 95 page The Dietary Guidelines for Americans have been document that translates the Committeeâ&#x20AC;&#x2122;s work released jointly by the United States Department into plain language that is intended to be used by of Agriculture (USDA) and the Department of nutrition educators, health professionals (e.g., Health and Human Services (HHS) since 1980 dieticians), and policymakers in developing and and are revised every 5 years, as mandated by conducting nutrition guidance, promotion, and the Congress. The 2010 Dietary Guidelines outreach programs, including Federal nutrition were released jointly by Agriculture Secretary, assistance and education programs. Tom Vilsack, and Health and Human Services Secretary, Kathleen Sebelius, on January 31, 2011. They are based on the comprehensive scientific report of a 13- member Dietary Guidelines Advisory Committee composed of renowned nutrition and health researchers

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The 2010 Dietary Guidelines recommendations are intended for Americans ages 2 years and older, including those at increased risk of chronic disease. This seventh edition of the Guidelines is being released at a time of rising concern about the health of American population. Poor diet

and physical inactivity have been shown to be the most important factors contributing to an epidemic of overweight and obesity affecting men, women and children in all segments of the American society. These factors are equally contributing to the increasing trends for diet-related illnesses. Thus, the importance of the Dietary Guidelines as the centerpiece for Federal nutrition policy and programs has never been greater. The intent of the Dietary Guidelines is to summarize and synthesize knowledge about foods and individual nutrients and food components into an interrelated set of recommendations for healthy eating that can be adopted by the public. Taken together, this dietary guidance and nutrition information can help Americans choose a healthy, nutritionally adequate diet that is balanced with adequate exercise.

Other highlights of the Guidelines include a recommendation for sodium, most of which comes from salt in the diet. On average, Americans are consuming about 3400 mg of sodium daily. For the general population, the recommendation is to reduce daily sodium intake to less than 2,300 milligrams and further reduce intake to 1500 mg among persons who are 51 and older and those of any age who are African American or have hypertension, diabetes, or chronic kidney disease. Excessive intake of sodium has been shown to cause increased blood pressure (hypertension), heart disease and stroke. The risk of these conditions increases with age and people 51 and older have a high incidence of hypertension. Similarly, African Americans, diabetics, and those with chronic kidney disease, of all ages, are more sensitive to the blood-pressure-raising effects of sodium. The 1500 mg recommendation applies to about The 2010 Dietary Guidelines contain 23 half of the U.S. population, including children, recommendations for the general population and and the majority of adults. six for specific subpopulations, e.g., pregnant women and older adults. The Guidelines To move the US population toward eating recommendations encompass four major themes: more foods with greater amount of nutrients Maintaining calorie balance over time to achieve for the amount of calories they contain, the and sustain a healthy weight; Consuming more Dietary Guidelines also emphasizes the need for fruits, vegetables, whole grains, and fat-free and increased consumption of vegetables, especially low fat dairy foods; Consuming less often foods dark green, red and orange vegetables, and with significant calories from added sugars, solid fruits. The majority of fruits should come fats (e.g., meat fat and butter), and significant from whole fruits, including fresh, canned, amount of salt or sodium; and Being physically frozen or dried form rather than from juice active. because of the benefits of the fiber whole fruit contains. Consumption of vegetables and fruits The key recommendations of the 2010 Dietary is associated with reduced risk of many chronic Guidelines call for managing calories consumed diseases, such as cardiovascular, including heart with calories expended to manage body weight, attack and stroke. Some vegetables and fruits thereby preventing or reducing the prevalence may be protective against certain types of cancer. of overweight or obesity. For people who are overweight or obese, the Guidelines recommend The new Guidelines also emphasize that, to consuming fewer calories from food and drinks move Americans to healthier eating patterns, and reducing time spent in sedentary behavior. Americans need to reduce their consumption of

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July 2011

foods that have significant amount of calories from added sugars and solid fats, typically found in products, such as grain-based desserts like cookies and cakes. Today, in a typical 2000 calorie diet, instead of limiting these calories to about a healthy 260, Americans are consuming about 600-800 calories from added sugars and solid fats, which provide little, if any, nutritional benefits. Of great concern is that about 7% of Americans’ added sugar calories are from sugarsweetened drinks alone.

are typically found in high calorie, high fat and sugar-containing foods, consumers should reduce the amount of refined grain-containing food choices, e.g., cakes and cookies, and switch to whole grain versions. On the average, Americans are consuming 11 percent of their calories from saturated fat. The recommendation is that consumers need to reduce saturated fat intake to no more than ten percent of their calories to reduce the risk of coronary vascular and other chronic diet-related diseases. Therefore, the recommendations call for switching from higher-fat dairy foods to increased intake of fat-free or low fat (1%) milk and milk products, yogurt and cheese. Total calories from saturated fats should be limited by replacing them with monounsaturated and poly unsaturated fatty acids and using more oils (e.g., canola and safflower oils) than fats that are solid at room temperature (e.g., butter and stick margarine).

Because Americans are not consuming enough whole grains and are over consuming refined grains, which do not fully contain the benefits of dietary fiber, the Guidelines recommend consuming less of refined grains and more of whole grains that include the grain seed, usually called the kernel. Some examples of whole grains include buckwheat, bulgur, millet, oatmeal, quinoa, rolled oats, brown or wild rice, whole grain barley, whole rye, and whole wheat. Whole grains are a source of important nutrients, such as iron, magnesium, selenium, In the newly named “protein foods” group B-vitamins, as well as dietary fiber. In addition, (previously termed “meat and beans”), for the because refined grains, such as wheat flour, first time, the Guidelines recommend consuming

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an increased amount of seafood. Currently, the intake of seafood in the US is estimated to be 3.5 ounces per week. It should be increased to 8 to 12 ounces of a variety of types of seafood per week. For the majority of Americans, the benefits of the omega fatty acids in seafood on reducing risks of heart disease outweigh previous concerns about methyl mercury, an environmental contaminant. For pregnant women, the fatty acids in seafood have been shown to benefit fetal development, except that for women who are pregnant or breastfeeding, the recommendation is to limit it to 6 ounces for white tuna and to not eat tilefish, shark, swordfish, and king mackerel. Besides seafood, other sources to fulfill the recommendation for consuming a variety of protein are lean meat and poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds. For those people who consume alcoholic drinks, the recommendation is to consume it in moderation -- no more than one drink for women and 2 drinks for men per day. A drink is defined as 12 fluid ounces of regular beer, 5 fluid ounces of wine, or 1.5 fluid ounces of 80-proof distilled spirits. Alcohol consumption may have beneficial effects when consumed in moderation. It is associated with lower risk of cardiovascular disease and reduced risk of all-cause mortality among middle aged and older adults and may help to keep cognitive functions intact with advancing age. However, it is not recommended that anyone begin drinking or drinking more frequently on the basis of potential health benefits because moderate alcohol intake is also associated with increased risk of breast cancer, violence, drowning and injuries from falls and motor vehicle crashes.

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July 2011

The Dietary Guidelines are a roadmap to improved diet and lifestyle. The Guidelines establish recommendations for building eating and physical activity patterns that are focused on consuming fewer calories, making informed food choices, and being physically active can help people attain and maintain a healthy weight, reduce their risk of chronic disease, and promote overall health. By following the roadmap, science shows that all Americans can live a healthier life. A wealth of information for health professionals about the Dietary Guidelines is available at www. dietaryguidelines.gov. USDA’s award-winning tools and resources to implement the Guidelines are at www.MyPyramid.gov.

Bio Dr. Rajen Anand serves as the Executive Director, USDA’s Center for Nutrition Policy and Promotion in President Obama’s Administration (July 2009-current). He previously served in the Clinton Administration 1995-2001 in the same position. Previously, he was a Professor and Chairman of the Department at the California State University, Long Beach. Dr. Robert Post is the Deputy Director of USDA’s Center for Nutrition Policy and Promotion. He has 30 years of experience in food and agriculture public policy, food production, nutritional science, food marketing, and public health communications and education. Previously, he headed the USDA food policy program in the Food Safety and Inspection Service.

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July 2011