Chronic disease is the leading cause of death and disability in the United States, with more than 75 percent of deaths caused by one or more of the five most common chronic diseases – heart disease, stroke, diabetes, chronic respiratory disease, and cancer. In fact, chronic disease causes seven out of 10 deaths in the United States, being responsible for more than 1.7 million deaths every year. Nonetheless, the number of people living with these diseases is growing rapidly.
Approximately half (45% or 133 million) of Americans suffer from a chronic disease. In fact, one in four American adults has two or more of these diseases at any given time. These chronic diseases cause long-lasting disability, reduce quality of life, and lead to several hospital admissions, impacting health and long-term survival negatively.
This burden has not only impacted health and quality of life adversely, but it has also been a major driver of the rising healthcare costs.According to the Centers for Disease Control and Prevention (CDC), chronic disease accounts for 75 percent of healthcare expenditure – approximately $5300 per person – every year. This figure is more alarming for public insurance, as 96 cents for every dollar Medicare spends and 83 cents of every dollar Medicaid spends is toward the treatment of chronic disease.
The devastating effects of chronic disease also reflect on employee productivity and the bottom line. Chronic diseases constitute a few of the most costly health conditions for US. employers, causing reduced employee performance, increased rates of absenteeism and presenteeism, and high healthcare costs incurred by these employers. The CDC reports that absenteeism costs US. employers $225.8 billion – approximately $1,685 per worker – every year.
In addressing the huge public health challenge of chronic disease, promoting workplace health cannot be overemphasized. Workers spend much of their time at work- more than 40 hours per week - therefore, they are continuously exposed to the risk factors for chronic diseases, such as obesity, unhealthy dieting, physical inactivity, and work-related stress. Therefore, the culture of health at the workplace plays a huge role in improving or marring workers’ health.
In creating a healthy workplace culture, employers need to focus on two key components: promoting healthy behaviors among workers and redesigning the work environment with an employee-centric approach.
Promoting Health Behavior among Employees
Although this may be thought of as what employees could achieve by themselves, providing comprehensive workplace health programs may be a more effective way of helping employees to not only change their unhealthy behaviors but adopt healthy ones. Workplace health promotion involves health education programs, health screening programs, and employee assistance programs aimed at preventing and managing these diseases among workers.
Addressing Physical Inactivity
Physical activity is one of the key health behaviors that multilevel workplace health promotion could influence. Physical activity is a major risk factor for obesity, which leads to heart disease, diabetes, and several types of cancers. Providing health initiatives to address this issue may go a long way in stemming the incidence of obesity and, in turn, the risk of chronic disease.
Encouraging physical activity is a multidimensional process requiring a multilevel contribution. One of the several components of this is promoting fitness activities. Employers can promote physical activity by providing discounted gym memberships, providing fitness breaks during work, or leveraging wearable technology to help workers track and improve their activity levels. Employers can also provide onsite physical activity courses such as yoga.
In addition, long sitting meetings can also be replaced with walking meetings and prolonged sitting at the office can be prevented by redesigning the workstation to encourage regular activity. Employers may also incorporate fitness challenges, such as walking challenges, team wellness challenges, and weight loss challenges, into their yearly work plan.
Employers can also arrange staff meetings and seminars with exercise physiologists, personal coaches or a healthcare provider to provide information about the health benefits of physical activity. This information may also be communicated to workers via active communication conduits such as memos, newsletters, lunchroom meetings, and noticeboards. Personal trainers may also be invited to demonstrate and coordinate exercise activities.
Employers should note, however, that there is no one-size-fits-all strategy for curbing physical inactivity in the workplace. The chosen strategy should be based on what works best for their employees to produce the desired results.
Curbing Tobacco Smoking
Tobacco smoking is a strong risk factor for chronic diseases and the single most common preventable cause of disease, disability, and death in the United States. Tobacco smoking is responsible for $300 billion lost every year in reduced productivity and direct medical expenses. The CDC Foundation notes that productivity loss resulting from smoking-related diseases costs $156 billion each year.
Curbing tobacco smoking in the workplace begins with creating and implementing a clear tobacco cessation policy. The National Institute for Occupational Safety and Health (NIOSH) has made several recommendations, that should be reflected in workplace to tobacco-cessation policies. These include:
- Establishing smoke-free zones to prevent second-hand smoke, by installing appropriate signage in strategic points prohibiting the activity.
- Providing educational materials on the risks of tobacco smoking, as well as second-hand smoke. Employers can use effective communication channels such as social media, newsletters, and direct mails to provide this information to employees.
- Provide comprehensive tobacco-cessation programs and appropriate support for workers who smoke, in order to get them to quit. These programs should also include therapeutic interventions to manage complications of tobacco smoke to those who already have them.
- Employers are also advised to provide appropriate incentives, such as discounted treatment costs or free access to therapeutic interventions, to those who participate in the tobacco-cessation programs to encourage others to quit.
Integrating healthy nutrition into corporate wellness program cannot be overemphasized. Unhealthy dietary habits predispose to almost all chronic diseases, including heart disease, stroke, diabetes, and cancers. Experts note that only 26 percent of American adults eat vegetables three to four times daily, which is below the national recommendation on the consumption of vegetables. This makes food wellness a very important part of chronic disease management.
Promoting healthy nutrition in the workplace is not just about what people should avoid, but what they should eat. A diet low in fruits,vegetables, and low-fat dairy products, for instance, has been linked with breast cancer, colon cancer, and stomach cancer, not to mention diabetes, high blood pressure, and high blood cholesterol.
Making food wellness programs available in the workplace can influence these dietary behaviors and help employers choose healthier options for what they eat. Food wellness programs involve providing information on healthy dietary habits, creating group discussions on nutrition and interactive cooking demonstrations, as well as contracting corporate food wellness companies that will provide food services for the company.
Redesigning the Work Environment
The physical, organizational, and psychosocial aspects of work are also key contributors to chronic disease. A holistic approach to addressing chronic disease in the workplace involves tackling these aspects of work, alongside changing workers’ health habits.
For instance, the World Health Organization reports that 8 to 16 percent of all cancers are caused by preventable work hazards. In addition, physical workplace hazards such as carbon monoxide, carbon disulfide, and lead are strong risk factors for cancer and cardiovascular disease.
Psychosocial stressors at work, such as poor work schedule, long work hours, high-demand-low-control work, and high-effort-low-reward jobs also increase the risk of cardiovascular disease. These psychosocial stressors are responsible for about 15 percent to 35 percent of cases of cardiovascular disease.
In addition, poor workplace ergonomics, poor environmental conditions, such as heat and vibration, also lead to chronic diseases such as arthritis. In a recent study also, researchers found that prolonged exposure to noise in the workplace may be associated with heart disease.
Addressing these issues involves a systemic approach at all levels. At the organizational level, job redesign should take an employee-centric approach; workplace stress should be stemmed by providing workers with more control over their work, providing incentives and performance-based rewards, and prioritizing a healthy work-life balance. This curbs the psychosocial stressors that increase the risk of chronic diseases.
Employers need to invest in eliminating or reducing workers’ exposure to these physical hazards. This requires investments in the repair, maintenance, and replacement of heating, ventilating,and air conditioning (HVAC) systems to improve the quality of air in the worksite, and control of indoor and outdoor pollutants through regular air-cleaning and replacement of office materials that release harmful substances.
Chronic disease remains a leading cause of disability,death, and workplace productivity loss globally. Employers, therefore, are saddled with the responsibility of curbing this trend, by creating interventions that integrate a healthy work environment with health promotion programs aimed at changing individual health behaviors.