What do benefits professionals, firefighters, long-haul truck drivers and the Centers for Disease Control and Prevention have in common? On the surface, nothing. But according to Dr. L. Casey Chosewood, opening keynote speaker at this year’s Health and Benefits Leadership Conference, ongoing through April 6 in Las Vegas, these entities are all impacted by a shared concern: the chronic-disease epidemic plaguing American society.
Dr. Chosewood, director of the Office for Total Worker Health at the National Institute for Occupational Safety and Health (part of the CDC), said benefits professionals are impacted by chronic disease because they’re responsible for creating the best wellness plans and polices for employees. Firefighters and long-haul truck drivers have two of the most stressful occupations, and unmanaged stress manifests into chronic illnesses such as diabetes and obesity. And it is the CDC’s responsibility to report on and work to prevent epidemics like chronic disease.
He then shared a shocking statistic–the obesity rate among long-haul truck drivers is 75 percent, which is more than double the national average of 35 percent. Why?
“It isn’t because when there’s a job opening only obese people line up for that work,” said Dr. Chosewood. “It’s because of how the job is designed–and the demands placed on that job.”
On top of the sedentary behavior of driving, or poor food choices at the truck stop, Dr. Chosewood said, the statistics are connected to the nature of the work itself: “the constant vigilance, long hours, lack of high-quality sleep, which we know is a huge risk factor for obesity.”
When looking at risk factors for chronic disease beyond genetics and DNA, there are lifestyle behaviors that can be targeted as part of a prevention strategy. But, said Dr. Chosewood, two major risk factors are usually overlooked: stress and sleep.
Too often, when organizations create wellness incentives or benefit programs, they look at physical activity and nutrition as the only lifestyle modifications that can help prevent chronic disease. However, Dr. Chosewood cited research that indicates the best wellness investments look at factors such as stress and sleep as strong predictors of obesity risk and other chronic illnesses.
He cited a report from Willis Towers Watson that found workplace stress is the No. 1 workforce health issue and a major occupational risk, ranking above physical inactivity and obesity.
Workplace stress is responsible for one in five cardiovascular deaths in America, Dr. Chosewood said, and new research has found that workplace stress also has carcinogenic properties.
So, instead of taking away health benefits or trading benefits for wages, the most successful companies will design work that incorporates health, he said.
“You can’t overcome long hours and unfavorable work conditions with a lunch and learn on diabetes,” he said.
Instead of a one-size-fits-all approach, such as company-sponsored, monthly Tai Chi classes, employers should hand the health programming reigns over to the employees. If they design it, there is increased engagement, buy-in and productivity–all of which lead to improved health and well-being.
Dr. Chosewood said the best total-worker health solutions do the following:
- create EAPs that are proactive instead of reactive, and leverage the knowledge of professionals already involved in the program to gain insights;
- address job-insecurity concerns (increasingly important as machines and humans begin working together);
- promote ways to manage and reduce overall stress;
- train supervisors to manage employees with health, not just productivity, outcomes in mind; and
- integrate work, family and life in new health programs and policies.
Dr. Chosewood ended his keynote with the following engagement anecdote:
Three people are outside working construction, doing what looked like the same job. When asked what they were doing, the first person said, “I’m doing pretty well for myself, working this job making $20 an hour.” The second person responded, “I’m laying stones for this building; I’m a brick mason.” The third person says, “I’m building a cathedral where my children will get christened and my grandchildren will get married.”
Dr. Chosewood stressed that to have an engaged employee, like worker three in his story, benefits professionals must change how they address total-worker health to ensure that they are creating wellness plans that treat a whole person–and are not just relying on health biometric screenings and one-size-fits-all programs. Only when the whole person is treated can workplace stress, injuries and mortality begin to decrease and true employee engagement begin.
Employee Healthcare Engagement
Following Dr. Chosewood’s keynote was a panel discussion on transforming the employee-health experience. Carol Harnett, HRE benefits columnist, moderated the session. Joining her on stage were: Janet McNichol, human resources director at the American Speech-Language-Hearing Association; Dr. K. Andrew Crighton, vice president and chief medical officer at Prudential Financial Inc.; and Kristin Reilly, vice president of global people experience at Walmart.
Harnett kept the session casual and participation heavy–she asked attendees to text her questions for the panelists throughout the hour.
First, attendees were asked to close their eyes and imagine someone they loved–what did they want most for their loved ones’ healthcare? Top three answers: accessibility, affordability and mental healthcare.
Mental health became the focus of the conversation, as the panelists all shared ways in which their organizations were addressing this growing health concern.
At Prudential, Dr. Crighton said he sees three main challenges surrounding mental healthcare: unrecognized mental-health diagnoses, finding appropriate care (most mental-health professionals are out of network) and addressing the stigma of mental health at work.
To target the last challenge, Dr. Crighton said, some of the leaders at Prudential shared their stories of depression and substance abuse with employees. That openness from executives had a huge impact on the employee population, he said.
At Walmart, one particular location saw a lot of employees seeking mental-health assistance, 90 percent of which were subclinical. Instead of expanding its telephonic EAP, Reilly said, the company decided to bring in an on-site clinician. This happened six months ago and the results have been tremendous, she said: The on-site clinician helps normalize mental-health communication, which has made it “acceptable” for employees to go see her. Since the program launched, the clinician has been able to address 98 percent of requests for mental-health assistance onsite.
At ASLHA, McNichol was committed to keeping a traditional PPO health plan because it offers out-of-network coverage for mental healthcare.
“The most gut-wrenching stories I have heard were from employees struggling to find mental healthcare for their children,” she said.
McNichol said she listens to these employee concerns and continually adapts the health plan to meet the needs of her employees and their families.
The conversation then moved to educating employees about Centers of Excellence (hospitals with high marks for safety and patient-related care) as well as helping them understand that physicians don’t always get things right.
Dr. Crighton said that, many times, a primary-care physician may write a prescription for, say, a blood pressure drug, when the employee could instead make lifestyle changes to lower his or her blood pressure.
He said that PCPs only have seven minutes per patient to come up with a solution to the health problem. The easiest fix is for the doctor to write a prescription before moving on to the next patient. Getting employees to understand this challenge and be proactive in their own care is an important lesson employers should impart to their employees, Dr. Crighton said.
All of the panelists agreed that utilizing and leveraging the health programs already in place, such as an EAP, can be beneficial to employee health.
Equally important is sharing your story with your employees.
Reilly said that while she worked at Jet, which was purchased by Walmart, the organization was focused on how its story resonated with consumers, but also with employees.
“How do you bring your message about health and wellness to the employees, and how does it tie into the overarching culture?” she asked. “You may offer amazing benefits, but there’s an overload that can cause things to get lost in the shuffle. You need to tell your story to your people in a relevant, relatable way that they can take back and tell their families. If you get that right, you’ve really moved the needle toward true healthcare and overall well-being.”