Why employers should care about diabetes
There’s no question that diabetes is wreaking havoc in the workplace.
The number of people with diabetes is expected to more than triple in the coming decades, and a full-time employee with the condition misses an estimated 5.5 additional workdays per year. For employers, this translates to billions of dollars in direct medical costs and a huge impact on productivity.
And the number of people with Type 2 diabetes, the most prevalent type, is just the tip of the iceberg. Floating just beneath the surface are millions of people with prediabetes. In fact, one in three American adults has prediabetes—and 90% of them don’t know it. Without lifestyle changes, many of these individuals will develop Type 2 diabetes.
So, how can employers start to chip away at this problem? First, it’s important to understand the three primary risk factors for diabetes: age, being overweight or obese, and lack of physical activity. Considering that the population of the U.S. is aging, obesity is at epidemic levels and much of America is sedentary, it’s not difficult to grasp why the number of people with diabetes continues to rise.
These risk factors also contribute to the development of other chronic conditions. Many adults with diabetes have depression, hypertension and hyperlipidemia; heart attack strikes people with diabetes twice as often; and two out of three people with diabetes will die from cardiovascular disease. These multiple conditions can profoundly affect diabetes care, complicate treatment and increase costs.
According to the American Diabetes Association, lifestyle change is critical, whether dealing with Type 2 or prediabetes. Often left out of the equation are the influences of physical and social environments on health outcomes, also called social determinants of health. The impact of things like poor access to healthcare services, low health literacy and lack of affordable healthy foods are closely related to the soaring incidence of Type 2 and prediabetes in the U.S.
Employers have a unique opportunity to use the social and physical environment at work to engage employees in more effectively managing their health. But the influence of the external environment must not be overlooked. The communities where employees spend their non-working hours are powerful forces that have a tremendous impact on lifestyle choices.
Employers of any size can take actionable steps to address the growing challenges of prediabetes and diabetes in the workplace. Here are examples of tactics a few employers used to get creative in this space:
Leverage vendor partners. A global manufacturer, looking for innovative ways to support its employee population with prediabetes and diabetes, partnered with a vendor specializing in combatting metabolic syndrome and insulin resistance. The result was a 120-day intervention that includes use of a Fitbit and scale that transmit information to a coach, who works one-on-one with participants on their specific lifestyle behavior change goals. The vendor is only compensated if members are successful at normalizing at least one risk factor. To date, 80% of employees have achieved this outcome.
Modify your plan design. A multi-state life and investment employer evolved its value-based benefit-plan design from a focused diabetes medication therapy-management program to a comprehensive health-plan design for people with Type 1 and Type 2 diabetes. Benefits include waived or reduced out-of-pocket member costs for eligible medical services for diabetes, diabetic testing supplies and drugs and medication therapy management. Success is measured by the increased use of high-value medical services, improved drug adherence, favorable cost trends and reduced adverse events, including emergency-room visits and admissions from diabetic complications.
Address the social aspects of diabetes. A midsize manufacturer with a diverse and predominantly male employee population identified a unique and often-overlooked issue related to employee health—lack of access to affordable nutritious food. Enter Green Apron, a healthy meal-preparation service that provides a once-a-week healthy meal service that feeds a family of four for under $20. Participation in the program continues to grow due to word of mouth, a comprehensive communications campaign and weekly raffle prizes for participants.
An effective diabetes program needs a comprehensive communications strategy, including education about how to reduce diabetes risk factors; helping employees better understand the programs and health benefits available goes a long way in engaging people to participate in wellness initiatives, go to the doctor and/or seek the right treatment.
But many employees don’t fully understand how their benefit plan works or how to access valuable tools and resources. As you develop messaging for your diabetes strategy, create simple and straightforward communications built on trust, attention, affinity, need, solutions and action.
Employers, health plans, providers and community organizations must take an active role if we are going to be able to chip away at the iceberg to reverse prediabetes and prevent the onset of Type 2 diabetes. Only until all stakeholders work together will we be able to change the face of this disease.
Judy Hearn, CEBS, is director of membership initiatives at the Midwest Business Group on Health. Dawn Weddle, RD, is director of member engagement for the Midwest Business Group on Health.