With a chronic disease and obesity crisis raging through the country, leading to unsustainable healthcare costs, the traditional medical establishment and more governments have shifted the focus to prevention and wellness since the 1990s. Employee wellness programs have long been billed as something of a magic bullet—a low-cost means to a happier, healthier, more present, more productive workforce. Over the past decade businesses large and small have rushed to cash in. Part of the push has come from a big, swinging stick: soaring employer health care costs. But part has come from a carrot too: Employers can tie up to 30% of a worker’s insurance premium (or 50% in the case of smokers) to health outcomes such as weight loss and smoking cessation achieved in wellness programs. In other words, employees who don’t meet health goals pay more.
The result is that workplace wellness programs are now practically universal in corporate America. However, year after year, healthcare costs have continued to rise. Employees are under more stress and unhealthier.
Here are some facts about current employee health:
- 1 in 2 has one or two chronic conditions.
- 1 in 4 has three or more chronic conditions.
- 2/3 are at risk of developing heart disease or type 2 diabetes.
- You pay 3x more in medical costs for an employee with type 2 diabetes vs. a healthy employee each year $12,000 vs. $4,000.
- Type 2 diabetes accounts for: 15 million absent work days, 120 million work days with reduced productivity, and 107 million workdays lost due to diabetes-related unemployment each year.
- 1 in 3 has obesity and 1 in 3 is overweight.
Program Participation
We all know that if people aren’t participating, you aren’t getting results. Therefore, you will need to pull various types of data out of your wellness platform including how many people logged in, how often, how many participated in activity, and other interventions. Employee attitudes toward this workplace movement are often more complicated than those of employers. Some are wary of sharing health data; others are busy or overworked and resent the added burden—it is just another thing they have to do.
For these reasons, employee participation in corporate wellness programs—even when they are paid for it—is low. Engagement ranged, for example, from 10% (life coaches) to 53% (completing a basic health questionnaire).
Some helpful benchmarks can be found in the RAND Workplace Wellness Programs Study Employer Survey 2012 which indicates:
- 7% participation for smoking cessation
- 11% for weight/obesity
- 16% for disease management
- 21% for fitness
Whether wellness programs actually work—either by significantly improving health outcomes or by reducing healthcare costs—has become a subject of surprisingly fierce and unresolved debate. Though the industry has churned out plenty of data in its support, the most credible research—including a federally commissioned Rand report from 2013—suggests mixed, if not ambiguous, results.
The Myth of Exercising
Physical activities promote good health. Being active is well established to strengthen muscles, help maintain body weight within healthy ranges, reduce risk factors for chronic disease, and make you feel better. The amount of physical activity most closely associated with these benefits is a matter of some debate, but most authorities advise you to regularly engage in moderate or vigorous activity for at least half an hour on most days. This amount is more, sometimes much more, than most people do. Even so, the calories required to power this level of recommended activity are likely to add up to only a small percentage of those required for basal metabolism. Their number is also small relative to the calories that most people eat in a day. This, however, does not stop authorities from emphasizing physical activity as the primary strategy for maintaining or losing body weight. With that said, it is important to be as physically active as possible, but mainly for health reasons that go beyond just balancing food calories.
You may be surprised that aerobics was created for military training. U.S. Airforce Col. Kenneth Cooper, an exercise physiologist, and Col. Pauline Potts, a physical therapist, were puzzled about why some people with excellent muscular strength were still prone to poor performance at tasks such as long-distance running, swimming, and bicycling. In 1968, they published Aerobics. The book came at a time when increasing weakness and inactivity in the general population was causing a perceived need for increased exercise. Not for weight loss; by that time obesity rate was lower than 5%.
Solving Obesity and Chronic Disease First
Obesity is an epidemic sickness that must be treated by medical professionals, not by health gurus with pseudoscience. Wellness program objectives are mainly to prevent stress, overweight, and sleep deprivation, to promote smoke-cessation, and to improve well-being, physical activity, and job performance. However, they are not adapted to treat sicknesses such as obesity and diabetes.
Nowadays, Americans do more intentional “exercise” than people anywhere else in the world. Americans are voluntarily exercising more than ever. Other studies confirm that obese people do about the same amount of physical activity as lean people. Unfortunately, exercise alone has low impact on weight loss because of metabolism adaptation. The only “weight versus activity” relationship that has been proved is that obesity may lead to inactivity. More body fat may lead to less exercise, not the opposite. People may exercise less because they are overweight. They do not become obese because they are exercising less. Deep metabolic changes come with obesity that makes exercising harder. Also, common sense tells us that if exercising less is the cause of our collective weight issues, we must be collectively exercising less. As shown, this is the reverse. Exercise alone is of modest help in weight loss. How can this be? The answer is simple: weight loss is a different process from maintaining that weight loss.