Transcript Managing Chronic Disease Can it work at work?

Managing Chronic Disease
Can it work at work?
Chris Bonnett, MHSc, PhD (Cand.)
H3 Consulting, Guelph
www.hthree.ca
Three points in 15 minutes
 Review three prevalent and costly chronic diseases…among many
others affecting the workplace.
 Consider the value of prevention.
 Presenting a good solution…made better.
A snapshot of chronic disease
Cancer
 Lifetime prevalence is 40% for Canadian women and 45% for
men. Cancer is now the leading cause of death.
 Eight of 12 new take-home cancer drugs had treatment costs
of more than $30,000 annually.
 Cancer claims are ranked third in LTD plans, and present the
longest average duration STD claims.
 Studies indicate 60 – 80% of employed cancer patients want
to return to work after diagnosis and treatment, but need help
to accommodate fatigue, poor concentration, and nausea.
Sources: (1) Canadian Cancer Society, 2008, 2009. (2) Manulife Financial. (3) CancerBACUP 2005; Spelten 2002;
Bouknight 2006.
A snapshot of chronic disease
Mental health
 Mental illness is the leading cause of LTD claims and a major cause
of STD claims.
 The cost to Canadian workplaces nearly $20 billion annually.
 Stigma and misunderstanding remain widespread, diagnosis and
treatment are typically inadequate.
 There are at least seven different legal contexts for action against
errant employers.
Source: Mental Health Commission of Canada
A snapshot of chronic disease
Metabolic Disorder
 Metabolic disorder incorporates illness and costs from heart
disease, diabetes and obesity.
 Heart disease is the second-ranked cause of death: 17% of adults
have undiagnosed hypertension. Among adults age 40–59, 22% are
hypertensive.
 More Canadians are now overweight (37%) than ‘normal’ weight
(36%).
 Life expectancy for type 1 diabetics is cut by up to 15 years, and by
5 – 10 years for type 2. Canadian adults with diabetes, on average,
use 2.4 times more health resources.
Sources: (1) Canadian Health Measures Survey, 2009-2011. (2) Canadian Community Health Survey, 2008.
(3) Canadian Institute for Health Information.
The value of prevention at work
 High costs are correlated with more risk…by reducing risks, costs
can be better controlled.
 Studies estimate that 40% – 70% of the cost of chronic disease can
be avoided through lifestyle changes.
 Want to speak to executives?
“Today’s reality is that health
is a performance driver.”
(Loepkke et al., 2010)
A better life and more of it
Years Gained
The population health burdens
of smoking and lack of physical
activity were about the same.
Smoking
Alcohol
Life expectancy gain
Physical activity
Diet
Stress
All five risk factors
Health-adjusted life expectancy gain
Source: ICES, et al., 2012. Seven More Years: The impact of smoking, alcohol, diet, physical activity and stress on
health and life expectancy. To calculate your own life expectancy, go to: www.rrasp-phirn.ca/risktools.
Comprehensive Workplace Health Promotion
A good solution…made better
 One temptation:
• Avoid wellness as ‘lifestyle correction done to employees’.
 Two perspectives:
• Personal, and organizational.
 Three words:
• Scope, intensity, and duration.
Comprehensive Workplace Health Promotion
Key conclusion
Properly designed, implemented and
evaluated strategies are useful and
important for Canadian employers,
even though the evidence is mixed and
the research flawed.
“To be well, be wise.”
First understand the problem
…then build a Solution
 Chronic diseases have high prevalence, are influenced by lifestyles, and
are impacted by work environments.
 Chronic diseases create high personal, organizational, and societal costs
in drugs, work absence, disability, distraction, and social services.
 Chronic disease rates, along with demographic and competitive
pressures, mean a healthy and productive workforce is a strategic
business issue worthy of executive attention.
Solutions are at hand.