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Occupational health managers now have solid evidence of obesity costs: Take action
Study shows obesity costs 'spill over into the workplace'
[Editor's Note: This issue of Occupational Health Management is a special issue on the growing problem of obesity in the workplace. Our cover story reports on dramatic new evidence linking higher workers' compensation and medical claim costs to obesity. Inside, we report on research showing that obese workers have higher injury rates, we give the best approaches to combat obesity with employee wellness programs, we give you tips to assess your program's effectiveness, and we explore liability risks related to obese workers.]
The numbers tell an alarming story: Obese workers lose 13 more workdays a year, file twice the number of workers' compensation claims, and have medical claims almost seven times that of nonobese workers, according to research from Durham, NC-based Duke University Medical Center.1
The researchers looked at the records of 11,728 Duke employees who received health risk appraisals between 1997 and 2004. The diverse group of workers included administrative assistants, groundskeepers, nurses, and professors. Workers with a body mass index (BMI) greater than 40 had 11.65 workers' comp claims per 100 workers, compared with 5.8 claims per 100 in workers within the recommended weight range.
Severely obese workers lost 183.63 days of work per 100 FTEs during the eight-year study period, compared with 14.19 lost days per 100 FTEs for workers in the recommended weight range. The average medical claims costs per 100 employees were $51,019 for obese workers and $7,503 for non-obese workers.
The study's findings will give occupational health managers strong leverage with employers to obtain resources targeting obesity, predicts Truls Ostbye, MD, PhD, the study's lead author and professor of community and family medicine at Duke. "We all know obesity is bad for the individual, but it isn't solely a personal medical problem. It spills over into the workplace and has concrete economic costs," says Ostbye.
Given this strong link between obesity and workers' compensation costs, helping workers maintain a healthy weight should be a very high priority for employers, says Ostbye. "Work-based programs designed to target healthful eating and physical activity should be developed and then evaluated, as part of a strategy to make all workplaces healthier and safer," he says.
Do your own study
The study's findings also should motivate occupational health professionals to do more rigorous evaluations of what programs are most effective, adds Ostbye. He recommends closely monitoring all employees who take part in wellness programs. Collect "before and after" data, not only on BMI, but also on nutrition and physical activity, and also collect data for a control group of eligible individuals who don't take part in the programs.
Ostbye recommends doing a similar study looking at your own employee population. "Different employee groups differ quite a lot, and the exact way a program is implemented in a certain work site may have its own strengths and limitations and idiosyncrasies," he says.
Obesity is a critical health risk factor, and it has a significant cost on productivity, says Kay N. Campbell, EdD, RN-C, COHN-S, FAAOHN, global health and productivity manager for GlaxoSmithKline in Research Triangle Park, NC. "It is essential that businesses address the issue as one of the components of a comprehensive health care strategy," Campbell says.
Employers are scrutinizing health care programs much more closely due to accelerating costs, and obesity is clearly a big contributor to those costs. "It is a huge problem," says Campbell. "If we can stem the tide with obesity, it will impact so many health issues down the road — chronic conditions that are costing employers a lot of money."
Is your program working?
Employee wellness programs usually aim for short-term return on investment, when in reality, successful behavior change may take months or years to occur. Grace K. Paranzino, MS, RN, CHES, FAAOHN, national clinical manager of Troy, MI-based Kelly Healthcare Resources, says, "The big question is how committed benefit design programs are to looking at health and productivity for the long term."
To evaluate the effectiveness of your obesity program, use benefits design to drive programs, and incorporate measures that are inherent in these types of programs, recommends Paranzino.
To prove the concrete cost savings of obesity programs to your employer, show data on utilization of programs, reduction in days away from work, and improved productivity. "Ultimately, you must look at the cost savings of benefits utilization, such as medication compliance," says Paranzino. "Also, demonstrate the improvement of metrics such as reduced BMI, cholesterol, and diabetes."
It's already known that obese workers are at high risk for heart disease and diabetes. James Hill, who heads the Center for Human Nutrition at the University of Colorado, says, "The beauty of this study is that it shows that there are costs we didn't even know about, on top of all the costs that we already knew about." The study's findings say it loud and clear: There is a big possibility to save costs by doing something about the weight of your employees. "We know now that if the employee is at a healthy weight, that will save the employer money. So now the employer can devote more resources because there are big savings here," Hill says.
It's very difficult to treat obesity, once it's present, and obtain sustainable results. The easy part is losing weight, Hill says. "We have programs that keep weight off right and left, but the problem seems to be keeping that weight off," he says. Your program should not address only people who are already obese, Hill says. "We need to keep people from getting there."
As for getting buy-in from employees, offering the right incentive could be the deciding factor. "It's the difference between an employer rewarding you with a hat and a T-shirt, versus a bonus and days off," Hill says.
1. Ostbye T, Dement JM, Krause KM. Obesity and workers' compensation: Results from the Duke health and safety surveillance system. Arch Intern Med 2007; 167:766-773.
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