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Posts Tagged ‘exercise’

Pre-diabetes, diabetes rates fuel national health crisis

September 15th, 2014 Comments off

Americans are getting fatter, and older. These converging trends are putting the USA on the path to an alarming health crisis: Nearly half of adults have either pre-diabetes or diabetes, raising their risk of heart attacks, blindness, amputations and cancer.

Federal health statistics show that 12.3% of Americans 20 and older have diabetes, either diagnosed or undiagnosed. Another 37% have pre-diabetes, a condition marked by higher-than-normal blood sugar. That’s up from 27% a decade ago. An analysis of 16 studies involving almost 900,000 people worldwide, published in the current issue of the journal Diabetologia, shows pre-diabetes not only sets the stage for diabetes but also increases the risk of cancer by 15%.

“It’s bad everywhere,” says Philip Kern, director of the Barnstable Brown Diabetes and Obesity Center at the University of Kentucky. “You almost have the perfect storm of an aging population and a population growing more obese, plus fewer reasons to move and be active, and fast food becoming more prevalent.”

via Pre-diabetes, diabetes rates fuel national health crisis.

The health insurance crisis is a population health status crisis that is at its base an individual lifestyle crisis. That lifestyle crisis is ultimately a cultural crisis since cultural values influence lifestyle choices. In the 1970s and 1980s, exercise and fitness were cool. Hopefully they will come back in style — and soon.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

The California commute and its adverse implications for health status

April 21st, 2013 Comments off

Lancaster is also hoping to make its communities more pedestrian-friendly. Last month, the City Council revised its residential zoning ordinance to provide incentives for infill development and to require developers to include pedestrian and bicycle connections to nearby amenities.

Lancaster Mayor R. Rex Parris said residents’ long commutes concern him, adding that he knows hundreds of families who endure debilitating treks to the office.

“The mother and father spend most of their productive hours on the freeway,” Parris said. “It’s just not a good way to live.”

via After a long fall, Antelope Valley is back on upswing – latimes.com.

Parris is right.  It’s not only not a good way to live, research indicates the daily commute has adverse health implications. The Antelope Valley is located in California, an automobile-driven state noted for having some of the longest and most congested commutes in the United States, with the San Francisco Bay Area and Silicon Valley leading the nation in so-called “super commutes.”

The state recently formed a Let’s Get Healthy California task force made up of the Golden State’s top health experts.  Inexplicably given that commuting is such a big part of Californians’ daily lives, the role of commuting and its adverse affect on health is not discussed anywhere in the task force’s final report. As Mayor Parris implies, if residents are spending all their daily hours working and commuting, once they get home they aren’t going to have time or energy to get the exercise they need for maintaining good health on the pedestrian and bike trails that his city envisions.

Ironically, while Silicon Valley companies produce some of the longest and worst commutes, they have also innovated much of today’s modern information and communications technology that allows those who perform knowledge and information work to get their work done from their communities. It’s absurd Californians would jeopardize their health to drive hours each day to use a computer and telephone in some distant centralized office. And it’s a major oversight this was not addressed by the Let’s Get Healthy California task force.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Survey suggests lack of schedule control limits participation in wellness programs

April 13th, 2013 Comments off

Organizations are struggling with the transition from a commute-to-the-cubicle, 20th century Industrial Age environment where work is performed during set times in centralized locations to one that affords more control over when and where work is performed. As a result, many are also struggling with wellness programs, finding that staff lack the time in their daily schedules for sustained physical activity, as shown by the recently released 2013 Global Workplace Health and Wellness Report. The findings of the survey 378 organizations in various industries and a link to the report can be found in this Forbes article, Employees Don’t Have Time for Wellness Initiatives.

The survey’s finding that lack of time for exercise is a major obstacle for wellness programs is hardly surprising. The Industrial Age work style consumes most of people’s waking hours and energies in minimum 8-hour-long “shifts” and time sucking, stressful commutes. All involving prolonged sitting that studies show adversely affect health status. Then when they get home mentally exhausted, it’s more inactivity and collapsing onto the couch, often with take-out food. And we wonder why as a society we’re getting fatter and sicker.

Achieving wellness requires exercise.  And sustained exercise performed on most days takes time. The implication to be drawn from the Global Workplace Health and Wellness Report is wellness isn’t so much as a “workplace” issue as a personal time management and lifestyle issue.

The good news is organizations have 21st century Information and Communications Technology (ICT) at their disposal to help alleviate the time crunch. ICT allows staff to work most any place and time, affording them more control over their personal schedules to engage in exercise programs in their own communities chosen by them and their health care professionals. While organizations clearly have a stake in the health of their members, health is ultimately an individual lifestyle choice. The National Wellness Institute defines wellness as “an active process through which people become aware of, and make choices toward, a more successful existence.” Making the right choice for health requires organizations provide their members sufficient control over their work schedules to exercise that choice.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

California coalition’s report calls for overhaul to rein in health care costs – Health and Medicine – The Sacramento Bee

February 26th, 2013 Comments off

Simply put, participants said Californians should “collectively” create a health culture.

A critical part of this involves creating environments where people are eating healthier foods in smaller portions and getting exercise, especially walking.

“We need to reduce the burden of illness on the health care system,” said Shortell. “It’s important that we design communities and schools to increase and encourage physical activity.

via California coalition’s report calls for overhaul to rein in health care costs – Health and Medicine – The Sacramento Bee.

I would add that how people work should not be overlooked as it was in the Berkeley Forum report.  We should rethink how knowledge work is done in the 21st Century and develop more modern ways of performing it rather than adhering to the outmoded 20th Century paradigm of sitting in a commute to go sit another 8 hours in a centralized office.

Is the sedendary commuter/cubicle treadmill that also wastes time that could be spent engaged in sustained exercise really worth the price to our health?  I say it is not, especially when most information and knowledge work can be accomplished outside of a central office location.   If Californians are properly to be expected to take more responsibility for their health status and prevention, they must also be afforded the fullest possible degree of freedom and time to exercise — literally– that responsibility.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Time for sustained exercise to bend the healthcare cost curve — and promote better thinking

January 1st, 2013 2 comments

Knowledge workers earn their livings analyzing, abstracting and communicating.  In today’s Information/Internet economy, all too many knowledge workers needlessly do so working under legacy Industrial Age 8-5 office schedules, spending even more time each day relatively immobile than sleeping.  Add to that another 1-3 hours spent sitting in a daily commute to a central office location.  Month after month, year after year of this occupational lifestyle sets the stage for the development of preventable chronic conditions such as diabetes, hypertension and obesity that drive the health cost curve and the health insurance crisis.

But that’s not all.  Lack of physical movement can also dull the knowledge worker’s most important tool: their brain.  This Sacramento Bee article cites research linking physical activity to the brain’s ability to perform learning and memory tasks.

The clear conclusion to be drawn is sustained exercise could produce dividends for organizations by not only lowering their healthcare and insurance costs, but also the added bonus of better and more creative thinking.  For knowledge organizations, affording workers control over their schedules and time for sustained exercise probably is likely the most cost effective “workplace wellness” program going.  A key program component is ditching outmoded Industrial Age commuting and office hours and becoming a more virtual organization and maximizing the use of Information and Communications Technology (ICT).  Knowledge work can be done anywhere, and some of the most creative thinking happens during and after sustained exercise.  That requires freeing up time for it every work day by getting people out of their cars and cubicles.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Schedule control necessary if contingent wellness programs are to achieve meaningful results

December 23rd, 2012 Comments off

In November, the U.S. Department of Health and Human Services (HHS) issued a proposed rule governing wellness programs offered as part of employer-sponsored health plans for plan years beginning January 1, 2014.  The proposed rule is aimed at boosting incentive for large employers to increase the health status of their employees since large employers will be continue to be regarded as discrete risk pools under the Patient Protection and Affordable Care Act, whereas small employers will be collectively treated as a single risk pool.

In addition to the traditional participatory wellness programs such as discounts on fitness club memberships, health assessments and seminars, the proposed rules create an enhanced incentive for employers to offer health contingent wellness programs.  The contingency?  Employees must adopt a lifestyle changes and health improvement plans designed to help them reach target biometric goals such reducing weight, body mass index (BMI), blood pressure, or cholesterol levels.  If they hit the prescribed targets, the proposed rule would allow employers to reward the employee with a payout of up to 30 percent of the cost of the employee’s health coverage for the plan year, an increase over the current 20 percent permitted under rules adopted in 2006.

The rulemaking’s preamble suggests HHS believes the increase in the maximum reward is necessary to boost participation in contingent wellness programs. It cites a 2010 survey by NBGH and TowersWatson in which just four percent of responding employers reported offering financial incentives for maintaining a BMI within target levels.  Only three percent did so for maintaining targets for blood pressure and cholesterol levels.  Based on these numbers, increasing the maximum award level alone isn’t likely to produce a significant increase in the number of employers and employees participating in contingent wellness programs.

However, if such programs were joined with affording employees greater control over when and where they work, participation could increase substantially and employers would see a potentially large payoff in improved employee health status and reduced medical utilization.  Schedule control eliminates the “I don’t have time” excuse for not engaging in health promoting behaviors such as regular exercise and getting sufficient amounts of sleep.  If employers want employees to take responsibility for their health, they must give them the means to adopt healthy lifestyles and avoid the daily sedentary (and hardly health promoting) routine of commuting to and from and sitting in a centralized office.  Plus they would likely enjoy the added bonus of crisper and more creative thinking and better ideas from employees getting plenty of sleep and exercise thanks to having more control over their work schedules.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Lack of exercise kills roughly as many as smoking, study says – latimes.com

August 25th, 2012 Comments off

People across the world are falling so far short on exercise that the problem has become a global pandemic, causing nearly a tenth of deaths worldwide and killing roughly as many people as smoking, researchers warned this week as an alarming series of studies was published in the Lancet.

via Lack of exercise kills roughly as many as smoking, study says – latimes.com.

What the article doesn’t discuss — and should have — is the role the Internet plays in contributing to inactivity. People are wired 24/7.  Rather than computers, tablets and smartphones being a yoke around peoples’ necks, they should instead be used as tools to alleviate the daily commute to the office.  That would free up more time for exercise given that a top reason people aren’t more active is lack of time.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Don’t bribe employees with wellness incentives; give them more control over their schedules

August 14th, 2012 Comments off

Aon Hewitt’s survey shows a growing number of employers are beginning to link incentives to a result, as opposed to simply participating in a program. Of companies that offer incentives, 58 percent offer some form of incentive for completing lifestyle modification programs, such as quitting smoking or losing weight. About one-quarter offer incentives for progress or attainment made towards meeting acceptable ranges for biometric measures such as blood pressure, body mass index, blood sugar and cholesterol.

*  *  *  *  *

“Employers know that eight health behaviors, including risks such as lack of physical activity and failure to complete recommended preventive screenings, drive 15 chronic conditions that lead to higher medical costs and increased absence from work. An effective incentive strategy rewarding those who take action to improve their health is fundamental for improving health and reducing cost,” said Stephanie Pronk, clinical health improvement leader for Health & Benefits at Aon Hewitt.

via Aon Hewitt Survey Shows Use of Incentives Grows as U.S. Employers Look to Improve Workforce Health and Productivity – Aug 8, 2012.

Rather than offer incentives for healthy lifestyle choices, employers seeking measurable gains in the health status of their workforces and decreased medical utilization for preventable conditions should afford employees more control over their schedules in order to free up time for exercise and adequate sleep.  One of the biggest reasons employees don’t exercise is lack of time — largely due to the outdated expectation that they must commute to an office five days a week in order to perform their jobs.  It effectively chains workers to their cars and their desks most of their waking hours and is a prescription for employee sickness, not wellness.  This situation cannot be rectified with any amount of “wellness” incentives.  Instead of trying to bribe workers to take better care of themselves, employers should treat them as adults and give them more responsibility and control over their schedules as long as they get their work done.  How?  By adopting a Results Only Work Environment (ROWE).

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

California’s top health official struggles to meet physical activity goals

June 21st, 2012 Comments off

A recurrent theme of this blog is how American cultural values relative to work and the workplace affect and limit health promoting behaviors — particularly vigorous exercise and adequate sleep time.  For most Americans, a tradeoff has been made between these activities.  Work and the often stressful time suck of commuting to and from the workplace win out.  Even for those who by virtue of their positions such as physicians and public health officials who are cognizant of the need to set a good example of healthy behaviors.

Case in point: Ron Chapman, a physician and director of the California Department of Public Health.  This profile of Chapman appearing earlier this week in The Bay Citizen tells of Chapman’s struggle to find enough time for a consistent, meaningful exercise routine. The article contains a link to a survey Chapman’s department conducted in 2009 and points to the findings at Table 78 indicating one third of survey respondents indicated they don’t have time to be more physically active.

If we are going to bend the relentless rise of the heath care cost curve that’s driving America’s health insurance rates, I believe we as a society need to rethink how we work in order to free up more time during the day for exercise.  Do we really need to be in a sedentary position in a designated office space 8 hours a day (plus sitting another hour or two commuting) to be productive?  And most importantly, is the tradeoff in terms of potential adverse health effects really worth it?

I believe the answer is no.  To improve our overall health status, we should change how we work, shifting and staggering work times and breaking up the pace of work.  There is no natural law that holds information work can only be accomplished between the hours of 8 and 5 in an office building.  Information and knowledge work can be performed at any time and place we can relax and concentrate, particularly with Internet access becoming nearly ubiquitous.  In fact, for this type of work, much productive thinking occurs during exercise when the brain is stimulated by activity, hormones and oxygen.  Getting adequate sleep also keeps the mind sharp, creative and productive.

Dr. Chapman, how you resolve your struggle has implications for all of us.  Use your position of influence as the top health official of the nation’s most populous state to raise some of the questions here and spark reassessment and positive change in how we define work that can improve and preserve the health of all Americans.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Nearly one third of California state worker health care costs attributable to preventable chronic conditions

May 5th, 2012 Comments off

An Urban Institute Health Policy Center study released this week commissioned by the California State Controller’s Office found nearly 30 percent of health care expenditures for California state workers in 2008 were attributable to lifestyle-related chronic conditions such as diabetes, heart disease and hypertension. Ironically, the study determined, state entities with the highest percentages of employees with these preventable conditions staffed health-related departments including the Department of Health Care Services and the Department of Public Health. According to this Sacramento Bee story, the latter department will pilot a workplace wellness program that was kicked off in a ceremony emceed by television personality Dr. Mehmet Oz.  Later in the week, Gov. Jerry Brown, noting preventable and chronic health conditions account for 80 percent of the Golden State’s healthcare expenditures, ordered the state’s Health and Human Services Agency to create a task force to develop a 10-year plan for improving the health of Californians.

California is to be commended in recognizing that some form of intervention is required to bring down medical utilization costs among its workers where a degree of choice and control can be exercised. The California Public Employees Retirement System (CalPERS), is one of the nation’s biggest purchasers of health benefits, so whatever the state does to demonstrably bend the cost curve is likely to serve as a national model for public and private employers as well as payers and providers as an emerging accountable care paradigm begins to take root.

However, state officials should give thoughtful consideration to how this intervention is framed and executed if it is to have more than symbolic value and actually reduce medical expenditures.  “Workplace wellness” is a misnomer insofar as the lifestyle choices that can exacerbate — and prevent — chronic conditions are made mostly outside of the workplace and involve personal decisions concerning exercise, meals and sleep.  Moreover, a 2011 survey of employers found mixed results among those that adopted workplace wellness programs in terms of tangibly improving the health status of employees.

Instead of “workplace wellness,” the focus should be simply on wellness. It should treat employees like adults and give them the freedom to make the personal lifestyle choices they and their medical providers believe can best improve and preserve their health and fitness.  Confining employees to a cubicle for set work hours 40 hours a week and adding on more sedentary time spent commuting to and from that cubicle is hardly a health promoting activity. It robs workers of valuable time that could be spent on activities that enhance health, particularly sustained exercise. Nor is it necessary since Information and Communications Technology (ICT) has matured to the point state employees who are mostly knowledge and information workers can do their jobs from a home office or wherever else they can concentrate and be productive.

On this point, California’s pilot employee wellness program should incorporate a Results Only Work Environment (ROWE).  A ROWE values getting the work done over daily office attendance. Early indications are that workplaces that adopt ROWE can achieve better health status. A University of Minnesota study issued in December 2011 found workers in a ROWE realized increased health-related behaviors of more sleep and exercise — behaviors that can go a long way toward maintaining health and reducing medical utilization.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

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