The $8 Million National Healthy Worksite Program – Will It Make Any Difference? Probably Not

Introduction: An Experimental Initiative for Worker Health Promotion

The U.S. Centers for Disease Control and Prevention (CDC) has placed a bet on the corporate health promotion business with an $8 million injection of funds made possible by the Affordable Care Act (ACA). It is called the National Healthy Worksite Wellness Program or NHWP. The goal is to reduce chronic disease among Americans.
The three areas of emphasis are nutrition, exercise and smoking cessation.

Some might view the goal of less chronic disease and the nature of the three-part emphasis as consistent with and likely to include positive REAL wellness, activities that promote high quality of life outcomes. I would not be among them. Some might view any distinctions between reducing chronic disease and advancing quality of life as quibbling over semantics. I think the difference matters a lot, for it reflects an unfortunate fact, namely, that the new worksite initiative is likely to consist of more medical screenings, more preaching against bad habits and more lamentations about the perils of high risk indicators.

When I first heard about NHWP, I had hoped it might bring more education, incentives and support for personal effectiveness. I hoped for goals addressed to increased happiness, life satisfaction and similar elements addressed to the art and science of advancing reason/exuberance/athleticism and liberty. Perhaps this will have to wait for another day, another program. But, maybe not. Let’s look closer at the announcements about the NHWP.

The CDC, VHM and the Participating Communities

CDC will be working with 104 organizations; the program will be administered by Viridian Health Management, henceforth VHM.

VHM describes itself as a healthcare company focused on improving individual and population health through health coaching, an integrative approach to wellness, powerful technology and analytics. VHM announced the selection of the 104 employer organizations that will participate in the NHWP located within the eight counties or “participating communities.”

The eight counties are as follows: Buchanan County, Mo.; Harris County, Texas; Kern County, Calif.; Marion County, Ind.; Philadelphia County, Pa.; Pierce County, Wash.; Shelby County, Tenn.; and Somerset County, Maine. The basis of selection consisted primarily of the presence in each area of high rates of chronic disease.

Assessment

The NHWP program is a product of the double-edged sword ACA guidelines:

Early worksite wellness exercise program

Companies can charge workers with unhealthy lifestyles up to 30 percent more for medical insurance but they also must offer health improvement programs. Speaking of such swords, here’s a little good news, bad news courtesy of the Rand Corporation. As of 2010, 92 percent of employers with more than 200 employees offered wellness programs. That’s good. But, this is not – only 20 percent of employees participate! And this is worse – these programs have been found not to be effective in any event! In other words, it would not have mattered much if 100 percent of workers participated – they don’t work!

Actually, full participation would have mattered – costs would have been about five times greater.

As expressed in an article in Healthline News, the most targeted employee behaviors were exercising, smoking and losing weight-the same issues addressed by the new CDC program. Is that the kiss of death or what? Remember, these are the issues that attracted the participation of only 20 percent of workers and that did not work! (Source: Brian Krans, Workplace Wellness Programs: Do They Work? Healthline News, June 11, 2013.)

So much for more screenings, more preaching against bad habits and more lamentations about the perils of high risk indicators.

I do hope the CDC folks expect more of VHM for their $8 million under the NHWP initiative. REAL wellness, anyone?

Be weller than well, if you can and at least look on the bright side, to the extent possible.

Gastric Sleeve Surgery to Kick Start Weight Loss

Gastric sleeve surgery, also known as tube gastrectomy, is a weight-loss surgical procedure that involves removing a large portion of the stomach in order to induce weight shedding in severely obese patients. OSSANZ (the Obesity Surgery Society of Australia and New Zealand) claims that in the first 1 to 2 years, patients on average lose 40-60% of excess weight with this procedure.

Basically, a large portion of the stomach is removed along the major curve and the remaining parts are then stitched together in the shape of a tube or sleeve. This reduces stomach size so that the patient feels fuller after eating smaller meals. In fact the amount of food that can be taken in is often only about 10% of that which could be consume before the procedure. The technique also removes the portion of the stomach that produces hunger-inducing hormones thereby helping to control appetite. It is performed laparoscopically, meaning using minimally invasive methods, which also allows for a quicker recovery. Sometimes it is used as part of a two-phase operation in conjunction with gastric bypass, particularly in patients who have a BMI of greater than 60.

According the Healthline.com, many employees in the U.S. are now missing work days due to obesity-related illness to the point of costing employers more than $13 billion per year. There’s little doubt that a similar problem is developing in other western countries. Obesity and the complications from it are becoming more common than at any time in history. While we have solved the issue of inadequate food, we have at the same time created a new problem thanks to excess food and sedentary occupations and means of travel. With more food intake and less daily exercise, it’s not hard to see why our society in general is becoming obese each year.

Of course the best way to deal with this problem on an individual level is through diet and exercise. However for some people, attempts result in continual failure as they go through the yo-yo effect of losing weight and putting it back on again. Their weight often increases over time, despite frequent dieting.

Gastric sleeve is quite a radical surgical procedure but it can help the severely obese to lose weight quite quickly and effectively. It is not a solution on its own as it requires the co-operation of the patient in changing their lifestyle and diet. Unlike gastric banding, the operation is permanent and irreversible.

All surgery carries some degree of risk and it is important to be well-informed of this if you are considering gastric sleeve surgery to help you lose weight and improve your health. The important thing is to discuss it thoroughly with a specialist medical professional and consider your options before making a decision. If you have struggled for years to lose weight and your health is failing as a result, gastric sleeve surgery may well be an option.

Weight Loss – Problems From Weight Gain

Problems from weight gain are very numerous within the human body. These include obesity, thyroid, diabetes, high blood pressure, asthma, coronary heart disease, and more. I’ll discuss some of the more common ones that occur as a direct result of weight gain.

This article is only to define what can happen as a result of having problems with weight gain. It does not address causes and preventions. Those topics will be reserved for other articles.

Obesity

Obesity is defined simply as too much body fat and is a medical condition in which excess body fat has accumulated to the extent that it may have adverse effort on health. It can be a significant health risk and for adults is defined by using the “Body Mass Index” (BMI). If you have BMI between 25 and 30, you are considered overweight. If your BMI is between 30 and 40, you are considered morbidly obese.

Thyroid Problems

When your thyroid doesn’t function, it can affect every aspect of your health, and in particular, weight, depression and energy levels. Weight gain problems are one those conditions that can occur when the thyroid is under producing hormones. Fortunately, most thyroid problems can be managed well if properly diagnosed and treated.

Diabetes

Excessive body weight in itself does not cause Type 1 diabetes but it is not uncommon to become overweight after being diagnosed with diabetes. However, if you are overweight, it may make it much more difficult to control your blood sugar levels and being overweight or obese increases the risk for developing Type 2 diabetes.

High Blood Pressure

High blood pressure or hypertension is the most common chronic adult illness in the United States and being overweight increases your risk of developing high blood pressure. Obesity is one of the strongest predictive risk factors for developing high blood pressure.

Asthma

It has been shown that those who experienced problems with weight gain when first going on asthma control were significantly more likely to have problems with their asthma control than those who maintained their weight levels.

ModernMedicine reported on Aug 27, 2009, that in adult women, obesity and abdominal obesity are independently associated with adult-onset asthma.

Coronary heart Disease

Obesity is now recognized as a major risk factor for coronary heart disease which can lead to a heart attack. Your risk of heart disease increases if you are more than 30 percent overweight.

Cancer

In 2001, experts concluded that cancers of the colon, breast (postmenopausal), endometrium (the lining of the uterus), kidney, and esophagus are associated with obesity. Obesity and physical inactivity may account for 25 to 30 percent of several major cancers-colon, breast (postmenopausal), endometrial, kidney, and cancer of the esophagus.

As you can see, there are many problems with excessive body weight and especially if you are considered obese. Obesity is involved in each of the major health factors in one way or another. If you are overweight, getting your weight back under control will most likely improve your way of life and will go a longs ways towards either maintaining or improving you heath.

For more information on any of the topics, refer to the references below.

References

  • Medline Plus
  • Wikipedia
  • WebMD
  • Weight and Diabetes
  • Healthline
  • About.com:High Blood Pressure
  • Athma Health Center
  • America Heart Association
  • National Cancer Institute