Spokane Journal of Business

Obesity places burden on bottom line

Meaningful intervention will require multifaceted effort, workplace support

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It's been said that "health is wealth," and it's becoming more evident to employers that the opposite is also true.

According to the Workforce Wellness Index, unhealthy behaviors among the U.S. workforce cost employers annually a total of $670 in medical care and pharmaceuticals per employee, with costs associated with obesity accounting for $400 of that total.

Experts estimate that obesity in the workforce costs businesses more than $73 billion each year in increased health care expenditures and loss of productivity. What could American employers do with $73 billion? Employers could afford to hire 1.8 million workers each year at the U.S. average salary of $42,000.

Unfortunately, data indicate that the high price of obesity will continue to impact the bottom line for years to come. Currently, 36 percent of the U.S. population is considered obese, up from 12 percent in 1990. Health conditions associated with obesity, including heart disease, stroke, type 2 diabetes, and certain types of cancer, aren't only some of the leading causes of preventable death, they also are some of the most expensive conditions to treat.

The Centers of Disease Control and Prevention has estimated that total medical costs for obese individuals were $1,429 per person higher annually than for their non-obese counterparts, equal to an estimated 42 percent increase when compared to those who are of healthy weight.

What makes obese employees more expensive? They're much more likely to spend more on necessary medications and access more expensive medical procedures. But the price of obesity may be much more than the direct cost of pharmaceuticals and medical treatments. Indirect costs of obesity play a significant role in the bottom line for employers as well.

According to data released by Kaiser Permanente, obese individuals miss one more week of work per year than other employees. And when they are working, they are less productive. In fact, loss of productivity due to obesity may cost as much as medical expenditures for the condition.

A recent study examined the issue of presenteeism, which is lack of productivity while at work, and found that productivity can be closely linked with body mass index. That index is a calculation of height and weight used to assign an individual with a BMI number and to classify obesity, with obesity being classified as 30 or above.

In the study, presenteeism measures doubled with each increase from mild to moderate to extreme obesity. For example, women with BMIs between 30 and 34.9 experienced the equivalent of six days of lost time per year at work, and those with a BMI greater than 40 experienced the equivalent of 23 days of lost time per year.

This loss of productivity might be due in part to the increased susceptibility to illness among obese individuals. Many people continue to "power through" illness without wanting to miss work, leading to a less productive work day and increased exposure to illness for other employees.

Due to the increasing burden of health care costs, employers are finding it beneficial to assess the cost of obesity in the workplace. Forward-thinking organizations can use that data to prepare for and to address the growing epidemic. The Obesity Cost Calculator, which can be accessed from the CDC website, is a free resource to estimate the financial burden of obesity in individual workplace settings. Basic wage, health, and health insurance information is necessary to obtain a specific idea of the financial burden of obesity for individual organizations using the tool.

Though the numbers are disturbing, the quantification of the problem of obesity may be a positive step toward change. Many have suspected that obesity is dangerous for the well-being of our society and our organizations, and now there are numbers to prove it.

Extensive research has been conducted to better understand the causes of obesity as well as effective preventive measures that can address the growing problem. Certainly a number of factors, including the growing number of sedentary jobs where individuals are sitting and inactive for eight hours or more per day, contribute to the expanding American waist line. Any meaningful intervention will require complex measures to address many levels of influence: at the policy level, community level, family level, and individual level. But with the extended time spent in the office by many, and the economic impact on employers, it might make sense to address obesity within the workplace.

The Task Force on Community Preventive Services conducted a review of the literature examining the effectiveness, economic efficiency, and feasibility of interventions addressing employee weight.

Promising practices emerged from the data review indicating that interventions that target physical activity and nutrition in the workplace can be effective at managing weight.

The most effective interventions involved environmental or policy change, informational or educational activities, and behavioral interventions. Promising practices included interventions addressing the following:

Environmental and policy changes can involve increased access to physical activity combined with health education. Examples include walking trails, workshops, classes, physical activity classes, and worksite fitness facilities.

Informational and educational strategies often involve having a professional prescribe an exercise plan in accordance with individual needs. Multicomponent education practices are interventions with information on weight management, cardiovascular disease, exercise prescription, and nutrition prescription. They can involve small media, such brochures or electronic messages.

Behavioral strategies can include weight-loss competitions and incentives, with rewards for physical activity or weight loss.

Rewards can be financial, in-kind, or honor/pride incentives, but behavioral practices without incentives also can be effective.

Worksite wellness programs can make a significant difference in reducing medical costs, absenteeism, and presenteeism rates.

In a recent study published in Health Affairs, medical costs fell by $3.27 for every dollar spent on worksite wellness programs. In that same study, absenteeism costs fell by $2.73 for every dollar spent.

Though many large organizations have versions of large-scale wellness programs, small businesses can also make changes that can impact their bottom line.

Spokane businessman Nick Murto, co-owner of Seven2 and 14Four, promotes weight management in his organizations by providing each new employee with a new pair of Nike running shoes. Employees also have access to an onsite gym, where they and their significant others are encouraged to work out.

Murto says, "Our employees tell us how much they love having the opportunity to work out. We are really excited when employees come and tell us how they have never worked out before, but because of our active culture, they are now hooked on it and crave it when they miss a day."

It's important to note that hiring practices that discriminate based on weight are both unethical and illegal, though there is certainly evidence that this practice occurs.

Employers might address the growing issue of obesity best by creating a plan to promote wellness in the workplace using interventions historically proven to be cost-effective.

  • Robin Pickering

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