Karen Andalman's blog

This is the time of the year that many employers are sponsoring biometric screening events. This usually encompasses a lab panel, blood pressure reading and measurement of Body Mass Index (BMI). The BMI calculation usually includes height, weight, and waist circumference.

According to Wikipedia, “The body mass index (BMI), is a heuristic proxy for estimating human body fat based on an individual's weight and height. BMI does not actually measure the percentage of body fat. Body mass index is defined as the individual's body mass divided by the square of his or her height.

I can’t stress enough the impact of employers integrating Wellness Coaching into their Corporate Wellness Initiatives. Just doing a Biometric Screening or taking a Health Risk Assessment alone, without coaching intervention, gives participants information with a lack of knowledge as to long term health impact or support in making appropriate lifestyle changes.

It is important that changes are sustainable. Many individuals struggle with maintaining that instantaneous weight loss or the exercise program. With frequent sessions with the Wellness Coach, goals can be set, barriers to change can be addressed, and participants can get that accountability and support necessary to sustain changes.

“Good coaches look at people who are struggling and see the possibility and opportunity for
healthy change, even transformation. With a good coach, the journey of change is engaging, even fun, more like an adventure than hard work,” according to Margaret Moore, M.A., founder of WellCoaches Corporation.

Most employers offer wellness and disease management programs because they believe the long term benefits are worth the financial expense. If an employer finds effective strategies to motivate the employees, utilization in these corporate sponsored initiatives will increase. Nurse Coaches play a key role in helping individuals identify areas of risk, goal setting and ongoing support and encouragement. Nurse Coaches have the ability to touch and impact a large population.

“Some coaching solutions offer telephonic outreach by Nurse Coaches to initially engage users in coaching. This process successfully engages many more individuals than requiring individuals to opt-in to a program.”

I recently came across a study done by Blue Cross Blue Shield of Michigan that breaks down the health care spending by disease. Chronic diseases are the leading cause of disability and death in this country.  Unfortunately, most individuals with chronic diseases have co-morbidities (more than one chronic disease).  This only serves to drive up the per person cost for health care. As we know, ultimately, the burden is placed not only on the Medicare/Medicaid system, but on private employers that offer health insurance benefits.

There are health risks that are controllable.  We make the choice to smoke. Overweight/obesity can be modified.  We can lower the risk of disease by making healthier food choices.

Employers are becoming aware that healthier employees will lower their healthcare costs. One of the proactive ways that employers can create their own culture of wellness is to make healthy foods available at the worksite. This can include vending machines, breakfast and lunch meetings, and the employee cafeteria or lounge.

According to the CDC:

• In 1995, an estimated $9.3 billion in lost productivity associated with morbidity from coronary heart disease, cancer, stroke and diabetes was attributed to diet.
• In 1999-2000, 65% of adults reported being overweight or obese. People who are overweight or obese are more likely to suffer from many chronic illnesses and conditions.

To eat healthier at work, employers should try to select healthier choices for the following:

We all know about the perils of smoking cigarettes. Cigarette smoking accounts for a majority of deaths in the United States due to lung cancer, coronary heart disease and chronic lung diseases. But there exist myths that other forms of tobacco use are “less deadly” than cigarettes. I will address the most common alternatives to cigarettes as well as the risks.

Cigar Smoking

Evidence shows that cancers of the lip, tongue, mouth throat larynx and esophagus are associated with cigar smoking. Cigar smokers that inhale are at increased risk for heart and lung disease. The biggest difference between cigar and cigarette smoking is the degree of inhalation. The health risk difference between cigars and cigarettes has to deal with the degree of inhalation. The exposure to the same carcinogens is the same. The lung cancer risk from inhaling smoke from five cigars a day is comparable to smoking a pack of cigarettes a day. 

 Smokeless Tobacco

Fast food is easy: no meal preparation, no clean-up. Plus, there are usually multiple places to stop between work and home, making it really convenient.

When you compare people who eat a lot of fast food with people who don’t, there are several
differences between the two groups. Fast food eaters consume more dietary and saturated fat. They also have more body fat, and they eat fewer fruits and vegetables. Studies have shown this to be true for children, African American and Caucasian adolescent girls, college and middle aged adults according to Steven G. Aldana, PhD.

Fast food consumption is contributing to chronic diseases such as obesity, high cholesterol and diabetes. Most fast foods contain red and processed meats, butter, white flour, high fat dairy products and most importantly, they are fried in trans fats.

Studies have shown a direct link between consumption of trans fats and chronic diseases. Healthy oils such as olive, soybean and peanut actually improve blood cholesterol. Trans fats are thought to be 10 times worse than saturated fats, increasing the risk for heart disease.

We have all seen reports in the news lately about the increase in obesity, as well as diabetes, in the United States. Smoking in teenagers is on the rise. On the plus side, unhealthy behaviors are “front and center” and there is certainly an increased public awareness. But what isn’t as discussed is the financial drain that unhealthy individuals put on the healthcare system. Primarily, the dollars that employers are spending on medical premiums, as well as monies out of pocket for self-insured plans. 

The areas of major costs are: tobacco use, sedentary lifestyle (lack of physical activity), and obesity.

The following are some examples and startling statistics according to Dr. Steve Aldana, Professor of Lifestyle Medicine in the Department of Exercise Sciences at Brigham Young University:

Recently I had the opportunity to attend a biometric screening for one of my clients. In addition to the venipuncture draw, the participants had their height and weight measured, as well as a blood pressure check. Quite of few had elevated blood pressures. Many of the comments we heard were:

“These numbers are my norm-it always runs like this so for me it is OK”

“I know it is on the high side but I don’t want to take blood pressure medication”

Or even scarier “my doctor knows about this and he is watching it”

I am concerned that people have a misconception that high blood pressure is OK. Because they are not experiencing any symptoms, then it is acceptable to go through life with high blood pressure. High blood pressure can be a “silent killer”. Untreated high blood pressure can put you at risk for heart failure, heart attacks, strokes, kidney failure or aneurysms.

We are all children at heart. There is nothing more exciting than receiving presents or rewards for positive behaviors. This philosophy transcends into the arena of corporate wellness programs. People on their own are not necessarily motivated to make the changes that will improve their health. A wellness program that is well designed with appropriate incentives will increase employee participation. Increased participation should result in better outcomes; stabilize and lower claims cost.