chronic disease workplace wellness

The Cost of Chronic Disease — And Why Prevention Matters

Helping prevent chronic disease — or, at the least, help manage it — is a central part of any well-run workplace wellness program.

A recent study outlines not only the importance of addressing chronic disease, but also how the workplace can play a role in the prevention.

The National Academy of Medicine’s Vital Directions for Health and Health Care Initiative published “Chronic Disease Prevention: Tobacco, Physical Activity, and Nutrition for a Healthy Start: A Vital Direction for Health and Health Care.”

The study clearly states the problem: “Smoking, obesity, inactivity, and excess intakes of added sugar, saturated fats, and salt are major contributors to the rates of chronic disease in the United States, and the prevalence and costs of chronic diseases associated with those modifiable behaviors account for a growing share of our gross domestic product. Our medical system has evolved to treat people for diseases that result from these behaviors rather than to prevent the diseases. However, as described in the following sections, the prevalence of the diseases associated with the behaviors greatly exceeds the capacity of our medical system to care for people who have them. Furthermore, few providers are trained to deliver effective behavioral-change strategies that are targeted at the risk factors to prevent their associated diseases. There is a need for broader preventive solutions that focus on the social and environmental determinants of chronic diseases.”

The report outlines key issues and cost implications across four main areas: Tobacco, obesity, sodium, and physical activity.

Tobacco: “Despite substantial efforts to prevent the onset of smoking and increase rates of smoking cessation, smoking is still a major cause of chronic obstructive pulmonary disease, heart attack, and lung cancer. For every person who dies from smoking, 20 suffer serious smoking-related illnesses. Smoking costs the United States $170 billion in health care expenditures and $156 billion in lost productivity—a total economic im- pact of $326 billion—per year (CDC, 2016).”

Obesity: “According to the National Health and Nutrition Examination Survey (NHANES), conducted by the Centers for Disease Control and Prevention (CDC), obesity is present in almost 38% of US adults (Ogden et al., 2015), is a major cause of heart disease and type 2 diabetes mellitus, and is associated with 16–20% of adult cancers. Rates of obesity and severe obesity are greatest in His- panic and black women. A recent estimate suggested that the medical costs of adult obesity in the United States amounted to almost $150 billion per year (Fin- kelstein et al., 2009).”

The piece further outlines how factors such as “Foods and Beverages that Contibute to Obesity,” “Fruit and vegetable consumption continues to fall short of recommended intakes,” and “Consuming foods away from home (FAFH), particularly from restaurants, has increased in the last few decades.”

Sodium: “It is estimated that a 40% reduction in US sodium intake would save 280,000–500,000 lives over the next 10 years. Adults who have prehypertension or hypertension, which together affects 32% of US adults, or over 70 million people, would benefit from further reduction to 1,500 mg/day (Dietary Guidelines Advisory Committe, 2015). However, because most of the sodium in foods is added during processing by the food and restaurant industry (Dietary Guidelines Advisory Committe, 2015), it is difficult for consumers to regulate their intake.”

Physical Activity: “About 6–10% of all deaths from chronic diseases world-wide can be attributed to physical inactivity. Regular physical activity reduces the risk of premature death and disability from a variety of conditions, including coronary heart disease, diabetes, osteoarthritis, osteoporosis, and some types of cancer. According to CDC, only about 20% of US adults and less than 30% of high-school students meet the 2008 Physical Activity Guidelines for Americans (Physical Activity Guidelines Advisory Committee, 2013). The public health goal is to get people moving—some activity is better than none, and more is better than some.”

Further: “A wide array of physical-activity interventions have proved effective in a variety of populations and geographic settings (IOM, 2013a; Task Force on Community Preventive Services, 2016). The National Physical Activity Plan (NPAP) (2016) has extended the Guidelines in a comprehensive set of evidence-based strategies and tactics to increase physical activity in all segments of the U.S. population.”

Tomorrow we’ll address the report’s findings on how “Workplace health-promotion (wellness) programs can potentially reach a large segment of adults who are not otherwise exposed to or engaged in organized health-improvement efforts.”