The Toronto Transit Commission recently provided 12,000 employees with an interesting benefit — its first-ever diabetes screening program. As a workplace with a lot of employees performing rather sedentary tasks, providing such testing pre-emptively made sense.
And it makes sense for many employers in Canada, where cases of Type 2 diabetes are increasingly on the rise.
“Type 2 diabetes is a significant problem in Canada — the prevalence is rising. It’s doubled from the year 2000 to 2010, and it continues to increase,” says Seema Nagpal, director of public policy and epidemiologist at the Canadian Diabetes Association in Ottawa.
“Just over 11 million Canadians have diabetes and pre-diabetes now, and it will continue to increase unless we do take measures to try to prevent diabetes… So (in) making people aware of the risks, and allowing them an opportunity to modify the risks if possible, you can put them on a different trajectory.”
Catching issues early
But diabetes isn’t the only costly and all-too-prevalent health condition that can be caught early through preventative health screening.
The four most prevalent diseases often screened for include hypertension or high blood pressure, heart disease, diabetes and obesity, according to Joshua Pollack, director of sales and marketing at the Health Team in Toronto, which provided the screening to TTC employees.
“Those four chronic diseases are the most prevalent in society and are actually the top causes of death, intertwined as well into what they call metabolic syndrome. So they all play off each other and they all deal with the same sort of lifestyle decisions you’re making,” he says.
“The lifestyle factors that we’re trying to address are exercise, nutrition, smoking, alcohol consumption and stress.
It’s important because these conditions are so prevalent, says Pollack.
“And the amount of time that employees can miss having to deal with some of these issues (can be significant).”
A good screen often includes metabolic disease, cardiovascular, some areas of cancer risk prevention and muscular-skeletal issues, and it can even include mental health issues, says Yolanda Billinkoff, vice-president of sales and account management at MedCan in Toronto.
“Allowing someone to have time with a doctor instead of being rushed allows the person to feel that they have a safe (situation) to talk about things related to mental health that they may not be calling their EAP provider for because it’s just not something that they’ve put on their list.”
Whether it’s the employee himself or a family member, these health conditions can have a major impact on the workplace, says Pollack. They could translate into missed time, lost productivity or presenteeism — where people are at the office but distracted or not performing well — lethargy or other symptoms that can impact the job.
Preventative screening is a valuable benefit for employees that’s actually quite quick and easy — generally, it entails about a 20-minute appointment with an on-site nurse, he says.
Preventative screening is also important because the current health system does not allow for preventative medicine — instead, it’s managing reactions to health care, says Billinkoff.
“(That leaves) an employee who is strapped for time to wait until a health concern escalates before they address it,” she says. “And when they do address it, there is a considerable amount of inconvenience — transport, time in waiting rooms, multiple clinics, unproductive communication.”
Investing in wellness
It’s also important to look at the actual culture an organization portrays when it says prevention is important, says Billinkoff.
“We’re all human and we all get sick, and we all could strive toward better health,” she says. “I work with a lot of legal and financial services firms where a lawyer doesn’t feel they have permission to spend time with their physician unless the company says from above that they’re going to invest (in that)… they can make their health a priority and their company agrees with it.”
Long-term, it’s an investment that makes sense.
“Metabolic disease is one of the leading concerns that we have in North America, and these people are in corporations. They’re costing companies productive time; they’re also costing companies drug and other resources because it’s a wellness disease. They’re not taking care of themselves and they’re not making their health a priority,” says Billinkoff.
“Some preventative screening means that people get ahead of things before they become insurmountable. When you are working long hours, you can’t necessarily get ahead of that, so this opens up the door to be able to do that.”
The healthier a person is, the more engaged she is in life and at work, says Pollack.
“As an employer, you’d hope your employees are the healthiest they can be while at work because the spillover benefits of them being healthy (are significant),” he says.
Worth the expense
There’s also the competitiveness factor.
“Major employers with deep pockets who can spend a lot on treating employees well, you want to be seen as providing everything you can to your employees,” says Pollack.
“The personal benefits at the employee level are important, so making sure your employees are healthy benefits the company.”
Some employers might be concerned that implementing these programs is relatively expensive and the return on that investment is not worth it, says Pollack.
“But when you’re looking at the amounts a company is going to spend on insurance programs, when you’re spending $2,000 to $4,000 a year on an employee… (preventative screening clinics) can cost $40 to $100 per person, per year,” he says.
“If you think of it as something you can combine into your benefits package, an extra $50 to $100 per employee — and you’re only paying for people who are using it — it’s not that expensive.”
And if a person finds out through preventative health screening that he has a condition such as pre-diabetes, for example, he can take action to try to prevent the progression of the condition, says Nagpal.
“From an employer’s perspective, a person being able to modify their risks and not develop diabetes, that would allow that person to not require medication, to not require time to manage their condition during work. It’s perhaps an opportunity to allow someone to experience their full health potential rather than develop a chronic illness that they’ll have to manage their whole lives.”
There are certainly budgetary constraints and a tight market, says Billinkoff, and that’s the reality.
“I get that our current economic system is not in the same talent acquisition mode that we used to be. But I do think if you look at the cost commitment… to do preventative screens, we do so many other things — bring speakers in on wellness, have a catered lunch, have work buildings close to subways stops, those kinds of things,” she says.
“Being able to actually do something about our medical situation to create some prevention and real benefit… is just a cost of doing business.”
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