Chronic disease raising ‘alarm bells’

Lack of prevention can mean higher absenteeism, presenteeism
By Shannon Klie
|Canadian HR Reporter|Last Updated: 11/30/2010

Chronic diseases are looming as a major potential barrier to competitiveness and productivity and organizations need to take steps to prevent and manage these conditions, according to the Conference Board of Canada.

“We’re seeing massive increases, across a number of chronic conditions, that are raising alarm bells,” said Diana MacKay, director of education and health at the Conference Board of Canada in Ottawa.

In 2005, 42 per cent of Canadians over the age of 12 were living with at least one chronic disease, such as high blood pressure, diabetes, epilepsy, heart disease or mood disorders, according to the Public Health Agency of Canada.

And chronic diseases are increasingly manifesting in the workplace and affecting organizations’ ability to “get the job done,” said MacKay.

With more employees being diagnosed with these conditions, the costs on organizations — from increased absences, short-term disability and reduced productivity — are adding up, she said.

In fact, productivity losses among workers with chronic diseases are nearly 400 per cent higher than the costs for treating the disease itself, according to the World Economic Forum, one of several sources cited in the Conference Board of Canada report Addressing Chronic Diseases: What’s Business Got to Do With It?

And while absenteeism is definitely a problem, organizations should be even more concerned about employees who are well enough to be at work but distracted by not feeling well, the stress of the illness or having to manage their illness. This is called presenteeism, said MacKay.

“I think that’s possibly a larger concern than absenteeism,” she said, citing one study that found the cost of presenteeism to be as much as 32 times that of absenteeism.

“It could be stunningly large and more work needs to be done to measure and understand this idea of presenteeism.”

The vast majority of chronic illnesses are preventable if risk factors are addressed, according to the Conference Board’s report.

In fact, about 80 per cent of premature heart disease, stroke and Type 2 diabetes, as well as 40 per cent of cancers, can be prevented through healthy diet, regular physical activity and avoidance of tobacco, according to the World Health Organization.

And businesses have a vital role to play in the prevention and management of chronic disease, mostly through the development of prevention and wellness programs, stated the report.

“The business sector depends on a healthy and productive workforce. That’s really the business interest in this,” said Chris Bonnett, owner of Toronto-based health services consulting firm H3 Consulting. “The workplace plays a really important part in the lives of 17 or 18 million Canadians in the workforce and it turns out work sites are a great place to offer comprehensive health promotion.”

While there are many tools available to help an organization develop health and wellness programs to prevent or mitigate chronic disease, an organization needs to invest time upfront to assess the issues in the workforce and determine what solutions will work best, he said.

This can include performing a health risk survey or engagement survey to find out what concerns and issues employees have and then developing appropriate programs.

“You really have to understand the needs of the workforce. Just because a program crosses your desk, it doesn’t mean it’s the right program at the right time for your group of employees,” said Bonnett.

Once an organization has identified the issues in the workplace, it needs to figure out how best to prevent them.

For example, if an organization wants to prevent mental illness, it needs to ensure the workplace is a psychologically sound environment conducive to healthy living, said MacKay.

If it is trying to prevent diabetes, it needs to look at what food choices are available and what employees are eating (are they bringing their own food, going to a nearby fast food restaurant or eating in the cafeteria?).

An organization can also look to services in the community and ensure employees are aware of them instead of duplicating something that’s already available, said Bonnett.

Organizations also need to ensure employees are ready for change and that leadership supports the programs, otherwise they won’t be successful, he said.

One way to get leadership on board is to show them the return on investment of wellness programs, said MacKay.

“The big obstacle is most employers still don’t see this as an effective investment, they see it as a cost,” she said.

An analysis of various studies found for every $1 spent on wellness programs, there is an associated $3.27 drop in medical costs and $2.73 drop in absenteeism costs, found the Conference Board report.

“There’s increasingly more and more organizations that really need to see some kind of measurement attached to the funding and that’s probably the way that this becomes an investment if there is an organized approach to measuring outcomes, the satisfaction, the value of a program. That really should be designed right at the onset,” said Bonnett.

But some organizations will just never be ready for these kinds of programs, he said. They will never see the benefits, only the costs that aren’t consistent with their idea of business, which is to generate profits and growth.

“That probably explains why the public sector tends to have more of these kinds of programs and strategies than the private sector — it’s perhaps a more natural fit for many public sector organizations,” he said.

It’s also harder for smaller organizations to take on these kinds of initiatives because they don’t have the resources of larger employers, said Bonnett. This makes community resources even more important, especially since about one-third of all Canadians work for organizations with 50 or fewer employees, he said.

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