Health-risk assessments show cholesterol, hypertension, diabetes risks
With the holidays over, many people have returned to work a little worse for wear. But employees may want to reconsider those extra servings of turkey and gravy in the future, judging by a Canadian report.
In conducting a wellness screening program at a Canadian equipment company, health-care services provider Medisys Corporate Health found many of the 893 participants did not know or understand their cardiovascular health risks.
Cholesterol risk was underestimated by 258 per cent, hypertension by 58 per cent and diabetes by 76 per cent, found Medisys, which distributed health-risk questionnaires along with performing blood tests and taking each participant’s height, weight and blood pressure.
A low percentage of the participants self-reported they had high cholesterol (10.4 per cent), hypertension (13.2 per cent) and diabetes or pre-diabetes (5.6 per cent).
And yet overall, 37.2 per cent had high cholesterol, 20.9 per cent had high blood pressure and 9.9 per cent had glucose levels outside of Health Canada’s recommended norms, found the report, Wellness in the Workplace: Cardiovascular Risk Benchmarking.
Why the lack of awareness?
One of the reasons people may be unaware of their risk factors is the small amount of time they spend with their physicians, through infrequent or short visits.
One-third (34.8 per cent) of the Medisys participants said they did not have a family physician, and even those who did did not always have regular checkups.
"(Physicians) don’t necessarily have the time to spend talking about prevention, nutrition, fitness, that type of thing, so if they see results that are either borderline or just a little bit above, they’ll maybe tell the patient, ‘Oh, you’ve got to watch this and we’ll just monitor it for next time,’" said Randy McCaig, director of strategy and business development at Medisys in Montreal.
Preconceptions around age could also be a factor. Screening for conditions such as heart disease or colon cancer generally starts in the 40s and 50s, but 59 per cent of the respondents newly diagnosed with high cholesterol, 58 per cent of those newly diagnosed with high blood pressure and 62 per cent of those newly diagnosed with elevated glucose levels were under the age of 45, found Medisys.
And more than one-quarter of all newly diagnosed risk factors were found in participants under the age of 35.
"Prevention needs to start from day one. It’s not just because you turned 40 that you have to start eating well and start to take care of yourself. We see a large population that’s newly diagnosed that were under the age of 45," said McCaig.
Canadians should really learn more about their numbers, said Kate Chidester, national director of adult prevention at the Heart and Stroke Foundation in Calgary.
"Often we think, ‘Well, I can wait until I’m older to have the discussion about my cholesterol and blood pressure and think about my weight,’ and we really would encourage people to have those conversations with health-care providers — and employers are a good conduit."
And the sooner the better, she said, as 90 per cent of Canadians have at least one risk factor for heart disease or stroke, while almost four in 10 have at least three risk factors.
Are health-risk assessments the answer?
If 30 per cent of your workforce has high cholesterol but they don’t even know it, they’re not going to attend a health seminar, said McCaig.
"These are the people who are going to show up in your drug costs... in your absenteeism, decreased productivity, etcetera," he said. "There’s massive, massive costs to the employer that aren’t being addressed here."
A lot of employers put together wellness programs that include lunch and learns, health fairs or smoking-cessation programs, he said. But without doing basic baseline assessments, they’re not necessarily targeting the right people.
"The people who don’t know they’re at risk are not going to attend your events and it’s only going to be the people that are already aware of their health that are going to be attending, so most of the time these people are just taking… reactive steps."
Some employers may have a workforce where 60 per cent have high cholesterol, while other companies are closer to 25 per cent, so health-risk assessments (HRAs) make sense, said McCaig.
They can also identify risks at an individual level, through one-on-one sessions, giving employees the education and tools to cope.
"Once this is done, they will be significantly more likely to participate in the targeted initiatives that employers put together," he said.
"By analyzing HRA results, biometric testing results, drug costs, absenteeism, (short-term disability, long-term disability) causes together, employers will be able to focus their wellness investment on initiatives that bring the biggest bang for the buck."
While the survey found many people were effectively managing their risks at the time of testing, 39.8 per cent of the people who had been previously diagnosed with high cholesterol still did not have their risk under control, while 42.4 per cent of those with hypertension were still above Health Canada’s recommended norms and 54 per cent of those with high glucose were still within at-risk ranges.
Cost-effective approach
Biometric testing is the key to accurate cardiovascular risk benchmarking and plays a pivotal role in employee education and wellness program planning, said the report.
"It’s more costly, obviously, than launching a lunch and learn or health fair — there’s a lot more involved, employees have to take an hour off work so there’s a productivity issue — but the returns are well worth the investment of time," said McCaig.
"It should not be seen as (an) expense because every one of your wellness initiatives will stem from that aggregate report afterwards."
Most people don’t know their cholesterol numbers so it’s about having that information, having that conversation, so they can set goals around them, said Chidester.
"We really encourage people to be involved in their health, so we do think that risk assessments are very valuable for people to participate in," she said, adding her organization’s 700 employees are encouraged to take the Heart and Stroke Foundation’s online risk assessment.
"Up to 80 per cent of premature heart disease and stroke is preventable… but we do have to have an understanding of what our risk factors are, and because our risk factors are connected with our lifestyles, the more information we have, the better," said Chidester.
A risk assessment can bring any concerns to the forefront, said Cindy Hitsman, senior director of business development at VON (Victorian Order of Nurses) Canada in Ottawa.
"It does help people to recognize that these are some factors."
Full picture needed
But one test may not provide a full picture, so it’s about what people do with the information, she said.
"If you’re just going to take your blood sugar one day or your blood pressure, any one given day, it could be anything, so there really does need to be a baseline and followup thereafter... so getting that information and sharing it with your health practitioner is pretty important. And making sure you’re following through."
And while many diseases can take years to take effect, that doesn’t mean employers should ignore the risks, said Hitsman.
"It instills the fact that the employer actually cares about the employee and, in that sense, it does increase people’s productivity and their likelihood they’re going to continue working in that workforce," she said.
"So there are cost implications — a healthy employee is a productive employee, an active employee is a productive employee — so by employers showing employees that they care enough and really want their employees to be healthy, it helps their bottom line."
