"A healthy workforce is a productive workforce" is a concept embraced by modern day business minds. It implicates that the more companies put into their workforce, the more they will get out."
Dr Glen Hagemann from Energi, a company specialising in workplace wellness, has conducted local research and reviewed various studies related to health in the workplace and has made some astonishing findings.
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His review entitled The Total Value of Corporate Health explains the basic logic behind a healthy workforce. "If you improve the health of employees, their quality of life improves. Therefore health care claims are reduced, disability is controlled, and productivity is enhanced. Thus having a positive impact on the bottom line," his report reads.
Preventable illness (i.e. diseases that could have been avoided by adopting a healthy lifestyle) is responsible for 40 to 65 percent of illnesses and their associated costs, reads Hagemann's report. "Modifiable health risk (MHR) factors are precursors to many diseases and premature death … and MHR can be improved through effective health management programmes," says Hagemann. "Improvements of the health risk profile of an employee population can lead to reductions in health-related costs and improvement in productivity."
"South African companies are addressing the health issues of their workforce, however, in some cases they're focussing on one risk while neglecting others," says Hagemann. He argues that HIV/Aids is a serious threat to productivity and indirectly to the country's economy. Therefore, justifiably, most health efforts are aimed towards fighting HIV/Aids. "However, HIV/Aids mostly affect the younger component of the workforce (25 to 40 year olds), while non-communicable diseases, such as heart disease, stroke, etc. are risk factors among the more experienced senior workforce."
He highlights six key factors implicating employee health:
1. The effect of chronic disease on workers
Seven of the 15 top causes of death among South Africans are largely due to preventable diseases. These include HIV/Aids, ischaemic heart disease, stroke, hypertension, diabetes, chronic obstructive pulmonary disease (COPD) and lung cancer.
The effects of chronic disease on workers
To illustrate this point Hagemann used rates among South African males according to age distribution. According to the South African National Burden of Disease study conducted in 2000, the death rates among the workforce (25 to 55 year olds) were particularly higher than among the rest of the population. And the two main causes of death among this group were HIV/Aids and non-communicable disease, i.e. mostly diseases that could have been prevented by lifestyle modification.
Non-communicable disease (NCD) in South Africa
In 2002, the Medical Research Counsel (MRC) found that 41 percent of mortality in South Africa is due to NCDs, and the figures are ever-increasing. In 1996, 487 people died per day due to NCDs. This figure rose to 536 in 2001, and is estimated to rise up to 563 by 2010.
"Many of these deaths occur in the middle-aged and senior members of the workforce," says Hagemann, therefore having a substantial effect on the country's productivity and economy.
Burden of NCDs in South Africa
The MRC also reported that approximately 6 million South Africans suffer from hypertension, 4 million have diabetes, 7 million are smokers and 4 million have hyperlipidaemia.
"Approximately 56 percent of the population are reported to have at least one of these risk factors and about 20 percent are at high risk for NCD," says Hagemann.
2. High-risk employees are high cost
The following monetary value has been calculated as the annual healthcare claims cost for certain health risk factors (regardless of whether or not a patient is on treatment):
Depression risk – R1763
Elevated cholesterol – R1171
Stress – R881
Body mass index (BMI) – R748
Glucose levels – R558
Blood pressure – R354
Alcohol – R329
As the level of these risk factors increase, for example, elevating blood pressure levels, the cost of medical claims also increase.
3. Absenteeism
Health risk factors also impact on the amount of sick leave taken by the employee, ultimately leading to lower productivity output of the company.
Annually a person with an elevated BMI costs the company 49 percent more in direct costs associated with paid time off (PTO) than a normal weight person.
An employee at risk for depression takes an estimated 5.7 days sick leave due to this condition, costing the company 65 percent more in PTO payroll costs than a person that’s not depressed.
High stress levels leads to an average of 4.2 sick days every year, costing the company 98 percent more in PTO payroll costs than a person with normal stress levels.
An employee with elevated cholesterol levels will take an average of 6.8 days of sick leave due to this condition, costing the company 66 percent more in PTO payroll costs than a person not at risk.
4. Presenteeism – the hidden enemy
Presenteeism is when an employee is present, but unproductive because of ill health. This condition also has a great effect on an employee's work output. Direct costs can be measured for medical and pharmacy claims, absenteeism, workmen’s compensation and long an short term disability. However the indirect cost of presenteeism is more difficult to measure and can be termed the “hidden enemy” as companies do not know the extent of this.
According to an American study, the following diseases are believed to cause an astonishing amount of unproductive work hours per day:
Heart disease – 4.3 hours/day
Respiratory infection – 4.1 hours/day
Diabetes – 4 hours/day
Blood pressure – 3.4 hours/day
Migraine – 3.4 hours/day
Arthritis – 3.2 hours/day
Allergies – 2.8 hours/day
Stress – 2.3 hours/day
Depression – 2.2 hours/day
Anxiety – 2.2 hours/day
The annual cost of presenteeism (calculated according to disease), according to another US study, are as follows:
Hypertension - $392.31
Heart disease - $368.34
Depression - $348.04
Diabetes - $256.91
5.Do not neglect the healthy
Hagemann warns that companies should not just focus their health improvement efforts on those at high risk, but also aim to keep healthy employees healthy, as low risk employees could become high risk, eventually leading to higher medical and other related costs. "It’s strategically more cost-effective in the long term to keep a healthy person healthy than to try to move a high risk individual to a medium or low risk."
6. The impact of physical activity
Inactive people tend to take more frequent and on average longer sick leave, and cost the company more in sick leave/payroll costs as active employees.
Hagemann reports that physical inactivity was significantly associated with the female gender, people with an elevated BMI, people with moderate to high levels of stress as well as unhealthy eating habits.
However, the same study found, no association between physical inactivity and medical expenditure, which is opposite to the international literature which generally shows an increase in medical expenditure for inactive people vs active people.
Possible solution
In order to reduce these health risks, and in turn increase workforce productivity, Hagemann suggests that companies implement a health management programme tailor-made for the health needs of its employees and aligned with the organisations objectives.
"Resources for such programmes are often limited and companies should spend their money wisely," says Hagemann. "Companies shouldn't settle for a generic health management programme. They should assess their workforce and identify the group's specific needs. Only then should they design and implement an appropriate health risk management programme," Hagemann concludes.
Source: The total value of corporate health, Some key insights. By Dr Glen Hagemann, March 2008.
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