Every year in the United States, there are approximately 735,000 heart attacks [1]. I the United Kingdom, there are more than 100,000 hear attacks per annum [2]. Many countries around the globe are experiencing a rise in obesity, hypertension, diabetes, and coronary heart disease. These medical conditions can lead to myocardial infarctions, or heart attacks.
It is well known that work stress is a factor in coronary heart disease [3] [4]. In the classic Framingham heart study in the USA during the 1970’s, researchers administered a 300-item psychosocial questionnaire to 1,674 coronary-free individuals between the age of 45 and 77. Subjects were followed for the development of coronary heart disease (CHD) for more than eight years. Females who developed CHD scored significantly higher on Type-A behavior, suppressed hostility, tension, and anxiety than those remaining free of CHD. Type-A behavior and suppressed hostility were independent predictors of CHD incidence when controlled for standard coronary risk factors and other psychosocial factors. Males exhibiting Type-A behavior, work overload, suppressed hostility, and frequent job promotions were at increased risk of developing CHD, especially in the 55–64 year old age group. Type-A behavior was associated with a twofold increase in the risk of CHD in males and females aged 45–64 yrs. This association was found only among white-collar workers and was also independent of the standard coronary risk factors and other psychosocial factors. Results suggest that Type-A behavior and suppressed hostility may be involved in the pathogenesis of CHD in both sexes [5]. It is interesting to note that the Type-A behavior associated with a doubling the risk of CHD in 45-64 year old males and females was found only in white collar workers.
So can employers help to lower the risk for CHD despite the standard coronary risk and psycho-social factors? Should they help to lower this risk? I believe that both quetion deserve a resounding YES!
Ergonomics and Wellness
Although preventive health management is an ideal tool in businesses for driving down high healthcare costs, many companies have neglected this important area. Businesses are slow to recognize that preventive activities can actually pay dividends within a short timeframe. Both small businesses and big multinationals often lack the essential know-how for putting preventive health management into action, and that includes ergonomics in the workplace [6]. This neglect is many times attributed to corporations being busy “doing business.” Yes, many companies look at purchasing ergonomic tools and computer workstation peripherals, but why not employee wellness? Is adding corporate fitness to help lower the risk of CHD the same challenge as improving safety initiatives to prevent machine accidents or purchasing PPE? Companies often focus only on the employees on the manufacturing floor (who generally have a record of higher injury rates than their office dwelling colleagues) and forget about the managerial and administrative staff. An employee who has CHD has a greater chance of catastrophic health consequences, including death, than the employee who may have a RSI. Is the prescription for wellness significantly different for the white collar cohorts?
A Different Prescription
Are safety training programs different for machine operators than forklift drivers? Why? White collar worker may have different stressors than their manufacturing floor cohorts, but that shouldn’t disqualify them from their own regiment of tailed safety training. Different strategies for safety or wellness training for the managerial and administrative staff are a reflection of the type of work and the setting in which that type of work is done.
This setting is usually physically sedentary, involving long periods of sitting in static postures, coupled with mentally active processes, tied to large volumes of work and tight deadlines. Sometimes the “shift” is longer than eight hours, and maybe work is done at home to meet the daily job demands. Where is the employee to go to get away from the tasks and demands, then?
A different prescription is needed for these managerial and administrative employees. The production floor employee usually has rest breaks and a lunch break built in to their work day; the office crew may not. For those on computers for most of the day, there should be a five to ten-minute to get out of the work area at least twice a day., in addition to a 1-2 minute get out of the chair break every 30 minutes. This affords the employee time to clear the mind and allow for better blood flow to the lower extremities. This break may be in conjunction with a colleague and can help promote collegiality, another stress reducer. In addition to these breaks, a separate lunch area with bright and cheerful décor is beneficial -- particularly when it include sunlight and/or some sort of classical music (another stress reliever) [7].
Long-Term Solution
Healthy employees not only save on healthcare costs but also cut productivity losses, since loss of productivity is three times greater than the cost of healthcare [8]. So in addition to the aforementioned activities, businesses should employ a long-term solution to improve health, lower healthcare costs, and raise productivity. This solution is Corporate Fitness.
Some companies have added this successfully to their facility in the form of a gym or workout space. This space is designed with the help of a health professional, such as a Physical Therapist, and the company administration. The employees are offered health screens by this health professional, directed to the most advantageous form of exercise for their current physical condition; later, they may begin their cutomized exercie program, if medically cleared by a primary care provider. The employee can be periodically rechecked by the on-ite health professional to assess the need for upgrading their exercise program and to monitor their overall success rate,.Fitness goals may vary from shedding excessive weight to lowering their blood pressure or fasting blood sugar level.
Getting Started
Strong organizational program support and low employee co-payment were identified as drivers of employee participation in corporate health programs. Hence, intensifying both social and financial support of employee participation may help to drive enrollment rates. Corporate leadership should not only encourage program participation through role model behavior but also establish a corporate culture in which health is of high value is a key factor for program success [9]. Several researchers who looked into the association between organizational level factors and participation suggest that manager and co-worker support has a positive effect on employee program participation [10]. The degree to which employees feel that a certain behavior is socially expected and encouraged at the workplace is predicted to have an impact on program participation [11]. Given the growing evidence of the positive effect of financial incentives on behavior change, it's no wonder that corporate wellness continues to receive attention [12]. As with any ergonomic intervention, managerial commitment, coupled with employee input, can make corporate fitness a reality which can bring a host of benefits to any company.
References:
[1] Heart Disease Facts, https://www.cdc.gov/heartdisease/facts.htm
[2] Facts and Figure for UK Health, https://www.bhf.org.uk/for-professionals/press-centre/facts-and-figures
[3] The association between study characteristics and outcome in the relation between job stress and cardiovascular disease - a multilevel meta-regression analysis
Szerencsi, Karolina, MSc; van Amelsvoort, Ludovic G P M, PhD; Viechtbauer, Wolfgang, PhD; Mohren, Danielle C L, PhD; Prins, Martin H, PhD; et al. Scandinavian Journal of Work, Environment & Health; Stockholm Vol. 38, Iss. 6, (Nov 2012): 489-502.
[4] Coronary Heart Disease; Research from University College London in the Area of Coronary Heart Disease Published
Psychology & Psychiatry Journal; Atlanta [Atlanta]30 June 2012: 133.
[5] The relationship of psychosocial factors to coronary heart disease in the Framingham study: III. Eight-year incidence of coronary heart disease
Haynes, Suzanne G; Feinleib, Manning; Kannel, William B .American Journal of Epidemiology Vol. 111, Iss. 1, (1980): 37-58
[6] Boost Employee Wellness and Lower Costs in the Workplace with Ergonomics, Anonymous.Assembly, suppl. HOW-TO GUIDE; Troy (Mar 2016): 16-17
[7] Building employee wellness through the implementation of exercise, nutrition, and chronic health education, Montgomery, Sheryl Lynn. University of South Carolina, ProQuest Dissertations Publishing, 2008. 3321424
[8] Corporate fitness, Butler, Shery, lAmerican Fitness v28 n4 (Jul/Aug 2010) 42
[9] Organizational-level determinants of participation in workplace health promotion programs: a cross-company study, Lier, Liesa Marie, Breuer, Christoph & Dallmeyer, Sören, BMC Public Health 19(1):268 (2019)
[10] Crump CE, Earp JAL, Kozma CM, Hertz-Picciotto I. Effect of organization-level variables on differential employee participation in 10 federal worksite health promotion programs. Health Educ Q. 1996;23(2):204–23.
[11] Weiner BJ, Lewis MA, Linnan LA. Using organization theory to understand the determinants of effective implementation of worksite health promotion programs. Health Educ Res. 2009;24(2):292–305.
[12] Cuellar A, Haviland AM, Richards-Shubik S, LoSasso AT, Atwood A, Wolfendale H, et al. Boosting workplace wellness programs with financial incentives. Am J Manag Care. 2017;23(10):604–10.
