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By ERIN GAZICA, a freelance writer from Pottstown, Pa.

It's no secret that cancer, heart disease, obesity, diabetes and stress are top challenges at U.S. companies. These health risks, however, are now growing for multinationals with employees at international locations, but companies have been slow to adopt a global health strategy.

Nicole Serfontein, senior international consultant with Towers Watson, said that historically these so-called "lifestyle diseases" were not as prominent outside the United States, but in the past decade, the trend has changed. As U.S. employers expand their offshore workforces, they are feeling the burden much more.

The survey also found that companies managed an average of 25 health plans globally, contrary to the perception that privatized healthcare is found only in the United States. In some countries this coverage either supplements an existing healthcare program or fills a crucial gap in the public health system.

"I think these are opposite sides of the same coin," said Serfontein. "On the one hand, the need to have a global health strategy is fairly recent over the last couple of years. On the other hand, the strong prominence in where they do have healthcare and the fact that only 25 percent have a strategy and not many are thinking about taking steps to implement them--that is a little bit of a concern."

LACK OF TOOLS, DATA

Despite facing the challenges of workplace stress, aging workforces and chronic disease, multinationals lack important health management tools, according to the survey.

Only 25 percent of respondents provide health risk assessments in most or all countries, while only 40 percent provide case management programs. Just over 30 percent of respondents offer health promotion and screening programs, and only 25 percent of companies provide chronic disease management programs.

Serfontein said that there are several reasons for those low numbers. Dealing with healthcare in foreign nations requires foresight, yet there is a lack of knowledge about what's going on with healthcare outside the United States.

The challenge is obtaining reliable data, which is difficult for employers to do overseas. In addition, vendors aren't sophisticated enough in terms of breaking down data so companies can use it.

"I think there is also a cultural perception. Especially in Continental Europe, there's always been an expectation that the government will provide for healthcare needs, and it's never been seen as an area where employers can provide meaningful intervention," she said. "That is slowly changing.

CENTRALIZATION THE ANSWER?

John Leifer, national director of health policy at CBIZ, a Cleveland, Ohio-based consultancy, said that research dating back decades documents the impact of chronic conditions and their correlation with lifestyle risk factors.

Leifer was surprised that more isn't being done to address what he calls the "low-hanging fruit" in the battle to improve employee health and productivity.

Basic strategies such as health risk assessments are readily deployed via the Internet, said Leifer, who challenged the survey's assertion that vendors aren't available or sophisticated enough to address some of these issues.

"We're talking about something that could be disseminated globally in nanoseconds, compiled and assessed very, very rapidly," Leifer said. "I'm sure that vendors aren't available in a number of countries, but there could be centralized initiatives relative to health risk assessments and certain types of health and well-being interventions that could be easily deployed from a central location."

Towers Watson conducted the online survey of HR and health and wellness executives in North America and Asia from Nov. 19 to Dec. 23, 2009. Respondents included 106 participating organizations with at least 500 employees and significant business operations in more than one country.

April 23, 2010

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