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As the workplace becomes more sedentary, many employees are becoming fatter, sicker and less productive due to chronic conditions, according to a new report.

The study, prepared by the PricewaterhouseCoopers Health Research Institute and released last February, identified chronic disease as a growing and costly threat to corporations and their workers. Researchers called on CEOs to make wellness central to their corporate business strategy, suggesting that multinational employers may have the best opportunity to prevent chronic disease. The institute said too little attention is being paid to preventing chronic diseases.

With obesity a growing epidemic, researchers said employers are paying the price. Experts estimate that nearly two-thirds of U.S. adults are overweight.

According to statistics compiled by the Institute on the Costs and Health Effects of Obesity, a creation of the National Business Group on Health, the total cost of obesity to U.S. companies is estimated at $13 billion per year. Health insurance costs related to obesity represent the largest percentage of the total--$8 billion, followed by paid sick leave, life insurance and disability insurance.

Obesity has also emerged in a number of research studies as a major contributing factor in industrial accidents. Even when obesity is not a factor in causing a traumatic injury, it can complicate treatment and extend the time necessary for recovery. More lost workdays translate to higher workers' compensation costs and reductions in productivity.

The study found that approximately 2 percent of capital spent on the workforce is lost to disability, absenteeism and presenteeism--diminished productivity from ill employees who go to work but work below par--due to chronic disease. Combined, these indirect costs are more than the additional direct medical claim costs that some employers incur.

Wellness programs offer a solution to the problem.

Researchers said preventable risk factors such as poor diet, lack of physical activity, stress and smoking are the biggest contributors to chronic disease. To target these preventable risk factors, employers should turn to corporate wellness programs. Researchers said corporate wellness programs have been shown to provide a three-to-one return on investment.

"There are quantifiable benefits from using wellness programs to attract and retain talented, healthy employees," said Simon Leary, partner at PricewaterhouseCoopers LLP. "You can improve the health and well-being of your workers while also bolstering your bottom line. The economic case for prevention is overwhelming."

Some employers seem to be getting the message, Leary said. The study found a growing emphasis on prevention in the workplace. More than half of the corporations surveyed expect to introduce or expand corporate wellness programs over the next five years. One third (33 percent) of multinational companies are rolling out comprehensive wellness programs in multiple countries, while another 17 percent are rolling out a single wellness program in multiple countries.

What can you do to help? Don Goddard, an ergonomist for the U.S. Army Center for Health Promotion and Preventive Medicine in Aberdeen, Md. said that wellness programs can help companies make greater strides toward reducing obesity and improving employee health. To encourage employees to make healthier lifestyle choices, Goddard recommended employers target physical activity and eating habits.

To promote employee exercise, employers can install an onsite workout facility; sponsor or subsidize health club memberships; install bicycle racks to encourage employees to bike to work; organize an intramural sports team; start a walking club for informal exercise or participation in community walks and runs; and encourage employees to take the stairs rather than an elevator. Environmental changes will make the stairs more accessible and inviting, and managers should even consider playing music or hanging artwork in stairwells. Employers can also provide workers with flex time to encourage physical activity before or during the workday.

To improve eating habits, employers can offer onsite weight loss programs; bring in lunchtime speakers to discuss health and nutrition topics; develop heart-healthy taste clubs to test heart healthful recipes; include healthful menu options at the onsite cafeteria and healthy snacks in vending machines; display nutritional information including caloric content to help educate workers; implement a policy that requires food served at meetings or training to meet certain dietary guidelines and nutritional standards; and encourage employees to purchase more nutritious foods through the pricing structure for food items sold in the cafeteria or vending machines. In other words, offer healthful selections at lower prices.

And if all those incentives don't work, there's always cash. Moderate financial incentives can promote employees to stay healthy on the job, according to the findings of a recent study by researchers at RTI International and the University of North Carolina at Chapel Hill.

The study, published in the September issue of the Journal of Occupational and Environmental Medicine, examined the impact of monetary rewards on weight loss in the absence of a structured weight-loss program.

Health and safety experts are concerned about the increasing obesity epidemic. Previous studies have found that having a body mass index in the overweight or obese range increases the risk of traumatic workplace injury.

Severely obese people suffer more hand, wrist and finger injuries. In addition, they file twice the number of workers' compensation claims, have seven times higher medical costs from those claims, and lose 13 times more work from work injury or illness than non-obese workers.

For the study, more than 200 participants were recruited from among employees at one university and three community colleges in North Carolina. During the first three months, participants were randomly assigned to receive either no money, $7 per percentage point of weight lost or $14 per percentage point of weight lost.

The researchers found that the larger financial incentive resulted in the greatest short-term weight loss. At three months, participants with no financial incentive lost two pounds, those in the $7 group lost about three pounds and those in the $14 group lost nearly five pounds. The participants in the $14 group were five and a half times more likely than those in the no-incentive group to lose 5 percent of their body weight, a point where weight loss has clinically important health benefits.

Overall, researchers said 67 percent of participants lost some weight. Between baseline and six months, when the financial gains were equalized, weight losses were similar across groups. A previous RTI study found the annual costs of obesity-attributable medical expenses and absenteeism range from $400 to more than $2,000 per obese employee, suggesting that modest financial incentives may reduce weight and, if sustainable, may improve the financial health of the company.

"Financial incentives tied directly to weight loss are an attractive strategy from an employer's perspective because they require no start-up costs and employees receive the incentive only if they achieve the targeted weight loss goal," said Eric Finkelstein, director of RTI's public health economics program and the study's lead author.

What incentives can employers provide? Although deciding to lose weight and live a healthy life is ultimately up to the employee, companies can encourage employees to improve their health in many ways. Some strategies used by other companies to promote healthy living and weight loss include:

- Discounted health club memberships. If employees receive a discount to a health club facility nearby, they will be more likely to sign up.

- Healthy living and weight loss seminars. One major challenge to weight loss is knowing where to start. Occasionally, bring in speakers from the community--from dietitians and nutritionists to personal trainers and weight loss consultants. A different topic for each seminar can help employees make small changes that could eventually yield big results.

- A company fitness club. This club could include prizes for employees who meet their exercise and weight loss goals.

- Healthy items in the vending machines. If your office's break room options are limited to chips, cookies and soda, it's time for a change.

- Support. Forge a partnership with Jenny Craig or Weight Watchers so employees can get a discount on weight-loss programs.

JOSHUA CLIFTON is editor of the Workers' Compensation Report, a newsletter owned by the parent company of Risk & Insurance®.

December 1, 2007

Copyright 2007© LRP Publications