"They had no idea of what their blood pressure or cholesterol levels were," says Kerr. "It took a face-to-face health screen to [get across] the stark reality."

Kerr adds that the three-month program had a "huge impact" on employees' living habits. He also readily acknowledges that this will have a positive effect on the health of the organization as well as its future benefits' expenses.

Project Impact involved employees from eight organizations. Individuals with at least two modifiable risk factors (smoking, weight, high blood pressure and/or cholesterol and inactivity) underwent a health assessment and intervention program, including exercise, weight management and smoking cessation.

After just three months, employees were re- evaluated and there was a "massive improvement" in cardiovascular health, says Dr. Lydia Makrides, director of the Atlantic Health & Wellness Institute in Halifax. All major risk factors had decreased notably and 40% of the smokers had kicked the habit without medication.

The most important lesson emerging from Project Impact is the value of preventive medicine. "We [employers] talk about compensation and providing for the future, but we don't talk a lot about a healthy lifestyle and it can't help reduce [benefits] costs," says Kerr. Indeed, heart disease--the No. 1 driver of healthcare costs in organizations and the public system--is preventable in 80% to 90% of cases involving working-age citizens, adds Dr. Makrides.

The value of a proactive approach to healthcare is evident in the return on investment data from the study. For every $1 invested in Project Impact (funded by Atlantic Blue Cross, Aventis Pharma and the Atlantic Health and Wellness Institute), there is a minimum return of $1.64 for the employer. For plan members with three risk factors, the return is $2.04. It jumps to $3.93 for blue-collar workers. The returns include projected disability, absenteeism and drug savings, but they do not incorporate savings to the public system, which would make them even more impressive.

Despite the growing body of research on wellness programs, the focus on health within the public system and in most organizations, sadly, remains on a curative or reactive approach to health and medicine. Most provincial healthcare plans don't pay for preventive health practices.

At the employer level, things are better. But Makrides points out the irony of plan sponsors using the term 'early intervention' when they become involved in health management after an individual is already off sick. "Then they start talking about stress management, etc.," she says.

Another case in point is a recent high blood pressure study. It shows that Canadians are half as likely as U.S. individuals to have the condition under control because we have failed to invest in disease prevention, which is costing employers and the public system dearly, says David Maclean, head of community health at Dalhousie University in Halifax and co-author of a recent report on disease prevention.

The good news is that Makrides says employer attitudes are starting to change. While wellness efforts were once a casualty of tough economic times and benefits cutbacks, she believes they will weather the current fiscal pressures on benefits plans.

"We simply cannot afford the healthcare that we have. The time is right for the [preventive medicine] message. It is now a matter of when [we do it] because unhealthiness in the workplace is simply too costly." For the sake of workplace health, let's hope this assessment is right. BC

The Romanow Commission has released its final report on the future of healthcare in Canada.

For Commissioner Romanow's recommendations, click here.

Click here for Senator Michael Kirby's report, "The Health of Canadians – The Federal Role: Recommendations for Reform."