Benefits Canada’s 2015 Healthy Outcomes Conference shows how employers can encourage healthy behaviours while containing costs
10 steps to improved health: lessons learned from Chronic disease prevention and rehabilitation
Some populations are healthier than others. Can Canadians change their basic health behaviours relating to diet, alcohol, smoking and physical activity?
Epidemiologists’ research has found that four unhealthy behaviours account for 80% of the chronic disease burden and mortality in Canada and around the world. But Canadians living with a range of chronic diseases can learn to improve their health with the following 10 steps.
1. Maintain a healthy weight
Think about process instead of outcome when thinking about weight, said Dr. Paul Oh, medical director and scientist, cardiovascular prevention and rehabilitation program, with the Toronto Rehabilitation Institute.
“If losing weight is based on the scale, sometimes, you feel like a failure.” You have to really focus on what it means to be healthy, he continued. “Fit trumps unfit no matter what your body weight.”
2. Lower your cholesterol
Drugs such as statins can be helpful by reducing the production of cholesterol in the liver and encouraging the transportation of LDL back from plaques in blood vessels and other depots, says Oh. You can significantly lower your cholesterol through a combination of lifestyle
3. Eat your fruit and veg daily
Try the DASH diet (Dietary Approaches to Stop Hypertension), which focuses on consuming more fish, fibre, nuts, seeds, fruits and vegetables. Studies show it can decrease blood pressure by as much as 11/6 millimetres of mercury (which is as effective as any medication).
“Diet is not about taking things away,” said Oh. “The Greek word diaita means a way of living, a way of life.”
4. Control your glucose levels
“If you have diabetes or not, normal glucose is the goal,” explained Oh. “That is the single goal for everybody.”
5. Lower your blood pressure
Having an arbitrary threshold for high blood pressure (usually 140/90) is helpful, but it could be doing us a disservice, he said. Some patients with high blood pressure may be able to avoid taking medications and simply lower their blood pressure through diet. A recommendation such as the DASH diet might be all they need, Oh added.
6. Limit alcohol
“If you don’t drink, don’t start,” said Oh. “And if you drink a lot, drink less.” A healthy amount of alcohol is one drink per day for women and two drinks per day for men.
7. Quit smoking
Don’t stop the campaigns to quit smoking, and make sure employers continue to offer smoking cessation programs, said Oh. If a person quits, his or her risk of cardiovascular disease decreases. And while some people may feel they’re too old to give up their cancer sticks, it’s never too late to quit, he added.
8. Manage stress
There’s a difference between stress and strain, explained Oh. Strain occurs when we take a stressor and repeat it over and over, making it real in our heads. “We all need stress,” he said. “Strain, we don’t need.” He advised developing ways to manage stress, such as breathing deeply for 30 seconds.
9. Get enough sleep
Sleep is a needed part of a healthy life, so make sure you’re getting about seven to eight hours a night. And, if you have sleep apnea, seek help, because it can elevate blood pressure and increase your risk of stroke, Oh added.
10. Get moving
Physical activity is one of the secrets to longevity, said Oh. “The fitter you are, the lower the risk of dying or developing heart disease.”
Just 1% of the world’s population behaves in a healthy way, he noted. But our actions make a difference. “Every day, health is a choice, and we can choose. Be part of that 1%.” changes and medication.
Understanding chronic disease and patient assistance programs for plan members
Chronic diseases (such as rheumatoid arthritis) affect many Canadians, and the drugs to treat these conditions can be costly. Government programs don’t cover all drugs or costs, so employers—and, sometimes, employees—have to foot the bill.
That’s where patient assistance programs (PAPs) can help. These programs are administered via hospitals, health charity/ advocacy groups or pharmaceutical companies, and are funded by pharmaceutical companies.
The features of a PAP will vary by company and by drug within a specific company, explained Suzanne Lepage, a private health plan strategist. “They’re designed to meet patient needs or requirement of the disease or specific drug [e.g., if a drug requires a certain exam before and after taking the drug because of potential adverse events.] They fill in the gaps in the healthcare system.” However, a PAP usually includes the following:
- Connecting the patient with treatment (e.g., co-pay assistance)
- Direct patient support (e.g., online tools or training in person or by phone)
- Risk management (e.g., if a new drug has potentially severe side effects, Health Canada may require the manufacturer to set up a risk mitigation program as a condition of approval) and compliance (based on Health Canada requirements)
- Reimbursement support (e.g., co-ordinating reimbursement)
- Medication administration support (e.g., home infusions, if the patient lives in a remote area)
- Success support (e.g., patient coaching and medication adherence)
- Medication administration (e.g., drug dispensing).
According to a 2012 BioAdvance Patient Survey, 86% of respondents with a PAP improved in their ability to work, and 58% said the program helped them miss fewer days of work.
What an Employer Can Do to Maintain a Healthy, Productive Workforce and Manage Healthcare Costs
Stephen Loh, director, health solutions, Shoppers Drug Mart
With one in 12 Canadians living with diabetes, it’s prevalent in the workplace. How do you create a successful diabetes management program?
- Help employees know their numbers (e.g., blood pressure, cholesterol).
- Build an incentive or nudge to encourage participation.
- Change the co-pay on diabetes drugs as a reward.
- Determine the barriers to accessing diabetes medications and why adherence has been a problem.
- Identify a champion.
- Ensure a collaborative approach.
Challenging Workplace Perceptions
Adam Marsella, senior external affairs manager, Novo Nordisk
The medical community may recognize obesity as a chronic disease, but do employers and private benefits plans see it that way? Currently, only onequarter of private health plans in Canada cover anti-obesity medications. How do you overcome the barriers to managing obesity as a chronic disease?
- Get rid of the stigma—obesity is a visible disease, so people are stigmatized.
- Understand what leads to obesity.
- Ensure employers are using the services they have to help employees (e.g., a registered dietician through the employee assistance program).
- Make sure the workplace isn’t part of the problem (e.g., longer hours, shorter lunches, stress).
Challenges and Opportunities
Peter Gove, innovation leader, health management, Green Shield Canada
Studies show employers typically offer benefits plans to attract and retain employees and to reduce absenteeism and disability claims. But how do you integrate a benefits plan with a health program?
- Don’t look at a health plan in isolation; incorporate absences and absence statistics.
- Focus on the purely preventative aspects of the plan (e.g., a dental plan with preventative services covered at 100%) and communicate to employees the value of prevention.
- Avoid the shotgun approach—target your employee population.
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