Health check

Healthy employees can lead to a healthy—and wealthy—organization. At Benefits Canada’s Healthy Outcomes Conference in June, plan sponsors and industry experts came together to focus on connecting their bottom line with wellness and benefits programs.

We’ve highlighted the main themes here. You can also read the online coverage, “Helping employees with role overload.”

Eldercare Challenges

There is a growing demographic shift in Canada that most organizations may not be prepared to deal with. While employees can choose not to have children or have fewer later in life, they can’t choose not to have parents, noted Linda Duxbury, a professor with the Sprott School of Business at Carleton University. This means, most workers will have to balance work and eldercare.

Eldercare is a growing concern because Canadians now have a life expectancy up to 83 years and are living longer with chronic illness. “According to the 2012 Canadian census, the elderly are the fastest growing group,” said Duxbury. Increased participation of women in the workforce has had a significant impact on eldercare, since more women who traditionally cared for elders are now working outside the home. In addition, women who are focusing on their career may delay having children, which leads to responsibilities for teens and elderly parents at the same time. Career-minded women may also choose to have fewer or no children, resulting in fewer family caregivers to help. According to Duxbury, 80% of elderly caregiving is done by family members, and it would cost $5 billion annually for Canada to fund the support given by families.

It is much more difficult for workers to deal with eldercare issues than childcare issues because there is not the same support infrastructure available. Even if adult children uncover the limited eldercare programs, Duxbury says they often feel guilty about paying someone to care for their parents. “They feel a responsibility because of everything their parents did for them,” she explained.

Whether dealing with childcare or eldercare issues, many workers will refuse additional work responsibilities or opportunities because they feel they can’t manage. Employers will need to consider eldercare issues in their planning and provide much-needed workplace support and flexibility to retain skilled employees.

Support Network

Linda Duxbury, a professor with the Sprott School of Business at Carleton University, provided these tips for employers to support employees who are wrestling with eldercare issues.

1| Find ways to implement performance metrics that move away from a focus on hours to a focus on results. “Hours at work are a lousy measure of productivity,” Duxbury explained.

2| Give employees a sense of control over their work. Employees’ perception of workplace flexibility has an impact on how they view their employer. According to Duxbury’s 2012 National Study on Balancing Work and Caregiving in Canada, two forms of flexibility are particularly important:

  • the ability to arrange one’s work schedule to meet personal or family commitments (only 36% of those surveyed feel they have this flexibility); and
  • the ability to interrupt one’s workday to deal with a personal or family matter and then return to work (only 43% feel they have this flexibility).

According to Duxbury, employees’ perception of flexibility in the workplace is not predicted by company policies but by whom employees report to. If employees feel their manager does not support a flexible work policy, “they are going to feel angry, lie and take a sick day.”

Best Practice Makes Perfect

Implementing wellness programs effectively is always a concern for employers. A panel of industry experts at the conference provided practical strategies for Canadian businesses.

Employers should ensure that the wellness programs they develop fit their organization by considering both data and corporate culture. A starting point, said Claudine Ducharmes, partner, health and benefits consulting, with Morneau Shepell, is to consider the costs and what is driving them. She recommended that organizations look at data from their employee assistance program and health and drug benefits plans, and consider their company demographics. In addition to helping plan sponsors develop programs, “the collected data will provide baseline numbers to assist in measuring the return on investment of programs,” Ducharmes added.

It’s important to consider organizational issues and risk factors as well as individual risk factors, such as employee health risk assessments. Patrick Gagne, senior national manager, organizational health and wellness, with CBC/Radio-Canada, offered the analogy that the workplace is like an aquarium: employers can focus on the fish (the individual employees) or on the quality of the water (the workplace culture). If you don’t tackle issues such as workload, role overload, work/life balance and management practices that negatively affect workplace culture, your wellness programs won’t deliver results because “culture trumps programs,” Gagne explained. Culture change can take six to eight years, and it requires senior management to buy in and embody the values and culture that the organization is trying to develop.

Tanya Hogan, director, health solutions and pharmacy projects, with Shoppers Drug Mart, suggested that some organizations might not need to develop new programs; rather, they need a new communication program because employees may not remember all the programs offered by their employer. “Because a wide variety of programs are outsourced to different providers at different times, there is often not a consolidated or cohesive communication tool or access point,” explained Hogan. Gagne added that “frontline managers need to know what programs are available so they have them on their ‘managerial tool belt’ and use them when dealing with employee issues.”

Chris Camp, chair of the Halifax Professional Firefighters Benefits Trust, described how the Halifax Professional Firefighters peer referral program evolved to support workers who might not be comfortable approaching their manager on certain issues, for fear they won’t be promoted or may be viewed as weak. Some firefighters feel more comfortable approaching trained peers, who can then refer co-workers to the services they need.

Ducharmes expressed concern that if top management does not promote and model best management practices, or it does not value people management, managers will not take the time to effectively manage their teams. Gagne suggested that managers have a performance objective focused on managing and supporting the people on their team. “Managers will focus on their people if they will be measured on what they are expected to achieve.”

Sound Advice

Four recommendations to improve productivity and health in the workplace:

  • Leverage existing programs offered by different suppliers by summarizing them and developing a communication and outreach program to ensure that employees know what is available.
  • Train managers to become familiar with the tools and programs so they can suggest them to employees as needed.
  • Include time for employee support in managers’ objectives and schedules.
  • Develop a peer referral program for employees who do not feel comfortable approaching their manager directly.

The Impact of Arthritis

Roughly 4.6 million Canadians live with at least one of the more than 100 different types of arthritis. Osteoarthritis is the most common form, characterized by damaged joints with no capacity to repair themselves. The only solution is pain management and/or joint replacement.

According to the Arthritis Alliance of Canada (AAC), inflammatory or rheumatoid arthritis (RA) affects 1% of the population and is characterized by joint inflammation. And a 2011 AAC study showed that, within 10 years of showing symptoms, up to 50% of people living with RA will be unable to work if untreated. The economic impact of arthritis costs $33 billion a year. Without action, this figure will double to roughly $68 billion by 2040.

A 2012 Fit for Work Survey polled 1,057 Canadians living with arthritis to discuss their experiences in the workplace. Less than half (48%) were able to work in the previous four weeks. Two-thirds were going to work in pain, and 41% said they had difficulty managing their symptoms at work and their arthritis was so bad that it made it difficult to carry out their responsibilities. One-third found it a challenge to even travel to work. And one-third had to stop working or retire due to their illness, of which 60% were between the ages of 18 and 54.

Almost half (46%) reported being unable to access needed treatments over the past year. While 30% were unable to access physiotherapists and occupational therapists, mainly due to out-of-pocket costs (81%), one in four were unable to access prescription medications due to out-of-pocket costs (61%).

Among those surveyed who were still at work, only 45% reported having told their employer about their condition. The main reasons they did not disclose it to their employer were: it would put their career at risk (10%); the employer could not help so there was no point in disclosing it (40%); and they felt their symptoms were under control (43%).

Employers can support employees with arthritis by providing access to medication, said Janet Yale, president of The Arthritis Society and chair of the AAC, and RA patients should work closely with their physicians to find the particular medicines that work best for them. The 2011 AAC study showed that by facilitating early diagnosis of arthritis and access to medications, Canada could save $5 billion in direct costs and nearly $34 billion in indirect costs over the next 30 years.

In addition, employers can help to ensure access to physiotherapy and occupational therapy, as well as provide equipment, workplace adaptations and adjustments to the way an employee with arthritis completes his or her work. For example, an employee with arthritis who could not comfortably move a hand lever due to shoulder pain found that when her employer installed a foot pedal, her productivity increased fivefold. The employer quickly switched all of the other employees to foot pedals to capitalize on this operational improvement.

Bringing it Home

Conference delegates also participated in a series of moderated roundtable workshop discussions to generate wellness tips and best practices. Here are their key take-aways.

  1. Wellness incentives in the workplace don’t have to be expensive. The objective should be to move as many people as possible to healthy behaviours. Best practices include competition between departments, involving partners and children in incentive programs, and offering year-long programming that allows participants to gain points toward a larger incentive or draw.
  2. Work culture and wellness must come from the top down, with senior leaders showing visible support for the long term. Organizations need to tie health and wellness to bigger organizational drivers, and managers need to be accountable for the health and well-being of their employees.
  3. Effectively managing cancer and other serious illnesses in the workplace means having all possible employee resources mapped out and available when employees need them. Employees who are caregivers also need information, support and flexibility in times of crisis.
  4. Linking disability with wellness requires open dialogue and honest communication while also respecting employees’ privacy. Wellness and disability program suppliers need to find a way to share information that is in the best interests of their mutual client—the employer—to improve employees’ health outcomes and reduce disability risk. One effective way to engage employees is to have a champion in the organization come forward and tell the story of how his or her improved health had a positive impact.
  5. The value of prescription drug plans includes a positive impact on employee satisfaction, recruitment, competitiveness and retention, as well as reduced absenteeism. Employers most value their drug plan’s flexibility, convenience, security and comprehensiveness.
  6. Linking drug plans, wellness and disease management can benefit employers by identifying the disease states that affect their employee population and helping them to develop programs. The industry still has work to do to develop best practices in sharing and analyzing data.
  7. Pain management starts with making individuals more accountable for their own health. Most employers already have many tools available; the challenge is ensuring that employees are aware of them. Drug plans must provide access to required medications, and paramedical programs must be flexible to allow exceptions for employees with specific needs.

Suzanne Lepage is a private health plan strategist based in Kitchener, Ont.

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